. STATE OF GEORGIA EPARTMEN DD ANNUAL REPORT 1944 STATE OF GEORGIA DEPARTMENT OF PUBLIC HEALTH T. F. ABERCROMBIE, M.D., Director ANNUAL REPORT FOR THE YEAR 1944 State Office Building Atlanta, Georgia Table of Contents Page Division of Local Health Organizations__________________________ _ 13 Division of Public Health Nursing_________________________________________ _ 59 Division of Public Health Engineering__________________________________ _ 67 Division of Dental Health Education _______________________________ _ 95 Division of Maternal and Child Health______________________________ _ 107 Division of Public Health Education________________________ ________ _ 123 Division of Preventable Diseases____ --------------------------------------- 129 Cancer Control Service____________________________________________________ 131 Epidemiological Service ------------------------------------------------ 140 Industrial Hygiene Service______________________________________________ 176 Social Hygiene----------------------------------------- ______________________ 190 Typhus Control Service.. _________________________________________________ 194 Venereal Disease Control Service___________________________________ 201 Division of Malaria and Hookworm Service____________________________ 221 Division of Tuberculosis ControL__________________________________________ 231 State Tuberculosis Sanatorium________________________________________________ 237 Division of Laboratories__________________________________________________________ 251 Division of Information and Statistics______________________________________ 299 STATE OF GEORGIA DEPARTMENT OF PUBLIC HEALTH T F ABERCROMBIE, M 0. DIRECTOR ATLANTA To His Excellency Hon. Ellis Arnall Governor of Georgia Dear Sir: I have the honor to pxesent to you the annual report of the work of the Department of Public Health for the year 1944. It is a tribute to the medical and public health services that Georgia recorded a decline of 5.1 per cent in mortality despite wartime conditions prevailing during 1944. Further evidence of the progress achieved is shown by a 9.3 per cent decline in maternal and 6.1 per cent decline ir. infant mortality. It is only in the past few years that Georgia has shown any appreciable decline in these rates. It is noteworthy that all of the disea.ses considered readily amenable to specific public health measures, except typhus fever, show declines ranging from 51.1 per cent in malaria to 17.3 per cent in tuberculosis. Typhus deaths increased ?.1 per cent. Heart diseases, nephritis, and cerebral hemorrhage, the principal causes of death in the order named, all show slight declines. Cancer records a 5.? per cent increase. There has been an 11.9 per cent decline in pneumonia. Influenza, however, increased 16.? per cent. Deaths from diarrhea and enteritis (under two years) also increased 13.1 per cent, although there was a 21.4 per cent decline in dysentery deaths. The health record of Georgia in wartime has been satisfactory. Respectfully submitted ~Abercrombie, M. D. Director MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH RoBERT F. MADDOX, Chairman ___________________________ .... ___ --------------Atlanta C. L. RIDLEY, M. D., Vice-Chairman____________ _________ _ c. K. SHARP, M. D.___________________________________________ --------------- __________ Macon _____ .Arlington J. C. PATTERSON, M. D.------------------------------------------Cuthbert J. A. CoRRY, M. D. ____ ---------------------------------------------- w. P. HARBIN, JR., M.D.___ ----------------- - ---- ------H. w. CLEMENTS, M.D._________________________________________________ ____ Barnesville ____ Rome _______Adel R. L. RoGERS, M. D..________ ---------------------------------------- ________________Gainesville D. N. THoMPSON, M. D---------------------------------------- ____________Elberton GEORGE WRIGHT, PH. G..............---------------------------------------------------Elberton JoHN W. WHITE, PH. G. __________________________________________________________ Thomasville J. G. WILLIAMS, D. D. S------------------------------------------------------- ___________Atlanta W. K. WHITE, D. D. S--------------------------------------------------------Savannah Brief History of Public Health in Georgia England set a fine example of early public health effort by appropriating, in 1732, 13 guineas ($62'.4,0) 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 he quarantined. Later, in 1817, a Georgia law was passed prohibiting the sale of unwholesome meat, bread, and liquors. Offenders could be fined for the first offense and imprisoned for the second. In 1823, a law was passed establishing an office in each county for the purpose of recording births. In 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 present except the Secretary, who was delayed in Savannah on account of aiJ. epidemic of yellow fever. . Doctor Taliaferro made a complete investigation of the o:r;igin .of the yellow fever epidemic and reported that sailors on the "Maria Carlina", who had moved their bedding to a boarding house, brought the fever to Savannah. At that time, sanitary conditions in Savannah, as well as in other parts of the State, were very poor and played an important part in 10 Georgia Department of Public Health :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 St?te! a'he 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 small.pox 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 deter- mine the cause of pellagra. A laboratory was opened in 1905. With assistance, Doctor Harris expanded his activities to include the manufacture of Pasteur treatment in 1908; diphtheria antitoxin in 1909; and typhoid vaccine in 1912. The first full-time county health project was established in Glynn County in 1914. Later in the year, the Ellis Health Law was passed, thereby creat ing a board of health in every county in the State. This law further provides for the employment of a full-time county health officer upon two successive recommendations of the grand jury. Following the passage of this law, Glynn and Floyd Counties adopted its provisions. At a meeting of the State Board of Health, in January of 1914, Doctor Harris expressed a desire to retire from public health work as soon a~ he could be relieved of his duties without prejudice to the work, in order that he might devote his entire time to research. At a meeting of the State Board of Health in July of 1917, Dr. T. F. Abercrombie, formerly Commissioner of Health of Glynn County, was elected Secretary. A Brief History 11 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 Social Hygiene ---------------------------------------------------------- 1943 Division of Local Health Organizations GuY G. LUNSFORD, M. D., Director W. B. HARRISON, 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 R. B. GRIFFIN, 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 JUNE 15, 1944 COUNTY HEALTH UNITS COUNTY HEALTH DISTRICTS NURSING COUNTIES ,../ HEALTH REGIONS .. SCAI.t.. tt4gMrt..S . . . Division of Local Health Organizations Loss of Personnel As has been the case since 1940, the expansion of full-time public health service has been handicapped by the lack of qualified personnel. At the end of 1944, there were vacancies in the position of commissioner of health in eighteen county and district health departments, and in the position of public health nurse in twenty counties that had previously had public health nursing service; these, of course, in addition to the vacancies in the nursing staff of the health departments. From the beginning of the war emergency, ninety-seven employees of local health departments have resigned to enter the Army or Navy: eleven in 1940, fourteen in 1941, thirty-five in 1942, thirty-one in 1943, and six in 1944. Replacement of a large part of this personnel has been impossible. Change in Status of Counties Houston and Long Counties made arrangements late in 1943 to combine with other counties for full-time public health service. However, early in 1944 this arrangement was discontinued. Houston County has no public health service except in the Warner Robins area and that rendered from the regional office. Long County continued with public health nursing service. Oconee (June 15, 1944) and Berrien {Aug. 1, 1944) Counties employed public health nurses for the first time during the year. Plan for Expansion In 1943, the General Assembly of Georgia authorized the appointment of an Agricultural and Industrial Development Board to study conditions in the State and to make recommendations for the more efficient use of the State's resources and for the improvement of the moral, physical and financial status of all citizens. A panel or committee of this Board, known as the Health Panel, was appointed to make a survey of public health work, hospitals, physicians, and other facilities for medical care, and to make recommendations to the Board. Every county in Georgia was visited and surveyed by trained persons selected by this panel. The study was thorough and exhaustive. The conditions found were far from satisfactory or adequate to meet the mini mum needs of the people, and recommendations were made for their correction. The survey and suggested plan of the experts selected by the Health Panel were approved by this panel, and were adopted by the Agricultural and Industrial Development Board and by the State Board of Health. The survey and plan were then submitted to two committees and the Council of the Medical Association of Georgia and to the Council of the Georgia Hospital Association, and approved by all of these. The plan suggested is sound and reasonable, although its consummation will ,require several years under present world conditions; yet it is proposed 16 Georgia Department of Public Health to hegiri 'to put theplan in operation at an early date. Briefly, it is for the State to supply public health service to all counties and throughout the State, and that local funds now being spent or which should he spent for public health services he used, with what State or Federal funds may be available,. to build, equip and operate hospitals and supply needed medical care for those financially unable to secure it for themselves. Statistics In the local health departments, there was a slight increasein the number of" cases admitted to service for the control of communicable diseases in 1944 over 1943. During 1944, there was a rather marked decrease in all venereal disease control service because of the large number of patients referred to the rapid treatment centers in Augusta and Savannah and the decrease is the admission of new cases. Preschool health services showed a slight increase in services rendered during the year, as was the case of milk and gene1al sanitation service, the latter due to the increased activity in certain war areas. There was some decrease in most of the! other services due to the loss of personnel, hut in order to compensate for this loss, remaining workers took over as much of the work as possible. On December 31, 1944., 64..39% of the population had health departments, and 24.33% had full-time nursing service budgeted, a total of 88.72% of the population of Georgia. This is an increase of .72% over 1943. However, as has been brought out above, although money is .budgeted, vacancies exist in numerous instances. Sometimes, as in the case of health officers, the vacancies existed throughout the year, while frequently replacement was obtained. This was especially true of nurses, when persons not qualified because of lack of training were employed on an. emergency basis under the supervision of the regional consultant nurses, looking forward to the time that the nurse can take training in public health. Of the remaining counties, eighteen had services rendered by itinerant nurses, who served three or more counties, devoting most of the time to V. D. clinics and follow-up, and fourteen counties had no public health service provided locally, but were rendered occasional services by the staff of the regional office. Year 1915 1920 1925 1930 1935 1940 1941 1942 1943 1944 REcORD oF CouNTY HEALTH WoRK IN GEoRGIA 1915- 1944 Number Number Organized Persons Population Total Per County Counties Employed Served Budget Capita Budget 2 5 17,545 ~ 4,637.00 .26 $ 4,637.00 18 42 436,106 72,695.00 .17 70,895.00 23 71 598,107 179,812.00 .30 168,272.00 34 205 1,011,974 31 233 1,327,018 451,217.00 .45 459,292.00 .35 440,904.00 399,256.00 55 498 1,893,441 1,066,126.20 .56 785,049.20 56 544 1,920,119 1,124,729.00 .59 813,065.59 59 550 1,960,851 1,370,304.90 .70 956,863.05 62. 578 1,995,159 1,456,824.58 .73 1,023,983.78 62 531 2,011,426 1,534,562.24 .76 1,107,939.95 P..- CapitO!- ~26 .16 .28 .44 .30 .41 .42 .49 .51 .55 Local Health Organizatioru 17 TABULATION oF SPECIFIED AcTIVITIES IN 1944 SHOWING PER CENT OF INCREASE OR DECREASE OVER 1943 Per Cent Increase Total for Dec.rease COMMUNICABLE DISEASE CONTROL Year 1944 1943 Admissions to service.~----------------------------------------------------------------- 6,031 9.5% Consultations with physicians_----------- Field visits -------------------------------------- Smallpox immunizations --------------------------------Diphtheria immunizations --------------------Typhoid fever immunizations...--------- 1,169 20,413 65,943 48,325 290,565 -9.9% -6.5% -15.0% 4.4% -1.5% VENEREAL DISEASE CONTROL Admission to medical service----------------- Clinio visits ------------ Field visits -------------- 50,863 759,893 53,067 -29.0% -33.1% -25.1% TUBERCULOSIS CONTROL Individuals admitted to medical service_----- Individuals admitted to nursing service------------------- Clinio visits ------------------------------------ Nursing visits -------------------- 15,801 20,454 31,206 80,587 1.9% -8.0% 1.2% -7.0% lUATERNITY SERVICE Cases admitted to- medical service.......------- Cases admitted to nursing service......------------------------------- Visits by antepartum cases to medical conferences------------ Nursing visits --------------------------------- 22,150 43,232 60,074 122,571 -7.6% -9.1% -7.2% -12.0% INFANT HYGIENE Individuals admitted to medical service.......................-- Individuals admitted to nursing service.--------- Visits to medical confer_ences_________________________________.................. Nursing visits ----------------------- 11,727 32,083 28,187 93,247 -6.1% -5.2% -3.2% -1.9% PRESCHOOL HYGIENE Individuals admitted to medical service.............------------Individuals admitted to nursing service.............----- Visits to medical conferences-------------------- Nursing visits -----------------------Inspections by dentists or dental hygienists----- 12,411 26,680 24,910 66,126 1,3!5 2.6% 3.6% 5.2% 3.5% 68.7% SCHOOL HYGIENE Inspections by physicians or nurses.....------- Examinations by physicians---------------- Individuals admitted to nursing service.............------ Nursing visits -----------------------------------------lnsp~ctions by dentists or dental hygienists........---------~----- 285,294 44,477 18,649 48,100 38,202 -9.4% -39.4% -15.9% -10.5% -13.9% ADULT HYGIENE Medical examinations - 56,336 MORBIDITY SERVICE Medical visits -------------- Nursing visits ------------------------- Admissions to hospitals...----------- 21,581 21,642 7,882 GENERAL SANITATION Approved individual water supplies installed................-- Approved excreta disposal systems installed.......- ............................._ 804 2,478 Field visits ----------------------------- 393,316 O.S% -33.6% -22.3% -0.7% -41.4% -22.5% 90.4% 13 Georgia Department of Public Health TABULATION OF SPECIFIED ACTIVITIES IN 1944 SHOWING PER CENT OF INCREASE OR DECREASE OVER 1943-Continued 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 farm"-----------------------------------------------------Milk plants registered for supervision....------------------------------- Field visits to milk plants.------------------------------------- 7,648 85,359 1,230 9,092 95 4,882 3.1% 6.3% -1.7% - 4.5o/o 21.8% 74.7% LABORATORY Specimens examined ----------------------------- 444,344 -2.1% Local Health Organizations 19 CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLic HEALTH WoRK IN GEORGIA, 1943-1944 Organized Counties 1943 1V44 All Counties 1943 1944 COMMUNICABLE DISEASE CONTROL Admissions to medical service..- .................... Admissions to nursing sel~vice_____________________ Admissions to medical and/or nursing service --------------------------------Consultations with physician---------------------- 4,163 5,895 8,678 1,149 Field Visits: Diphtheria Typhoid fever and paratyphoid fever -------Scarlet fever -----------------------------------------Smallpox ---------------------------------------------------Measles -----------------------------------------------------Whooping cough ---------------------------------------Malaria ---------------------------------------------------:ffookworm -------------------------------------------Typhus ------------------------------------------------Other communicable diseases -------------------- 1,793 475 2,104 22 1,503 1,569 174 1,515 434 3,896 Total field visits for communicable disease control ----------------------------------------- 13,485 Persons treated for hookworms ----------------- 1,114 Admissions to hospitals: Diphtheria ----------------------------------------------- 45 Typhoid !ever and paratyphoid fever ........ 14 Scarlet fever -------------------------------------------- 51 Smallpox --------------------------------------------------------Other communicable disease patients admitted to hospitals ------------------------------ 158 Total admissions to hospitals for communicable disease control --------------- 268 .Immunizations (persons immunized) : Smallpox --------------------------------------------------------Diphtheria-under 1 year-----------------------------Diphtheria-1 through 4 years.................... Diphtheria-5 years and over ------------------ 52,699 11,320 14,032 10,273 Total diphtheria immunizations --------------- 35,625 Schick tests given ------------------------------------------- 8,289 Typhoid fever ----------------------------------------------- 196,258 Whooping cough-under 1 year ----------------- 3,368 Whooping cough-over 1 year ------------------- 1,661 Total whooping cough immunizations .... Public lectures and talks ---------------------------Attendance -------------------------------------------------------Pel'Sons tested in surveys ----------------------------- 5,029 134 5,613 15,050 5,050 7,943 9,182 1,079 1,539 479 2,535 27 2,513 733 100 1,155 596 4,215 13,892 1,318 42 6 36 2 224 310 49,753 12,019 15,261 13,147 40,427 9,479 208,235 7,174 2,237 9,411 153 6,111 14,090 5,508 8,418 11,284 1,298 6,031 9,514 10,880 1,169 2,098 748 2,287 45 1,546 1,665 4,381 4,561 466 4,027 21,824 2,039 1,740 619 2,628 50 2,543 757 4,430 2,586 663 4,397 20,413 2,202 45 57 15 7 53 36 1 4 172 236 286 340 77,599 14,670 19,098 12,536 46,304 8,968 295,098 4,550 2,481 7,031 180 7,442 16,980 65,943 14,591 19,276 14,458 48,325 10,948 290,565 9,592 2,810 12,402 178 6,896 24,984 20 Georgia Department of Public Health CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLic HEALTH WoRK IN GEORGIA, 1943-1944-Continued Organized Counties 1943 1944 All Counties 1943 1944 VENEREAL DISEASE CONTROL Admissions to medical service ------------ 57,102 Admissions to nursing service -------------------- 45,660 Total admissions to medical and/or -nursing service ------------------------- 60,439 Cases transferred to private physicians.._.... 2,483 Clinic visits (by patients) ---------- 867,266 Field visits (to patients) ----------- 59,756 Number of clinic treatments ------- 797,788 Dismissed !rom service -------------------------------- 21,492 Office visits ------------------Publia Jeetures and talks ----------------------- Attendance ------------------------- 325 90 5,353 TUBERCULOSIS CONTROL Individuals admitted to medical service...... Positive cases--------------------Suspicious cases ---------------Contacts -------------Individuals admitted to nursing service......_ Positive cases ---------------------------------------Suspicious cases ---------------------------------Contacts ---------------- Total individuals admitted to medical and jor nursing service -----------------------Positive cases ----------------------------------------------Suspicious cases ----------------------------------------Contacts ------------------------ Physical examinations in clinics --X-ray examinations ------Clinic visits (by patients) ------------ Visits to State clinics (by patient) ---- 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 ----------------- Offiva visits of cases of tuberculosis - Office visits of tuberculosis suspects .......... Office visits o:f contacts ----- Admissions to sanatoria ------ Number tuberculin tests completed ---- Number positive ------------ Number negative (completed tests) .............. Contacts broken ----------Contacts partly broken ---------- Relief secured for tuberculosis cases - 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 41,531 32,442 43,181 2,545 615,888 43,742 551,144 19,576 764 89 3,195 71,644 60,551 75,432 2,737 1,136,792 70,846 1,050,265 24,457 860 106 6,330 12,679 2,123 3,905 6,651 15,685 2,614 4,435 8,636 17,812 2,821 5,186 9,805 11,869 17,074 27,657 5,647 629 861 1,079 47,730 13,117 9,324 25,289 21,643 6,185 6,477 8,981 450 19,127 5,256 13,871 1,167 197 339 15,493 2,461 4,979 8,053 22,245 3,597 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 50,863 42,036 52,799 2,715 759,893 53,067 685,425 22,073 2,447 105 4,636 15,801 2,570 4,633 8,598 20,454 3,334 5,710 11,410 23,653 3,752 6,707 13,l94 11,901 20,627 31,206 9,114 763 1,056 1,321 55,526 15,291 10,994 29,241 25,061 6,714 7,572 10,775 560 22,322 6,136 16,186 1,307 215 358 Local Health Organizations 21 CoMPAB'A.TIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLic HEALTH WoRK IN GEORGIA, l943-l944~Continued Organized Counties 1943 1944 All Counties 1943 1944 TUBERCULOSIS CONTROL-Continued Cottages, sleeping porches, etc. (Number built) ------------------------------------------- Public lectures and talks ------------------------------Attendance --------------------------------------------------- 16 301 29,724 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 conferences ------------------------------------------------------Visits by prenatal cases to private p h y s i c i a n s________________________________________________________ _ 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 nut'Sing 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 ---------------------------Visita for midwife supervision -------------------Publia lectures and talks ------------------------------Attendance ------------------------------------------------Enrollment in maternity classes ------------------ Attendance ----------------------------------------------- 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 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 -------------------------Sessions held -------------------------------------Visits to medical conferences (by patients) ---------------------------------------- 10,710 28,920 29,784 216 6,512 20 37 25,515 15 634 51,809 15,632 19,890 20,459 51,376 951 24,434 44,517 57 2,890 858 16,961 37,818 163 5,333 13 22 1,190 768 5,745 3,017 160 1,138 1,066 3,567 10,653 28,942 29,664 219 6,751 31 85 25,792 16 324 32,742 20,155 26,523 27,222 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 18 655 55,001 18,811 24,501 25,131 60,074 1,025 26,837 55,264 69 3,339 884 18,662 40,470 220 6,593 13 22 2,017 1,118 7,735 4,041 176 1,418 1,072 3,575 12,488 33,829 34,809 279 7,718 20 37 29,137 11,727 32,083 32,855 265 7,666 31 85 28,187 22 Georgia Department of Public Health CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1943-1944-Continued Organized Counties 1943 1944 Visits to private physicians (by patients) ----- Field visits ---- Offic. ~" =" !>. ;:! =.= .. 1=. =t=: ~ = -=~" ==.. IgI :.5. t.l ..I.,I .a. t.l COMMUNICABLE DISEASE CONTROL Adm. to medical service ------------------------------ 236 2 ------ 8 24 --- Consultations with physicians ----------------------------- -------- ------- ------- -------- Field visits ---------------------------------- 747 1 ---- 105 28 3 19 1 14 95 1 21 1 -------- 22 1 15 34 35 8 Smallpox immunizations ---------------------------------- 1682 300 ------ 679 10 740 561 194 371 160 Diphtheria Immunizations -------------------------------- 1236 183 ------ 417 120 318 256 164 203 50 Typhoid Immunizations ----------------- --------- 1484 1323 ------- 3211 1984 3424 3978 1871 2019 1486 VENEREAL DISEASE CONTROL Adm. to medical service --------------------------- ------- 4241 136 -------- 261 213 621 616 260 323 56 Clinic visits ---------------------------------- ___________________ 58676 2145 ------ 4681 3013 7046 7119 5002 3183 759 Field visits ----------------------------------------- 6163 294 ----- 164 23 473 643 147 54 87 No. of clinic treatments ----------- ------------------------ 57035 2145 ------- 4217 3013 6977 7119 4671 3183 596 TUBERCULOSIS CONTROL Adm. to medical service ------------- ------------------------- 595 56 8 167 124 87 106 71 34 6 Adm. to nursing service --------------------------------------- 595 60 2 256 134 115 125 87 87 14 Clinic visits --------------------------------------------- 2237 57 Field and office visits_______________________________________________ 1573 109 8 166 133 91 103 93 34 6 5 336 288 360 493 192 81 28 MATERNITY SERVICE Adm. to medical service ----------------------------------------- 1270 91 ------- 166 57 299 760 111 147 5D Adm. to nursing service _______ ------------------------------ 1512 98 ------ 365 57 316 760 147 151 72 Visits by ante-partum cases to medical conferences ---------- ------------------------------ 5448 234 -------- 644 160 771 2187 885 345 59 Field and office visits....---------------------------------------- 2345 252 -------- 1193 164 1002 7326 564 846 136 INFANT HYGIENE Adm. to medical service --------------------------------------- 852 38 ------ 6 18 236 371 46 14 41 Adm. to nursing service ------------------------------------- 1393 Visits to med. conferences ---------------------------------- 2883 46 110 -_-._-_-_-_-_- 280 8 23 148 371 578 371 757 192 82 14 27 46 41 Field and office visits..----------------------------------------- 2061 187 -------- 931 66 875 8211 406 38 52 . ..=a II t.l 20 28 t'-< ~ 340 0 187 1555 ::X:: ~ ~ 106 o:l 1417 c 112 1374 ~ o:l 45 56 66 0::1 g~ 157 ; 80 90 230 267 23 56 40 111 ~ CONDENSED REPORT OF ACTIVITIES OF LocAL HEALTH DEPARTMENTS, BY COUNTIE&-1944--Continued :1 iii !.. i.. Ill i Ill ..: J~ !! ..Ill I"ll' .. =I"ll' .:: ~0" Q .:: "CC II Q PRESCHOOL HYGIENE Adm. to medical service ------------------------------------------ 667 ------- --- -------- -------- 139 26 137 ---- 24 Adm. to nursing service ----------------------------------------- 1878 ------ ------- 149 -------- 141 ------- 231 187 29 Visits to med. conferences ------------------------------------- 1636 -------- ------- ------- ------- 266 31 151 -------- 24 Field and office visits ---------------------------------------------- 2307 -------- ---- 603 ------ 389 ------ 411 137 32 Dental inspections ------------------------------------------------ -------- ------- --- ------- ---- --- ---- --- --- ---- SCHOOL HYGIENE Inspections by physicians or nurses ------------------- 26909 187 -------- 3631 143 689 2391 687 100 243 Examinations by physicians -------------------------------- 8016 ------- ------- 1 ------- -------- ----- ------ 114 ------- Adm. to nursing service -------------------------------------------- 1618 6 -------- 77 -------- 33 6 33 -------- 20 Field and office visits ---------------------------------------------- 1983 6 ------- ----- Dental inspections ------------------------------------------------------ ------- ------- 298 -------- 66 6 33 -------- 814 71 ------- -------- ------ ------- ------- ---- ADULT HYGIENE Medical examinations ---------------------------------------------- 436 69 ------ ------- -------- -------- 209 -------- -------- 32 MORBIDITY SERVICE Medical visits -------------------------------------------------------- -------- -------- -- -------- 9 2 32 Nursing visits ----------------------------------------------------- -------- 6 ------ 18 155 4 7 --- ----- Admissions to hospitals ------------------------------------------ ------- -------- ------ ---- ---- 4 -------- 36 93 -------- 91 17 ---- ----- SANITATION Water supplies approved------------------------------------- 1 Privies and septic tanks installed --------------------- 88 Food handling establishments registered ---------- 334 Dairy farms registered -------------------------------------- 117 Milk plants registered --------------------------------------- 6 --------------- 10 ---- --- ------------- --------------- --------- ------------- 33 48 ------- 4 1 7 9 21 --- 44 ----- ------ 20 68 Field visits -------------------------------------------- 26812 160 ----- ---- 2 1178 1883 161 -------- 46 LABORATORY SPECIMENS Specimens examined -------------------------------- 38984 616 -- 4188 602 1876 8630 1842 1006 462 CJ,) 0 :.; Q= 24 ~ "' 28 41 0 ~ s 48 "' --- l:::) '1::1 241 ~ ;:t --- ~ -"' 19 33 .;:.:s.. ------- 0 ------ ;":1:::1 0" ~ "' -------196 :::r:: -- ~ ;:s-o 10 860 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIEs-1944---Continued Et.l I" t.l r:: .~c t.l E ~" .c t.l ..c" .8"c =" ".c t.l .=c"c .c t.l t.t .a t.l . i! 0 ~ t.l .rs:: ~ t.l COMMUNICABLE DISEASE CONTROL Adm. to medical service ---------------------------------------Consultations with physicians ----------------------------- Field visits ---------------------------------------------------------------Smallpox immunizations --------------------------------------Diphtheria immunizations --------------------.-----------------Typhoid immunizations ----------------------------------------VENEREAL DISEASE CONTROL Adm. to medical service ----------------------------------------- Clinic visits ---------------------------------------- ---------------- Field visits ____________________________________ ----------------------------No. of clinic treatments ..... ___________ ---------------------- TUBERCULOSm CONTROL Adm. to medical service _________________ --------------------Adm. to nursing service _____________ ---------------------------Clinic visits ------------------------- ___________ -----------------------Field and office visits _________________________________________ MATERNITY SERVICE Adm. to medical service --------------------------------------- Adm. to nursing service ___________ ------------------------------ Visits by ante-partum eases to medical conferences ________ Field and office visits _____________ -------------------------.-.--------- INFANT HYGIENE Adm. to medical service -----------------------------------------Adm. to nursing service ----------------------------------------Visits to med. conferences.................---------------------- Field and office visits ------------------------------------------- 3 3 3 974 351 4018 215 4113 232 3850 55 129 55 254 -------- 2 -------3 -------- 9 ------- 23 1 -------- 28 188 467 3441 1 5 2 5 63 42 56 448 1 12 -------- 39 24 122 14 256 25 ------- 59 132 50 999 u 1130 85 1130 58 63 63 201 68 73 229 346 30 56 111 196 694 274 2355 3587 2238 6125 4670 70107 5546 41654 577 667 1822 6666 1086 1233 3302 9091 349 3316 461 18664 4 ~------- -------- 152 -------- 1 2 -------- -------- -------- -------- ------- 6 6 1 643 -------- 5 8 -------- ------- 562 ---- 208 6 -------- -------- 943 ------- 77 93 -------- -------- 2257 -------- 2037 34 37 30 238 -------- 146 491 201 488 5048 -------- 2073 12 105 36 325 -------- 42 385 146 477 4827 -------- 1966 17 1 -------- 134 2 80 19 3 -------- 153 11 92 17 1 -------- 83 2 69 46 4 -------- 696 14 168 18 -------- ----- 163 -------- 63 33 -------- -------- 174 ------- 64 33 -------- -------- 378 -------- 148 122 -------- -------- 660 -------- 171 16 -------- -------- 281 -------- 21 29 -------- 1 356 ------- 23 36 -------- -------- 965 -------- 29 108 ------ 1 1107 -------- 39 ..c =r:: t.l 28 ------- 112 t'-t 0 170 2.... 94 817 ~ ~ 102 c 1718 28 1810 ~ 1:1 ;::! 52 ~1:1 .o.. 75 56 i;! 100 82 48 138 154 17 33 66 139 Colo) to-' CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1944-Continued .=e 1:,) ! 1:,) j .'5a 1:,) 1B .a j . 1: g .a .~a 1:,) Q 1:,) i.1.: .a Q ~ .!! 1:,) .!"!" 1:,) ! ~ 0 PRESCHOOL HYGIENE Adm. to medical service --- - -- Adm. to nursing service ------------------Visits to med. conferences ---------------Field and office visits ---------------------------Dental inspections ---------------------------------------- SCHOOL HYGIENE Inspections by physicians or nurses -------Examinations by physicians ------------------Adm. 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 ---------------- -------13 -------- 30 -------- 109 -------- 18 24 -------- 22 -------8 -------- -------- 5 --------------- ----- 66 48S 37 101 31 94 -------- 326 28 ------- 2 -------- ------17 1 ------- 12 72 20 161 40 256 -------- 823 ---------------------- 631 560 1456 528 5981 438 48101 1673 4916 9396 1304 ------- 3383 ll 5582 34 4643 ---- 2830 ------ 489 -------- 166 ----- 960 -------- 28 -------- 7 1 204809 314 76978 22 37 25 75 -------- 84 39 49 104 93 20 87 106 -------- ---------- -------------- -------- -------- ------------------------------------ --------------- -------- --------------- -------- ---------------------- 1 47 --------------- 54 86 -------- -------- -------- -------- -------- ---------------------- -------- ---------------------- -------- 72 -------- 247 -------- 2366 931 56 76 -------- 1446 -------- 136 15 -------- 87 -------- 126 ------- 81 -------- 6 7 13569 33 6085 -------- ------- ---------------------------------------------------- -------- -------- --------------- -------- ---- 2 2 2 2 ------- 26 26 --------------------------- ----164 -------- 18 73 601 ~ ~ 11 : Q ~ 2 ~ .0.. 7 at:! 3 l:i' 8 l;::j ...... ---- ~ "':! ~ 467 -... ------ ~ ~ 3 ;:! 8c ------- '"c::1 g. -------- !o;::- 6 ::X:: 24 ~ 5~ ;:- 826 CoNDENSED ilEPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1944---Continued u""""" COMMUNICABLE DISEASE CONTROL Adm. to medical service ___________________________ Consultations with physicians ______ ----------------------- Field visits -----------------------------------------------------------------Smallpox immunizations ______________________________________ Diphtheria immunizations -------- __ -------------------------- Typhoid immunizations ------ ---------------------- VENEREAL DISEASE CONTROL Adm. to medical service ____________________ Clinic visits ----------------------------------------- _____________ Field visits ______________ -------------------------- No. of clinic treatments -------------------- --------------------- TUBERCULOSIS CONTROL Adm. to medical service _ ----------------------------------- Adm. to nursing service ______________ ------------ Clinic visits __________ ----- Field and office visits ____________________________ MATERNITY SERVICE Adm. to medical service --------------- ------------ Adm. to nursing service ---------------------- __________ Visits by ante-partum case to medical conferences __ Field and office visits __________ INFANT HYGIENE ----------------------- Adm. to medical service ______ ----------------------- Adm. to nursing service ___________________________________ Visits to med. conferences ----------~ ________________________ Field and office visits ________ ------------------------- 178 8 620 981 583 4826 351 4655 1083 4407 203 257 194 1233 9 60 8 152 12 78 12 146 ~"" u" --------------- 233 3521 1502 9945 517 6174 752 3909 109 109 107 852 257 283 784 840 264 :190 744 800 ....;.. .. :ci E = = <1 u u" 60 19 88 676 745 2694 388 3827 267 3784 140 141 178 392 177 237 507 1128 83 290 166 434 --------------- ---------------------- 160 2426 95 2364 5 ------ 5 --- ----- -- -------- ----------- ~ u"" 3 8 7 ---------------------- 173 2554 413 2364 5 1 4 1 ---- ------ ---------------------------- !l "il: u" 6 3 12 195 78 693 367 6815 658 5906 91 90 82 549 -------- 154 365 3 44 3 105 ..I..."..I...: u 2 11 33 32 628 71 1323 67 1075 49 80 53 192 1 82 1 192 56 106 ... ;'":: u 23 4 77 369 297 3463 379 4807 157 4176 210 266 145 743 289 294 701 749 65 167 96 338 ...".. ~ 2 1 2 ------------------ -------- --------------- 2 2 2 2 -------- ------- --------------- -----1 -------1 .: ..i"'l": ~ 1 -------- 15 30 31 179 2 1 7 -------- 1 8 1 7 -----42 -------52 -------41 -------60 3... ~"" 2 172 g_ 90 364 ct--o 352 3158 1085 7015 s-.l::t:: (b !;:> a 299 5807 ~ !;;:::>:, 86 r:; 203 .!;.:>.. c 198 N, "' 733 ;:::, 345 355 1127 1245 98 183 213 358 ~ ~ CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIEs-1944-Continued ....cc 0 t.l PRESCHOOL HYGIENE Adm. to medical service ---------------------------------------- 168 Adm. to nursing service --------------------------------------- 312 Visits to med. conferences ------------------------------ 182 Field and office visits ---------------------------------------------- 441 Dental inspections ---------------------------------------------------- 104 SCHOOL HYGIENE Inspections by physicians or nurses -------------------- 467 Examinations by physicians --------------------------- ________ 200 Adm. to nursing service ------------------------------------------ 52 Field and office visits ---------------------------- ---------------- 171 Dental inspections ------------------------------------ ----------------- 49 ADULT HYGIENE Medical examinations -------------------------- ____________________ 228 MORBIDITY SERVICE Medical visits ------------------------------------------------------------ 51 Nursing visits ----------------------------------------------------------- 96 Admissions to hospitals -------------------------------------------- -------- SANITATION Water supplies approved ---------------------------------------- -------- Privies and septic tanks installed ------------------------ 21 Food handling establishments registered __ 17 Dairy farms registered ------------------------------------------ 1 Milk plants registered ---------------------------------------------- -------Field visits ---------------------------------------------------------------- 397 LABORATORY SPECIMENS Specimens examined ---------------------------------- ___________ 2435 ....... 0 t.l 72 81 322 326 -------- 8454 -------- 2 6 ------- -------- -------- 63 -------- -------- ----------..--- -------- 2164 ~0.". t.l 19 23 49 74 ------- 62 643 1 7 -------- 357 --------------------- 2 7 18 8 2 153 2456 :E Ei 0" t.l ------- ------- --------------- --------------- --------------------- -------- ---------------------- 2 4 ---------------------- 14 210 .01 0 0 t.l ---------------------- -------- -------- --------------- ------- ------ -------- --------------- ---------------------- -------- --------------- 250 ..:1 ~ 0 t.l -------46 -------66 -------- 1 -------- 1 2 -------- ------- 2 8 -------- -------- 33 -------- --------------- 104 1088 ."CC ...e~. t.l -------30 -------- 40 -------- 1 2 4 5 -------- -------- 2 82 3 -------- 3 ---------------------- 18 301 .";:' t.l 15 312 18 367 -------- 285 39 4 51 1212 139 34 16 6 -------- 26 so 3 -------- 437 2489 ..."CC Cl -------- -------- -------- --------------- ---------------------- --------------- -------- -------- --------------- ------------------------------------ 12 1 .c:: 0 ~ Cl -------- 6 -------- 7 -------- -------- ----------------------------- -------- -------- 16 ------- --------------------- -------- ------- 1 86 ~ .... ....s Cl ~ 74 ~ Q 77 162 ~..... ~ 160 -------- ~ ~ "'t::1 4186 ..~...... 8 ~ ~ 3 .;.:.l. 8Q 971 -"tl 161 ~o- -~ 1 ::r:: 1~ ------- 1;::::;.::;;:- 19 123 44 4 4 2189 4312 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1944--Continued .~ ~ ~ ......... ~" 0...... ~ !..' ....c.:. ~" .-;, ~"" ;.:.:.. "fol .s "..uc: fol ...Ec.:. c: 5 fol ..... ~ '; cE": fol COMMUNICABLE DISEASE CONTROL Adm. to medical service ----------------------------------Consultations with physicians -------------------------------Field visits ------------------------------------- Smallpox immunizations ----------------------------------------Diphtheria immunizations ---------------------------Typhoid immunizations ------------------------------- 147 56 373 947 667 2711 22 -------21 69 191 782 3 --------------------- 673 446 70 11 335 749 195 3881 2 1 3 355 18 -------- 1 1 2 -------- -------- -------- ----------------------------- -------- 7 13 150 112 1371 1 1 2 ---------------------- 2 2 4 452 124 3342 VENEREAL DISEASE CONTROL Adm. to medical service__----------------------Clinic visits ---------------------------------------- Field visits ------------------------------- No. of clinic treatments ----------------------------TUBERCULOSIS CONTROL 559 8283 200 8283 236 3333 160 3333 174 2086 40 1988 329 3493 216 3244 20 -------- -------- 115 -------- 205 112 -------- -------- 2119 -------- 1630 3 -------- 50 -------- 6 111 -------- 2004 -------- 1628 Adm. to medical service --------------------- 300 83 1 ~11 -------- -------- 5 29 -------- 63 Adm. to nursing service ---------------------------------------- 335 94 11 256 36 -------- ---- 51 -------- 81 Clinic visits ------------------------------- 320 83 -------- 294 ------ -------- 5 32 -------- 94 Field and office visits ----------------------- 1055 280 32 1998 59 -------- -------- 113 -------- 230 MATERNITY SERVICE Adm. to medical service ----------------------------------- 240 146 ------- 301 Adm. to nursing service -------------------------- 462 198 ~------- 436 Visits by ante-partum cases 7 -------- -------- 19 -------- -------- 30 -------- 88 65 -------- 121 to medical conferences -------------------------- 771 Field and office visits --------------------------------- 1037 INFANT HYGIENE 452 ------ 1571 654 -------- 2010 9 -------- ------- 57 -------- 219 31 -------- -------- 159 -------- 306 Adm. to medical service -------- 114 89 -------- 87 2 -------- -------- 19 -------- 12 Adm. to nursing service ------------------------------------------ 348 139 ------- 482 13 -------- -------- 69 -------- 20 Visits to med. conferences ---------------------- 323 134 -------- 125 2 -------- -------- 46 -------- 22 Field and office visits ---------------- 675 215 -------- 1130 19 -------- -------- 220 ------- 116 .. c: ~ fol 90 150 207 311 -ct-o< 2 1810 ::t: (l> 131 ;~:;- 2462 ~ 627 0 2273 ~ ;~::s ... 95 ~:; 104 ~ 112 c; "' 253 ;::s 84 105 218 394 36 89 116 251 ~ til CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CoUNTIES-1944--Continued .1> :".;: Q" PRESCHOOL HYGIENE Adm. to medical service _____________ ------------- Adm. to nursing ser.vice ------------------------------------------ Visits to med. conferences -------------------------------------- Field and office visits ------------------------------------------------ Dental inspections ------------------------------------------------------ SCHOOL HYGIENE Inspections by physicians or nurses ---------------------- Examinations by physicians ____________ ----------------------- Adm. 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 ------------------ _ ----------------------- 407 533 416 774 -------- 4326 443 244 244 -------- 967 632 451 70 7 162 16 -------466 3040 ...".' 0 Q --------------- -------- -------------- 328 -------- 328 328 ------- 45 -------61 -------- -------- -------- -------- 1528 i 0 Q -------- ---- -------- ----- -------- --------------- -------- -------- -------- --------------- ---- ------- -------- --------------- ----- ------- ------- !: ....""c': "0 Q 508 909 1457 4451 -------- 6505 44 129 179 -------- 51 28 2 -------- 18 47 26 4 2 366 3833 .."... "0 Q --------------- --------------------------------------- ------------ 62 5 .;.:.: r.1 ---------------------------------------------------------------------------- -------- =" ..c: "r.1 ------------------------------------------------------------------------------ ----------- ------4 ..e. ..c: ..E.. r.1 5 39 7 68 -------- 30 -------- 22 34 --------------- 149 -------- 16 589 ... :""9' r.1 ------------------------------------------------------------------------------ --------------- 10 -------- ,.; ."ec. r.1 -------------- -------- --------------- 63 -------- -------- ------- -------27 -------35 -------- 17 939 CJ.,l 0\ ..c".. r.1 ~ Cb 60 16 ~.... 6~ 21 t::::l -------- Cb '1::l ... 46 ------- ... 17 .~... ;:; ;C::bs 42 -------- ~ ""t:i -------- I;: ~ (:) -------366 ::z:: Cb ~ -------- 7 813 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1944-Continued --- COMMUNICABLE DISEASE CONTROL Adm. to medical service -----------------------------------------Consultations with physicians . ---------------- ___________ Field visits ------------------------ ---------------------------------------Smallpox immunizations ------------------------------ _________ Diphtheria immunizations ____________ Typhoid immunizations -------------------- ----------------------VENEREAL DISEASE CONTROL Adm. to medical service ------------------------------------------ Clinic visits ----------------- --------------------------------------------Field visits -------------------------------------------- ----------------------No. of clinic treatments ------------------- ---------------------TUBERCULOSIS CONTROL Adm. to medical service __ Adm. to nursing service _ ----------------------------- Clinic visits -------------------------- _________ --------------------------- Field and office visits ---------------------------------------------MATERNITY SERVICE Adm. to medical service ----------------------------------------Adm. to nursing service -----------------------------------------Visits by ante-partum easel to medical conferences --------------------------------------- Field and office vis1ts -------------------------------------INFANT HYGIENE Adm. to medical service -------------------------------------------Adm. to nursing service _------------------------- ____________ Visits to med. conferences ------------------------- -------Field and office visits ------------------------------- _____""____ .c;c.: "' .. 31 235 193 1808 8 86 16 71 98 304 110 774 108 184 269 461 65 210 167 503 ~..".. "' 4 2 5 ------ 76 1714 206 1506 5 5 5 5 -------- ------- -------- --------------------- -------- .... ~ 32 60 149 1095 525 6766 525 8619 1117 8630 253 604 291 1838 42 115 42 317 1 207 ------ 648 ...~s "' --------------- ------------- ---------------------- ---- -------- -------- ------- ------- ------------------------------------ ...:;5:; c ... "' c ~ r".. 1 2 1403 234 2430 30 4 874 2282 1186 10816 80 3269 728 30245 26 2100 632 29681 42 1746 91 1158 41 2837 106 3584 1 420 117 731 1 1201 187 3192 3 590 102 1383 5 1363 170 6852 .. "e --------------- 2 --------------- 3 3 --------------------------------------------------------- .".."....' :; G cc G' -------- -----------------1 50 29 168 II 164 ----------------------------- --------------- -------- ------------------------------------ 1836 120 1286 2320 2182 4838 2196 29347 70 22713 578 581 518 787 237 277 634 437 104 704 199 1381 ....c.... c --------------- 59 666 138 3375 50 610 28 596 135 285 150 668 ----.--- 10 -------- 17 ------ 32 -------- 148 ....... c 37 11 47 t'-< ~44 368 0 .2.... 6181 1:!:: (1) 217 3311 ~ ;~ ;::.- c 193 ~ 2838 60 r: .... 124 .~... 49 0 "' 186 ;:! 143 166 406 491 49 142 89 843 ~ -.! CoNDENSED REPORT OF AcTIVITII!:S OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1944--Continued --- PRESCHOOL HYGIENE Adm. to medical service -----------------------------------------Adm. to nursing service ------------------- ---------------------Visits to med. conferences ------------------------------ _____ Field and office visits -------------------------------------------Dental inspections --------------------------------------------------- SCHOOL HYGIENE Inspections by physicians or nurses -------------------Examinations by physicians ---------------------------------Adm. 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 ------------------------- ------------------------ .===. "" 67 231 114 414 -------- 525 2 8 8 -------- -------- -------- 143 -------- -------6 ------- -------37 711 .:l ..'.;.:. "" ------- -------- -------- -------- ----------------------------- -------- -------- ---------------------- -------20 -------- -------61 231 '"C i 150 363 160 763 -------- 2497 1819 37 135 --- 1661 8 105 4 -------- 111 91 51 i 1675 2884 ....s... "" ---------------------- -------- -------- ----------------------------- -------~ ------- ------------- ---------------------- -------- 11 ---- ~..==. .:.=.:..: "" "" 2 20 2 28 -------- 1674 3317 2087 8531 --------------- 3 3 -------- 7995 894 1320 2207 2288 -------- 1900 -------- -------- ------ 485 125 ----2 ------------- 21 128 355 159 15 2378 475 12480 s..e ---------------------- -------- --------------- -------- --------------- 11 --------------- 21 8 ....Ill "" t5 ~== " -------------- -------- 614 720 648 968 -------- -------- 2481 -------- 42 -------- 939 -------- 10134 -------- -------- ---- ---- 1967 -------- 225 -------- 205 -------- 12 1..=!. " 50 113 50 169 -------- 959 -------- 2 3 ------ ------ 11 -------- 9 184 1 -------- 135 -------- 9 -------- 98362 32 36 21944 186 ~ 00 '"...C... " ~ 14 c~ s 19 ~ 26 31 t::l -------- ~ '"c:1 o..:.l. 483 -------- ~ -------- .;.:.:.!. ------- c 13 -~ ------- 0" -r:: 43 :::.r:: 33 ~ -------- o:l !:;' ~ 11 5301 2577 CONDENSED REPORT OF AcTIVITIES OF LOCAL HEALTH DEPARTMENTS, BY CouNTIES-1944---Continued . c c.t.. COMMUNICABLE DISEASE CONTROL Adm. to medical service --------------------------------- _______ Consultations with physicians _____________________________ Field visits ------------------------------------------------- _______________ Smallpox immunizations ----------------------- ---------------- Diphtheria immunizations ________ -------- Typhoid immunizations --------------------------------- __________ VENEREAL DISEASE CONTROL Adm. to medical service _________ --------------------- __________ Clinic visits ________________ ----------------------------------------- Field visits ----------------------------- --------------------- _____________ No. of clinic treatments ___________________ ------ TUBERCULOSIS CONTROL Adm. to medical service ________________________________________ Adm. to nursing service ___________________________________ Clinic visits -------------------- ____________ ----~ -----------------------Field and office visits ___________ -------------------------- MATERNITY SERVICE Adm. to medical service ________________________________________ Adm. to nursing service ________ --------------------------- Visits by ante-partum cases to medical conferences ------------ ----- Field and office visits ___ _____ _ ___________ ------- INFANT HYGIENE Adm. to medical service ___________________________________ Adm. to nursing service _____________ ----------------------- ______ Visits to med. conferences --------------------------------Field and office visits ------------------------------------- 15 341 140 2336 219 4166 56 4166 108 238 128 1177 198 231 419 526 67 265 123 834 .t: c -~ "' 37 622 225 2931 222 3160 21 3049 8 356 306 625 72 110 242 388 69 203 187 474 .-..e...;.], = . :; = --------------- 55 1045 147 2708 40 512 55 489 18 69 39 279 36 67 74 209 21 45 40 124 4. -----378 552 697 5041 382 6626 284. 6121 209 217 213 641 70 165 191 516 81 294 220 1421 .c......, ...=.;.... .. ..;.:.:. ... "..E. .c..... = == = = = 1 6 3 5 11 -------- 1 44 247 263 122 51 36 66 104 29 31 773 2067 1268 24 392 64 64 205 79 -------- 149 809 1406 3154 1491 -------- 2372 26 37 60 169 -------- 803 1407 2569 1425 1965 57 -------- 30 123 55 66 56 -------- 40 158 103 133 2 5 36 1 5 27 2 -------- 53 1 6 98 316 4 171 249 32 173 -------- 2 617 4 461 505 60 480 -------- -------- 3 141 3 198 57 205 3 325 124 20 36 36 22 44 -------- -------- 192 $...= = 1 -------- ct-< ~ -------- ~ -------- ::t:: <1> --------------- l:l ;~ ::,.. 2c -------- ~ 3 rl;:::sl 3 -------- ..lc..:..l... 3~ 1""0' CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIES-1944--Continued ..= "(.') PRESCHOOL HYGIENE Adm. to medical service ------------------------------------------ Adm. to nursing service ----------- Visits to med. conferences _ -------------------- Field and office visits ---------------------------------------------- Dental inspections ----------------------------- _ ---------- SCHOOL HYGIENE Inspections by physicians or nurses ________________ Examinations by physicians ----------------------------------Adm. to nu~sing 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 ----------------------------------------------- 108 622 245 2390 -------- 122 -------- -------- -----1 ------ ----------- -------- -------- -------- 999 .:;: ==; (.') 72 126 113 226 2 1389 11 17 20 1 2 17 175 15 -------- ------ -------------- 2 943 ".=...,."Er":...: 16 87 37 173 -------- 1071 ........ 2 29 -------- -------- -------16 4 1 7 II 4 262 768 :;; = 75 345 255 1249 2 1329 17 66 -------- -------- -------131 5 1 15 35 21 2585 2836 .>I =.""". . ...."="!..! ,. ;:: " = == 65 127 124 175 3 2 13 18 -------- 6 2 7 -------- 2 79 2 156 -------- --------------- 12 21 -------6 -------- -------- ---------------------- 1 -------- -----~-- -------- -------- -------3 -------- 21 -------- 731 338 756 t.:. = -------- -------- --------------- -------- ........ -------- 1 4 30 332 .."... = -------- -------- ----- ------- 1 3 30 .. ==". -------- -------- 6 9 --------------191 16 93 396 ~ ~= ="" ~ ------ c~ ------- ~ ------- ~"' - - i:::l -------- ~ '"<:;:; g~.... ------ ------- ----- ------ -------- -.;~,:.;,. c '"\:! ~ -------- g: ("')' ------- ::t: -------- ~ ;~:;::- ;::.. 28 52 100 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIEs-l94~Continued ..1:: ~ .... ......"1....:.: ....."..' .....:!l ...~........ ...1:: ......:..:. .. ..:1;:: 1:: .... ..1:: .,.1c:;: .... .."' ..1.:.: ..E..! ,.;j ..a. ,.;j ..1'":: =.. ,.;j COMMUNICABLE DISEASE CONTROL Adm. to medical service -------------------------------------------Consultations with physicians ------------------------------ Field visits ---------------------------------------------------------------Smallpox immunizations -----------------------------------------Diphtheria immunizations ------------------------------------- Typhoid immunizations -------------------------------------------VENEREAL DISEASE CONTROL Adm. to medical service -------------------------------------------Clinic visits ----------------------- -------------------------------Field visits ------------------------------------------------------------------No. of clinic treatments ----------------------------------------TUBERCULOSIS CONTROL Adm. to medical service -----------------------------------------Adm. to nursing service ________ --------------------------------Clinic visits --------------------------------------------------------------Field and office visits ___________ -------------------------------MATERNITY SERVICE 1 1 1 21 5 578 43 262 2 260 -------3 -------15 1 1 8 411 475 4325 136 1972 121 1951 91 123 91 202 1 1 "1145 552 2422 193 2078 218 2019 53 53 44 140 62 -------- 62 26 32 244 49 484 34 440 38 45 38 144 36 -------~ 83 218 244 2381 298 4110 433 3832 90 103 75 259 36 23 45 403 285 2837 210 2573 34 2573 59 67 115 442 -------- ----- 15 3 96 1338 91 1051 123 1036 30 73 65 280 11 -------- 69 178 153 2358 152 2724 209 2723 48 98 62 344 -------- -------- -------17 17 253 100 681 42 630 39 58 40 103 4 -------- 35 52 153 426 17 70 8 68 1 2 -------8 64 112 .... 56 270 ct"'< ~ 847 ~ 6294 :::::: ('b .,.. 480 ~ ~ 10195 436 0 ~ 10195 ... 90 ;;:::;l 90 .~... 163 c "' 255 ;::l Adm. to medical service ____ ------------------------------------- 23 43 79 10 429 229 76 99 30 Adm. to nur.sing service -------------------- --------------------- 24 47 160 20 429 229 93 142 49 Visits by ante-partum cases 7 111 7 111 to medical conferences ---------------------------------------- 45 77 218 14 1478 751 268 266 65 Field and office visits _____ ------------------------------- 49 94 457 42 1589 856 336 378 90 INFANT HYGIENE 7 21 9 233 Adm. to medical service ------------------------------------------ 12 47 35 Adm. to nursing service ------------------------------------------ 17 66 106 Visits to med. conferences -------------------------------~----- 22 121 84 Field and office visits ---------------------------------------------- 26 185 269 6 237 146 5 56 3 6 237 230 106 159 76 1 6 332 363 10 174 6 -------- 35 860 411 144 408 107 1 172 172 25 281 ...j.:.>... CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIES-1944--Continued =; .!:: =0 . ..~"' ..... ..~" ..... ..;.";.:' ~ ... .."... ..=0 .""' ...... .. .:=; ..=... =0 ."=.:' ..0... . ..=0... ..e.. ~ .. ."a. ~ PRESCHOOL HYGIENE Adm. to medical service ---------------- -------------------- 15 14 1 13 50 -------- 61 -------- -------- Adm. to nursing service ---------------------------------- ------- -------- 15 34 1 13 14 5 302 57 -------- Visits to med. conferences ___________ ------------------------ -------- 56 21 1 25 58 -------- 141 -------- -------- Field and office visits ------------------------------------------------ 63 45 1 61 23 5 584 52 -------- Dental inspections --------------------------------------------------- -------- ------- -------- -------- -------- -------- -------- ------ ------ SCHOOL HYGIENE Inspections by physicians or nurses ____ 300 -------- 1508 -------- -------- 990 -------- 5 Examinations by physicians ------------ ---------- -------- -------- -------- -------- -------- 804 -------- 2 Adm. to nursing service ------------------- 1 -------- 2 6 53 -------- -------- 32 ------- 2 Field and office visits ___ ------------------------------------- 1 -------- 4 6 78 16 -------- 233 -------- 7 Dental inspections _____________ ------------ -------- -------- -------- -------- -------- -------- ------- -------- ADULT HYGIENE Medical examinations -- ---------- 26 -----~ 17 68 -------- 144 -------- -------- MORBIDITY SERVICE Medical visits ----------------------------- ----- _____ ------- 11 19 27 -------- 18 -------- ------- Nursing visits --------------------------------------- ---------- --- 5 8 65 50 -------- -------- 53 -------- -------- Admissions to hospitals ------------ ----------- -------- -------- -------- 4 1 -------- -------- 19 -------- ------- SANITATION Water supplies approved ----------------------- ------ -------- 1 -------- -------- -------- 2 ------- -------- -------- -------- Privies and septic tanks installed ----------- 4 1 -------- -------- 12 -------- 5 16 -------- Food handling establishments registered -------- ------- ---- -------- 39 -------- -------;-- -------- Dairy farms registered ------------------------ -------- ------ -------- -------- -------- -------- -------- ------- -------- Milk plants registered ______ -------- -------- -------- ------- -------- -------- -------- -------- Field visits ---------------------------------------- 20 12 -------- 2 1045 3 49 72 -------- LABORATORY SPECIMENS Specimens examined --------------------------------------------- 90 887 633 226 1747 845 745 336 245 45 .... 1:-.J ~".."~. ~ c(II 119 s 119 ~ 21 ----246 t::::1 (II "1::! 1232 284 .~... (II 160 478 -------- 1876 .;.:.I. c -~ Io;:- -g 12 12 :::z:: (II ------- ~ ;~ ::-. 18 105 7 4 11 525 1919 _/ CoNDENSED REPORT OF ACTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CoUNTIES-1944--Continued . "..l ..:.... :9 ..l 0~.==.. Ill ~ ..l .=..~.. ..l ~ "'=11 ..l .;..;.: Q=... ::;:! ..: .=...... ::;:! =.... :=..a "::;:! "::;:! COMMUNICABLE DISEASE CONTROL Adm. to medical service ---------------------------- _________ 1 Consultations with physicians _____________________________ 1 17 ------- ti9 162 5 ------- 1 76 1 -------- 132 1 -------- 34 4 3 -------- Field visits ---------------------------------------------------------------- 4 138 -------- 320 428 71 27 27 5 -------- Smallpox immunizations ------------------------------------------ 189 347 ------ 671 406 109 766 45 84 Diphtheria immunizations ------------------------------------ 89 285 ------- 196 1066 113 40 80 26 2 Typhoid immunizations ---------------------------------------- 558 1947 -------- 1023 329 1491 841 946 829 VENEREAL DISEASE CONTROL Adm. to medical service --------------------------------------- 229 518 -------- 72 639 -------- 300 107 132 51 Clinic visits -------------------------------------------------------------- 1711 5115 ----- 1648 8523 4768 1269 1792 623 Field visits --------------------------------------------------------- 152 274 -------- 58 198 3 163 525 116 141 No. ot clinic treatments ------------------------------------------ 1454 4694 -------- 1550 7090 1 4679 817 1631 571 TUBERCULOSffi CONTROL Adm. to medical service ------------------------------------------ 49 73 ------ 27 321 57 55 54 56 -------- Adm. to nursing service ------------------------------------------ 53 88 -------- 40 329 95 87 70 48 Clinic visits ------------------------------------------------------------- 55 102 ------- 40 757 59 54 54 56 -------- Field and office visits ---------------------------------------- _____ 157 368 ------ 145 2268 158 200 182 272 -------- MATERNITY SERVICE Adm. to medical service ------------------------------------------ 227 194 -------- 44 435 -------- 36 49 160 Adm. to nursing service ------------------------------------------ 235 226 -------- 62 573 92 53 55 165 Visits by ante-partum cases to medical conferences -------------------------------Field and office visits ______________ ---------------------- 197 632 -------- 220 1660 -------- 63 49 352 659 696 -------- 221 2833 166 100 112 347 INFANT HYGIENE Adm. to medical service --------------- ------------------------- 136 196 -------- 17 291 -------- 6 37 11 Adm. to nursing service ------------------------------------------ 155 273 ------- 83 473 117 47 41 24 Visits to med. conferences ------------------------------------- 284 489 -------- 34 784 ------- 10 37 12 Field and office visits --------------------------------------------- 393 591 ------- 140 1911 250 78 61 43 -------- ~ )1,! 1 6 t-o C) 4 18 ~ 239 l::t: ~ 75 ~ c 1512 o:167 1303 ~ 2 2 .1.!;..:I..:.' ------- ;C::), 2 "' -------- .........., CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNnEs-1944--Continued t.o 1: ..;1 ;~ ":s c.".'. ;":s' bO ~ ..;1 .. ..".. :;".;' ".~ ' ..;1 E"' "..;1 s" :Q:".;.:. .;l -3 ;;.";.:'. :"":;' ::;: :."~;.' ::;: PRESCHOOL HYGIENE Adm. to medical service ---------- ---------------Adm. to nursing service ________________ Visits to med. conference ------------Field and office visits ------------------- ----------- Dental inspections ----------------------------SCHOOL HYGIENE Inspections by physicians or nurses Examinations by physicians -------------Adm. 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 --------------------------------- 79 101 132 252 -------737 33 4 31 -------- 11 -------210 1 1220 97 111 168 191 -------1050 254 32 74 -------68 29 9 705 2818 ~------- -------- -------- ------.. -------- -------------- -------- -------- ------- -------- ---------------------- 1 -------- 14 1 13 35 66 65 -------- 494 2 27 40 -------- 4 6 -------- 5 -------- 29 445 304 726 969 1559 -------- 2131 3319 805 1546 -------- 2GG4 2062 5560 -------- ---- ------ -------- 6323 ----- 87 -------- 152 ------- 1 4 4 -------- 40 3 22 311 25 24 33 32 36 24 44 32 -------- -------- 44 59 28 -------- 25 26 40 66 1116 -------- 196 -------- 27 29 42 1 -------- 11 ----- -------- 34 13 10 635 366 -------- --------------- 109 ----------------------------- -------- -------238 -------- 11 23 392 -------- -------- ---------------------- ------ 7 12 95 .{::.. ~ ..;"Q;:' ::;: :;) "' ---- .0.., ----- (1q -------- "~' ----- t;:, "' ---- ~ ;>::>;. ------------------- ------ ;:: -.";.:.'l. 0 ~ ~ ------- c;:: -------- ::X:: "' -------- -------- ;>::>:;;::,... 7 14 183 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIEs-1944-Continued ~.... .;il::: ::;.: . ~ i ...=:; i -.... -- e.. ee !! ::e=;.: ::e=;.: ..= bG ::e;.: ...... "::;.: . ..ebG ::";.: .s= II: z . 8. Q COMMUNICABLE DISEASE CONTROL Adm. to medical service ---------------- --------------------------- Consultations with physicians ------------------- Field visits ------------------------------------------------------------- Smallpox immunizations _ ------------------- Diphtheria immunizations ------------------------------- Typhoid immunizations _____ ------------------ VENEREAL DISEASE CONTROL Adm. to medical service ___________________________ Clinic visits ----------------------- -------------- Field visits -------------------------------------- ----- No. of clinic treatments _______________________________________ TUBERCULOSIS CONTROL Adm. to medical service ____________ --------------------Adm. to nursing service _____ ---------------------- ------------Clinic visits ________________ -------------- ---------------------------Field and office visits -------------------- ----------------------- MATERNITY SERVICE Adm. to medical service ________________ -------------------Adm. to nursing service ----------------- -----------------------Visits by ante-partum cases to medical conferences ,__________ -------------------------- Field and office visits -------------------- ----------------------INFANT HYGIENE Adm. to medical service ..------------------------------ Adm. to nursing service ----------------------------Visits to med. conferences----------------------------------Field and office visits ______..____________, ________...._. -------- 6 43 329 102 1656 285 5024 17 4526 67 115 69 236 159 206 473 540 118 154 158 223 --------------- -------- -------- ----- --------------- ----------------------------- --------------- -- ------ ------ -- ------ ---- -3 23 126 186 393 150 2302 955 1797 37 179 67 602 478 _478 1067 1318 326 326 611 782 3 2 4 66 62 204 181 1346 33 1255 44 63 47 94 40 43 93 91 15 36 15 41 10 -------- 16 350 84 2322 62 639 33 638 74 90 129 241 51 73 102 158 15 50 19 106 ------- 2 217 128 1786 127 1336 36 1195 72 36 80 113 148 154 298 326 60 117 108 172 -------- -------- 2 ---- 12 3 501 1034 984 5421 -------- 3 -------- 2509 40777 1006 38404 423 2 737 1091 2 1475 ------- 854 1251 4331 5191 ------ 1010 -------- 1852 -------- 2730 -------- 7685 1 398 130 1905 249 4374 290 4286 112 85 123 202 48 146 10 28 13 29 15 212 35 721 94 591 2 16 -------31 9 78 19 32 .e.".' ~ 'ii Q 1 29 ct'-t <':> 23 ~ 67 t:J::: ('b s: 93 I:> 1660 131 0 ~ 1412 ;::, ------- -------- ------ ------- a1::' ;c.:.:.,.. "' ------- ~ CoNDENSED REPORT OF AcTIVITIES OF LOCAL HEALTH DEPARTMENTS, BY CouNTIES-1944--Continued --- ;...i .;J:: :::! .. ~ i :; ..c: ~ :::! ..0 0:: 0 :::! .J>. e 0 ~ a:: ..a:: ...J>. .. ..u0 0 :::! 0 :::! ::":! ::":! a:: 3 il z" . 0:: u0 0 PRESCHOOL HYGIENE Adm. to medical service ---------------------------------------Adm. to nursing service -----------------------------------------Visits to med. conferences -----------------------------------Field and office visits _____ ------------------ ------------------- Dental inspections ---------------------------------------------------- 125 151 173 212 -------- -------- -------- --------------- -------- 36 2 -------- 36 -------- 708 -------- -------- 36 3 1 46 -------- 2623 3 1 32 3 -------- 54 -------- 2287 ------- -------- 38 3 1 73 -------- 7258 3 1 13 -------- -------- -------- -------- ------- -------- SCHOOL HHYGIENE Inspections by physicians or nurses ------------------Examinations by physicians -------------------------------Adm. to nursing service ---------------------------------------Field and office visits ----------------------------------------Dental inspections ---------------------------------------------- 110 -------110 114 -------- ------------------------------------ 202 ------- 172 -------- -------- 9125 -------- 1 30 -------- 3 3 -------- 298 -------- 1 64 -------- 65 _______ ., 3 -------- -------- 2499 -------- 1 3 -------- -------- 4307 -------- 490 9 -------- ------- 614 -------- -------- -------- -------- ADULT HYGIENE Medical examinations _____ ---------------------------------------- ------ -------- 2 ------- ------- ------- -------- -------- -------- -------- MORBIDITY SERVICE Medical visits ------------------------------------------ 33 -------- ------- -------- ------- -------- -------- 4 ------ -------- Nursing visits ------------------------------------------- 114 -------- 1 ------- 47 -------- -------- 787 -------- 11 Admissions to hospitals ------------------------------------ -------- -------- 1 -------- ------- -------- -------- -------- -------- -------- SANITATION Water supplies approved Privies and septic tanks installed ----------------------- -------- 13 -------- 1 -------- 93 0 3 Food handling establishments registered ------ -------- -------- ------- ------- -------- -------- 220 Dairy farms registered ---------------------------------- -------- ------- -------- -------- -------- -------- 76 Milk plants registered ----------------------------------- -------- ----- -------- -------- -------- -------- -------- 3 Field visits --------------------------------------- -------- ---- -------- 72 7 13 1 11253 11 20 LABORATORY SPECIMENS Specimena examined ------------------------------------------ 835 -------- 1231 196 500 1 3 24301 337 251 ..... 0\ ...."0c:' ....! 0 ~ ------- c(!> -------- ~ ------ ~ -------- t:l ------- ------------------------- ------ ----- (!> .....,"1::1 1:1 ;:; (!> ;::! ...c -"':: I;: C"' -~ ----- -------- :::t:: (!> ------ ~ 1.:,1.. 8 0 206 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIEs-l94~Continued bo ;:=a; "II. COMMUNICABLE DISEASE CONTROL Adm. to medical service -----------------------------------------Consultations with physicians ---------------------------- Field visits --------------------------------------------------------------- Smallpox immunizations ---------------------------------------- Diphtheria immunizations ___ -------------- Typhoid immunizations ---------------------------- _____________ VENEREAL DISEASE CONTROL Adm. to medical service ---------------------------- ------------ Clinic visits --------------------------------------- ------------------------ Field visits ------------------------------------------------------------------ No. of clinic treatments -----------------TUBERCULOSIS CONTROL --------------- --------------- --- -------- 34 407 10 401 Adm. to medical service ---------------- ----------------------- Adm. to nursing service ------------------------------------------ Clinic visits ---------------------- --------------------------------------- Field and office visits __ --------------------------------- MATERNITY SERVICE Adm. to medical service --------------------------------. Adm. to nursing service ------------------------------------------ Visits by ante-partum cases to medical conferences____________ ------------------------------- Field and office visits _______ ------------------------------------- INFANT HYGIENE --------------- -------- ------- -------- -------- ------------ Adm. to medical service ----------------------------------------Adm. to nursing service -----------------------------------------Visits to med..conferences ------------------ _________________ Field and office visits ---------------------------- ----------------- -------- ------- -------- ------- ...c..: I""I. a .0"..:. li: 9 -------7 ------- 22 3 48 -------- 23 -------- 788 -------- 260 -------- 1767 -------- 140 -------- 1622 ------- 59 -------- 62 2 65 -------- 136 2 91 ------114 -------- 222 -------- 277 -------- 28 -------- 62 ------31 -------7~ -------- ..... li": 23 -------- 176 718 216 2706 138 2017 81 1843 69 86 77 169 73 80 157 216 34 74 67 232 .. .0: ~ c.0: ..~ ;";' II. II. E ."s "II. ."e= ; a ..c: I"""I=": .c.=."..' II: 2 2 7 90 178 1298 102 2026 178 1887 81 98 182 189 77 119 268 417 6 87 10 200 3 1 3 ---------------------- 298 5371 436 5207 -------- 4 4 --------------- --------------- -------- ---------------------- ---------------------- 114 66 525 245 2561 -------2423 36 74 74 132 -------224 -------622 -------160 -------274 -------- -------- --------------- 119 5713 647 6268 -------- --------------- -------- -------- -------- -------- --------------------- -------- -------- -------- -------- -------- -------- -------- -------- --------------- -------- -------- --------------------- --------------- -------- -------- -------------------- -------- -------------- 102 192 93 1099 11 172 24 172 69 33 59 110 24 61 72 202 4 138 7 470 6 8 20 t'-< i 644 0 221 3598 ::t:: C1> 350 8013 ~ ;~ ;::-. c 258 ...,~ 7947 ... 117 ..... 139 ~ 120 c; 288 &! 363 377 1390 1461 25 47 ,j:>. -l CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIES-1944-Continued .. =:=.=;-. PRESCHOOL HYGIENE Adm. to medical service ------------------------------------------ Adm. to nursing service ------------------------------------------ Visits to med. conferences ----------------------------------- Field and office visits ________ --------------------------- Dental inspections ----------- _________ ----------------------------- SCHOOL HYGIENE Inspections by physicians or nurses ______ ------------- Examinations by physicians Adm. 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 ------------------------------------------ -------- --------------- -------- -------- ------------- ---------------------- -------- --------------- -------- -------1 -------------- 17 47 ....c: " =- 17 23 19 27 -------- -------- -------- -------- -------- -------- -------4 -------- -------8 -------- -------- 28 307 .=., .Ill ii":: ------------- ---- -------- ----- -------- ----------- ----- ------------- --------------- 12 --------------- 21 4 .."... ii:: 60 89 80 225 ----- 439 ---17 25 -------- ------- -------9 -------- ------_--_-_--_-_--., -------- 1 1392 ~" --------------- -------------- ------75 -------3 5 -------- -------- -------12 -------- -------- 4 ------- ------- 23 521 .Ill 0 =- ------------------------------------ --------------------------- -------- ___ ,_ -------- --------------- -------- -------- 29 4GO :.;; ."!' ="- -------11 ---- 29 --------------- -------12 23 ---- -------- 1 ----- ---------------------------- -------- 748 ..Es.i ="- -------- -------- ---------------------- ---------------------- ______ ._ -------- ---------------------- -------- --------------- ------- -------- 627 ...=. Ei ; " --------------- -------- -------- -------- -------- --------------- -------- -------- -------- ---------------------- --------------- --------------- -------- -------- ."..=.. ll:l 4 21 6 30 -------- 234 -------- 14 14 -------- -------- -------13 -------- 2 26 28 4 270 626 ~ ..c: .c.."=...' ll:l !;') ~ -------- 0 -------- a";i -------- 15' -------- 0 ------- ~ ~ ... 219 .!.;..l ... ------- ;: ~ 53 ;::l 63 ..0.... -------- 9 :;~ :::::: ;::; 1 ::t: 17 ~ -------- ;.!,;;.l.-. 2163 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1944--Continued ., .: .:"e..:. i:a COMMUNICABLE DISEASE CONTROL Adm. to medical service -------------------------- --------------- 3 Consultations with physicians ---------------------------- 1 Field visits --------------------------------------------------------------- 1301 Smallpox immunizations ---------------------------------------- 2332 Diphtheria immunizations ------------------------------------ 2686 Typhoid immunizations -------------------------------------- 9623 VENEREAL DISEASE CONTROL Adm. to medical ser.vice ----------------- _____________________ 3101 Clinic visits ----------------------------------------------------- ---- 49163 Field visits -------------------------------------------------------- 1848 No. of clinic treatments ------------------ ____________________ 42638 TUBERCULOSIS CONTROL Adm. to medical service__ ---------- __ ------------------ -------- Adm. to nursing service _________ ------------------------------ Clinic visits --------------------------------------------------------------- Field and office visits ------------- -----------------------------MATERNITY SERVICE Adm. to medical service _________ -------------------------------- Adm. to nursing service ---------------Visits by ante-partum cases ----------- to medical conferences -------------- -- _________________ Field and office visits -------------- ----------- INFANT HYGIENE Adm. to medical service ________ ----------- Adm. to nursing service _____ Visits to med. conferences .... ____________________ Field and office visits ______ ....------ .. _____________ 1369 1432 5565 4478 1153 1521 4528 4500 938 1890 2563 8257 . .;...,;... "ll:l --------------- 1 ---------------------- 69 1439 70 1270 ------ --------------- --------------- -------- -------- ------- --------------- ------ .... :a... ell 20 15 27 --------------- 2 85 1159 292 1070 2 2 -------- 2 --------------- ------------ ------- -------- ------ ----- .>=..... . "-=.i;i :=";' ;; 0. ell ell ell 18 9 39 348 231 1929 389 4875 86 4836 146 167 145 531 190 222 575 609 99 169 303 417 -------- --------------- ------- -------- ----------------------------- -------4 -----4 -------------- ----------- ----- ---------------------- 15 -------- 64 435 1291 3179 539 10157 368 12485 163 163 275 1750 270 307 887 1162 233 544 487 1351 =.., .:: 0. .!l ell --------------- 34 458 255 3556 120 3403 216 3258 142 131 142 294 28 41 69 166 12 44 14 144 ..... /1: .!l ell 2 6 21 380 57 1167 184 2154 89 1795 64 110 57 246 115 128 275 348 14 16 15 29 ... .!l E "ell 55 29 131 424 531 2292 405 5940 239 5796 122 249 112 678 422 464 1814 1812 238 308 724 899 .. ~" !-< -------74 98 100 1492 275 1310 2 2 -------2 -------- .....".. .;!;! !-< -------- -------- ct--< (") -------- ~ -------- ::X:: ('1) !;l 139 ~ 2072 ~ ... 59 a 2010 ~ ------------ ~ .;:.:.s.. ac":'; i; -------- -------- ~ CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CoUNTIES-1944--Continued ~--.e=== PRESCHOOL HYGIENE Adm. to medical service ------- 1029 Adm. to nursing service ________________________________________ 1080 Visits to med. conferences _________ ------------------------- 3101 Field and office visits ------------------------- Dental inspections ---------- ----------------------------- SCHOOL HYGIENE 4009 -------- Inspections by physicians or nurses ------------------ 25673 Examinations by physicians ---------------------------------- 1820 Adm. to nursing service ------------------------------------------ 1804 Field and office visits _____________________________ 3343 Dental inspections ----------ADULT HYGIENE -------------- ------- Medical examinations ------------------------------------------ 2900 MORBIDITY SERVICE Medical visits ----------------------------------- ----------------------- -------Nursing visits -------------------------------------------------------- 1021 Admissions to hospitals ---------------------------------------- -------- SANITATION Water supplies approved --------------------------------- -------- Privies and septic tanks installed -------------------- 76 Food handling establishments registered _______ 1300 Dairy farms registered ------------------------------------------- 123 Milk plants registered ------------------------- ------------------ 5 Field visits ----------------------------------- -- ----------- 25525 LABORATORY SPECIMENS Specimens examined -------- - -------- -------- ------------- 69525 .". ...->.=..I ~ ------------------------------------ ------------------------------------ -------- ---------------------- 1 7 -------- -------- 11 103 :.."a...' 00 ----------------------------- -------------------------------- ------ ------------------ -15 ---- ----- 24 U5 ....=...... ..!1 .."e5 00 00 18 23 11 36 -------- 395 1 11 71 ------- 126 18 5 ------- 5 11 34 6 1226 1908 ---------------------- -------- -------- -------- -------- --------------- -------- ---------------------- -------- ---------------------- -------- ------- .:=tao 0"0 ' . -:=.".=l.' .. "II: :l 00 00 296 498 593 1201 -------- 405 -------- 64 79 -------- 529 19 19 10 2 9 20 7 546 3609 -------- 10 -------- 63 -------- 2410 -------- 58 118 -------- -------- -------1 -------- 4 1 22 1 311 1113 --------------- -------- 1 -------- ---------------------- -------------- -------- ------- 3 -------- -------- -------- -------- -------- 483 ...e... 00 56 67 174 200 ----- 1089 135 -------- 387 -------- 402 40 69 -------- 15 35 26 2222 3623 ...~... ~ --------------------- ------------ -------- -------- -------------------- -------- -------- --------------- -------- 12 30 219 <:11 0 ........ ~" ~ ------- <1> 0 ----- ~ ------- ~ ------- t:::l ------------- ------- ---- <1> '".l.O:..:.,!l. ;:! ...<1> ;::! ------- ----- .s. ~ .... ------- I;: .0..."..' (") ----- -- ------- ~ Ol ~ ~ 1 9 12 216 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIEs~l944----Continued COMMUNICABLE DISEASE CONTROL Adm. to medical service --------- Consultations with physicians --------------------- Field visits -------------------------------------------------------------- Smallpox immunizations --------------Diphtheria. immunizations _____________ Typhoid immunizations ---------------------- VENEREAL DISEASE CONTROL Adm. to medical service ________________ ---------- Clinic visits ------ ------------------------------ ----- Field visits ____________________________________ ----------- No. of clinic treatments __________ TUBERCULOSIS CONTROL Adm. to medical service ........ ------------------- Adm. to nursing service ______________ --------------- Clinic visits --------------------------------- ---------- Field and office visits ------------------ ________________________ MATERNITY SERVICE Adm. to medical service ........ _____ Adm. to nursing service ___________ Visits by ante-partum cases to medical conferences ____________ Field and office visits ________ INFANT HYGIENE ----------------------------------- Adm. to medical service -----------------------------------------Adm. to nur.sing service ------------------------------------------ Visits to med. conferences ---------------------------------Field and office visits --------------------- -------------------------- .;~=; (of 35 2 104 353 129 1784 145 2445 23 2430 120 121 125 200 30 31 83 89 16 22 51 64 ....... (of 21 1 29 -------67 1303 128 4236 100 3957 20 27 19 63 4 71 4 188 -------1 -------27 ...;... '4l (of 28 ------ 5 96 214 1270 86 1743 196 1558 44 59 so 192 97 97 369 324. 41 45 224 289 =.... E-o 4 3 7 795 358 2552 279 4044 8 3905 30 31 29 64 418 418 1466 1466 121 121 487 496 E..... -=(of 10 -------- 27 418 260 4577 222 2762 27 2692 110 155 93 278 412 417 1223 1178 267 334 878 986 ..... !::: 1 2 49 503 323 2472 313 4000 114 3977 113 361 170 785 238 262 755 922 112 274 224 703 .,Q"' E "E-o so 1 114 1045 264 2253 197 1857 13 1812 93 145 93 348 109 113 285 315 84 91 159 185 . c fl: "(of -------- ----------- -------- -------------------------------------------------------------- c ~"... ."..... E-o (of -------- -------1 64 88 122 50 527 88 516 39 58 48 126 69 76 210 274 49 75 113 206 21 16 298 834 1102 6546 582 10026 325 9129 42 299 415 1049 252 306 671 998 150 350 168 590 =... "E-o -------- ct-< ------- () -------- ~ .... -------- ~ !;l s. -------- -------- ------- 0 -------- ~ l;::sl ... 1 r; .... 46 !;l "' -------105 ;c:s -------- ,~ ..... Cil CoNDENSED REPORT OF AcTIVITIES OF LoCAL HEALTH DEPARTMENTS, BY CouNTIEs-1944----Continued ~ ..E..... ......s.... PRESCHOOL HYGIENE Adm. to medical service __ --------------------------------------- 3 Adm. to nursing service _______ ---------------------------------- 4 Visits to med. conferences _________________________________ 7 Field and office visits ------------------------------------------ 8 Dental inspections ---------------------------------------------------- -------- SCHOOL HYGIENE Inspections by physicians or nurses -------------------- 577 Examinations by physicians __________ ----------------------- Adm. to nursing service __________ -------------------- Field and office visits _____ ------------------------- Dental inspections ------------------------------------------------- ADULT HYGIENE 5 5 -------- 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 ----------- 3 Speciments examine. ....... E:: -------~ 10 -------- 10 -------- 637 --------------- 6 -------- -------- --------------- ------- --------------- -------- -------- 1606 13 16 46 60 ------ 42 64 9 22 ----- ------- -------2 -------- -------56 -------4 4 1174 2298 31 187 68 518 -------- 1053 7 87 149 -------- 1 1 -------- -------- ---------------------- -------- -------- 2048 .".,' IS C> ..C.>. 88 97 156 113 -------- ----------------------------- 72 -------- -------1 -------- ------------------------------------ 17 1294 ., c:: ~ ..C.>. -------------------- -------- ----------------------------------- -------- ---------------------- -------- -------- -------- -------- -------3 ------- .c:: ..:;: ..".. .... .."C.>. 5 11 .6 23 ------ 10 3 3 -------- ---------------------- ----------------------------- -------- 9 420 5 135 5 232 5786 918 306 321 -------- 295 30 144 5 36 182 121 40 2 1647 4537 .. c:: .."".. ~ "' -------- 0.... s -------- l)q -------- ---- t::l "' -------- '"'l;:j ....l.;..l -------- ;3 .".'. ---- -------- ;:l ~ ------- "tt !;:: ---- 0'"' ff ---------------------- ~ ~ ;:- CoNDENSED REPORT OF AcTIViTIES OF LocAL HEALTH DEPARTMENTs, BY CouNTIEs-1944-Continued .. ttoo -~ ": iii ~ ..<= 0 iii ..". ~ ~ ...<..= ~ ;::. ;~ ::- 33 0 ~ 244 ;::3 5 1:; .... 22 .>.:.:.. -------- c 36 i;; 4 6 10 8 5 2 11 <:11 ""' CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1944---Continued ... ; r;.. a= >:;1 ~ ~ .. ~ ~ ~= ~ .. ~" ..=. ~" .=c. ::=a; ~ . ~= :..I.. i ~ ~ PRESCHOOL HYGIENE Adm. to medical service ______________ ------------------------Adm. to nursing service ----------------------------------------Visits to med. conferences --------------------------------Field and office visits ------------------------------------------ Dental inspections -------------------------------------------------SCHOOL HYGIENE Inspections by physicians or nurses ------------------- Examinations by physicians ---------------------------------Adm. to nursing ser.vice ----------------------------------------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 ----------------------------------------------- 3 3 3 3 -------- 13 -------- -------- ------------ ----55 --------------------- 1 1019 ----------------------------- -------- -------- -------- -------- ---------------------- -------- -------------- -------5 13 10 10 14 21 ------ 1 -----33 307 272 38 z 141 3 13 ---- ----- ------- 96 1666 8 154 18 249 ------- 109 23 26 37 35 61 ------26 -------- 8 3 ------- 124 60Q 62 192 83 304 -------- 1451 398 96 765 -------- -------- 12 109 4 156 156 186 315 -------- -------415 32 96 ------- 1418 782 -------2970 9 ------------- -------- 651 1714. 49 275 12 2 31044 9826 --------------- --------------- ------------------------------------ -------- ---------------------- 2 ------------ 6 379 135 66 98 66 ------- 25 2270 -------- 177 -------- 597 -------- 23 33 4 918 2294 2 29 23 108 -------- 257 -------- -------- -------- -------- 103 1 14 4 173 868 --------------------- ---------------------- ----------------- ----------------------------- -------- ------ .C..J.l '...i.i ..c: ~ ~ 1 cCb 1 ~.... 1 1;:1 2 t; ------- ~ - -6 ..1..;..:1,.. ;:! Cb 1 .~.... 110 109 .Q.. '"t:l -- ~ 0"' f ------ ----- ::t: Cb .... --- ;1:;::1;:- 118 Local Health Organizations 55 CoNDENSED REPORT OF AcTIVITIEs OF LocAL HEALTH DEPARTMENTs, BY CoUNTIEs-1944-Continued :$a j:r; COMMUNICABLE DISEASE CONTROL Adm. to medical service ---- Consultations with physicians Field visits ------------------ Smallpo'( immunizations -Diphtheria immunization -----------Typhoid immunizations VENEREAL DISEASE CONTROL Adm. to medical service --------- Clinic visits ------------------------------ Field visits ------------------------------------- No. of clinic treatments -TUBERCULOSIS CONTROL Adm. to medical service Adm. to nursing service __ Clinic visits --------------------- Field and office visits MATERNITY SERVICE Adm. to medical service Adm. to nursing service Visits by ante~partum cases to medical conferences ---Field and office visits INFANT HYGIENE --------------------- Adm. to medical service ________ -----------------Adm. to nursing service -------------------------------------- Visits to med. conferences -------------- ------------------Field and office visits --------------- ----------------------- ... ~=: ..1:1 j:r; .. 0 ~ .. :!!! ~ 36 48 132 727 1031 1478 265 3008 228 2469 308 320 916 2122 16 129 26 270 105 375 241 891 10 215 119 1561 170 2212 70 1938 76 131 74 331 0 8 17 6 22 20 1096 536 1666 264 5372 101 5182 35 42 39 92 98 129 261 359 104 150 240 412 fl 0 .9 :!!! .-1 ~ 0 j:r; 11 lOS 461 269 7 2404 24 414 77 4849 10 333 77 4238 205 296 210 776 7 222 7 351 7 769 9 1198 162 364 371 827 56 Georgia Department of Public Health CoNDENSED REPORT oF AcTIVITIEs OF LocAL HEALTH DEPARTMENTS, BY CoUNTIEs-1944-Continued :; :E ~ PRESCHOOL JIYGIENE Adm. to medical service ----------------------Adm. to nursing service --------------------------------Visits to med. conferences ----------------------------Field and office visits ------------------------------------Dental inspections ---------------------------------------- SCHOOL HYGIENE Inspections b:r physicians or nurses ---------------Examinations by physicians ----------------------------Adm. 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 ------------------------------- 1 Privies and septic tanks installed --------------- Food handling establishments registered________ Dairy farms registered ---------------------------------- Milk plants registered ----------------------------------- Field visits -------------------------------------------------------- 21 LABORATORY SPECIMENS Specimens examined ----------------------------------------------- 9 ~ :5a i::: 291 362 447 613 4054 1105 447 60 3 8 1 35 23 1 329 2603 .H ..:1 ~"" ~ ~ 367 412 1627 1895 5 2410 146 20 2 68 10 1 10 297 635 r:: =. .a""5 i::: i::: 89 200 120 362 118 32 7 21 145 11 11 3 6 52 2143 Local Health Organizations 57 CoNDENSED REPORT OF AcTIVITIEs OF LocAL HEALTH DEPARTMENTS, BY CoUNTIEs-1944-Continued NOTES: The following counties have full time health unit- Atlanta, City of Appling-Wayne* Baldwin Bibb-Jones* Bleckley-Dodge- Pulaski '1. Brooks Bulloch Burke-Jenkins- Screven* Calhoun Chatham Clarke Cobb Coffee Colquitt Crisp-Worth* Decatur DeKalb Dougherty Floyd Fulton Glynn-CamdenMcintosh* Grady Greene-Hancock- Wilkes* Gwinnett Habersham-Rabun- Stephens* Hall Harris-Meriwether* Jefferson Laurens Liberty 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 Ben Hill Berrien Brantley Bryan Butts Candler Carroll Charlton Clayton Clinch Coweta Crawford Dade 58 Georgia Department of Public Health Dawson Douglas Echols Effingham Emanuel Evans Fannin Forsyth Franklin Glascock Gordon Haralson Henry Irwin Jackson Jasper Jeff Davis Johnson Lamar Lanier Lee Long Lumpkin McDuffie Macon Monroe Montgomery Morgan Murray Newton Oconee Peach Pierce Pike Randolph Seminole Stewart Tattnall Taylor Toombs Treutlen Turner Twiggs Upson Webster Wilcox Wilkinson Work in the remaining counties was done by regional personnel and special venereal disease control itinerant nurses. Division of Public Health Nursing MRs. ABBIE R. WEAVER, R. N., B. A., M. A.____________________________________Director Miss ELSIE CROSBY, R. N., B. A ...___ ------ __________________________Associate Director MRs. BESSIE F. SwAN, R.N., B.S. Ed., M.S. P. H. Maternal and Child Health Consultant s._______ MISS FLORRIE L. ERB, R. N., B. _/nstructor in Public Health Nursing Miss MARY G. DEVINE, R. N. ____________________________fndustrial Hygiene Consultant MISS ELOISE MILLER, R. N., B. s.______________Tuberculosis Nursing Consultan: Division of Public Health Nursing A narrative report of public health nursing in Georgia during 1944 can be scarcely more than an account of the effort made day by day and week by week to hold the gains made in previous years and to take care of emergencies as they occurred; few new developments have been possible. The census of public health nurses which is taken annually on January lst shows a total of 559 nurses for 1945 as compared with 551 for 1<>t14, an increase of eight nurses. However, an analysis of these totals shows an increase in the industrial nursing group from 185 to 219, a gain of 34, and a decrease in all other types of public health nursesi from 366 to 340, a loss of 26. These figures represent a loss of 7.2% in the number of nurses available for the generalized public health nursing program. When one considers the urgent appeal for an ever increasing number of nurses for military service, the loss in staff is less than might have been expected. The loss in nursing service is not to be measured only in the total number of nurses available hut also in the educational qualifications o the staff. There are many instances in which an efficient public health nurse has had to he replaced with a graduate nurse who has had neither post-graduate preparation nor experience in public health nursing. Such nurses hold war emergency appointments and will be replc:ceJ when fully qualified public health nurses are again available. At the close of the year, 130 of Georgia's 159 coun.ies had made budgetary provision for public health nursing serviCe. However, many of these counties are still awaiting the assignment of a public health nurse. On January first there were 43 rural counties without full-time nursing service as compared with 2,9 on the same date of the preceding year. Thirteen counties are still being provided with part-time service through itinerant nurses on the staff of the State Deparment of Health. These nurses have devoted the major part of their time to venereal disease cvntrol. Only two new nursing services were established during the year, one in Oconee County and one in Berrien County. In spite of the war emergency it has been possible to carry on a limited educational program for public health nurses. Sixteen new nurses were accepted for training. Thirteen attended Peabody College, one Vanderbilt University, one Teachers College, Columbia University, and one the Medical College of Virginia. Twelve in-service nurses were granted educational leave. Seven attended Peabody College, one the University of North Carolina, one the University of Pennsylvania, and three the Medical College of Virginia. A number of additional nurses attended short courses in specialized fields of public health nursing. Eighty-six nurses attended the two weeks program at Warm Springs, Georgia, offered by the Georgia Chapter of the National Foundation for Infantile Paralysis; this was an intensive course intended to familiarize public health nurses with the care of polio- 62 Georgia Department of Public Health mylitis during the acute stage and included the newer methods of treatment in the use of hot packs and exercise. Four nurses attended the course in tuberculosis nursing offered at the University of North Carolina durng the month of June. Eight public health nurses and three institutional nurses were given experience in the care of premature babies. Five of these students went to Michael Reese Hospital, Chicago, two to Harlem Hospital, New York City, three to Presbyterian Hospital, New York City, and one to New York Hospital, New York City. The Georgia Department of Health has administered a program through which supervised practice in public health nursing has been provided for 21 senior cadet nurses. These nurses have been assigned to the following county health departments-Fulton 13, Spalding two, Walton two, Floyd two, and Hall two. One of the outstanding developments in the field of nursing in Georgia during the past year was the establishment of collegiate schools of nursing at Emory L1niversity and at the University of Georgia. The Emory University School of Nursing has full professional status and the director holds the rank of dean. The School of Nursing in the University of Georgia is located in the Department of Education. Both of these schools offer a four to four and one-half year program leading to the Bachelor of Science degree in nursing. During the year two manuals were completed by Miss Elsie Crosby for the guidance of public health nurses in the venereal disease control program, an "Interviewing Manual" and a "Patient Educational Manual." A special committee was appointed to prepare a manual on the nursing care of premature babies. Although a great deal of work has been done, it is incomplete. The county public health nurses have continued to give nursing care to crippled children under the general direction of the specialized consultants of the Crippled Children's Service in the State Department of Public Welfare. During the year they made 2,190 nursing vsits to 654 children. The two small maternity homes in Georgia have experienced great difficulty during the past year in maintaining a nursing service. In April a graduate nurse-midwife was assigned to the home in Duluth, Georgia as a lend-lease nurse from the U. S. Public Health Service. After a few weeks' service, she resigned. The position has remained unfilled. However, throughout the year one of the local physicians delivered the patients admitted and nursing care was provided by the resident nurse with the assistance of nursing aides. For the greater part of the year nursing care for the home in Clayton Georgia, has been provided by the use of practical nurses and nursing aides under the general supervision of the county public health nurses, one of whom is a nurse-midwife. At the close of the year the home was without a resident nurse. During the year the Director and the two Associate Directors made 19 visits to the regional offices and 65 visits to county and city health depart- Public Health Nursing 63 ments. They gave assistance in program planning, evaluation of services, staff education, statistical studies, and general consultation about special problems. They also attended 12 regional educational conferences and contributed to the programs. Throughout the year Miss Crosby devoted a considerable amount of time to the supervision of the venereal disease nursing program. She spent 6 weeks with the Chatham County Health Department assisting in the reorganiation of the nursing service and paid subsequent supervisory visits to this service. She also reviewed the venereal disease control prigram in Richmond, Bibb, and Floyd Counties, and paid advisory visits to the Medical Rapid Treatment Center established in Savannah. She attended the National conference on Postwar Venereal Disease Control held in St. Louis and also the annual meeting of the Southern branch of the American Public Health Association and contributed to the program. Miss Crosby also made a field trip to accompany Miss Mary Conner, Educational Director of the National Organization for Public Health Nursing, on visits to several local health departments which gave promise of being suitable for student practice fields in the program being developed by the University of Georgia. Mrs. Swan's activities included 16 visits to hospitals, two to maternity homes, and five to day nurseries. In the hospitals instruction was given in the nursing care of premature infants and emphasis placed on the early reporting of these infants to the local health departments. This is a comparatively new phase of public health work in Georgia and is bringing about a closer coordination between the work of hospitals and health departments. She also paid 21 visits to maternal child health conferences in order to give assistance in the organization of the clinics, inerviewing of patients, demonstration of procedure and other phases of clinic activities. Mrs. Swan also made an out of state trip to visit four hospitals in New York City in an effort to arrange a period of observation and experience in premature infant care for Georgia nurses. During the year eight public health and two institutional nurses have been given this type of training. This trip als oincluded a visit to the University of North Carolina for the purpose of evaluating the course in public health nursing. The conclusion was reached that the course is now well developed and is a desirable one for Georgia nurses. A visit was also paid to the midwifery course at Tuskegee, Alabama. Mrs. Swan assisted Dr. Paul Ensign, Pediatric Consultant, in conducting two day conferences on teaching skills. These conferences were held at the Muscogee County Health Department, the Atlanta Health Department, and in Greensboro and Gainesville for group~ of rural nurses. The narrative reports of the specialized nursing are included in the report of the Division which each one serves. Careful consideration has been given to certain revisions which seem desirable in the Merit System requirments for public health nurses. A meeting was held in November which included representatives from the Division of Public Health Nursing, the Children's Bureau, and the U. S. INCUBATOR DESIGNED BY STATE HEALTH DEPARTMENT Public Health Nursing 65 Public Health Service. Plans have been made for another meeting early in the new year, at which time the director of the Georgia Merit System Council and the federal advisors on the Merit System will be present. The nursing division contributed two articles to the Public Health Nursing magazine--one by Mrs. Bessie F. Swan entitled "I Got a Heap To Do At Once," a story of a grannie midwife, and the other by Mrs. Abbie R. Weaver entitled "The Role of the Public Health Nurse in the Immunization Program." Members of the Division of Public Health Nursing have served throughout the year on the following committees; The Nursing Council for War Service, the Advisory Committee to the University of Georgia on the Development of the School of Nursing, The Nursing Committee on Procurement and Assignment Service and on the Red Cross Home Nursing. Miss Edna Squires, a Canadian nurse, holding the position of supervisor on the staff of the Ontario Department of Health, spent two weeks in Georgia observing the public health nursing program. Miss Squires was a fellow of the Rockefeller Foundation. Division of Public Health Engineering L. M. CLARKSON___________________________________________ _____________________________________Director N. M. DE ]ARNETTE_______ ______ Acting Associate Director Division of Public Health Engineering ADMINISTRATION AND COORDINATION This division of the Georgia Department of Public Health has the responsibility of planning and administration of the program of public health engineering, including the assignment of duties, reviewing all activi ties of the personnel and coordinating the program with other divisions of the department. It has the responsibility of maintaining cooperative relationship with the engineering profession and consulting engineers, all agencies, other departments of the state and federal government whose activities relate to sanitation through engineering for protection of the public health. Public health engineering is a normal function of federal, state, dis trict, county, and municipality. Public health engineering service is avail able to the public from the following organizations (a) central administra tion, Georgia Department of Public Health Atlanta, and other field offi ces (b) regional engineers in each of the six regional offices located at Marietta, Gainesville, Swainsboro, Griffin, Waycross, and Albany (c) county public health engineers and sanitarians in organized county health departments (d) municipal sanitary engineers functioning in the larger city health departments. In counties without health departments, regional engineers render valuable service. TYPES OF SERVICES RENDERED Studies of needs for satisfactory development of water and sewerage faciliites. Approval of engineering design and sanitary supervision of the operation of municipal, institutional, public and semi-public, recreational, and industrial water and sewerage 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 ho~es, schools, state and local institutions and build ings, 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 incinera tion 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 analyses. Malaria surveys and plans for control through the mosquito vector, including drain age, semi-permanent and permanent ditch lining, fluctuation of pond and lake water levels and larviciding breeding areas. Malaria control operations conducted in extra-cantonment areas at all military, naval and war industrial plants through facilities made availble by the U. S. Public Health Service in cooperation with military, naval, and maritime authorities. 70 Georgia Department of Public Health Investigation of proposed impounded water projects, issuance of permits under state regulations for construction and 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 passenger traffic. 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 sanitarry 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 require ments 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 sanitation 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 A major activity of the Division of Public Engineering consists in rendering service to the various communities in the state on matters pertaining to public water supplies and sewage collection, disposal and treatment. The exercise of the general supervision of the Department over such matters insofar as they pertain to sanitation and public health includes such items as field investigation of existing conditions, promotion of needed works projects, training plant operators, reviewing and approval of plans and specifications, conferences with local governing bodies or other federal or state agencies, etc. These activities were carried on during 1944 insofar as was possible with limited personnel and restricted travel. Only a relatively small amount of new water and sewerage works construction has been undertaken during the year due to the shortage of Public Health Engineering 7l labor and critical material. All major construction projects have been in areas where nearby war activities have brought about increased populations. The manpower shortage has been acutely felt by many water works and sewerage departments where trained operators have been lost to the armed forces or have resigned to accept more remunerative positions in industrial or governmental positions with the result that less efficient operation has been had in certain instances. Late in the year the Division was asked to coop~rate with the public works panel of the Georgia Agricultural and Industrial Board in formulating a post-war planning program in various Georgia communities. Preliminary surveys and reports covering water and sewerage needs in those places requested have been rendered that panel. In addition many other towns needing major improvements to water works or sewerage systems have been encouraged to inaugurate engineering studies and prepare detailed plans and specifications in order that these improvements may be started as soon as labor and materials are available. WATER WORKS AND SEWERAGE SCHOOL The Division helped sponsor and conduct the 13th Annual School for water works and sewerage operators. This school was held at the Georgia School of Technology and was attended by approximately 250 water and sewerage plant operators, engineers and superintendents from municipal and industrial plants throughout the state. CERTIFICATION OF WATER FOR USE ON INTERSTATE CARRIERS The Division made inspection, investigations, recommendations regarding the improvements and laboratory examinations on samples from all water suppliesi n the state where water is used for drinking or culinary purposes on railroad coaches, vessels or airplanes engaged in interstate traffic. Favorable certification to the United States Public Health Service was made in thirty-five cases and provisional certification in one case. Where follows a list of the water supplies upon which action was taken. Favorable A del Albany Americus Athens Atlanta Augusta Brunswick Camilla Cedartown Columbus Cordele Cornelia Dublin Fitzgerald, City Fitzgerald, A.Bl.&CR.R. Fort Valley Griffin Jesup Macon Manchester Moultrie Rome Savannah, City Savannah Sugar Ref. Corp. Savannah, A.C.L.R.R. Smithville Statesboro Sylvania Tennille Thomasville Valdosta Vidalia Wadley Waycross Provisional Ashburn 72 Georgia Department of Public Health PLANS AND SPECIFICATIONS FOR WATER WORKS AND SEWERAGE CONSTRUCTION Plans and specifications for twenty-five water works and sewerage projects were examined and approved by the Department during the year. Eleven of these were for water supplies and fourteen were for sewerage or sewage treatment works. Atlanta. Additional chlorination and chemical feed equipment installed 1944. Atlanta. Exposition Cotton Mills. New hypo chlorinator installed on deep well supply previously untreated. Augusta. New raw water line from river to filtration plant completed 1944 (FWA). Bainbridge. Standby pumping equipment and new chlorinator on previously untreateJ deep well supply installed 1944 (FWA). Buchanan. New hypo chlorinator installed to replace obsolete chlorination equipment. Chatsworth. New hypo chlorinator installed on spring supply previously untreated. Columbus. Distribution system extensions (FWA) and additional filters totaling 9 MGD capacity under construction 1944. Covington. New chlorinator installed replacing obsolete equipment. Cumming. New raw water pump and raw water line from creek to filter plant installed 1944. Dahlonega. New hypo chlorinator installed on spring supply previously untreated. Dalton. Improvements to water softening and filtration plant under construction 1944. Dawson. Chlorination equipment installed on deep well supply previously untreated. Dublin. Additional deep well pumps and distribution system extensions completed 1944 (FWA). DeRalb County Water Works System. Major water main extensions completed 1944. East Point. New surface supply including raw water station, raw water line, storage res.. ervoir, 2 MGD filtration plant, high service pump station and distribution system extensions completed 1944 (FWA). Edison. New hypo chlorinator installed to replace obsolete equipment. Fitzgerald. New chlorinator installed to replace obsolete machine. Gainesville. Water main extensions, reservoir and booster pump station to serve naval training school completed 1944 (Navy). Glennville. New deep well, chlorinator and distribution system extensions completed 1944 (FWA). Hampton. New deep well completed and put in service 1944. Hinesville. New deep well, chlorinator and distribution system completed 1944 (],'WA). Hogansville. U. S. Rubber Company. Chlorination equipment installed on deep well supply previously untreated. McCaysville. New water works system comprising spring, calcite filter, hypo chlorinator reservoir and distribution system completed 1944 (FWA). Public Health Engineering 73 Midville. Hypo chlorinator installed on deep well supply previously untreated. Nashville. Chlorination equipment installed on deep well supply previously untreated. Norcross. New deep well constructed and put in service 1944. Perry. Distribution system extensions completed 1944 (FWA). Porterdale. New chlorination equipment installed to replace obsolete machine. Roberta. New deep well completed and put in service 1944. Sandersville. New deep well completed and put in service 1944. Savannah. New deep well completed and chlorination equipment installed 1944. Swainsboro. New chlorinator installed on deep well supply previously untreated. Thomasville. Distribution system extensions under construction 1944 (FWA). Union Point. New deep well completed and put in service 1944. Warner Robins. Distribution system taking water from army supply installed to serve the village of Warner Robins completed 1944 (FWA). ENGINEERING LABORATORY- 1944 The Engineering Laboratory serves to supplement the work of the Division of Public Health Engineering by performing such tests, analyses, or examinations of a physical, chemical or bacteriological nature as may be required in the general state-wide sanitation program. For the most part, the work consisted primarily of the bacteriological examinations of samples of water from public and semi-public supplies, public school supplies, improved private supplies, approved swimming pools, and samples from shellfish growing waters. The comparative study on the use of a special "EC" medium for the isolation of the coliform group of bacteria in drinking and shellfish growing waters which was begun in 1943 was continued through May, but had to be discontinued on account of the loss of one laboratory technician. The total number of samples examined in 1944 was 15,499 which was an increase of 875 samples, or approximately 6%, over the number of samples handled in the previous year. The distribution of work is shown in the following table: Bacteriological samples: Public and semi-public._________________________________________________ 12,687 Private -------------------------------------------------------------------------- 507 Swimming Pool ------------------------------------------------------------ 137 Shellfish ---------------------------------------------------------------------- 1,818 Comparative Media ------------------------------------------------------ 277 Chemical Samples ------------------------------------------------------------- 63 Miscellaneous ------------------------------------------------------------------- 10 TotaL_______________________________________________________________________ 15,499 74 Georgia Department of Public Health GEORGIA MALARIA CONTROL IN WAR AREAS ACTIVITIES DURING 1944 The Engineering Division has supervised the operation of the Malaria Control in War Areas program since its inception in March of 1942. During these three years of operations, the following war area programs were active in one or more years: Albany, Americus, Atlanta, Augusta, Bainbridge, Brunswick, Columbus, Douglas, Dublin, Hinesville, Macon, Moultrie, Rome, Savannah, Statesboro, Thomasville, and Valdosta, and all of these were active during the 1944 malaria mosquito breeding season. In addition, occasional inspections have been made in the Tifton and Waycross Areas, which indicated that malaria control measures were not necessary in these two war areas. A member of the Division serves as State MCWA Director, setting state policies and plans, and coordinates the state program with the national program in accordance with the general plans and policies of the U. S. Public Health Service-Malaria Control in War Areas Headquarters Office, located in Atlanta. The Engineering Field Office at Macon functions as the State MCWA Office and is staffed by nine persons including: Assistant State Director, State Entomologist, State Administrative Assistant, and their assistants. Preparation of payrolls, purchase orders and other administrative matters are handled by the Administrative Assistant; all entomological collections are examined and idehtified by a trained entomologist; operations and other reports are reviewed by the State Staff and summarized for submission to the State Director and MCWA Headquarters. Field operations are planned and technically supervised by the Assistant Director and the Entomologist who assists in the selection and training of entomological inspection personnel and also reviews their findings. Supervision of area activities, with one exception, is conducted by an Area Supervisor of Civil Service or U.S.P.H.S. commissioned officer status. The Brunswick Area is supervised by Dr. M. E. Winchester, Glynn County Health Commissioner. The area programs are coordinated with the local Health Departments and, where requested, monthly progress reports are furnished to the interested Commissioner of Health. Likewise, most of the area offices are located in the local Health Department buildings unless adequate space is not available, in which event the area office is located in a portable field warehouse. The following rules have governed the Georgia MCWA operations: l. The control areas are limited to the areas within malaria mosquito flight range and contiguous to defined war establishments, access roads, and military recreational centers. 2. All efforts are directed towards the control of the local malaria vector, Anopheles qzuulrimaculatus or "quad" mosquito, and control of non malaria mosquitoes was not authorized. 3. Operations are planned and conducted in the most economical Public Health Engineering 75 manner, in order that only definite malaria problems are given attention. Therefore, the following routine of operations has been consistently followed: I. Larvicidal control measures have been confined to those locations in which quad breeding was demonstrated by larval collections. 2. Paris green was selected as the main larvicide to be employed due to its proven effectiveness and lower cost as compared to other present known and available larvicides. 3. No major drainage project has been, or will be undertaken unless it can be shown that its cost can be amortized by the consequent saving of larvicidal and inspection costs during a reasonable period. 4. Minor drainage has been confined mainly to maintenance or reconstruction of existing waterways and the clearing and cleaning of areas to be larvicided, all of which are performed by the crews, ranging in number from 2 to 20 men per area, whose principal duties are application of larvicides. The mode of operation of the Georgia program may be briefly summarized as follows: l. Before operations of any nature are started in a War Area, an initial larval and adult survey of the area is made by an experienced Entomologist to determine the general extent of quad breeding. This survey determines the preliminary plans for selection of personnel and equipment for control in the area. 2. After the area has been staffed with adequate inspection personnel, larval and adult stations are designated and their locations shown on the best map available, which, in most instances, is a special map made by state and MCWA personnel from the most recent aerial photographs available. 3. Weekly inspections are made of all known significant anopheline breeding areas and suitable resting stations. These collections are daily forwarded to the State Office for species identification of the larvae and for verifying the inspectors' identification of anopheline adults. Identifications are made on the day shipments are received and results are immediately returned to the area, generally arriving there on the second day following inspections. 4. During the breeding season (April-October in most areas) every station showing the presence of quad larvae twice within 30 days is placed on a weekly schedule of larviciding and is checked by inspection within 48 hours of larviciding. Where this inspection shows the presence of an appreciable number of anopheline larvae, larvicide is immediately reapplied. During the remainder of the year, stations showing the presence of quad larvae are larvicided only once following such findings. 76 Georgia Department of Public Health 5. The Area Supervisor prepares and forwards to the State Office a weekly operations report, weekly activity report, and the semi-monthly progress report. . 6. All administrative functions, summarization and analyses of collection data, and engineering planning are performed by personnel in the State Office. (The 1944 procedure closely follows that of 1942, a report of which may be found in the Journal of the National Malaria Society, Vol. II, No. 2, pages 49-60.) A brief resume of activity by areas follows: Albany. Consists of Darr, Turner Field and USO Zones. Extensive breeding areas in the Georgia Power Company Reservoir and various limesinks. Control was secured in the smaller areas by hand dusting methods and on the reservoir by power dusters operated by Georgia Power Company crews. Weekly fluctuation of water level by the Georgia Power Company increased efficiency of control and reduction in cost. Topographic mapping is to be performed during winter to further refine control methods and improve efficiency of control. Americus. Consisted of Souther Field, Access Road, and City Zones. Hand dusting by Albany area personnel maintained satisfactory control. Breeding in one large limesink was eliminated by its dewatering which was effected by pumping the water a distance of about 1200 feet to an existing ditch. Atlanta. Consisted of Bell Bomber Plant, Army Depot, Naval Air Base, Lawson General Hospital, City of Marietta, Fort McPherson, and Candler Field Zones. Considerable inspection involved but little Iarvieiding required due to the few quad positive stations found. Augusta. Consists of City, Aero Tech, and Camp Gordon Zones. Intensive breeding areas located in brick yard excavations and one lake within flight range of Oliver General Hospital. Hand dusting combined with water level management secured satisfactory control in most of the excavations and the lake was drained. Several acres of breeding surface were permanently eliminated by filling, utilizing waste brick plant materials hauled by plant trucks, and by controlling the deposition of water borne sediment. A 4" hydraulic dredge was constructed for use at Macon and its description is included with that area. Bainbridge. Consists of Access Road, Air Base, City and West Bainbridge Zones. Extensive and intensive breeding principally found in limesinks. Several limesinks were permanently drained by dragline-eonstructed conn~~Ction to outfall at C.A.A. Air Base. Many other limesinks were permanently drained by MCWA installation of individual vertical-filter drains and several were temporarily drained by pumping. Hand and power dusting larviciding employed in this area. Brunswick. Consists of City, Naval Blimp Base, and St. Simons Island Zones. Light breeding, controlled by hand dusting, found in many ditches and small ponds. Scarcity of labor increased difficulty of operations. Columbus. Consisted of Chattahoochee and Muscogee Zones. Temporary program operated during 1944 using hand oiling methods with county personnel except for MCWA in:spector. Douglas. Consisted of Air Base and Douglas Zones. Quad breeding limited and very well controlled by hand larviciding and minor drainage construction. Dublin. Consisted of Naval Hospital and City Zones. Operations began in spring of 1944 and satisfactory control secured by hand dusting and minor drainage. Hinesville. Consisted of Flemington, Midway, and Camp Stewart Zones. Although in a reputedly malarious section of state, hand dusting and oiling provided satisfactory malaria control and principal breeding areas were found in artesian-well fed roadside ditches. Public Health Engineering 77 Macon. Consisted of Camp Wheeler, Cochran Field, Fuse Plant, Housing, and Robins Field Zones. Hand and minor power dusting, facilitated by draining and dredging operations. provided satisfactory control. A 4"' hydraulic dredge was constructed and operated in the Fuse Plant and Camp Wheeler Zones. In the Fuse Plant Zone, the dredging work resulted in a material reduction of the extent of quad breeding area and proved to be a practical procedure where other types of machine excavation and manual or dynamite excavation were not practicable. Moultrie. Consisted of Access Road, Spence Field, and Thomasville Highway Zones. Many small quad breeding areas satisfactorily controlled by hand dusting methods. A considerable pest mosquito problem exists in and about Moultrie, but our offer of technical supervision of a city financed pest mosquito control program was not accepted by the City. Rome. Consisted of Battey General Hospital, Berry Schools, and City Zones. Surprisingly large number of quad breeding areas located and controlled by hand oiling methods in the Hospital Zone and by hand dusting methods elsewhere. One area reduced in extent by South ern Railroad installation of culvert under a heavy fill. Savannah, Consisted of Air Base, Chatham Airport, Machine and Foundry, Port Wentworth, and Quartermaster Depot and Southeastern Shipyard Zones. Hand dusting control operations have provided satisfactory control in most zones. Quartermaster Zone control problems have been reduced by County installation of tide gates at mouth of Pipemakers Canal. Savannah Area includes the most extensive breeding areas in the state with most of the breeding found in abandoned rice fields and poorly constructed or maintained ditches. Statesboro. Consisted of Air Base and City Zones. Many light breeding areas located and controlled by hand dusting methods. Interesting features of area include: construction and installation of precast L. L. circular joint ditch paving; apparently successful elimination of parrot feather vegetation from ponds in vicinity of Statesboro Teachers College; and the construction of a spring and pump-fed stock watering trough so that the owner would eonsent to the drainage of his stock pond, which had shown the most intensive quad breedin~ in the area. Thomasville. Consisted of Air Base, Access Road, Hospital, and Thomasville Zones. Light and scattered quad breeding effectively controlled by hand and minor power dusting. Valdosta. Consisted of Access Road, City, Moody Field, and Valdosta Zones. Many light quad breeding stations controlled satisfactorily by hand dusting and effective minor draina~e. The operation of the Georgia MCWA program has been one of considerable magnitude: 150-160 persons were employed during the active season and their payrolls for the year aggregated approximately $300,000; 35 automotive vehicles, 200 hand dusters, 5 power dusters, 1--4" dredge, 8--V/:{' to 3" pumps, and other miscellaneous equipment were employed. While provisional malaria morbidity and mortality data for 1944 indicate the lowest rates on record, the areas protected by this program show an even greater reduction or prevention of malaria. In no instance has a military establishment reported a case of malaria due to transmission by mosquitoes from the MCWA extra cantonment zone. Members of the MCWA Headquarters Office have expressed considerable satisfaction in the efficiency, economy, and overall results of the Georgia program. Considerable experience and information have been gained in conducting this program and many features of it can be translated into 78 Georgia Department of Public Health future county operated programs where technical assistance is provided by the Engineering Division. The following was accomplished for the year: 358.6 acres ditch clearing 26.4 miles ditching 398 miles ditch cleaning 116.6 acres of water surface eliminated 440 square miles under mosquito control by larviciding Control o Impounded Waters for Malaria Prevention. It is estimated that under State Health Department Regulations o Impounded Waters approximately 200,000 acres of hydroelectric, recreational and other impoundments are under control. lll permits were issued for the year. MALARIA CONTROL ON LARGE IMPOUNDMENTS The several agencies and corporations in the state continue cooperation for mosquito control on hydroelectric development lakes. This includes the electric power companies and the Tennessee Valley Authority. Regular reports are received relative to clearing, cleaning, and larviciding. These lakes include the following. Georgia Power Company: Bartletts Ferry in Muscogee and Harris Counties lloyd Shoals in Newton, Jasper, Butts, and Henry Counties Flint River in Dougherty and Lee Counties Crisp County Power Company: Lake Blackshear in Worth, Lee, Crisp, Sumter, and Dooley Counties Georgia Power & Light Company: Spring Creek in Decatur and Seminole Counties Tennessee Valley Authority: Nottley in Union County Blue Ridge in Fannin County Chattooga in Towns County MALARIA CONTROL ON SMALL IMPOUNDMENTS During 1944 the Agricultural Adjustment Agency included assistance to farmers who wished to construct arm ponds or stock watering purposes. This resulted in a tremendous increase in impoundment permit applicartions as the AAA participated only in projects on which the owners had pond maintenance permits rom the health department. Maintenance Public Health Engineering 79 permits were issued on 111 ponds, including 299.4 acres, during the year. The financial assistance will not he granted during the ensuing year, hut scores of ponds on which dam construction work was completed during the calendar year will be given three additional months to obtain permits. It is expected that the net benefits from properly constructed ponds will he outstanding enough to inspire owners of poorly built ponds to either condition them properly or drain them completely. County Maintenance Permits Baldwin ____________________ ---------------------- 1 Barrow ------------------------------------------------------ 6 Burke ---------------------------------------------------------- 1 Carroll -------------------------------------------------------- 2 Clarke -------------------------------------------------------- 4 Clayton ------------------------------------------------------ 1 Coweta 2 DeKalb ------------------------------------------------------ 9 Early ---------------------------------------------------------- 4 Emanuel ---------------------------------------------------- 2 Franklin ------------------------------------ _________________ 1 Fulton -------------------------------------------------------- 3 Grady -------------------------------------------- ________ 2 Greene --------------------------------------------------------- 1 Gwinnett ---------------------------------------------------- 4 Hall ------------------------------------------------------------ 1 Heard -------------------------------------------------------- 1 Jackson ------------------------------------------------------ 4 Johnson ------------------------------------------------------ 1 Jones ---------------------------------------------------------- 2 Lincoln ----------------------------------------------------- 1 McDuffie ------------------------------------ 1 Macon -------------------------------------------------------- 1 Madison ---------------------------------------------------- 2 Marion l Monroe ------------------------------------------------------ l Morgan ______________ ------------------------------- l Oconee ______________ ----------------------------------- l Paulding --------------------------------------------------- 2 Peach --------------------------------------------------------- 9 Pickens ------------------------------------------------------ 5 Polk --------------------------------------------------------- l Acreage Covered 1.5 11.5 2.25 8 5.5 7 6 26.25 25 2.5 .3 6.6 11 2 8.25 1 2.5 3.5 3.5 13.5 1 2.25 3 .3 2 1.5 l 2 1.6 14 8.55 .75 80 Georgia Department of Public Health Taylor -------------------------------------------------------- 2 Troup -------------------------------------------------------- 1 Walker ------------------------------------------------------ 1 Walton ------------------------------------------------------ 15 White ---------------------------------------------------------- 1 Whitfield __________ ----------------------------------------- 4 Wilkes -------------------------------------------------------- 8 Wilkinson -------------------------------------------------- 1 TotaL_______________________________________111 4.25 .75 2 57.75 2 21 25 1 299.4 SHELLFISH SANITATION There are numerous records of epidemic caused by unsanitary conditions relating to shellfish. The General Assembly of Georgia two years ago passed an Act to regulate the sanitary conditions of shellfish and to provide for inspection of oyster beds; to prohibit taking of oysters from contaminated waters; to regulate the sale, distribution and handling of same; and to provide that the authority to enforce the provisions of this Act shall be in the Department of Public Health under the Board of Health of the State. The effective sanitary control requires the essential provisions: l. The oysters should come from beds which have been as nearly as possible free from pollution and disease producing organisms. 2. The conditions of storage, handling, and distribution should protect the food from contamination with pathogenic organisms and deterioration or adulteration. 3. Careful epidemiological studies of disease outbreaks which incriminate shellfish. Pursuant to this law the State Board of Health adopted sanitary rules and regulations and authorized the State Health Department to enforce same. The rules and regulations adopted were consistent with requirements of the United States Public Health Service to permit such oysters to be shipped from Georgia into other states. Previous to the provisions of this law Georgia oysters were not so approved for interstate shipments. The following is a tabulation of the work accomplished: Samples of water and oysters bacteriologically examined____ 1,820 Acres of water investigated for safe sources____________________________26,863 Number of shucking houses permitted to operate__________________ 19 Public Health Engineering 81 MILK SANITATION The milk situation in the state during the war emergency has differed little from that of the general food sit,uation. There has been an unprecedented demand for fluid milk for the armed forces, at hotels and restaurants and at war industries where food is served. The milk industry has been faced with the greatest demand in history for fluid milk. In attempting to meet this demand it has been difficult to maintain high quality milk supplies. Because of the perishable nature of milk, its suitability as a medium for propagation of bacteria, and the potentialities for contamination on the long route from production to consumption, milk is more vulnerable than any other food. The processing of milk from the animal through the intricate mechanics of pasteurization is a public health science. Milk sanitation is generally a responsibility of a local health department with assistance by a milk sanitarian from the State Health Department. Legal authorit:y of the municipality or county to adopt a local ordinance is a necessary adjunct. A milk sanitarian is available in this Division for the purpose of assisting local health departments, municipal administrations, the milk industry, and others to insure a safe and wholesome milk supply. He serves in promoting the adoption of a local ordinance and in interpreting same for the dairies and the local authorities. He makes constant surveys of the various milksheds for the following purposes. (a) To make a check of items found to be in violation of the ordinance, (b) to determine which items and to what degree they may affect the supplies, (c) to make suggestions and recommendations for the purpose of improving such items found to be in violation, and (d) to evaluate the rating of the total milkshed based upon the deficiencies found. There were several notable advancements made in the milk sanitation program during the year. One of these was adoption by the State Board of Health of rules and regulations pertaining to milk production and sale, and the other was development of a better understanding and agreement where the responsibility for milk supplies overlaps in two state departments. Also progress was made for future mobile laboratory service for the various milksheds in the state. Plans and specifications were studied and assistance rendered in dairies, milk plants, and pasteurization plants. Considerable educational work was conducted during the year. During the year the following routine was also accomplished. Number local health departments rendered assistance____ 26 Number dairies visited and inspected ____________________,___________248 Number school milk supplies inspected__________________________ 6 On the first of November 1944, the State Board of Health in regular session adopted Rules and Regulations for milk sanitation, establishing 82 Georgia Department of Public Health definitions, bacterial and sanitary standards. It also provides that the State Department of Health shall provide technical personnel to render technical and advisory service to all local and county and municipal health departments, and other public officials, and shall promote the milk sanitation ordinance, and perform bacteriological, chemical and physical tests as may be necessary in compliance with the regulations. RESTAURANT SANITATION War time emergencies have placed a great burden on restaurant and eating establishments. Thousands of people have left their homes to work in war industrial establishments, depending upon restaurants to supply their meals. Members of families of thousands of service men stationed in various portions of the state have over crowded hotels and eating establishments. Soldiers on furlough have thronged many communities further increasing the demand upon hotel and restaurant facilities. It would be impossible to estimate the great percentage increase of people patronizing public eating places. The migration of people has never been so great. Added to these emergencies has been the loss of hotel and restaurant workers for the armed services, the rapid turnover of food handlers, the difficulty of replacing and adding to restaurant equipment, the greater demand for food which has definitely influenced a lower quality of food. The combination of all of these factors has developed a rather acute situation in the production and dispensing of food to a greatly increased population with below normal facilities for meeting the situation. It is evident that the result has been a very definite increase in foodborne epidemics. Some of these developed dangerous in nature and in serious proportions, indicating by laboratory examinations stophylococcus and salmonella infections. As would be expected, the sickness in epidemic proportions was chiefly at war industries and at schools and colleges where large groups eating food from the same source were under observation and investigation. On the other hand, many endemic cases in cities were scattered because of the wide distribution of patrons in scattered populations. These could be observed only generally but not studied specifically. Recognizing this problem there was initiated an educational program for restaurant operators and food handlers. Food seminars were held at various places lasting from a minimum of three to six days. The instruction was comprised of lectures and demonstration in bacteriology, sanitation, personal hygiene and the use of equipment and dishwashing. The schools were held in cooperation with the local health departments, restaurant operators associations and chambers of commerce. The importance of local food ordinances and cooperation with the local health department were stressed. There follows a list of places Public Healtk Engineering 83 where these food handlers schools were held and the attendance of food handlers. Columbus ---------------------------- 3,692 Atlanta -------------------------------- 4,291 Savannah ---------------------------- 3,175 Hinesville ---------------------------- 186 Jesup ------------------------------------ 46 Brunswick -------------------------- 1,280 St. Simons -------------------------- 150 Milledgeville ---------------------- 706 Thomasville ------------------------ 455 Reynolds Corporation ________ 60 T o t a L_____________________________ l 4 , 041 Tot~l loca~ health d~partments rendered assistance in mspection of eatmg places________________________________________ 17 Total number restaurants visited____________________________________ 90 Total number food handlers schools conducted________________ 10 SCHOOL SANITATION The Division is progressively active in hygiene and sanitation at the schools of the state. There are approximately 6000 schools and the total attendance is between one-half and three-quarters of a million. Of course, many of these are urban schools with adequate provisions for water and sewerage. On the other hand, many are rural schools in which cases it is necessary to project individual water and sewerage systems, sanitary privy construction and other projects. The service of the Division is chiefly on water, sewage and food and milk for school lunches. All plans for water and sewerage must be approved by the Division before construction. This includes new works or improvements. All sources of milk served for school lunches must be inspected and approved by the Division. On the 19th of October 1944, the State Board of Health, with cooperation of the Department of Education, adopted rules and regulations for the preservation of the health of the school children of the state. For many years previous to this adoption the actual provisions included have been effected by mutual agreement between the two State Departments. The Rules and Regulations adopted are as follows: RULES AND REGULATIONS ADOPTED BY THE GEORGIA STATE BOARD OF HEALTH It is essential to the preservation of the health of the children of the State that every school shall have a safe water supply and satisfactory system of sewage disposal. Therefore, pursuant to authority granted by the General Assembly of Georgia the Georgia State Board of Health hereby adopts and promulgates the following rules and regulations pertaining to school sanitation. 84 Georgia Department of Public Health Section 1. Every school in this State shall be provided at all times when in use with an adequate supply of safe, potable drinking water, safely protected against pollution in conformity with plans approved by the State Health Department. Section 2. All school buildings in this State shall be provided with an adequate system for sewage or excreta disposal of design and construction approved by the State Health Department, with separate compartments for each sex. Section 3. Drinking fountains of a sanitary type approved by the State Health Department shall be provided at every school, or every pupil in attendance shall be required to have and to use an individual cup which shall be for his own exclusive use. Insanitary bubblers, inverted spigots, and other insanitary devices shall not be used. Section 4. Any city, county, school board, trustee, or any person, firm or corporation contemplating the construction of or additions to any building to be used for school purposes in this State, shall submit, before contract for construction is let or work is started, duplicate plans and specifications to the State Health Department, showing clearly all details of the water supply system including the source of supply, and also all details of the sanitary facilities, sewerage system and sewage disposal, f<>r approval. No contract shall be let or work started until such plans are stamped approved, and no changes in locations, additions, or alterations shall be made subsequent to this approval without the written consent of the State Health Department. Section 5. Any school now in operation not conforming to any section of these rules and regulations shall after due notice be given one year from the date of such notice to comply with such provisions. Section 6.. If any school after a thorough inspection is found to be in an insanitary condition and a menace to the health of the pJlpils, orders for immediate corrections shall be issued by a duly authorized representative of the State Board of Health, and in event of the failure to comply with such orders the school may be closed until such corrections are made. Section 7. Any school serving lunches such as milk or other items of food at the school or other establishment for the school shall be interpreted under the definition of "restaurant" under rules and regulations adopted by the Georgia State Board of Health relative to restaurant sanitation and it shall conform to such items of the regulations as may be required. Passed by the Georgia State Board of Health this 19th day of October 1944. Public Health Engineering 85 RURAL SANITATION According to a fact finding committee in 1930, there were approximately 402,603 rural homes in Georgia. It was estimated that less than 100,000 of these had means of sanitary sewage disposal. A survey conducted in 1934 showed that of all the farm homes sixteen percent had no toilets whatsoever, only one percent had bath tubs and bath room plumbing, eighty-three percent had outdoor toilets, ninety three percent of which were actually a menace to public health; only two percent had kitchen sinks. Since that time, over 100,000 sanitary privies have been constructed and a high rate of annual construction continues in spite of war conditions affecting priorities on materials and the great loss of sanitation personnel. There follows a tabulation by Counties, showing that during the year 1944 a total of 3,669 privies for homes and schools were constructed and repaired; and that 1463 Septic Tanks were constructed. SANITATION PROVISIONS WITH RURAL ELECTRIFICATION In the emergence of National Rural Electrification and as usual with many of the National Projects, provisions for rural use of electricity only was given consideration. It seems evident that it was not realized that provisions for rural expansion of electricity would necessarily involve development of water supplies under pressure, together with bathroom and toilet facilities and individual home sewage disposal. Therefore, it became necessary for health and sanitation authorities to illject into the program due consideration for rural sanitation. This Division has exerted every effort to inject into the program the factor of home sanitation planning. This has entailed contact and cooperation with the many cooperative rural electrification agencies throughout the state, furnishing of standard plans and specifications for home water supplies and sewerage and advice to home owners in construction and installations. With continuance of this program over a period of years many homes in Georgia will be adequately provided not only with electricity but with sanitation and health protective facilities. PRISONER OF WAR AND LABOR CAMPS Early in the year the Division became concerned with the bringing into the State of prisoners of war and also the establishment of labor camps for the purpose of increasing production of certain commodities, harvesting of crops and gathering of fruits and vegetables. The potentiality of introduction and spread of diseases prevalent in foreign countries, especially malaria, became evident. The Division made prompt contact with the Chief of Operations of the War Food Administration for Labor Camps, the Rural Industries Supervisor of the WMC and the U.S. Employment Service for Prisoner of War Camps. Particular 86 Georgia Department of Public Health attention was given to selection of safe sites for the camps. Desirability of close proximity to public water and sewerage, without being too close to congested populations was stressed. Prevention of selection of sites within flight range of malaria bearing mosquitoes, was given prime consideration. The result was that these agencies agreed that any site for a proposed camp would be submitted for approval before final selection, and that after the camp was established careful frequent inspections would be made in order to maintain a safe and sanitary camp. Numbers of these camps were established and have been under close supervision of the Division. PROBLEMS OF WATER SUPPLY AND SEWAGE DISPOSAL IN THE SELECTION OF HOUSING SITES In the selection of property for residential use, careful consideration is given to all sanitary problems that may be associated with the area and its development. Too frequently, irrespective of whether the property is in urban, suburban or rural district, little or no consideration is given to such major problems as the water supply and the disposal of sewage and domestic wastes. As a result, our health department is constantly being asked for assistance in cases where, because of improper selection or development of sites, serious health hazards have arisen that are difficult if not practically impossible to correct. To avoid the occurrence of such health hazards, careful land-planning studies are made of the following: 1. Areas which are subject to flooding. 2. Areas which have an exceptionally high ground-water table. 3. Areas where the topography is such that proper drainage cannot be obtained. 4. Areas that have been platted without sufficient information on soil conditions to determine whether an adequate and safe water supply and a proper means of sewage disposal can be secured. 5. Areas where soil conditions make individual sanitary installations impossible, and some type of community system must be constructed to provide adequate sanitary facilities. War Housing has been an emergency which has given the Division considerable concern and has caused many difficulties in selection of sites for housing projects, particularly such proposed sites which involve extension of public sewers or the alternative of construction of separate systems. Also a separate water supply may be involved. The Division is particularly interested in promotion of zoning ordinances adopted by counties in which the local health department participates in sanitary selection and planning. It is hoped that as time goes on more counties will take advantage of zoning provisions so that this Division can better coordinate state and local interests in adequate sanitation and in health protection in suburban areas and communities. Public Health Engineering 87 PRIVIES CoNSTRUCTED BY CouNTIES Coanty Home School Wood Concrete Wood Concrete Wood Concrete Barrow ------------------------------------------------------------ 5 1 Bibb ----------------------------------------------------------------- 2 26 Bulloch --------------------------------------------------------- ____ 12 Burke -------------------------------------------------------------- Butta ----------------------------------------------------------------- 2 7 Carroll ----------------------------------------------------------- 6 Chatham ------------------------------------------------------------ 80 Chattooga -------------------------------------------------------- 47 Clarke ------------------------------------------------------------ 36 Clayton ------------------------------------------------------------ 2 Cobb ----------------------------------------------------------------- ---- 2 Columbia ---------------------------------------------------------- 1 Coweta -------------------------------------------------------------- ---- 23 Crawford --------------------------------------------------- 2 Crisp ___ ---------------------------------------------------- 18 2 Decatur 113 DeKalb 2 Dougherty 22 Fayette ------------------------------------------------------------ ____ 5 Floyd -------------------------------------------------------------- ---- 2 Franklin ---------------------------------------------------------- 1 Fulton 67 Gilmer ------------------------------------------------------------- 9 Glascock ---------------------------------------------------------- ____ 9 Grady -------------------------------------------------------------- 10 Habersham ------------------------------------------------------ 1 Hall ------- ------------------------------------------------------------ 4 Harris -------------------------------------------------------------- ____ 2 Hart ------------------------------------------------------------------ ---- 1 Heard --------------------------------------------------------------------1 Henry ------------------------------------------------------------- ____ 5 Houston ----------------------------------------------------------- 1 3 20 .Jackson --------------------------------------------------------- 3 .Jasper 1 .Tenkins ------------------------------------------------------------- 6 Lamar ------------------------------------------------------------- 3 5 Laurens ---------------------------------------------------------- SO 19 16 Long --------------------------------------------------------- ----- 1 Lumpkin -------------------------------------------------- ______ 3 6 2 2 30 79 2 14 1 54 9 12 5 80 207 47 36 820 3 10 2 23 6 2 20 113 12 2 1 22 6 4 2 1 2 67 9 9 10 13 1 4 33 2 8 4 5 3 1 5 5 23 24 3 3 3 1 7 39 8 10 8 73 60 1 3 43 Georgia Department of Public Health PRIVIES CoNSTRUCTED BY CouNTIEs County MuDuffie Macon Madison Marion Meriwether Miller --Monroe Morgan Musco gee 1\'ewton Oconee Oglethorpe Paulding Peach Pickens Pike Rabun Richmond Rockdale Schley Screven Spalding Stephens Sumter -------- Talbot -----------Taliaferro Taylor Thomas Troup Upson --------------------- Walker Walton Ware -Warren -----------Washington Total Home School Wood Concrete Wood Concrete Wood Concrete 17 7 12 4 15 1;) ., 2 4 17 9 8 15 2 28 18 8 49 49 2 2 12 4 6 20 14 1 6 2 5 4 6 4 9 12 28 19 118 7 5 ---- 6 3 2 2 6 5 5 12 4 19 9 34 114 7 8 7 6 4 32 1 7 6 7 23 4 9 12 28 143 116 7 29 3 5 115 11 465 2 6 17 -----365 677 65 24 1131 2538 Public Health Engineering SEPTIC TANKs CoNSTRUCTED BY CouNTIES County Home Pub lie Property Baldwin Barrow Bartow Bibb Bulloch Burke Butts 51 2 2 66 33 2 8 11 Camden Catoosa Chatham Clarke Clayton Cobb Colquitt Columbia Coweta Crawford Crisp 20 1 85 12 3 19 7 3 10 5 Decatur ___ _ DeKalb __ -----..-----------Dougherty 10 157 3 25 Fannin Fayette Floyd Fulton 5 14 ----------------- 12 279 9 Gilmer 2 Glynn 184 Gordon Grady Hall _______ Harris Henry Houston 10 4 10 2 4 Jackson Jenkins 5 Jones ---------------------------- ----------------------- ------------------------------- 4 2 Lamar ------------------------------------- - --------------------- Laurens Liberty Lincoln Long ------------------------------------- 8 25 7 8 1 4 89 Total 51 2 2 66 35 8 12 20 85 1 15 19 7 3 10 1 6 10 160 25 5 14 13 288 2 184 11 4 12 5 5 6 8 32 9 4 90 Georgia Department of Public Health SEPTIC TANKS CoNSTRUCTED BY CouNTIES County Home Public Property JllcDuffie -------------------------------------------------- 2 Jilacon ------------------------------------------------------------------------------ 2 Jilarion ------------------------------------------------------------------------- 1 Jileriwether ------------------------------------------------------------- 4 2 Jilonroe ---------------------------------------------------------------------- 5 Jiluscogee --------------------------------------------------------------------------- 34 8 Newton 2 1 Oconee 2 Peach 3 Rabun 2 2 Richmond ------------------------------------------------------------------------ 40 3 Schley ------------------------------------------------------------------------- 8 Screven -------------------------------------------------------------------------------- 5 1 Spalding --------------------------------------------------------------------- 3 2 Stephens ---------------------------------------------------------------------------- 1 Sumter ------------------------------------------------------------------------ 27 1 Talbot --------------------------------------------------------------------------------- 7 1 Ta:rlor ------------------------------------------------------------ ----------------- 11 4 Thomas -------------------------------------- 25 3 Troup 21 16 Upson 6 Walker 5 Walton 1 2 Ware ----------------------------------------------------------------------------- 37 Washington --------- 13 Whitfield ------- 1 Wilkes 2 Total ---- 1872 91 Total 2 2 1 6 5 4.2 3 2 3 4 43 8 6 5 1 28 8 15 28 37 6 5 3 38 14. 1 2 1463 SANITATION AT ALTO SANATORIUM The following is a narrative relative to previous sanitary and other engineering service rendered to Alto Sanatorium by the Engineering Division of the State Health Department. None of these technical, advisory and consultative services were charges against the operation of the institution. Very extensive sanitary, physical, plant and utility improvements have been accomplished. These comprise chiefly water supply, sewage treat- Public Health Engineering 91 ment, dairy and pasteurization plant, refrigeration, mapping and general planning. The Division has supervised a program o general planning and construction o various projects, including extension o sewers, extension o water mains, water reservoir storage, refrigeration, and approval o all plans and specifications and supervision o construction. The Division succeeded in having the United States Geological Survey establish a stream gauging station on a stream near the institution for the purpose o studies o the quantity flow o water throughout the year in anticipation o future needs of water supply expansion. The water supply plant was projected and plans and specifications examined and approved by the Division before construction. The plant is constantly under inspection, supervision and advisory service in maintenance and in operation. The water supply is constantly bacteriologically examined for safety for the consumers. The sewage treatment plant was projected and plans and specifications examined and approved by the Division previous to construction. It is under constant supervision for proper maintenance and operation together with recommendations or prevention o nuisance and detriments to health. The milk and pasteurization plant has been renovated and remodeled, including modern pasteurization and other new sanitary equipment, and tlie operation is under the supervision of the Division so that clean, wholesome and safe milk is assured the inmates o the institution. Until recently there was no adequate map o the institution property. Consequently, the Division, without any cost whatsoever for field work, office drafting, etc., has provided a large scale map o the entire property. This map shows all boundaries o acquired property including total acres in each tract. It shows all railroad property, all main and secondary roads, all streams, wooded and cultivated sections, all houses and other buildings including the institution proper. It is the most accurate and complete map possible to produce. It would be difficult to estimate what the cost o this map would have been on a charge basis. It is invaluable in planning for various types of projects for the institution. There are various and sundry smaller contributions made by this Division too numerous to list in this report. Other important services are anticipated. 92 Georgia Department of Public Health COOPERATION WITH OTHER AGENCIES There are numerous Federal and State Agencies with which it has been necessary to coordinate the services of this Division. A few of these are now becoming either wholly or partially defunct. A description of these follows. U. S. Public Health Service Certification of Water Supplies, Common Carriers. Certification of Milk Supplies, Common Carriers. Certification of Shellfish Interstate Shipments. Malaria Control in War Areas. Emergency Problem during' War Period. Federal Housing Administration Issuing Standard Plans and Specifications for Home Sanitation. Private Installations or Connections with Public Water and Sewerage. Final Inspections and Approval Before Loans Are Granted. Farm Security Administration Issuing Standard Plan and Specifications for Home Sanitation. Wells, Springs, Septic Tanks, Privies, Screening, and Other Sanitary Requirements Previous to Granting of Loans. Federal Public Housing Authority War Housing Projects Federally Financed and Supervised. Collaboration on Planning and Approval of Plans for Water, Sewerage, and Miscellane ous Sanitation Problems. Federal Works Agency Agency to Supervise Spending of Funds Under Lanham Act. Collaboration on Planning and Approval of Plans for Water, Sewerage, and Miscellaneous San itation Problems. Office of Civilian Defense Member of Division Serves as Coordinator and Chairman for Water and Sewerage for Public Utilities Committee on State Civilian De fense. War Manpower Commission Director of Division Serves as State Advisor to Sani tary Engineering Committee, Procurement and Assignment, War Manpower Commission, Deter mining Availability of Engineers for Military Service. Federal Power Commission This Commission Licenses all Hydro-Electric Proj ects. Collaboration on Clearing, Larviciding, etc., for Mosquito Control. Licensing Contingent upon Meeting State Board of Health Regulations for Impounding of Waters. Public Health Engineering 93 Tennessee Valley Authority This Authority Constructs and Acquires Hydro-Electric Projects in Georgia. Cooperates in Conformance with State Board of Health Regulations for Impounding of Waters, Clearing, Larviciding, Inspections, etc. Soil Conservation Service In promotion of Soil Conservation Areas and Projects, Cooperates in Drainage and Fish Ponds for Malaria Control and Conformance to State Board of Health Regulations for Impounding of Waters. Agricultural Adjustment Administration Under Soil Conservation and Allotments for Benefit payment to Farmers Aerial Photographic Maps are Provided. These Maps Loaned to Engineering Division for Basis of Preparation of Sanitation, Malaria Control, & other Health Purposes Maps. U. S. Fish and Wildlife Service and State Department of Game & Fish Propagation and Sanitation of Shellfish in Conformance with State Law Placing Shellfish Sanitation under the State Health Department. Certification for Interstate Shipment and Sale. National Resources Committee This Committee (now temporarily defunct) is a National Planning Agency. Planning for Water Uses Involves Water Supplies, Sewage Disposal, Flood Control, Hydroelectric Development, Drainage and Malaria Control. All Past Planning Has Been Recorded and May Be Activated for Postwar Projects. Committee on Water and Sewage Works Development Postwar Projects This Committee is Providing for Postwar Planning for Promotion and Expansion of Public Water and Sewerage Projects for Postwar Projects. Objectives: Adequate, Safe, and Satisfactory Water Supplies Together with Sewage and Trade Wastes Treatment and Disposal. U. S. Engineer Office and U. S. Coast and Geodetic Survey Advisory Service from this Office Relative to Coastal Waters and Areas and Sources of Maps of Coastal Regions in Shellfish Sanitation Program. Veterinarian, Fourth Service Command Advisory Service in Connection with Milk Supplies for Army Areas Under Army and Public Health Service Ordinances. Division of Dental Health Education J. G. WILLIAMS, D.D.S.____________________________________________________uirector (Part-time) ANNIE TAYLOR_______________________________________________________________Educational Director Division of Dental Health Education PERSONNEL There have been no changes in personnel during the year. The personnel consists of: A dental director (part-time) ; an educational director; and a secretary. COOPERATION WITH STATE AGENCIES More emphasis than in any previous year has been placed on the coordination of the dental health education program of the Georgia Department of Public Health with and through state and local agencies, both official and voluntary. With limited travel and personnel, this has been the most effective way of reaching the public. The major part of the efforts of the Division of Dental Health Education has been spent in planning with and working through the State, regional and local staffs and personnel of such agencies as the State Department of Education, the Georgia Dental Assoc~ation, the Agricultural Extension Service, and the Georgia Congress of Parents and Teachers. The Public Health Committee of the Georgia Dental Association has cooperated in every possible way. The shortage of dentists throughout the State is a serious handicap to a dental service program. Judging from reports of dentists, public health and education workers, more people than ever before are seeking dental services. EDUCATION Teacher Education Working with the State Department of Education in its special project of teacher education (in-service and pre-service) has afforded opportunity to reach teachers in a more effective way than at any previous time. The interest in health education among teachers is at a high level. The educational director has participated as a consultant in practically every teachers' workshop in the State. They have been as follows: Atlanta University (Negro) Cherokee County Georgia State College for Women University of Georgia Leaders Workshop Principals and Teachers Coffee County Mercer University Floyd County Stephens County Tift County Schools in Spalding County Emphasize DENTAL HEALTH EDUCATION Dental Health Education 99 Planning conferences for teachers prior to the opening of schools and also during the year have emphasized teacher education and community organization for dental health education and dental service. The following county teachers' conferences were attended: Fayette Pulaski Chattooga Spalding Floyd Bulloch Three health education conferences or workshops have been attended by the dental director and educational director. (l) Southeastern Regional Health Education Conference. (2) Joint Health Education Conference for the Staffs of the Georgia Georgia Department of Education and the Georgia Department of Public Health. (3) Atlanta City Teachers' Health Education Conference. This Division recognizes the value of working with County Supervisors of Education as a way of influencing local schools. There are now about forty county supervisors employed in the State and others are being trained. It has been our purpose to make each supervisor an advocate of dental health by furnishing her with information and materials and by giving her every guidance and assistance. Parent-Teacher Associations, Women's Clubs, and Civic Organizations The educational director has again been elected to the Board of Managers of the Georgia Congress of Parents and Teachers and has attended six state and regional meetings and also as many local meetings of ParentTeacher Associations, civic clubs, and other clubs as time and travel would allow. Educational Aids The Division has used and distributed widely, free of cost, the following aids: Bulletins Your Child's Teeth Dental Health Guide About Faces Dental Health Education What to Teach and How to Teach It The Truth About Teeth Hold On to Your Teeth Dental Care for the School Child How to Save Teeth and Money 100 Georgia Department of Public Health Films The Student Flyer About Faces Our Teeth Told by a Tooth. Dental Clinics Activities in dental clinics operating according to Regulations for Paying Honoraria to Clinicians Conducting Dental Clinics may be summarized as follows: There were twenty-three clinics in twenty-two counties with forty-eight white dentists and two Negro dentists, working 2,761 hours, admitting 2,400 white children and 109 Negro children. There were 12,373 operations or approximately five operations per child, including fillings, extractions and prophylaxis. There were twenty-three prenatal cases treated. Local dentists were paid $6,902.50 in honoraria for these services. The cli~ics have been visited and supervised by the Dental Director. Shortage of dentists and public health personnel is the explanation of the reduction of clinic activities over 1943. There are, of course, fewer indigents who are eligible for free service. Counties operating clinics during the year 1944 are as follows: County Months Operating in 1944 Type of Clinic l. Brooks 5 2. Charlton 8 3. Chatham 10 4. Clarke 4 5. Decatur 8 6. DeKalb 12 7. Floyd 5 8. Fulton (City of Atlanta) 8 9. Grady 2 10. Jenkins 8 11. Mitchell 3 12. Morgan 8 13. Rabun 12 14.. Spalding 12 15. Telfair 1 16. Thomas 4 17. Toombs 7 (Vidalia and Lyons) White Children " " White Children Negro Children White Children " " " " " " " " " " " " " " White Children and White Prenatal Cases White Children " " " " " " County 18. Upson 19. Walker 20. Ware 21. Wheeler 22. Whitfield Dental Health Education 101 Months 0 perating in 1944 12 9 6 4 3 Type of Clinic " " " " " " " " " " STATISTICAL REPORT OF ACTIVITIES MILES TRAVELED BY EDUCATIONAL DIRECTOR__________________________________ 6,664 PUBLIC SCHOOLS VISITED _ Talks ---------------------------------------Attendance -------------- -------- ------------ Films and Talks_________________ -------------- -Attendance ___________ _ --------------------------- 19 19 ---- ----- 5,090 16 4,890 TEACHERS' MEETINGS _ _______ _ ____ __ ____________ 20 Talks ---------------------------------------------------------- ------------------------- ------------------ 20 Attendance--White ------------------------------------ _________\ ________________________________________ 1,457 Negro -------------------------------------------------------------------------------------------- 60 Films ------------------------------------------------ ------------------------------------------------------------------ _____ 11 Attendance ---------------------------------------------------------------------------------------------------------- 730 COLLEGES VISITED -------------------------------------- ----------------------------------------------------------- 1 Talks ---------------------------------------------------------------------------------------------------------------- 1 Attendance ---------------------------------------------------------------------------------------------------------- 250 Films ---------------------------------------------------------------------------------------------------------------------- 1 Attendance ----------------------------------------------------------------------------------------------------- 250 PARENT-TEACHER ASSOCIATIONS ATTENDED________________________________________________ 9 Talks ------------------------------------------------------------------------------------------------------------------------ 9 Attendance ---------------------------------------------------------------------------------------------------------- 471 Films ------------------------------------------------------------------------------------------------------------------- 6 Attendance --------------------------------------------------------------------------------------------------------- 240 CIVIC ORGANIZATIONS --------------------------------------------------------------------------------------------- 3 Talks --------------------------------------------------------------------------------------------------------------------- 3 Attendance --------------------------------------------------------------------------------------------------------- 125 Films --------------------------'----------------------------------------------------------------------------------------- 1 Attendance --------------------------------------------------------------------------------------------------------- 45 OTHER MEETINGS ---------------------------------------------------------------------------------------------------- 17 Talks ------------------------------------------------------------------------------------------------------------------ 12 Attendance ---------------------------------------------------------------------------------------------------------- 462 DENTAL CLINICS VISITED---------------------------------------------------------------------------------------- 7 REGIONAL OFFICES VISITED__________________________________________________________________________________ 2 VISITS TO COUNTY HEALTH DEPARTMENTS_________________________________________________ 31 102 Georgia Department of Public Health CONFERENCES 221 1. Regional Medical Directors..---------------------------------------------------------------- 1 2. County Health Commissioners..---------------------------------------------------------------------- 22 3. Dentists ------------------------------------------------------------------------------------------------------- 35 4. School Superintendents -------------------------------------------------------------------------------- 10 5. Physicians ---------------------------------------------------------------------------------------------------- 1 6. Home Demonstration Agents -------------------------------------------------------------------------- 0 7. Nurses ----------------------------------------------------------------------------------------------------- 41 8. Parent-Teacher Workers --------------------------------------------------------------------------- 16 9. Others --------------------------------------------------------------------------------------------------------- 95 MEETINGS AND ASSOCIATIONS ATTENDED Meetings Attended Br Annual meeting of Supervisors of Education, Carrollton__________________ Taylor Southeastern Regional Health Education Workshop, Atlanta__________Taylor, Williams American Dental Association, New York_______________________________Williams American Association of Public Health Dentists, New York_____________Taylor, Williams American Association of School Superintendents, Atlanta________________Taylor Regional Social Hygiene Conference, Atlanta__________________________ Taylor Georgia Congress of Parents and Teachers, Atlanta________________________Taylor Georgia Public Health Association, Atlanta.-------------------------------------Taylor Departments of Education and Health Joint Conference in Health Education, Atlanta______________________________Taylor, Williams Georgia Dental Association, Atlanta______________________________________Taylor, Williams Georgia School Superintendents' and Administrators' Conference, Athens_ _Taylor Parent-Teacher Institutes in Athens, Statesboro, Douglas and Atlanta____Taylor Board of Managers, Georgia Congress of Parents and Teachers, Atlanta____Taylor American Public Health Association, New York._________________Taylor, Williams DENTAL CLINIC IN SPALDING COUNTY HEALTH DEPARTMENT SERVES NEEDY CHILDREN (Clinic equipment donated by Griffin Rotary Club.) 104 Georgia Department of Public Health DENTAL CLINIC REPORT January through December, 1944 White Negro NUMBER COUNTIES OPERATING CLINICS__ _________ _ 22 1 NUMBER CLINICS ---------------------------------- _______ _______________________ 23* 1. NUMBER CLINIC SESSIONS___________ ___ __ 1296% 84 NUMBER CLINIC HOURS (TOTAL) ________ _ 2593 168 NUMBER DENTISTS WORKING___ ___________ _____ 48 2 HONORARIA PAID DENTISTS __________ $6,482.50 $420.00 TOTAL ADMISSIONS ---------------------------------- ____ _ __ _ 2400 109 TOTAL ADMISSIONS BY AGES 6. 8 years ------------------------------------------- -------------------------------9 11 years -----------------------------------------------------------------------------12 14 years ---------------- ------------------------------------------------------------- % 6 8 years ---------------------------------------------------------------------------% 9 11 years --------------------------------------------------------------------------%12 14 years ---------------------------------------------------------------------------TOTAL VISITS ________________________________________:________________________________________ TOTAL PATIENTS DISMISSED____________________________________________________ Completed ----------------------------------------------------------------------------------Others ------------------------------------------------------------ ---------------------------% of Admissions Completed______________________________________________________ 1061 922 417 44% 38% 18% 3869 2499 2365 134 99% 73 28 8 67% 26% 7% 263 102 99 3 91% PROPHYLAXIS -------------------------------------------------------------------------------% of Admissions-------------------------------------------------------------------------- NUMBER TEETH EXTRACTED__________________________________________________ Decid. -----------------------------------------------------------------------------------------1st Perm. Molars------------------------------------------------------------------------Other Perm. Teeth---------------------------------------------------------------- 1104 46% 2980 2502 413 65 43 39% 158 140 16 2 NUMBER TEETH FILLED------------------,------------------------------------- 6232 304 Decid. ------------------------------------------------------------------------------------------ 1735 219 1st Perm. Molars-------------------------------------------------------------------------- 3429 80 Other Perm. Teeth______________________________________________________________________ 1068 5 NUMBER FILLINGS ----------------------------------------------------------------------- 7686 402 Cement ----------------------------------------------------------------------------------------- 496 15 Alloy ---------------------------------------------------------------------------------------------- 6789 278 Silicate __________ ------------------------------------------------------------------------------ 401 109 *Toombs County Operates Clinics at Lyons and Vidalia. Dental Health Education lOS ANALYSIS OF DENTAL CLINIC ACTIVITY REPORT OF WORK DONE FOR WHITE SCHOOL CHILDREN FOR JANUARY THROUGH DECEMBER, 1944 Per Hour Cases Admitted Per Hour.................. .93 Visits Per Hour---------------- 1.49 Cases Completed Per Hour__________________ .91 Extractions Operations Per Hour-Prophylaxis 4.54 Fillings Fillings Per Hour------------- 2.96 Work Done Per Case Operations Per Case Admitted.......... 4.90 Fillings Per Case Admitted................ 3.20 1st Perm. Molars Filled Per Case.___ 1.43 1st Perm. Molars Extracted Per Case .17 Perm. Teeth Extracted Per Case...... .03 Perm. Teeth Filled Per Case__________ .45 Cost (Honoraria Paid) Per Completed Case_________________________$2.74 Per Admitted Case______________________________ 2.70 Per Visit ---------------------------- 1.68 Extractions Per Operation-Prophylaxis ----- .55 Fillings Division of Maternal and Child Health EnWIN R. WATSON, M.D---------------------------------------------------------------------JJirector PAUL R. ENsiGN, M.D. ____________________________________________________Pediatric Consultant HUGH J. BICKERSTAFF, M.D. (Part-time) _____________________.Obstetric Consultant MARY EMMA BARNEs________________________________________________________Nutrition Consultant Division of Maternal and Child Health DIVISION OF MATERNAL AND CHILD HEALTH The Emergency Maternity and Infant Care program continues to require the attention of practically all personnel assigned to the Division of Maternal and Child Health. For this reason, very little time has been devoted to the extension of regular maternal and child health programs. Changes in Staff: Since the resignation of the nutrition consultant last August, the division has been without a consultant. The vacancy has not been filled because of lack of qualified and acceptable appointee for the position. The consultant nurse to the division suffered an injury as a result of an automobile accident which made it necessary for her to resign. The accident occurred in August while performing official travel. This position has not been filled because of lack of qualified personnel. Mrs. Bessie F. Swan was promoted to the position of Associate Director of Division of Public Health Nursing in order that her duties might be more generalized. Emergency Maternity and Infant Care Program: l The EMIC plan for Georgia has been revised in the following instances: l. Provision made for payment for prenatal care rendered not more than six weeks prior to date of receipt of application. 2. Modification of administrative statements to permit greater discretion by the division in dealing with unusual situations. 3. Preparation and adoption of fee schedule, following approval of Sub-advisory Committee of the Medical Association of Georgia. 4. Modification of basis of compensation in such a way as to increase payment to physicians for maternity care, non-obstetric care and infant care. -5. Provision made for payment of physician for time consumed. in travel to home of patient or to hospital outside of corporate limits of city in which physician maintains an office. The EMIC program is definitely not satisfactory to a number of hospitals for the following reasons: l. Fear of regimentation no Georgia Department of Public Health 2. Disagree with basis of compensation 3. Inability to meet minimum requirements 4. Inability of patient to pay for any part of hospital care The program is not satisfactory to physicians in urban areas because of the following reasons: 1. Inadequate fees allowed 2. Object to numerous forms and amount of data required 3. Object to policy that only participating hospitals can be utilized (In many areas hospital facilities are not available to EMIC cases) 4. Feel that EMIC program is an entering wedge for socialized medicine The following statistics reveal total EMIC activities from date of initiation of program on September 15, 1943 through December 31, 1944: MATER~ITY CASES Number 1. Maternity cases completed-------------------------------------------------------------------------------- 5,866 2. Cases completed after deliverY-------------------------------------------------------------------- 5,313 a. Person in attendance___ 5,313 (1) Doctors of medicine_ 5,311 (2) Osteopaths - - - - - 2* (3) Others - - - - - - 0 b. Place of delivery__________ 5,313 (1) In hospitals ------- 4,063 (2) At home -------------- 1,250 3. Cases completed before delivery-------------------------------------------------------------------- 553 Number of Cases Receiving Care Amount of Money Approved for Payment 4. Total ----------------------------------------------------------------------------- 5,404 $321,064.21 5. Both services of attending physicians and hospital care paid for, but paid separatelY----------------------------------------------------- 2,282 a. Physicians' services________________________________________________ b. Hospital care ----------------------------------------------------(days of hospital care 17,735) 189,124.81 88,673.00 100,451.81 6. Both physicians' services and hospital care paid for in single payments to hospitals------------------------------------- 0 7. Attending physicians' services paid for but not hospital care 1,349 49,701.00 * Babies delivered by osteopaths. Payment not approved. Maternal and Child Health 8. Hospital care paid for but not attending physicians' services 1,773 (days of hospital care, 17,500) . 9. Consultation service______________________________________________________ 95 10. Bedside nursing ------------------------------------------------------------- 1 11. Prenatal and postpartum care provided in clinics but not included in items 5, 6, or 8------------------------------------ 0 12. Drugs, ambulance, blood for transfusions, travel of consul- tants, and all other services not included above___________________ INFANT CARE 13. Total ---------------------------------------------------------------------------- 75* 14. Both services of attending physicians and hospital care for sick infants paid for, but paid separately_______________________ 14 a. Physicians' services ------------------------------------ b. Hospital care -----------------------------------------------------(days of hospital care, 79) 15. Both physicians' services and hospital care for sick infants paid for in single payment to hospitals_______________________ 0 16. Attending physicians' services for care of sick infants paid for, but not hospital care__________________________________ 41 17. Hospital care for sick infants paid for, but not attending physicians' services ---4------------------------------------------ 17 (days of hospital care, 208) 18. Consultation service ------------------------------------------------ 1 19. Bedside nursing for care of sick infants paid for________ 0 20. Medical care for sick infants provided in clinics but not included in items 14, 15, or 17------------------------------ 0 21. Drugs, ambulance, blood for transfusions, travel of consul- tants, and all other services for sick infants not included above ---------------------------------------------22. Immunizations of well infants______________________________________ 0 lll 79,213.75 1,845.00 170.25 1,009.40 2,247.72 827.14 269.00 558.14 441.50 905.58 50.00 23.50 Medical Activities: The Sub-advisory Committee of the Medical Association of Georgia to the Georgia Department of Public Health was appointed at the latter's request. The purpose of the Committee was to advise the Division of Maternal and Child Health regarding the professional aspects of MCH and EMIC programs. The Committee met in March and reviewed, amended, and approved the revised EMIC plan for the fiscal year 1945. The fee schedule was also approved. The Advisory Committee of the Medical Association of Georgia to the Georgia Department of Public Health met in June and approved administrative policies concerned with the EMIC program. Subsequently, the Committee's report was approved by the House of Delegates. ' Contacts were made with a number of medical specialists to ascertain their guidance in formulating professional phases of the EMIC program. Their recommendations were utilized by the Advisory and Sub-advisory Committees. The Department is indeed fortunate in having the guidance * This figure includes three cases closed without payment. 112 Georgia Department of Public Health of a sincere group of physicians in the preparation of medical care plans on a state-wide basis. The assistance rendered by individual physicians and committees has been largely responsible for the success of the program. Divisional representatives met with county medical societies upon request to discuss the EMIC program. In all instances it was found that physicians had erroneous impressions of the EMIC program. Following these meetings, not a single medical society hesitated to approve the plan and accept participation in the program. The EMIC plan was presented to the Board of Trustees of Fulton County Medical Society. The Board recommended that the plan be presented to the Society at the earliest possible date and that each member participate in the program, thus dividing the case load more equitably. A paper was presented to the annual meeting of the Medical Association of Georgia by the director on the subject of maternity problems in Georgia. Recommendations were made regarding extension of hospital care, establishment of maternity shelters, utilization of nurse-midwives in selected areas, nursing assistance at delivery for private physicians, and payment of private physicians for maternity care rendered indigent cases. During a part of the year the director served as clinical instructor in the congenital syphilis clinic at Grady Hospital and devoted his entire time to junior students of medicine assigned to the clinic. The two hour clinic session was devoted to physical examination and appraisal of infants and children attending the clinic and to a discussion of the diagnostic procedures to be utilized in appraising the status of each potentially infected individual. Since only two students attended each session, personal instruction was made possible. Lectures to junior medical students at Emory University School of Medicine and University of Georgia School of Medicine were continued in order to acquaint students with the public health phase of maternal and child health activities in the state. Conferences were held with Atlanta physicians in the field of pediatrics to discuss the EMIC program and formulate answers to queries received from the American Academy of Pediatrics. The director was elected president of the Migratory Health Association. This Association provides hospital and medical care to immigrant laborers in the southeastern states. The funds for the program is provided by the War Food Administration. The division has been requested to approve the use of silver acetate instead of silver nitrate in the prevention of gonorrheal opthalmia in the newborn. The request has been submitted to the Advisory Committee on Opthalmology for the Committee's recommendation. Such reccommendations will be referred subsequently to the State Board of Health for action. Maternal and Child Health 113 Hospitals: As a result of the EMIC program, practically all hospitals and similar facilities in Georgia have been inspected insofar as maternity and infant care is concerned. Few hospitals are maintaining desirable standards of care. Approximately 95 hospitals and doctors' offices have been approved, either professionally or otherwise; fifteen station hospitals have been approved. Recommendations were made to each facility regarding flagrant deficiencies, and suggestions were made when they appeared to be practical. It should be pointed out that as a result of the EMIC program, hospital services have been improved. This has contributed toward improving the MCH program, even though it constitutes an approach that grew out of a war emergency program. Information has been collected from each hospital visited with regard to source of income, quality of nursing staff and type of service rendered. Since many hospitals were found to be purchasing undesirable items of equipment, an attempt has been made to recommend, upon request, equipment items considered most satisfactory. These recommendations usually refer to types of bassinets, cabinets, incubators, resuscitation equipment, etc. A number of hospital facilities have built equipment in accordance with plans furnished by the Division of Maternal and Child Health. As a result of the EMIC program, and because of assistance rendered previously in related aspects of the program, numerous requests have been received for aid in planning hospital type facilities for mothers and infants. Often times assistance has been needed in planning other features of hospitals but the division could not render this service because of lack of qualified personnel. In some instances it has been desirable to discourage projects under consideration because it has been considered impracticable. Some means whereby the department can furnish adequate consultative service and guidance in the planning and operation of hospital and related facilities, is a primary need that should be met as soon as personnel is available, provided, of course, the department continues to assume this responsibility. Considerable time has been devoted to conferring with architects in appraising hospital plans for maternity and newborn infant care. As a result, a number of hospital plans have been materially changed and improved. The division has supplied hospitals, upon request, with data essential or good nursery care, including clothing, technique, etc. A bulletin on this subject has been distributed to hospitals when genuine interest in improving newborn infant care has been demonstrated. The director of the division was requested to discuss hospital problems at the Southeastern Hospital Association. The subject discussed dealt with basis of compensation for hospital care as well as hospital standards of care. Considerable time has been devoted to conferences with representatives of the U. S. Public Health Service and Federal Works Agency regarding 114 Georgia Department of Public Health need for new hospitals, renovation of hospitals and the matter of securing priorities where necessary. Several conferences have been held with Boards of Trustees of hospitals for the purpose of focusing attention on the desirability of planning hospitals in districts rather than in individual counties. Inasmuch as hospitals are compensated for EMIC cases on a calculated per diem basis, and because of the fact that few hospitals have acceptable accounting procedures, it has been necessary for divisional personnel to prepare many of the financial statements for the hospitals. This activity has provided an opportunity to suggest to hospitals standardized accounting methods prepared in bulletin form by the American Hospital Association. It is evident that Georgia hospitals are in need of guidance, beyond that available from this office, in the development of sound bookkeeping and accounting methods, compilation of census data, evaluation of medical and nursing standards of care, assistance in planning physical improvements, promotion of sound financing, development of district hospital plans on sound administrative basis, and assistance, in general, with all hospital problems. Unless this service is established immediately, the anticipated post-war expansion program will necessarily result in needless waste of money. Present conditions will require an intensive program of this type. HoweYer, such personnel must be adequately qualified in the field of hospital administration. Lay Groups: The director of the division has continued to serve as Child Hygiene Chairman of the Georgia Congress of Parents and Teachers. A new plan was prepared for the group in order to secure participation in child health centers. In a number of localities Parent-Teacher Associations furnish volunteer workers, transportation, etc., as outlined in the plan. The director of the division has continued to serve as a member of the Executive Committee of the Atlanta Social Planning Council. Considerable time has been devoted to analyzing factors causing juvenile delinquency, developing plans for mental hygiene service in Atlanta area. and providing for compilation of information on draftees for State's Selective Service Board in order to discover anti-social factors influencing Army assignments. The nutritionist made every effort to correlate her work with the work of other group agencies promoting better nutrition. Some of these groups were the Sub-committee on Nutrition in Industry of the State Nutrition Committee. Health Committee of the Wartime Commissioner of Education, the Advisory Committee on School Lunches of the State Department of Education, and lunchroom workers at the University of Georgia. Educational Group Activities: Division personnel attended JOmt conferences on health education called by the Departments of Health and Education. Numerous recom- Maternal and Child Health ll5 mendations were made in regard to the coordination of activities of the two agencies. The director of the division has been appointed a member of the joint committee from the two state agencies for the purpose of recommending plans for future development of health education problems. As a member of this committee, the director made a trip to Michigan to study the activities of the Kellogg Foundation to determine the feasibility of initiating a health education program in Georgia with the financial assistance of the Kellogg Foundation. Division personnel has continued to participate in the conferences o the State Nutrition Committee. Varied subjects have been presented to the Committee. A nutrition clinic was held in Atlanta in the spring. The nutritionist participated in five teachers' workshops in the first six months of this year. Conferences were held with the health officials and teachers on nutrition problems in schools, teaching materials, dietary and sanitation standards for school lunches and educational possibilities of school lunch. She appeared on the program at the annual meeting of the Georgia Public Health Association and presented a paper on "How Public Health Workers Can Promote Good Nutrition.'' As a part of the Food Right for Freedom Program, the nutritionist gave a radio talk on "Minerals and Their Importance for Optimum Health.'' Much o the nutritionist's time was devoted to working with the nursetrainees. They represent one of the most important groups that disseminate nutrition information since they make direct contact with families. The trainees were assisted in the development of good interviewing procedures, evaluating bulletins, films and posters, and planning low-cost food budgets and meals for families under their supervision. Recent nutrition findings were discussed with this group. The nutritionist participated in the two regional nurses' conferences and discussed ways of applying nutrition in public health. The nutritionist attended the United States Public Health education workshop which was conducted for the southeastern states. She also attended the Georgia Health Education w-orkshop. The division is continuing to prepare and edit the Department's publication, "Georgia's Health." The present circulation is approximately 30,000. Special Projects: Due to the lack of incubators in hospitals for premature infant care, a hospital unit was designed and 100 units were built. Following completion of the incubator, plans were made to place at least one hospital-type unit in each hospital establishing its need. In all instances, the incubators were loaned on an indefinite basis since they were constructed with state funds. The units were delivered and demonstrated by a member of the division staff. All of the units have not been delivered but they are being placed as 116 Georgia Department of Public Health rapidly as limited personnel can deliver them. Many of the hospitals were using the home-type incubator and the placement of the hospital-type unit in the hospitals made it possible to free the home-type unit for home use. In order to assist hospitals in securing qualified personnel to supervise newborn nurseries, the division has spent considerable time acquainting hospitals with our plan for offering postgraduate instruction in this phase of hospital service. Because the care of premature infants constitutes the most acute need, the majority of hospital staff nurses have been provided with experience in both premature and full-term infant care. This is desirable because in most instances there is a need for training and experience in both types of programs. In the past, mature and immature infants have been considered as different types of cases but the present trend appears to be in the direction of making mature and immature infant care somewhat the same, except for specialized procedures needed by the latter as a result of lack of development of certain functions. Thus far, the hospitals have been most interested in having staff nurses trained in premature care. Though hospital nursing staffs are depleted, hospitals have been willing to release members of the staff for this specialized training. It is hoped that obstetric training and experience of hospital nursing staffs will be made available in the future so that other phases of the maternal and child health program will receive equal emphasis. It should be pointed out that the EMIC program has made it possible for a large number of hospitals to participate in this training program because we are not permitted to use federal funds for this purpose unless hospital care is being purchased by the state health agency from the hospital to whom staff training is made available. It will be necessary in many instances to await additions to nursing staffs and make structural changes in hospitals before many facilities can put into effect some of the routines and techniques that are being used by the teaching hospitals that are utilized for in-service training. The division is continuing to offer scholarships to nurses on hospital staffs in order to adequately prepare them for development of acceptable premature infant care programs in the hospital concerned. This group of nurses is now assisting the division in the preparation of a manual to he used by hospitals in the development of such programs. Thus far, such training has been limited to white nurses; however, plans are under way to establish similar opportunities for Negro nurses. At the request of the Chatham County Commissioner of Health, the nutritionist evaluated the meal service of the new Savannah Tuberculosis Sanatorium. General rules and procedures concerning food purchasing, meal planning, preparation of foods, serving trays, storing foods and taking storeroom inventory, were submitted and discussed with the head nurse and health commissioner. General techniques for teaching good food habits to patients were discussed with the nurses at the Sanatorium. Considerable time and effort have been devoted to the two maternity homes in an effort to provide satisfactory nursing care, to supply plans Maternal and Child Health 117 for providing proper equipment, to establish proper records, to formulate professional procedures, to modify physical facilities in order that they might be more suitable for the purpose, and to coordinate the intrapartum phase of maternity care with local health department activities. The nutritionist devoted much time and effort to establishing good food service at the maternity home in Rabun County. The simple guide for good purchasing, menu planning, preparation and serving of foods, aided the head nurse and cook in serving low cost nutritious meals to patients. Aid was also rendered the planning groups of the new maternity home at Duluth in making arrangements for the kitchen and storage facilities. The division is continuing to offer scholarships to physicians serving in MCH centers who desire to attend the Southern Pediatric Seminar. Nineteen physicans attended this year. At the request of the Atlanta Southern Dental College, the director of the division lectured to the students on public health aspects of dentistry and future plans for dental care in Georgia. Assistance was given a group of Atlanta dentists in planniRg low carbohydrate diets suitable for different age groups. These diets are being used in a dental caries prevention and control study conducted by private dentists in cooperation with the Atlanta Southern Dental College and the Georgia Department of Public Health. Several private physicians were assisted in planning diets for patients suffering with diseases in which nutrition was an important factor of treatment. At the request of the Southern Regional Health personnel and the Baker County Public Health Nurse, aid was rendered health and school officials in developing a nutrition education program in one of our rural schools where there was an outstanding need for the program. The success of this project will undoubtedly serve as a stimulus to other counties and communities that need a well coordinated health and education program. Through the cooperation of the Industrial Hygiene Service of the State Health Department and the officials of the Chicopee Mills at Gainesville, the nutritionist was able to inaugurate an in-plant and industrial community nutrition education program. As a result, modern portable steam table food carts were installed in the plant to enable the employees to purchase fresh fruits, sandwiches and milk. A small canteen was built in which to prepare simple hot dishes. Space was provided the workers to relax during their lunch period. 118 Georgia Department of Public Health ACTIVITIES OF RABUN COUNTY MATERNITY HOME Jan. !-December 31, 1944 Total 1. Antepartum admissions -------------------------------------------------------------------------------- 184 (a) Private physicians' cases --------------------------------------------------------------------- 160 (b) Service cases ------------------------------------------------------------------------------------------ 24 (c) Non-registered cases ---------------------------------------------------------------- 0 2. Total deliveries ------------------------------------------------------------------------------------------------ 179 (a) Deliveries by physicians------------------------------------------------------------- 169 (b) Deliveries by nurse-midwife---------------------------~----------------------------------------------- 5 (c) Precipitate deliveries ------------------------------------------------------------------------------------- 5 3. Stillbirths 5 4. Abortions 0 5. Labor cases with complications________________________________________________________________________________ 2 6. Operative obstetric cases____________________________________________________________________________________________ 1 Forceps: (a) Low -------------------------------------------------------------------------------------------------------------- 6 (b) Medium ------------------------------------------------------------------------------------------ 0 (c) High ---------------------------------------------------------------------------------------------- 1 Version --------------------------------------------------------------------------------------------------- 1 Breech extraction ------------------------------------------------------------------------------------------------- 2 Destructive ------------------------------------------------------------------------------------- 0 7. Postpartum admissions (delivered in maternity home)---------------------------------------- 179 8. Postpartum admissions (delivered elsewhere)------------------------------------------------- 1 9. Cases transferred to hospitaL.........-------------------------------------------------------------- 2 (a) Antepartum cases ------------------------------------------------------------------------------- 0 (b) Postpartum cases --------------------------------------------------------------------------- 1 (c) Newborn ----------------------------------------------------------------------------------- 0 (d) Premature infants ----------------------------------------------------------------------- 0 (e) Infant --------------------------------------------------------------------------------------------- 1 10. Public health nursing visits in maternity home.._________________________________________________ 3,077 (a) Antepartum -------------------------------------------------------------------------------- 148 (b) Intrapartum ------------------------------------------------------------------------------ 50 (c) Postpartum -------------------------------------------------------------------------------------------- 1,424 (d) Newborn ----------------------------------------------------------------------------------------- 1,415 (e) Premature infant ------------------------------------------------------------- 31 (f) Infant --------------------------------------------------------------------------------- 9 11. Medical service (H.O.): (a) Cases examined ----------------------------------------------------------------------------------- 0 (b) Visits ----------------------------------------------------------- 0 (c) Consultations ------------------------------------------------------------------------ 0 Maternal and Child Health 119 12. Days of care....------------------------------------------------------------------------------------------------- 2,986 (a) Antepartum --------------------------------------------------------------------------------------------- 155 (b) Postpartum ------------------------------------------------------------------------------------------------- 1,400 (c) Newborn ----------------------------------------------------------------------------------------------------- 1,315 (d) Premature ------------------------------------------------------------------------------------------- 59 (e) Infant (readmitted or born elsewhere)------------------------------------------------------- 57 13. Newborn admissions (born in maternity home)-------------------------------------------------- 178 (a) Infants ------------------------------------------------------------------------------------------------------ 174 (b) Premature infants ----------------------------------------------------------------------------------------- 3 (c) Readmissions -------------------------------------------------------------------------------------------- 1 14. Newborn admissions (born elsewhere) ------------------------------------------------------------------ 4 (a) Premature infants ------------------------------------------------------------------------------------------ 3 (b) Infants ------------------------------------------------------------------------------------------------------------- 1 15. Morbidity cases -------------------------------------------------------------------------------------------------- 4 (a) Antepartum ----------------------------------------------------------------------------------------------------- 1 (b) Intrapartum ------------------------------------------------------------------------------------------------------- 0 (c) Postpartum -------------------------------------------------------------------------------------------------------- 4 (d) Newborn ----------------------------------------------------------------------------------------------------------- 0 (e) Premature ---------------------------------------------------------------------------------------------------------- 0 16. Births aud deaths: (a) Maternal deaths ----------------------------------------------------------------------------------------- 0 (b) Infant deaths ------------------------------------------------------------------------------------------------- 2 (c) Live births ------------------------------------------------------------------------------------------------- 145 17. Instruction and demonstrations to practical nurses--------------------------------------------- 332 18. Instruction and demonstrations to cases__________________________________________________________________ 477 19. Others ---------------------------------------------------------------------------------------------------------------------------- 0 Midwives: A review of the statistical data presented in the midwife section of this report will serve to emphasize the rapid decline in the number of midwives ~rtified annually. A decline of almost fifty per cent in the number of certified midwives during the past decade is principally due to mortality among the midwives certified and our refusal to certify additional individuals because of their lack of qualifications and preparation to practice :midwifery. Of the 290 individuals for whom certification was refused, the majority were individuals who had previously been certified as midwives but who were not recertified during the calendar year 1944 because of their inability to serve in a manner deemed desirable by local public health personnel. It is evident that the decline in the number of individuals certified is continuing. According to the present trend, we can expect an increasing number of communities to be without midwife service. Thus, some substitute for the midwife service must come to pass or else an increasing number of births will be attended by neighbors. There are several localities within the state where neither midwives nor physicians are attending maternity cases during confinement. 120 Georgia Department of Public Health It has been suggested that some facility be made available, for each county without hospital facilities, for normal obstetrical cases in order to provide for suitable conditions during delivery and early postpartum period, including nursing care. The maternity shelter at Clayton, Georgia has demonstrated that physicians can care for a much larger number of cases by using a centralized facility in lieu of home deliveries because of the marked reduction of physicians' time required for cases confined in maternity shelters. In approximately one-third of the counties no provision is made for medical supervision of midwife cases, and in a number of counties that do have health centers for this purpose, there is incomplete coverage due to the lack of number of centers required and deficiencies in content of services offered. This deficiency in health center activities, as well as in public health services in the field of maternal health, is largely due to inability to secure the services of public health personnel and private physicians. Therefore, one of the most urgent needs is concerned with extending prenatal care to all eligible individuals, improving the quality of services and extending the scope of services made available through these centers. During the emergency there has been a definite change in maternal health activities. More group wqrk activities have been utilized, and the individual aspects of the program have received less attention; for example, prenatal cases are being served in health centers without receiving the benefit of home visits and personal instruction. Thus, our follow-up activities have declined for lack of time and personnel to carry on this phase of the work. MIDWIFE APPLICATIONS, DEATHS, AND CERTIFICATIONS BY AGE GJtOUP Year Initial Certifications by A~re Group Certifications Under Over A~re Total w. c. 50 50-65 65 Unknown Total Applications Midwife Refused Deaths Retired 1932 3358 1933 3562 1934 3434 1935 1936 3510 3297 316 3194 326 2971 * 1937 3171 1938 3049 298 2751 1939 2951 1940 2861 267 2594 1941 2594 253 2341 37 22 4 1942 2412 233 2179 25 13 3 1943 2203 200 2003 24 16 6 1944 2074 180 1894 21 10 2 2949 3463 125 3402 99 3510 223 135 3509 165 134 5)8 134 59 749 85 75 653 86 5 68 638 71 2 43 447 64 37 6 52 394 46 45 34 290 43 as Fi~rUres not available. Maternal and Child Health 121 Maternal and Child Health Centers: NUMBER OF MCH CENTERS REPORTING TO THIS OFFICE, JANUARY- DECEMBER 1944 Unorganized Counties 40 Organized Counties 56 Maternal Centers 6 55 Infant Centers 4 90 Combined Centers 44 73 96 61 94 117 TOTAL NUMBER OF MCH CENTERS, INCLUDING FREQUENCY AND NUMBER OF SESSIONS (Data based on activities during December 1944) 1. Total MCH centers (Places where MCH sessions are conducted)---------- 233 a. Number used for prenatal sessions------------------------------------------ 62 h. Number used for infant and preschool sessions___________________________ 96 c. Number used for combined* sessions---------------------------------- 117 2. Sessions according to stated intervals: a. Number MCH sessions conducted weeklY---------------------------------- 125 h. Number MCH sessions conducted semi-monthly________________ 73 c. Number MCH sessions conducted monthly__________________________ 92 3. Total number of MCH sessions conducted__________________________ 790 a. Number prenatal sessions conducted------------------------------ 238 h. Number infant and preschool sessions conducted___________________ 246 c. Number combined* sessions conducted____________ 306 INFANT HEALTH CENTER ACTIVITY Admission-Infant and Preschool 1943 Admissions, total --------------------------------------------------- 16,572 :White ------------------------+-----+--------------------- 5,644 Negro --------------------------------------------------------------- 10,928 Age groups, total ---------------------------------------------------------- 16,572 Under 4 months.......-------------------------------------- 5,908 4-12 months -------------------------------------------------- 4,211 1-5 years ------------------------------------------------------------- 6,453 Visits and Activities Visits, total ---------------------------------------------------------- 42,531 White ---------------------------------------------------- 14,696 l\"'egro --------------------------------------------------------------- 27,835 Referred cases ------------------------------------------------------- 2,032 1944 % + orminua 16,230 6,233 9,997 16,230 6,435 3,922 6,873 -2 +10 -9 -2 -8 -7 +7 45,610 16,758 28,752 1,925 +7 +14 +3 -6 Combined sessions serve prenatal cases, infants and preschool children during the same Se.s3ion.. 122 Georgia Department of Public Health MATERNAL HEALTH CENTER ACTIVITY Prenatal Admissions Admissions, total White ----------------------------------------------------Negro ---------------------------------------------------------------------Period gestation, total __ Under 16 weeks -----------------------------------------16-27 weeks -----------------------------------------------------------28-36 weeks ------------------------------------------------------------Over 36 weeks ____ --------------------------- 1943 15,806 1,508 18,798 15,803 4,263 7,267 3,388 390 1944. % + orminua 18,838 1,190 12,643 18,883 8,808 6,973 2,747 305 -10 -21 -8 -10 -11 -4 -19 -22 Prenatal Activities Visits, total --------------- ----------------------------------------------------- 52,626 White ------------------------------------------------------------------------ 5,128 Negro -------------------------------------------------------------------- 47,498. Transferred, Total 686 47,467 8,677 43,790 268 -10 -28 -8 --68 Postnatal Activities Admission, Total ______ White --------------- ------------------------------Negro -----------Visits, Total ___ -------------------------- -------------------------------------White Negro ----- ---------------------------------------------------------- 8,435 412 3,028 4,290 525 3,765 8,213 433 2,780 4,089 558 8,531 -6 +5 -8 -5 +6 -6 Division of Public Health Education C. D. BoWDOIN, M.D.______ __ _________________________________________Acting Director Division of Public Health Education The personnel of the Division of Public Health Education during the year 1944 included Dr. C. D. Bowdoin, Acting Director and one secretary. The activities of the Division consisted largely of the distribution of health literature and health films to the various schools and organizations throughout the State of Georgia. The Division worked in close harmony with the numerous summer school workshops throughout the State, which are responsible, to a large extent, for the amount of literature and films distributed during the summer months. Usually there is a decrease in these totals during the vacation period. The Division of Public Health Education is still working in cooperation with the Woman's Auxiliary of the Medical Association of Georga, but their program this year has been retarded to a certain extent because of the continued restrictions on travel. The total number of films shown during the year was 695 to an audience of 133,877 persons. The total amount of literature distributed during the year was 171,796. Several new films were added to the film library during the past yearmost of them being nutrition and venereal disease films. We also had some excellent films loaned to us by the U. S. Public Health Service and the Metropolitan Life Insurance Company. ANNUAL REPORT OF ACTIVITIES DIVISION OF PUBLIC HEALTH EDUCATION January 1- December 31, 1944 Film Report No. Times Films were Shown January ------------------------ ----------------------------------------------- 96 February __ ___________________ __________ ___ ____________________ __________ 78 March ------------------------------------------------------------------------ 80 April --------------------------- ___________________ __ ______________ ________ 67 May ----------------------------------------------------------------------------- 52 June --------------------------------------------- --------------------- 42 July ----------------------------------------------------------------------------- 50 August -------------------------------------------------------------------------- 45 September ____ ___ _ ____ _____ _______________________ _ ___________ 34 October ---------------------------------------------------------------------- 70 November ----------------------------------------------------------------- 42 December ---------------------------------------------------------------------- 39 Attendance 11,634 18,823 13,542 11,594 14,121 3,598 4,353 6,916 3,003 18,088 15,532 12,673 Tot~L_________________________________________________________ 695 133,877 126 Georgia Department of Public Health ANNUAL REPORT OF ACTIVITIES DIVISION OF PUBLIC HEALTH EDUCATION January 1- December 31, 1944 Literature Report Amount Distributed January ___ 15,224 February _______ _ 15,731 March _______ .. __ 14,248 April ------------- . 10,840 May --------- 16,679 June -------------------- July ___________ _ __ 13,893 24,702 August ---------------- _______________ --------------------- September __ ____ ___ __ ----------------------- 12,644 ____ _ _____ _ 10,780 October _________________ -------------------------------- __________________________ _ 18,528 November _______ ____ __ _______________ 12,544 December _______________ __________ ______ --- __________ _ 5,983 TotaL_________ --------------------------- - -- -- ----- --- ___171,796 MEDICAL LIBRARY The Library of the Department has made a fairly good average of work for 1944, considering the handicap of cramped quarters under which it labored from June 1st until the end of the year. The Reference work showed a slight drop in 1944, 1,925 calls being answered, as compared with 2,018 such calls in 1943, or an average of 160 per month as compared with 170 for the previous year. The Circulation records show the loan of 608 books, 205 pamphlets, and 2,331 journals, or a total of 3,144 pieces of literature-an average of 262 per month as compared with the average of 226 in 1943. The Cataloging, according to accession numbers, included 330 books and pamphlets, an average of about 28 per month. The Library has, moreover, put out classified journal indexes each month for most of the divisional offices; has issued the annual publication, READING IN THE FIELD OF PUBLIC HEALTH; A GUIDE FOR THE LAY READER; and has sent all the local health offices in the State, as well as some of the State Departments, a list of the more important books in the Department collection. The Department spent in 1944 about $715.00 on reading matter for the Library, of which about $460.00 went for journals, and an additional amount of about $170.00 for binding. Approximately 80 new titles were added to the book collection, the present total of classified volumes now being about. 2,428. Subscription journals, with three new titles for the Public Health Education 127 year, total 88, and there are, in addition, 22 free publications regularly received. Cataloged pamphlets number about five thousand, and there are on file 66 health department bulletins, 70 health department reports, and a good many other free publications. A vertical file has been set up to hold the material of passing, or ephemeral, value, not included in this report. Users of the Library for this period include, besides official health workers of Georgia, the Atlanta Branch of the U. S. Department of Agriculture Library, the Carnegie Library of Atlanta, the Atlanta Tuberculosis Association, the Georgia Department of Education, the Social Planning Council of Atlanta, officers of the United States armed forces stationed in and around Atlanta, and students and teachers of various schools and colleges. The Department Library has established, moreover, relations permitting inter-library loans with most of the neighboring librariesEmory University, Georgia School of Technology, Fulton County Medical Society, Georgia Department of Education, the State Library, the Carnegie Library of Atlanta. STATISTICAL REPORT, 1944 Inventory No. Vols. I. Books, Classified ____ -------------------- ----------------------------- In main library _______________ ________________ 2,428 1,492 In divisional offices ------------- _ 540 In regional offices ______________ 328 In branch laboratories _ 68 II. Books, Law ----------------------------------------------------------------------------------- 371 III. Journals, Bound (37 titles-unbound, 73) ------------------ 489 IV. Bulletins bound in loose-leaf binders (66 titles) ______ _ 213 v. Annual reports l. U. S. Public Health Service______ 55 2. States and Territories_____ ______45 titles 3. Cities ------------------------------------4. Canadian Provinces --------- __ 20 titles ______ 7 titles VI. Pamphlets-96 boxes (about)--------------------------------- ____________________________________ 5,000 Report on Work I. Circulation Total Mo.Av. Books-608; Journals-2,331; Pamphlets--205 _____ 3,144 262 II. Reference calls ___ --------------------------------------------------------- _____________ 1,925 160 III. Cataloging -------------------------------------------------------------------------------------------- 330 IV. Indexes made for divisional offices_____ ________________ 116 v. &ok lists sent out (2 titles)-------------------------- _ ___________________ __ 250 Division of Preventable Diseases C. D. BowDOIN, M.D. ________________________________________Director and Epidemiologist PAUL C. BEAVER, PH.D.__________________________________________Assistant Epidemiologist WILLIAM J. MuRPHY, M.D. ______________________________________________________Cancer Control LESTER M. PETRIE, M.D.___________________________________________________/ndustrial Hygiene MAYOLA S. CENTER, Consultan't________________________________________________Social Hygiene RoY J. BosTON, Engineer______________________________________________Typhus Fever Control Division of Preventable Diseases CANCER CONTROL SERVICE The Georgia Cancer Control Program for indigent patients functioned without interruption throughout the year. Diagnostic and treatment service was provided for all eligible patients who applied for state aid. In spite of the crowded conditions in many of the hospitals, it was possible to provide hospitalization without undue delay for all patients requiring such service. The eleven treatment centers which were in operation at the beginning of the year gave uninterrupted service throughout the year. The Dalton Clinic, which d.iscontinued service to state-aid patients during I943, remained on an inactive status. The personnel of the Cancer Control Service remained the same. One of the two clerks resigned during the year to enlist in the WAVES but the vacancy was immediately filled. Two major changes were made in policy. The first affected the per diem charge for hospital board. Early in the year the University Hospital at Augusta petitioned for an increase in the rate. Figures were presented to show that in caring for indigent cancer patients the hospital was operating at a substantial loss. In May, I944 the Executive Committee of the State Cancer Commission approved an increase in the per diem charge for hospital board from $3.50 to $4.00. The new rate went into effect on June I, I944. The second change in policy dealt with Richmond County patients. Prior to the present year Richmond County has provided medical and hospital care for indigent cancer patients from that county without charge to the state. In May, Dr. G. T. Bernard, representing Richmond County, requested that patients from that county be accepted under the state-aid program. This request was approved by the Executive Committee of the State Cancer Commission and since June I, I944, Richmond County patients have been accepted for state-aid. Applications. During I944, applications for state-aid numbered I,842 as compared with I,9I5 in I943 and 2,249 in I942. This represents a decrease of about 4 per cent in I944 as compared with a decline of about I5 per cent during the previous year. During the last seven months of I944, however, 6I applications were received from Richmond County patients who were not recipients of state-aid in previous years. If these are excluded, the decline in the number of applicants during the past year would. have amounted to about 7 per cent. Clinic Activities. A total of I,637 patients reported to the clinics for the first time during I944. Of this number, I,047 or 63.9 per cent were 132 Georgia Department of Public Health diagnosed as having cancer. The proportion of malignant cases is substantially higher than the corresponding figure (56.8 per cent) for 1943. Actually, the number of malignant cases in 1944 showed an increase over the previous year while the number of non-malignant cases declined materially. In table I is shown the malignant cases according to site of lesion for the years 1943 and 1944. On the whole, the cases reporting in both years are quite similar as to type. More than 80 per cent of the cases had lesions involving the skin, buccal cavity, breast or cervix. In table I is also shown the percentage of cases in which the diagnosis was confirmed by microscopic examination of tissue. Biopsies were employed with slightly greater frequency in 1944 than in 1943. This was particularly true of cancers of the lower lip. As in previous years, biopsies were employed least often in cancers of the skin. Excluding these, approximately 67 per cent of the diagnoses in 1944 were confirmed. In table II is shown the number of patients hospitalized and the average hospital days per patient for 1943 and 1944. The figures deal only with patients reporting for the first time during these years. Most of the clinics showed some increase in the average number of hospital days and for the group as a whole the increase amounted to about one and one half days per patient. Approximately 41 per cent of all patients were hospitalized, the percentage for malignant and non-malignant cases being about the same. Malignant cases were hospitalized for an average of 13.2 days as compared with 9.1 days for non-malignant cases. Financial Aid. A total of 1,917 patients received financial aid during the year. In addition, 188 non-malignant cases and 87 malignant cases received diagnostic and treatment service without charge to the state. The sum of $83,275.64 was expended for diagnoses and treatment. Although the total cost of the program declined slightly in 1944, the average cost per patient increased for both malignant and non-malignant cases. For the former, the increase amounted to 55 cents per patient while for non-malignant cases the increase amounted to $4.89. With respect to malignant cases, the increase in cost was due entirely to the increase in per diem charge for hospital board. In fact, if the old rate of $3.50 per day had remained in effect throughout the year, the average cost per malignant case would have declined by about one dollar. In regard to non-malignant cases, the increase in cost can be accounted for only in part by the new rate for hospital board. A second factor is an increase in the average period of hospitalization. Approximately the same proportion of non-malignant cases were hospitalized in 1944 as in previous years but the average number of hospital days increased. The high average period of hospitalization (9.1 days) indicates that a substantial number of non-malignant cases were treated surgically. During the past few years the average cost per case has been steadily increasing and this is due, Preventable Diseases 133 apparently, to an increasing tendency to employ surgery in doubtful cases which are subsequently shown to be non-malignant. In table III is shown for each clinic the number of malignant and nonmalignant cases who received state-aid in 1944, the total cost for each group and the average cost per case. In table IV is shown a summary of the activities for 1944 as compared with those of the previous year. In table V is shown the expenditures by counties. Records. No changes were made during the year in the method of handling records. Data received from the clinics are summarized and transferred to punch cards. At the present time cards have been punched for all cases reporting to the clinics through December 31, 1944. Educational. Educational activities continued along the same pattern as in previous years. The material dealing with cancer for Georgia High Schools was completed during the year. Permission was granted the American Cancer Society to use it along with other material in the preparation of a booklet for nation-wide distribution. The booklet was published in December, 1944. Educational activities of the Cancer Control Service are summarized below: Addresses made ------------------------------------------------------------ 21 Meetings attended other than those addressed______________ 14 Consultations and miscellaneous visits _________________________ 18 Films shown ------------------------------------------------------------------ 2 Articles written -------------------------------------------------------------- 9 Literature distributed ----------------------- __________ _________________ 2,868 134 Georgia Department of Public Health TABLE I MALIGNANT CASES REPORTING TO CLINICS FOR THE FIRST TIME MICROSCOPIC CONFIRMATION OF DIAGNOSIS 1943 AND 1944 Site of Lesion Number Cases 1943 19U Skin ---------------------------- 444 496 Lower lip -------------------- 33 35 Mouth ------~------------------ 46 38 Breast -------------------------- 97 112 Larynx ----------------------- 9 9 Lungs and bronchi______ 8 3 Stomach --------------------- 11 6 Colon ---------------------- 12 5 Rectum ------------------------ 10 15 Cervix ------------------------- 184 211 Body of uterus___________ 13 10 Other female genitaL_ 21 ll Male genital --------~ 14 22 Urinary organs ------ 5 10 Bones ------------------- 4 8 Soft tissues ----------- 4 12 All others ------------ 59 44 TotaL_____________ 974 1,047 Per Cent of Diaposes Confirmed by Biopsy 1943 19U 21.8 22.1 21.2 57.5 54.3 57.9 52.5 62.4 77.7 66.6 37.5 66.6 36.3 50.0 75.0 80.0 90.0 66.6 76.6 75.8 92.3 90.0 61.9 63.6 64.3 63.6 60.0 20.0 75.0 87.5 24.0 83.3 55.9 56.8 43.8 45.8 MALIGNANT CASES BY SEX AND COLOR 1943 AND 1944 1943. White male ----------------------------------------------- 335 White female -------------------------------------------- 384 Colored male ------------------------------------------ 50 Colored female -------------------------------------- 205 TotaL__________________________________________ 974 1944 361 403 50 233 1,047 Preventable Diseases 135 TABLE II HosPITALIZATION PATIENTS REPORTING FOR THE FIRST TIME 1943 AND 1944 Clinic Number Patients Hospitalized 1943 1944 Americus ------------------- 62 47 Augusta -------------------- 135 144 Canton ---------------------- 15 20 Columbus -------------------- 13 14 Dalton -------------------------- 7 LaGrange -------------------- 41 30 Macon ------------------------ 176 145 Savannah ------------------- 35 35 Sheffield -------------------- 134 113 Thomasville -------------- 63 59 Waycross ------------------- 26 20 Winship --------------------- 48 45 TotaL___________ 755 672 Average Hospital Days 1943 1944 13.3 10.7 10.9 13.8 9.9 11.0 24.0 17.5 15.5 7.8 6.9 7.6 8.3 9.5 12.4 11.2 12.7 10.2 13.4 4.4 6.2 14.6 15.5 10.3 11.7 fw-' 0\ TABLE III SuMMARY OF PEOPLE ON WHoM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINics WITH CosT FOR MALIGNANT CALENDAR YEAR -1944 NON-MALIGNANT ~ <1> MALIGNANT and NON-MALIGNANT ~ No. Clinic Cases Ame11icus -------------------- 93 Augusta ------------------------ 240 Canton ------------------------ 61 Columbus -------------------- 35 LaGrange -------------------- 85 Macon -------------------------- 323 Savannah ------------------- 58 Sheffield ----------------------- 214 Thomasville ________________ 176 Waycross ----------------- 73 Winship ----------------------- 123 -- TotaL_____J,481 Averace Amount Cost 6,294.99 67.68 ll,698.89 48.74 2,010.51 3j2.95 2,600.00 74.28 3,796.15 44.66 12,031.49 - 37.24 3,355.75 57.85 10,688.38 49.94 7,148.71 40.61 2,577.23 35.30 5,338.98 43.40 -- 67,541.08 45.60 No. Cases 38 102 12 10 15 91 31 67 30 13 -2-7 436 Amount 1,054.77 5,380.90 383.50 232.40 435.75 2,127.44 945.95 2,903.70 982.40 180.00 1,108.75 15,734.56 Averace No. Cost Cases 27.75 131 52.75 342 31.95 73 23.24 45 29.05 100 23.37 414 30.51 89 43.33 281 32.74 206 13.84 86 41.06 150 -- -- 36.08 1,917 Amount 7,349.76 17,079.79 2,393.01 2,832.40 4,231.90 14,158.93 4,301.70 13,592.08 8,13l.ll 2,757.23 6,447.73 83,275.64 Averace ~- Cost 1::::1 <1> 56.10 ... 49.94 32.78 ".g.. ;:l <1> a 62.94 42.31 ~ - 34.20 ~ ~ 48.33 0"' 48.37 ~- 39.47 ::X:: <1> s: 32.06 !;l 42.98 43.44 The above figures include only patients on whom bills were paid. Preventable Diseases TABLE IV SUMMARY OF ACTIVITIES 1943 APPLICATIONS Total received --- 1,915 Number approved _____________________ _ 1,914 Number disapproved ___________________________ I Counties represented ----------------------- ______________ 152 CASE REPORTS FROM CLINICS Total received ----------------------- _____________________ 1,723 Classed as malignant_____________________________________ _ 974 Classed as non-malignant_________________________________ 723 Deferred diagnosis ------------------------------------------ 26 CASES GIVEN FINANCIAL AID Total cases ----------------------------------------------------- __ 2,047 Malignant -------------------------------------------------------'-- 1,504 Non-malignant -------------------------------------------------- 543 AMOUNT OF FINANCIAL AID GIVEN Total amount given________________________________________ $84,694.91 Average amount per malignant case (Including only those for which a charge was made) --------------------------------------------- Average amount per non-malignant case (Including only those for which a charge was made) ------------------------------------------- __ 45.05 31.19 137 1944 1,842 1,839 3 153 1,637 1,047 551 39 1,917 1,481 436 $83,275.64 45.60 36.08 138 Georgia Department of Public Health TABLE V SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINICS WITH COST FOR CALENDAR YEAR-1944 - ..:1 .. - ...:1 :.: 0 :: 0 Ill P,O E-oO Appling 10 10 Atkinson _ 1 2 Bacon - - 6 6 Baker __ 7 1 8 Baldwin _ 7 Bank& _ _ 13 2 9 2 15 Barrow -- 3 4 Bartow -- 5 2 7 Ben Hill_ 7 7 Berrien __ 6 2 8 Bibb - - - 65 21 86 Bieckley _ 11 3 14 Brantley _ 4 Brooks __ 11 Bryan __ 3 Bulloch __ 4 1 5 1 12 3 3 7 Burke - - 11 Butts __ 1 5 16 2 3 Calhoun _ 4 2 6 Camden 1 1 Candler 5 1 6 Carroll 21 22 Catoosa Charlton _ 1 1 Chatham_ 29 18 47 Chattahoochee Chattooga - 5 1 6 Cherokee_ 19 3 22 Clarke - - 13 Clay _ __ 4 17 Clayton __ 2 3 5 Clinch __ 1 1 2 Cobb--- 11 4 15 Coffee __ 8 6 13 Colquitt __ 2' 6 80 Columbia _ 10 11 21 Cook - - 8 Coweta - - 16 Crawford _ 3 Crisp __ 19 8 1 17 14 3 22 Jefferson _ 20 10 30 Jenkins - 7 Johnson __ 11 Jones ___ 3 3 10 11 1 4 Lamar 12 Lanier __ 2 8 16 ~ 533.80 Dade 106.50 Dawson 7 164.00 Decatur __ 8 127.60 DeKalb ___ 26 614.08 Dodge _ _ 15 487.25 Dooly ___ 19 232.50 Dougher.ty __ 5 360.50 Douglas ____ 7 7 8 7 33 4 19 3 22 2 7 5 12 778.47 Early ---- 16 4 19 298.25 Echols ----- 3 3 4,148.54 Effingham .- 5 3 8 314.07 Elbert ------ 5 75.00 Emanuel __ 36 5 10 6 42 654.40 Evans - - - 1 142.26 Fannin __ 15 1 2 3 18 169.60 Fayette __ 10 726.85 Floyd _ _ 4 27.82 Forsyth __ 3 3 13 1 5 1 4 636.10 Franklin __ 5 2 7 5.00 Fulton __ 236.25 Gilmer __ 4 1 5 1,285.85 Glascock __ 4 1 5 Glynn--- 4 1 5 3.00 Gordon --- 11 2 13 2,818.10 Grady--- 4 4 Greene __ 16 12 27 542.25 Gwinnett _ 17 4 21 906.88 Habersham _ 8 4 12 665.99 Hall - - 6 3 9 Hancock _ 8 1 9 289.50 Haralson _ 4 3 7 33.50 Harris __ 6 2 8 887.60 Hart--- 4 4 485.90 Heard _ __ 6 1 7 875.13 Henry _ _ 11 1 12 1,066.60 Houston _ 7 3 10 461.22 Irwin-- 5 787.55 Jackson __ 13 5 1a 76.25 Jasper __ 7 2 9 838.69 Jeff Davia_ 9 1 10 1,165.45 Richmond _ 43 14 57 372.33 Rockdale_ 322.75 Schley __ 5 1 6 67.25 Screven __ 20 10 30 806.12 Seminole 8 2 10 15.00 Spalding _ 28 9 37 146.60 366.70 1,606.15 608.47 1,664.62 401.50 463.25 677.30 111.75 360.00 887.55 1,608.29 78.00 658.75 246.50 449.30 126.80 429.00 132.60 43.00 98.50 631.12 313.16 1,627.25 923.50 485.65 544.60 330.48 547.25 809.50 166.25 458.12 778.75 384.97 195.80 671.26 306.66 282.06 2,425.28 292.95 1,695.65 307.00 1,946.12 Preventable Diseases 139 ;I:I 1:: "c t.l ... .1S:: : :;l;!lu= ;; 1:: ~ ~! ~~ Laurens 35 4 -- Lee - - - Liberty 7 4 3 3 Lincoln __ 9 7 Long - - Lowndes _ 18 3 Lumpkin_ 4 2 - McDuffie 16 7 - Mcintosh Macon - - 5 - - Madison - 13 Marion 5 3 1 Meriwether 16 5 Miller _ _ 11 1 Mitchell 20 --- Monroe 8 4 6 Montgomery 17 5 Morgan __ 5 4 Murray - - Muscogee - Newton __ 2 21 6 4 - - Oconee 63 Oglethorpe _ 9 2 - - Paulding - Peach Pickens __ 10 8 3 1 4 Pierce - - Pike - - Polk ___ 7 9 8 1 7 - - Pulaski 22 Putnam-- 8 1 Quitman - Rabun - -- Randolph 7 9 2 - ...:1 .. = 10-tt.l 39 10 7 16 21 6 23 1 5 16 6 21 12 24 14 22 9 2 26 7 9 11 11 12 3 8 9 15 '9 7 11 ... 0 t.l 717.97 378.00 197.60 612.43 1,226.33 97.50 981.90 93.00 243.65 663.50 401.10 868.75 185.20 793.35 448.10 707.10 540.30 204.00 1,677.66 262.26 559.87 281.76 366.00 497.50 17.00 122.00 483.24. 570.00 238.90 4.10.75 219.85 796.26 .. ;: 1:: "c t.l . -... ... ... 1:: 1:: ;.;~I! ~;; 'il:~ 1:: ., =~ Z0 u 0 1-tt.l Stephens 10 3 13 Stewart __ 5 3 8 - - Sumter 13 12 25 Talbot --- 1 1 2 Taliaferro _ 7 3 10 Tattnall __ 5 5 Taylor __ 3 3 - - Telfair 14 Terrell __ 4 4 18 59 Thomas __ 18 2 20 Tift ---- 14 - - Toombs 14 Towns - - Treutlen - 6 - - Troup - - 26 Turner 4 Twiggs -- Union - - Upson ---- Walker 8 7 22 4 Walton -- Ware ---- Warren 14 9 6 Washington 7 Wayne --- Webster 7 4 Wheeler __ 13 1 15 5 19 23 28 5 31 37 4 12 7 4 26 4 6 19 1 10 39 7 18 15 4 17 White - - 2 Whitfield - Wilcox - - Wilkes - - Wilkinson - -- Worth 5 8 13 10 18 2 5 19 2 16 8 18 6 19 .. :!l t.l 206.50 394.26 822.96 70.00 446.00 361.50 220.00 547.86 578.21 974.35 536.60 661.25 81.75 89.25 1,087.16 268.45 448.20 364.44 947.50 198.75 806.26 453.36 1,326.00 286.90 346.00 392.87 393.75 53.75 240.75 264.65 644.10 559.89 1,063.47 Tots! _ _1,481 486 1,917 $83,276.64 140 Georgia Department of Public Health EPIDEMIOLOGIC SERVICE Personnel The personnel of this Service consisted of the Director of the Division of Preventable Diseases, who was also state epidemiologist, an assistant epidemiologist, and one stenographer. The assistant epidemiologist resigned the first of June and for the last seven months the Service functioned without one. Other staff members of the Division of Preventable Diseases assisted in making epidemiologic investigations. Functions During the year 1944 there were no changes in the functions of this Service. The office of the state epidemiologist was a clearing center for the assembling and dissemination of information concerning the incidence of preventable diseases. Regional medical directors were notified in regard to cases reported to this office from various sources and were delegated to make such investigations as seemed pertinent. In the event assistance was desired from the epidemiologist, arrangements were made by him to either go or send aid. Weeldy and monthly morbidity reports were mailed to all staff personnel and health officers. Tabulation of morbidity reports was made for this Service by the Central Tabulating Unit. As an aid not only to this Service in communicating with private physicians in the state but for the convenience of other public health workers, a classified medical directory of physicians in the state by counties and type of work was mimeographed and copies furnished to all public health workers in the state. Subsequently, notices of all known changes during the year were transmitted to them. Field Visits The total number of field visits made in unorganized counties relative to epidemiologic work by regional medical directors, public health nurses and staff members of this service was 773 during 1944. The total number made in 1943 was 1,023, which was a reduction of 250 field visits or 24.4 per cent. This does not include those visits made in connection with the epidemic of salmonella typhi-murium which occurred in Milledgeville. This reduction in field visits is probably due to the fact that there was a 24.0 per cent decrease in the number of cases of reportable diseases as compared with the previous year. The following table shows the distribution of visits by type, physicians and public health nurses: Preventable Diseases 141 SUMMARY oF AcTIVITIEs IN THE CoNTROL OF PREVENTABLE DISEASEs, 1944 AND 1943 Type of Activity Regional Medical Directors and State Epidemiologists Nurses 1944 1943 1944 1943 Consultations with physicians 93 Admissions to medical service 993 Admissions to nursing service -----Admissions to medical and/or nursing service ------------------ ------ Field Visits: Diphtheria -------------------------- 22 Measles ----------------------------- 2 Scarlet Fever ---------------------- 4 Smallpox --------------------------- 4 Typhoid and Paratyphoid__ 34 Typhus -------------------------------- 53 Whooping Cough -------------Others ------------------------------- 38 128 1,482 9 11 15 100 28 2 33 1,455 174 44 88 3 120 19 22 146 2,534 297 43 72 9 179 4 94 117 Total 1944 1943 93 128 993 1,482 1,455 2,534 1,592 2,781 196 306 46 43 92 83 7 24 154 279 72 32 22 96 184 150 Total Field Visits________ 157 205 616 818 773 1,023 Note-Admissions to medical and nursing service include those admitted to malaria and hookworm service, which is incorporated in report of that service. The following tabulations will show the number of field visits made in the control of specified and other preventable diseases in non-health officer counties for 1944 as reported by regional medical directors, public health nurses, and staff members of the Epidemiologic Service: DIPHTHERIA; Baker ------------------------------------ 1 Barrow ---------------------------------- 14 Bartow ---------------------------------- 3 Berrien --------------------------------- 6 Bryan ------------------------------------ 3 Carroll ---------------------------------- 4 Clinch ------------------------------------ 22 Dawson ---------------------------------- 8 Emanuel -------------------------------- 2 Evans ----------------------------------- 4 Fannin --------------------------------- 2 Fayette ----------------------------------- 2 Gordon ---------------------------------- 4 Jackson ---------------------------------- 2 Jasper ------------------------------------ 2 Johnson -------------------------------- 8 Jeff Davis ------------------------------ 8 Lanier ------------------------------------ 3 Lumpkin -------------------------------- 36 Macon ------------------------------------ 1 McDuffie -------------------------------- 4 Monroe ---------------------------------- 2 Montgomery -------------------------- 1 Morgan ---------------------------------- 2 Peach ----------------------------------- 11 Pierce ------------------------------------ 4 142 Georgia Department of Public Health Pike ----------------------------------- 5 Randolph ------------------------ 4 Stewart ----------------------------- 10 Tay1or --------------------------------- 2 Toombs ------------------------------ 5 Treutlen -------------------------------- 1 Wilcox --------------------------------- 10 MEASLES: Baker ----------------------------------- 12 Butts --------------------------------- 2 Fannin ------------------------------- 16 Jasper ------------------------------- 1 Lumpkin -------------------------------- 9 Long ------------------------------------- 1 McDuffie -------------------------------- 5 SCARLET FEVER: Atkinson ------------------------------- 5 Butts ------------------------------------ 15 Clayton ------------------------------ 3 Crawford ----------------------------- 4 Dawson -------------------------~---- 4 Evans ---------------------------------- 3 Fannin ---------------------------------- 3 Gordon --------------------------------- 33 Fayette --------------------------------- 1 Lanier ----------------------------------- 3 McDuffie ------------------------------- 12 Montgomery -------------------------- 1 Peach ------------------------------------ 4 Tattnall ---------------------------------- 1 SMALLPOX: Atkinson -------------------------------- 1 Elbert ------------------------------------ 1 Franklin ------------------------------ 2 Lee ---------------------------------------- 2 Randolph ------------------------------ 1 TYPHOID: Bartow ------------------------------- 7 Chattooga -------------------------- 6 Ciayton --------------------------------- 1 Clinch -------------------------------- 6 Coweta --------------------------- 11 Crawford --------------------------- 7 Dawson ---------------------------- 3 Douglas --------------------------- 3 Elbert -------------------------------- 1 Emanuel -----------------~--------- 3 Fannin ------------------------------ 8 Gilmer ---------------------------------- 2 Haralson -------------------------- 3 Jackson ------------------------------ 5 Johnson ------------------------------- 5 Lumpkin ----------------------------- 27 McDuffie ---------------------------- 3 Monroe -------------------------- 1 Montgomery ------------------------ 4 Murray ---------------------------------- 2 Oconee --------------------------------- 13 Pickens ---------------------------------- 3 Pike -------------------------------------- 1 Polk -------------------------------------- 3 Randolph ---------------------------- 7 Rockdale -------------------------------- 1 Stewart ---------------------------------- 5 Schley ----------------------------------- 3 Union ----------------------------------- 6 Upson ------------------------------------ 4 Webster -------------------------------- 1 Preventable Diseases 143 TYPHUS: Baker ------------------------------------ 3 Candler --------------------------- 2 Clinch ---------------------------- 3 Emanuel ---------------------- 1 Evans -------------------------- 2 Fannin ------------------- 1 Fayette ------------------------ 2 Henry --------------------------------- 1 Houston ------------------------- 1 Lumpkin -------------------------- 1 McDuffie --------------------------- 3 Macon ---------------------------- 3 Marion ------------------------ 1 Peach ------------------------ 7 Schley --------------------------- 24 Tattnall -------------------- 1 Taylor -~----------------------- 7 Toombs ---------------------------- 7 Upson ------------------------------- 2 WHooPING CouGH: Butts ----------------------------------- 9 Clinch -------------------------------- 1 Evans -------------------------------- 2 Johnson ------------------------------- 2 Long ------------------------------------- 1 Lumpkin ------------------------------- 1 Marion --------------------------------- 4 Randolph ------------------------------ 2 OTHERS: Atkinson -------------------------------- 13 Banks ---------------------------------- 6 Bartow -------------------------------- 2 Berrien --------------------------------- 15 Butts ------------------------------------- 8 Carroll ------------------------------ 3 Cherokee ----------------------- 1 Candler ------------------------------- 1 Clayton ---------------------------------- 1 Cook ------------------------------------ 7 Coweta ---------------------------------- 1 Dade ------------------------------------- 2 EarIy ------------------------------------- 2 Effingham ------------------------------ 5 Emanuel ------------------------------- 3 Evans ---------------------------------- 41 Fannin --------------------------------- 1 Gordon -------------------------------- 22 Haralson -------------------------------- 2 Irwin ------------------------------------- 1 Jackson ---------------------------------- 1 Jasper ------------------------------------ 1 Jeff Davis ----------------------------- 3 Lumpkin ------------------------------ 6 Macon ------------------------------------ 1 Monroe ---------------------------------- 1 Newton ---------------------------------- 1 Oglethorpe ---------------------------- 1 Pike ------------------------------------ 1 Stewart ---------------------------------- 6 Tattnall ---------------------------------- 2 Taylor ---------------------------------- 8 Toombs ---------------------------------- 11 Upson ------------------------------------ 3 Whitfield ------------------------------ 1 Special Investigations Gastroenteritis-The first special investigation made by the epidemiologists and staff members was in Polk County at the request of the regional medical director and a physician in Rockmart, where they had numerous cases of this condition reported. From information obtained from physi cians in this town 'it was estimated that probably close to 300 cases had 144 Georgia Department of Public Health come to the attention of the three physicians. The earliest cases occurred about three or four weeks prior to the date of investigation. Cases had appeared over a wide area around Rockmart, at least as far as eight miles away, and had occurred in rural residents about as commonly as in urban. Apparently, white and colored persons were attacked with about equal frequency. The wide distribution of cases, including rural and urban, white and colored, the long interval of time over which cases continued to occur and the apparent lack of any widely distributed food in that area made it appear unlikely that any type of food served as a common source of infection. This was supported by cases histories. From an epidemiological standpoint, the outbreak did not conform to either of the known types of food poisoning. In many respects the outbreak resembled those which have been studied from time to time by the U. S. Public Health Service and which have been described as resembling food poisoning from the standpoint of symptomatology and bacillary dysentery from the standpoint of epidemiology. In none of such outbreaks was the etiological agent identified by the U. S. Public Health Service. Typhoid-At the request of the regional medical director of the North eastern Health Region, one of our staff investigated several cases of typhoid fever in Lumpkin County, comprising three families and nine cases, seven of which were in one family. In the latter family, six of the cases were secondary to the original case. The three families lived in widely separated parts of the county and apparently had nothing in common. There was no evidence of a common source of infection, no common source of milk, food or water, and no history of their having attended any common gathering where food was served. Consequently, efforts were directed toward finding a possible case or carrier who might have been responsible for the infection in each of the three households. In two of the families the infection was traced to direct contact with another case. In the third family the source of infection was undetermined. Typhoid Carriers-As a result of typhoid cases investigated by all public health workers in the state, 12 chronic typhoid carriers were found during the year. Salmonella Typhi-Murium Food Infection-Two outbreaks of salmonella typhimurium food infection were investigated at the Georgia State College for Women, Milledgeville, Georgia. Both outbreaks occurred during the month of September with a time interval of approximately a week between them. The first outbreak involved 44 cases and the second one 140 cases. No deaths occurred. In the first outbreak fecal specimens were obtained by rectal swab technique from all students showing symptoms of food poisoning who were available for examination. Salmonella typhi-murium was recovered from 34 of the specimens. Blood cultures were obtained from 11 of the patients and all of them were negative. In addition, fecal specimens were obtained from 19 food handlers, and, of these, five were positive for typhi-murium. Only one of these five food handlers showed symptoms of illness. Preventable Diseases 145 In the second outbreak fecal specimens were obtained from 56 of those showing symptoms. Salmonella typhi-murium was recovered from 46 of the specimens. In addition, specimens were obtained from 32 apparently healthy food handlers and, of these, 13 were positive. Both outbreaks resulted from the contamination of food served in the main dining room. Although it was possible to fix the date when the contamination occurred, in each outbreak there were two or three separate foods which may have been responsible. No left-over foods were available for examination. In each outbreak the foods in question had been prepared or handled by kitchen personnel who were found to be carriers at the time of investigation. It is not known, of course, whether any of these persons were carriers prior to the initial outbreak. An intensive study was made with respect to sanitary conditions in the kitchen, food storage, toilet facilities, rodents, pasteurization and handling of milk etc. A comprehensive summary of the findings together with recommendations was furnished to the school authorities. Other Activities In response to an invitation from the Warm Springs Foundation to physicians and nurses to attend a series of institutes on the care and treatment of acute and convalescent poliomyelitis which were being offered there during the months of April, May, and June, this Service was asked by the Georgia Chapter of the National Foundation for Infantile Paralysis to give publicity to this very much needed course in instruction. A letter was written to every nurse and physician in the state telling them of the need of these institutes so that the state would be prepared to give the very best of care to poliomyelitis cases as they occurred from time to time either sporadically or in epidemic proportions. They were also apprised of the fact that all their expenses would be paid by the Georgia Chapter of the National Foundation for Infantile Paralysis. Application blanks and an outline of the courses to be given were enclosed for their consideration. Thirty-six: white physicians, 6 colored physicians, 142 white nurses and 32 colored nurses attended the series of institutes. The interest manifested in a desire to attend these courses was far beyond expectations and, because of the lack of facilities for handling a larger number, it was necessary to decline the applications of 218 white nurses and 24 colored nurses. This Service was also invited by the National Foundation for Infantile Paralysis to make arrangements with the right hospitals at strategic points in the state for "hot-pack" units to be placed in these institutions and agreements secured from them to accept any poliomyelitis case that might be forwarded to them for treatment. The director of this Service was able to make these arrangements inenough hospitals to have a proper coverage of Georgia. On July 12 a quarantine regulation was released by the Director of the State Department of Public Health calling attention to the epidemic of infantile paralysis in North Carolina and notifying the public 'that chil- 146 Georgia Department of Public Health dren and young people coming into Georgia from areas where this disease was prevalent would be quarantined for a period of three weeks, with the exception of the bread winner in the family who must be isolated and remain away from the persons in quarantine in the home. Considerable time and energy were given to handling the public by telephone and correspondence concerning this quarantine period, which involved about three or four months. As a result of these efforts contact between citizens of Georgia and those in the epidemic area was greatly reduced. During the year 1944, 17 ~eetings promoting public health were attended by the epidemiologist, 9 of which were addressed by him with an approximate attendance of 695. A total of 23,264 bulletins on the control of communicable diseases was distributed to groups and individuals. Thirty-five special conferences were held relative to the control of communicable diseases. Analyses of Statistical Reports Comments on the morbidity and mortality rates in connection with reportable diseases are based on per 100,000 population and the fatality rates are the petcentage of cases that were reported as deaths. Diphtheria--The reported incidence of diphtheria continues to decrease, a reduction from 520 cases in 1943 with a case rate of 16.6 to 462 cases in 1944 with a case rate of 14.8. Likewise the number of deaths decreased from 47 in 1943 to 40 in 1944 with respective death rates of 1.5 and 1.3. Comparing the 462 cases reported in 1944 with the _1,232 cases reported in 1938, we find a 64.7 per cent reduction in the past seven years, which justifies every effort that has been made to eradicate this preventable disease. Dysenteries-Sixty-three deaths and 304 cases with a case rate of 9.7 and a death rate of 2.0 were reported during 1944 for dysenteries. The previous year 459 cases with a case rate of 14.7 and 79 deaths with a death rate of 2.5 were recorded, which gives a 33.8 per cent reduction in cases and 20.3 per cent reduction in deaths for dystenteries in 1944 as compared with 1943. The fatality rate, however, increased from 17.2 to 20.7 per cent over the previous year. Gonorrhea-Deaths from gonorrhea dropped from 36 in 1935 to 8 in 1944, and the 8,557 cases with a case rate of 273.9 showed a 14.7 per cent decrease from the 10,028 cases reported in 1943. Hookworm-Practically the same number of cases of hookworm was reported in 1944 as in 1943, 3,372 and 3,409 respectively, a difference of only 37, which is not of much significance since the number of cases recorded each year involved surveys and probably included those with hookworm infection but who were not ill with the disease. No deaths were reported in 1944 and only 1 in 1943. Preventable Diseases 147 lnfluenzar-During 1944, 3,118 cases of influenza with a case rate of 259.9 were reported and 742 deaths with a death rate of 23.8. There was a 36.7 per cent reduction from the 13,238 cases reported in 1943 and an 13.9 per cent increase over the 624 deaths in 1943. The fatality rate of 9.1 was a little less than twice the fatality rate of 4.7 in 1943, which indicates that the disease was more virulent in 1944 than the previous year when almost twice as many cases of influenza were reported. Malaria-A considerable decrease in the reported c~ses of malaria as well as deaths occurred in 1944 when 416 cases with a case rate of 13.3 and 34 deaths with a death rate of 1.1 were recorded. These were the smallest numbers of deaths and cases for malaria reported during the past ten years and a very marked reduction since 1937 when 6,813 cases were reported and in 1936 when 606 deaths were recorded. Measles-The reported incidence of measles increased from 4,413 cases in 1943 to 6,239 in 1944 and the case rate from 141.3 to 199.7. The deaths likewise increased from 27 to 68 and the fatality rate from 0.6 to l.l. Since 1941 when 11,009 cases of measles were reported, considered an epidemic year, approximately 50.0 per cent less cases were reported each year, but the increase in 1944 over 1943 indicates that we are starting upward into another epidemic year. Meningococcus Meningitis-During the year 1944, 215 cases of meningococcus meningitis were reported, with a case rate of 6.9, which approached the same number, 2ll, reported with a case rate of 6.8 in 1943. There was a 25 increase in deaths, 21 deaths having been reported in 1943 and 56 in 1944, giving an 80.6 per cent increase. The fatality rate also increased from 14.7 to 26.0 per cent. Pellagra-The 159 cases and 131 deaths with a case rate of 5.1 and a death rate of 4.2 were the smallest numbers reported for pellagra in the past ten years. There has been a decrease from 1,209 cases in 1938, the largest number reported in the ten-year period, 1935-1944, to 159 in 1944, or a reduction of 86.8 per cent in 6 years. Pneumonia-During 1944, 2,524 cases of pneumonia and 1,531 deaths were reported with a case rate of 30.3 and a death rate of 50.6. In each instance there was a decrease from 1943 when 3,797 cases and 1,734 deaths were reported. Poliomyelitis-The 104 cases of poliomyelitis with a case rate of 3.3 reported in 1944 was the largest number of cases reported since the epidemic in 1941 when 790 cases with a case rate of 25.1 were recorded. Nine deaths were reported for poliomyelitis in 1944, an increase of 6 over the previous year and an increase in death rate from 0.1 to 0.3 in 1944. Scarlet Fever-From 1939 through 1942 over 1,000 cases of scarlet fever were reported each year, but during 1943, 964 cases with a case rate of 30.9 were reported, and in 1944, 997 cases with a case rate of 31.9 143 Georgia Department of Public Health were reported, an increase of 33 cases. The number of deaths from this disease decreased from 6 in 1943 to 2 in 1944 and the death rate from 0.2 to 0.1. Smallpox-Only 7 cases of smallpox were reported in 1944, a decrease of 5 from 1943 when 12 cases were reported. The case rate dropped from 0.4 to 0.2. No deaths have been reported from smallpox since 1935 when 1 was recorded. Syphilis-During 1944, 13,954 cases of syphilis with a case rate of 446.7 and 373 deaths with a death rate of 11.9 were reported, the smallest number of each since 1937 when a more intensive control program was initiated. In 1943, 21,543 cases of syphilis with a case rate of 689.3 and 435 deaths with a death rate of 13.9 were reported. Tuberculosis-During 1944 the smallest number of cases of tuberculosis was reported for the past ten years. Also the smallest number of deaths in ten years was reported with a death rate of 35.4. Comparing the 2,603 cases with a case rate of 30.3 in 1944 with the 2,391 cases with a case rate of 92.5 in 1943, we find a 9.3 per cent reduction in the reported incidence of tuberculosis in 1944. Typhoid Fever-The number of reported cases of typhoid fever during 1944 is an all time low and there has been an increase of only 1 death over 1943. In 1943, 208 cases with a case rate of 6.7 and in 1944, 177 cases with a case rate of 5.7 were recorded, giving a 14.9 per cent decrease in 1944 from the previous year. Typhus Fever-Comparing the number of typhus cases reported in 1944, 1,182 with a case rate of 37.8 and the 1,256 cases with a case rate of 40.2 in 1943, we find a 5.9 per cent reduction. The deaths have increased from 57 in 1943 to 63 in 1944 and the fatality rate increased from 4.5 to 5.3. Undulant Fever-This is the only disease where we find an all time high in the reported cases, 159 cases with a case rate of 5.1, having been reported in 1944, which exceeds any other previous year by 30. The deaths from this disease numbered 3, the same as the previous year, and the fatality rate dropped from 3.1 to 1.9. Whooping Cough-The 792 cases of whooping cough reported in 1944 was the smallest number since 1936 when 702 cases were reported, and we find a 54.7 per cent reduction in the number of cases reported in 1944 when compared with 1943. The cases reported for the respective years were 1,749 with a case rate of 56.0 and 792 with a case rate of 25.4. The number of deaths decreased from 170 in 1943 to 65 in 1944, a 61.8 per cent reduction. Summary-The only diseases where we find an increase in the number of cases reported during 1944 over 1943 are: measles, meningococcus miningitis, poliomyelitis, scarlet fever, and undulant fever. The only dis Preventable Diseases 149 eases where we find an increase in the number of deaths reported in 1944 over 1943 are: influenza, measles, miningococcus meningitis, poliomyelitis, typhoid fever, and typhus fever. Attached are tables showing the distribution of cases of notifiable diseases by months for the year 1944 and morbidity and mortality figures with case rates per 100,000 population as well as percentage of fatality for the years 1940 through 1944. NUMBER OF CASES AND DEATHS FROM SPECIFIED NoTIFIABLE DISEAsEs REPORTED IN GEORGIA, 1940-1944 WITH RATES PER 100,000 PoPULATION AND PER CENT FATALITY Disease Year Cases Case Rate Per 100,000 Population Deaths Death Rate Fatality Per 100,000 Rate Population (Per Cent) Diphtheria: 1940 543 17.4 59 1.9 10.9 1941 758 24.1 63 :1.0 8.3 1942 660 21.1 55 1.8 8.8 1943 520 16.6 47 1.5 11.0 1944 462 14.8 40 1.3 8.7 ])ysentery : 1940 582 18.6 126 1941 516 16.4 109 1942 584 18.7 86 1943 459 14.7 79 1944 304 9.7 63 4.0 21.6 3.5 21.1 2.8 14.7 2.5 17.2 2.0 20.7 Gonorrhea: 1940 5282 169.1 22 0.7 0.4 11141 7229 229.8 24 0.8 0,8 1942 16786 537.4 6 0.2 0.03 1943 10028 321.0 12 0.4 0.1 1944 8557 278.9 8 0.8 0.1 Hookworm: 1940 1941 1942 1943 1944 17306 7143 4617 3409 3372 664.0 227.1 147.8 109.1 107.9 8 0.8 0.04 1 0.03 0.01 2 0.1 0.0( 1 0.03 0.02 Influenza: 1940 13420 429.6 924 29.6 6.9 1941 36021 1146.3 994 31.6 2.8 1942 2900 92.8 482 15.4 16.6 1943 13238 423.8 624 20.0 4.7 1944 8118 269.9 742 23.8 9.1 Malaria: 1940 2502 80.1 89 2.8 3.6 1941 1122 35.7 75 2.4 6.7 1942 981 31.4 76 2.4 7.7 1943 525 16.8 37 1.2 7.0 1944 416 13.3 34 1.1 8.2 150 Georgia Department of Public Health NUMBER OF CASES AND DEATHS FROM SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA, 1940-1944 WITH RATES PER 100,000 POPULATION AND PER CENT FATALITY Disease Year Measles: 1940 1941 1942 1948 1944 Meningitis: (Meningococcus) 1940 1941 1942 1943 1944 Pellagra: 1940 1941 1942 1948 19U Pneumonia: 1940 1941 1942 1943 1944 Poliomyelitis : Scarlet Fever: Smallpox: Syphilis: 1940 1941 1942 1948 1944 1940 1941 1942 1948 1944 1940 1941 1942 1948 1944 1940 1941 1942 1948 1944 Cases Case Rate Per 100,000 Population Deaths Death Rate Fatality Per 100,000 Rate Population (Per Cent) 3282 105.1 23 0.7 0.7 11009 350.0 157 5.0 1.4 5921 189.5 60 1.9 1.0 4418 141.3 27 0.9 0.6 6289 199.7 68 2.2 1.1 27 35 53 211 215 429 884 257 208 159 4480 3623 4172 8797 2524 30 790 49 28 104. 1000 1079 1148 964 997 11 11 7 12 7 21259 19640 21644 21648 13954. 0.9 1.1 1.7 6.8 6.9 13.7 10.6 8.2 6.7 6.1 143.4 115.2 133.6 121.6 80.8 1.0 25.1 1.6 0.9 3.3 82.0 34.8 36.8 30.9 31.9 0.4 0.8 0.2 0.4 0.2 680.6 621.8 689.7 689.8 446.7 9 17 18 31 56 285 204 181 175 181 2055 1714 1612 1734 1581 7 33 10 3 9 16 9 2 6 2 587 60S 462 486 872 0.3 0.5 0.6 1.0 1.8 7.5 6.5 5.8 5.6 4.2 65.8 54.5 51.6 85.5 50.6 0.2 1.1 o.a 0.1 0.8 0.5 0.8 0.1 0.2 0.1 33.3 48.6 34.0 14.7 26.0 5U 61.1 70.4 84.1 82.4 45.9 47.3 38.6 45.7 62.6 23.3 . 4.2 20.4 10.7 8.7 1.6 0.8 0.2 0.6 0.2 18.8 2.8 16.0 2.6 14.8 2.1 18.9 2.0 11.9 2.7 Preventable Diseases 151 NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA, 1940-1944 WITH RATES PEa 100,000 PoPULATION AND PER CENT FATALITY Disease Year Cases c..... Rate Per 100,000 Population Deaths Death Rate Fatali~ Per 100,000 Rate Population (Per Cent) Tuberculosis : 1940 1941 1942 1943 1944 Typhoid Fever: 1940 1941 1942 1948 1944 Typhus Fever: 1940 1941 1942 1943 1944 Undulant Fever: 1940 1941 1942 1948 1944 Whooping Coua:h: 1940 1941 1942 1943 1944 2806 2636 3067 2891 2608 487 397 884 208 177 689 944 1163 1266 1182 123 117 129 98 169 1020 1406 1869 1'149 792 89.8 83.8 98.2 92.6 80.3 16.6 12.6 12.8 6.7 6.7 18.9 30.2 86.9 40.2 87.8 3.9 8.6 4.1 8.1 6.1 32.7 44.7 43.8 66.0 26.4 1638 1386 1266 1304 1107 68 66 24 23 24 26 36 62 67 63 3 2 3 3 108 140 101 170 66 49.1 44.0 40.6 41.7 36.4 2.2 1.7 0.8 0.7 0.8 0.8 1.1 1.7 1.8 2.0 0.1 0.1 0.1 0.1 8.6 4.6 3.2 &.4 2.1 64.7 62.6 41.2 43.7 42.4 14.0 18.11 6.3 11.1 13.6 4.4 8.8 4.6 4.6 6.8 2.4 1.7 3.1 1.9 10.6 1o.cr 7.4 9.7 8.2 152 Georgia Department of Public Health NoTIFIABLE DISEASEs REPORTED IN GEORGIA BY CoLoR, SEx, AND AGE, 1944 Age Level by Years Diphtheria wc Amebic Dysentery wc Under 1 Year M 9 F 6 1 1 2 years M 16 3 F 17 4 2 3 years M 22 8 F 21 ,8 3 4 years M 32 7 F 16 7 4 6 years M 25 7 F 21 1 5 6 years M 19 4 F 26 6 7 years M 18 3 F 16 1 '1 8 years M 5 1 F 10 1 8 9 years M 7 2 F 14 2 9 10 years M 3 F 7 2 1014 years M 12 4 F 16 4 1 M 1 1 1 F 6 5 2024. years M F 3 2 2529 years M 2 3 30.34 years F M 3 1 1 '2 2 F 3 1 1 3539 years M 3 F 40-44 years M 10 F 2 45-49 years M F 1 50.54. years M F 1 65-64 years M 1 F 1 6574 years M F 75 and over M F 1 Unknown age M 6 F 10 1 Total M 178 41 19 1 F 193 43 8 4 **This includes Unspecified Dysentery. Bacillary Dysentery** wc 13 12 16 9 14 3 7 3 4 4 7 1 6 1 6 2 4 1 2 2 3 6 2 1 2 1 1 1 1 1 3 1 2 2 2 3 6 1 3 6 1 2 3 1 1 3 2 2 1 1 1 1 1 4 3 9 3 1 1 1 6 2 4 1 74 28 84 30 Malaria wc Measles wc 1 37 9 22 9 2 59 4 1 2 31 6 1 55 10 1 65 8 2 52 8 1 50 7 1 78 9 1 64 16 1 52 7 1 59 6 1 141 2 2 1 141 6 89 1 2 92 7 77 4 1 1 88 6 3 1 64 2 2 48 3 7 2 133 16 2 3 105 18 5 6 63 9 5 3 34. '1 20 ' 84 8 8 1 25 2 14 3 19 a 12 1 26 a 16 3 18 I 9 4 12 I 6 2 8 3 2 7 6 6. 2 6 4 6 4 2 6 2 8 6 ... 5 3 6 2 6 2 ... 3 1 7 2 1 2 2 8 44 125 113 37 1007 94 77 36 1007 106 Preventable Diseases 153 NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COLOR, SEX, AND AGE, 1944 A&'e Level by Years Under 1 year M F 1 2 years M F 2 3 years M F 3 4 years M F 4 6 years M F 6 6 years M F 6 7 years M F 7 8 years M F 8 9 years M F 9 10 years M F 1014 years M F 1619 years M F 2024 years M F 2629 years M F 3034 years M F 3639 years M F 40-44 years M F 4549 years M F 50-54 yearo M F 5564 years M F 65-74 years M F 75 and over M F Unknown Age M F Total M F Meningococcus Meningitis Pneumonia wc wc 6 2 104 144 3 1 84 131 1 12 33 10 26 19 5 11 18 2 10 13 3 4 8 6 7 6 6 13 2 1 4 '3 6 3 5 2 2 8 3 2 7 7 2 2 4 2 2 1 2 1 2 6 3 1 2 3 6 1 2 2 1 1 11 6 9 11 2 3 8 14 6 19 20 8 2 11 3 2 10 14 2 11 19 4 3 11 27 2 14 26 4 5 15 25 2 16 22 9 3 20 36 2 4 22 3 27 38 14 29 21 37 2 3 6 33 2 2 30 51 2 22 26 2 4 67 50 2 49 43 79 38 1 85 24 79 29 122 35 6 65 5 3 54 1 90 42 611 599 63 16 653 475 Poliomyelitis wc 2 3 3 4 2 5 1 2 5 3 4 2 4 2 2 5 2 3 5 5 1 7 11 4 3 2 2 1 48 5 44 6 Scarlet Fever wc 6 2 18 14 25 4 27 2 44 3 26 1 44 3 44 1 38 2 69 64 2 64 2 44 62 1 38 45 2 24 36 59 69 2 11 18 5 2 7 2 4 1 6 22 4 3 9 441 16 499 19 Septic Sore Throat wc 3 2 4 3 4 3 1 1 3 4 2 2 3 1 6 1 8 6 12 5 10 2 6 8 5 4 6 3 1 4 2 1 1 2 2 1 2 4 1 61 6 77 12 154 Georgia Department of Public Health NoTIFIABLE DisEASES REPORTED IN GEORGIA BY CoLoR, SEx, AND AcE, 1944 Aile Level by Years Under 1 year M F 1 2 years M F M F 3 4 years M F 4 5 years M F 5 6 years M F 6 7 years M F 7 8 years M F 8 9 years M F 9 10 years M F 1014 years M F 15-19 years M F 20-24 years M F 25-29 years M F 30-34 years M F 35-39 years 11( F 40-44 years M F 45-49 years M F 50-54 yeara M F 55-64 yeara M F 65-74 years M F 75 and over M F Unknown Ap M F Total M F Smallpox wc 1 1 1 1 1 Tubereulosis wc 2 3 5 2 3 2 5 2 2 6 4 4 4 6 6 3 6 1 1 1 1 2 2 6 2 1 4 2 3 2 3 2 2 2 17 9 10 20 33 47 22 65 59 72 61 112 55 77 57 85 98 116 47 94 81 62 37 52 59 86 30 45 58 87 25 19 65 84 16 20 88 37 49 28 52 12 39 12 Typhoid Fever wc 1 2 1 2 1 3 2 2 2 1 4 2 2 2 1 1 5 5 1 2 1 2 1 1 1 1 1 3 3 5 3 6 3 3 2 2 5 9 6 6 2 2 2 1 2 2 5 3 3 4 2 2 1 2 2 3 1 3 3 3 1 3 1 1 5 1 2 41 189 3 2 28 11 1 1 3 721 769 42 41 1 2 482 586 66 36 Typhus Fever wc 2 1 1 1 1 2 6 1 4 5 2 9 1 1 12 1 8 43 5 22 4 67 11 33 7 17 6 47 2 40 14 38 4 55 8 48 8 52 11 38 10 53 10 32 2 34 9 29 7 44 5 42 1 50 3 36 28 5 16 1 6 1 3 44 11 37 1 570 102 484 49 Undulant Fever wc 1 3 1 2 3 4 8 1 5 3 2 11 6 10 1 3 16 2 5 14 1 2 11 2 1 10 5 8 7 1 1 13 107 13 37 Preventable Diseases 155 NoTIFIABLE DisEAsEs REPORTED IN GEORGIA BY CoLoR, SEX, AND AcE, 1944 Age Level by Years Under 1 year M F .. 2 years M F .. 3 years M F a .. 4 years M F 4 5 years M F 5 - 6 years M F 6 - 7 years M F 7 - 8 years M F 8 9 years M F 9 -10 years M F 10-14 years M F 15-19 years M F Whoopinlt Cou~rh w c 23 9 28 31 18 6 17 10 18 5 18 9 14 4 14 6 2 11 11 4 9 2 10 1 6 7 9 14 6 1 5 1 7 1 3 1 2 8 9 4 Age Level by Years 20-24 years M F 25-29 years M F 30-34 years M F 35-39 years M F 40-44 years M F 45-49 years M F 50-54 years M F 55-64 years M F 65-74 years M F 75 and over M F Unknown Age M F Total M F Whoopinc Cou~rh w c 11 123 53 132 68 156 Georgia Department of Public Health NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEAsEs REPORTED IN GEoRGIA BY CouNTIEs, 1944 Area Census Population Diphtheria Cases Rate Gonorrhea Cases Rate Influenza Cases Rate Malaria Cases Rate State Total ____________________3,123,723 462 14.8 8557 273.9 8118 259.9 416 13.3 Rural ______________________________ 2,062,070 283 13.7 2134 103.5 4814 233.5 244 11.8 Cities 2500-5000 ------------ 135,683 30 22.1 250 184.3 217 159.9 19 14.0 Cities 5000 and above.... 925,970 147 15.9 4182 451.6 2766 298.7 51 5.5 Military Reservations 2 1991 321 102 Appling ---------------------Atkinson ---------------------Bacon ---------------------------Baker --------------------------- Baldwin ------------------------- USN Train. SchooL.. Banks ---------------------------Barrow --------------------------Bartow -------------------------- Ben Hill ------------------------- Berrien ---------------------------Bibb ----------------------------- 14,497 7,093 8,096 7,344 16,411 8,733 13,064 25,283 14,523 15,370 83,783 4 27.6 1 14.1 2 22.9 3 23.0 3 20.7 6.5 31 37.0 14 96.6 2 24.7 3 40.8 11 67.0 7.7 8 31.6 1 6.9 6.5 146 174.3 65 448.4 18 109.7 6 68.7 41 313.8 9 35.6 501 3449.7 4 26.0 11 13.1 2 13.8 2 28.2 1 13.6 1 6.1 4.0 2 2.4 H. Smart Airport....- 18 Cochran Field ------Camp Wheeler ------- 2 11 Bleckley --------------------- 9,655 Brantley ----------------------- 6,871 Brooks -------------------------- 20,497. Bryan ------------------------- 6,288 Bulloch --------------------------- 26,010 Burke -------------------------------- 26,520 Butts ------------------------------- 9,182 2 9.8 11 42.3 2 7.5 21 217.5 8 39.0 1 3.8 52 196.1 23 238.2 1 14.6 4 19.5 149 2369.6 168 645.9 105 395.9 5 54.5 7 72.5 23 112.2 2 31.8 40 153.8 3.8 Calhoun --------------------------- 10,438 Camden --------------------------- 5,910 Candler --------------------------- 9,103 Carroll ----------------------------- 34,156 Catoosa ---------------------------- 10,899 Fort Oglethorpe -------Charlton ------------------------ 5,256 Chatham ------------------------- 117,970 USN Section Base ..... 3 28.7 6 57.5 4 38.3 2 22.0 3 33.0 4 43.9 7 20.5 7 20.5 4 11.7 9.2 1 9.2 2 18.4 211 7 2 38.1 32 608.8 2 1.7 291 246.7 764 647.6 1 9.2 4 76.1 3 2.5 Fort Screven -------------- Savannah Air Base.... 1 Chattahoochee ----------------Fort Benning ------------- Chattooga ---------------------Cherokee ------------------------Clarke ---------------------------- USN Preflight Sch..... 5,138 18,532 20,126 28,398 1 7 37.8 7 37.8 8 39.7 3 14.9 2 7.0 104 366.2 4 21.6 4 19.9 8 28.2 1 5.4 1 5.0 Clay ------------------------------- 7,064 Clayton --------------------------- 11,655 4 34.3 1 14.2 1 8.6 1 14.2 .... Rates are based on enumerated population of 1940 census. l>'OTE: All Military Reservations are exclusive of county totals (included in State Total), are indented and follow the county in which located. Preventable Diseases 157 NuMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIES, 1944 Area Census Population* Diphtheria Cases Rate Gonorrhea Cases Rate Influenza Cases Rate Malaria Cases Rate Clinch -----------------------------~ 6,437 Cobb -------------------------------- 38,272 Coffee ------------------------------- 21,541 A.A.F.F.T.D. -------------- Colquitt -------- ------------------- 33,012 Spence Field -------------- Columbia ------------------------ 9,433 Cook --------------------------------- 11,919 Coweta ----------------------------- 26,972 Crawford ------------------------ 7,128 Crisp --------------------------------- 17,540 10 155.4 10 26.1 8 24.2 8.4 6 34.2 40 104.5 85 394.6 1 28.7 24 111.4 15.5 2 9.3 42 127.2 12 36.4 18 54.5 2 21.2 1 8.4 1 3.7 27 100.1 1 14.0 2 28.1 84 478.9 24 136.8 5.7 Dade ---------------------------------Dawson ---------------------------Decatur ---------------------------- A.A.F.B. Flying Sch. DeKalb ------------------------------ Lawson Gen. Hospital us Naval Air Base____ Dodge -----------------------------Dooly ------------------------------Dougherty ------------------------ Turner Field -------------Darr Aero Tech____________ Douglas ---------------------- 5,894 4,479 22,234 86,942 21,022 16,886 28,565 10,053 6 27.0 10 11.5 3 14.3 1 5.9 2 19.9 9 40.5 21 30 34.5 176 28 133.2 3 17.8 91 318.6 34 3 1 9.9 1 17.0 22.3 7 31.5 72 82.8 54 256.9 24 142.1 7 24.5 57 1 9.9 1 4.5 2 6 6.9 4 5 23.8 6 Early -----------------------------Echols -----------------------------Effingham ---------------------Elbert ------------------------------- Emanuel -------------------------- 18,679 2,964 9,646 19,618 23,517 5.4 2 20.7 5.1 5.4 4 41.5 5 21.3 3 16.1 54 559.8 9 45.9 13 55.3 5.4 3 31.1 Evans Fannin -----------------------------Fayette --------------------------Floyd ---------------------------------- 7,401 14,752 8,170 56,141 Battey Gen. HospitaL Forsyth -------------------------- 11,322 Franklin -------------------------- 15,612 Fulton ----------------------------- 392,886 2 27.0 13.5 2 27.0 4 27.1 6.8 39 264.4 12.2 13 159.1 3 5.3 182 324.2 372 662.6 5 8.8 2 17.7 1 8.8 3 19.2 8 51.2 75 480.4 42 10.7 2774 706.1 1363 346.9 13.5 1.8 6.4 5 1.3 Fort McPherson ------ NAS-Ga. Tech -------- 3 At!. Army Air Base____ Gilmer -----------------------------Glascock ---------------------------Glynn ------------------------------- NAS-St. Simons ----- NAS-Giynco ------------- Gordon -----------------------------Grady -------------------------------- 9,001 4,547 21,920 18,445 19,654 4.6 3 15.3 1 11.1 1 22.0 33 11 59.6 38 193.3 1 11.1 2 44.0 23 104.9 71 384.9 6 30.5 1 4.6 2 10.8 158 Georgia Department of Public Health NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION oF SPECIFIED NoTIFIABLE DisEASES REPORTED IN GEORGIA BY CouNTIEs, 1944 Area Census Population* Diphtheria Cases Rate Gonorrhea Cases Rate Influenza Cases Rate Malaria Cases Rate Greene -------------------------Gwinnett ----------------------- ~abersham -----------------Hall --------------------------------Hancock Haralson Harris ----------------------------Hart ______ -------------------------Heard -------------------------------Henry ----------------------------Houston ____ -------------------- Robins Field _ 13,709 29,087 14,771 34,822 12,764 14,377 11,428 15,512 8,610 15,119 11,303 Irwin ------------------------------- Jackson ---------------------- Jasper Jeff Davis -------------------- Jefferson -------------------- Jenkins ------------------- Johnson ------------------------JOnes ------------------------- Lamar -------------------------Lanier Laurens -----------------------Lee ---------------------------------- Liberty 12,936 20,089 8,772 8,841 20,040 11,843 12,953 8,331 10,091 5,632 33,606 7,837 8,595 Camp Stewart -------- Lincoln ----------------- Long ---------------------------Lowndes ------------- 7,042 4,086 31,860 Moody Field -------- Lumpkin ------------------ 6,223 Macon ------------------------Madison -----------------------Marion ------------------------McDuffie ------------ Mcintosh ------------------- Meriwether -------------Miller -----------------Mitchell ------------------ Monroe -------------Montgomery ------------Morgan -------------Murray ------------------Muscogee -------------------- Newton -------------------- Oconee -------------------Oglethorpe ----------------- 15,947 13,431 6,954 10,878 6,292 22,055 9,998 23,261 10,749 9,668 12,713 11,137 75,494 18,676 7,576 12,430 11 37.8 11 80.2 175 1276.5 12 41.3 13 44.7 21 60.3 1 7.8 1 7.0 2 17.5 3 26.5 6 40.6 63 180.9 5 39.2 5 33.1 10 88.5 11 74.5 169 485.3 152 1190.8 3 20.9 8.8 27 174.1 2 23.2 2 13.2 5 44.2 212 3 16 123.7 6 29.9 3 34.2 2 10.0 4 45.6 1 5.0 s 34.2 2 10.0 2 16.9 1 7.7 12 59.9 17 143.5 3 36.0 43 214.6 14 118.2 23 177.6 2 24.0 2 35.5 5 14.9 3 34.9 1 17.8 37 110.1 24 306.2 43 500.3 7 69.4 1 17.8 8 23.8 7 89.3 13 151.3 304 209 9 28.2 3 18.8 12 37.7 64 2 32.1 41 257.1 1 25.5 47 147.5 44 78 1253.4 2 12.5 3 22.3 2 18.4 2 18.4 1 9.2 3 56.7 10 45.3 80 362.7 3 30.0 3 30.0 1 4.3 38 163.4 8 34.4 1 9.3 11 102.3 1 10.3 3 31.0 4 31.6 10 78.7 105 826.9 1 9.0 1 9.0 1 9.0 33 43.7 524 694.1 26 34.4 3 16.1 6 32.3 1 13.2 2 16.1 1 13.2 86 691.9 3.4 6.4 1 6.6 8.8 9 5 38.7 1 6.0 2 10.0 4 33.8 4 30.9 3 8.9 17 216.9 1 11.6 73 3.1 1 16.1 3 18.8 1 4.5 1 10.3 4 6.3 Preventable Diseases 159 NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1944 Area Census Population Diphtheria Cases Rate Gonorrhea Cases Rate Influenza Cases Rate Malaria Cases Rate Paulding ------------------------- Peach ------------------------------- Pickens ---------------------------- Pierce -------------------------------- Pike ---------------------------------- Polk ------------------------ Pulaski ---------------------------- Putnam 12,832 10,378 9,136 11,800 10,375 28,467 9,829 8,514 2 19.3 2 21.9 5 42.4 9.6 3 10.5 7.8 39 375.8 3 32.8 8 67.8 3 28.9 29 101.9 30.5 2 23.5 8 62.3 1 9.6 70 766.2 10 84.7 168 1619.3 447 1570.2 1 10.2 6 70.5 6 57.8 10.9 3 10.5 10.2 Quitman -------------------- 3,435 Rabun -------- ----------------------Randolph -------------------------Richmond .. --------------------- 7,821 16,609 81,863 Oliver Gen. Hosp ......... Camp Gordon -----------Ga. Aero Tech .............. Camp Hancock ---------Daniel Field ---------------- 12.8 1 12.8 2 12.0 1 6.0 38 228.8 7 8.6 669 817.2 185 226.0 124 555 182 12.8 4 4.9 Rockdale 7,724 6 77.7 34 440.2 Schley ------------------------------ Screven ... -------------- Seminole Spalding -------------------------- Stephens Camp Toccoa ... Stewart Sumter ------------------- Souther Field ------------ Talbot ... Taliaferro Tattnall Taylor Telfair Terrel! Thomas ---------------------------------------- Finney Gen. Hosp..... Tift ----- -----------------------------Toombs ---------------------------- Camp Toombs ------------ Towns ----------------------------- Treutlen -------------------- Troup ------------------------------ Turner --------------------------- Twiggs ---------------------------- 5,033 20,353 8,492 28,427 12,972 10,603 24,502 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 19.9 4.9 50 245.7 11.8 4 14.1 145 510.1 4 30.8 7 54.0 7 139.1 9 44.2 20 235.5 3 10.6 3 23.1 1 9.4 14 57.1 53 216.3 2 18.9 179 730.6 3 18.5 8 52.8 2 12.0 5 16.0 5.4 5.9 8 49.3 6 39.6 6.0 30 95.9 11 30 161.3 5 29.5 2 24.6 3 47.8 5 30.8 3 27.9 2 13.2 1 6.0 11 35.2 4 21.5 4 23.6 9 20.5 11.0 3 39.3 53 120.8 9.2 5 54.8 3 39.3 276 629.0 6 55.3 12 131.6 14.7 24 282.6 3 10.6 9.4 4.1 6.2 1 6.0 1 3.2 2 2 4.6 7 76.8 160 Georgia Department of Public Health NuMBER OF CASES AND CASE RATE PER 100,000 PoPuLATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1944 Area Census Population* Diphtheria Cases Rate Gonorrhea Cases Rate Influenza Cases Rate Malaria Cases Rate Union -------------------------------Upson ----------------------------Walker --------------------------- Walton ---------------------------Ware ------------------------------- Waycross A.A. Base.. Warren --------------------------Washington -------------------Wayne -----------------------------Webster ---------------------------Wheeler ---------------------------White -------------------------------Whitfield -----------------------Wilcox ----------------------------- Wilkes ----------------------------Wilkinson ---------------------Worth ---------------------------- 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 3 39.1 2 8.0 4 14.3 2 8.3 10 76.2 5 105.8 7 109.1 4 15.3 1 7.8 3 19.9 7 32.8 1 4.0 28 90.3 18 86.6 48 171.9 22 1 9.8 6 24.8 22 167.7 1 15.6 143 547.8 6 47.0 8 53.0 47 219.9 117 1523.4 4 16.0 10 32.2 13 62.6 68 243.5 3 29.3 108 445.7 6 127.0 6 70.3 1 15.6 5 19.2 153 1199.5 384 2545.7 7 63.5 3 14.0 4.8 4 11 45.4 7.6 46 360.6 9.1 Preventable Diseases 161 NuMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1944 Area Measles Meningococcus Meningitis Pneumonia Cases Rate Cases Rate Cases Rate Poliomyelitis Scarlet Fever Cases Rate Cases Rate State Total ..............6239 199.7 215 6.9 2524 80.8 104 3.3 997 31.9 Rural ........................3539 171.6 77 3.7 1268 61.5 54 2.6 296 14.4 Cities 2500-5000 --- 220 162.1 7 5.2 127 93.6 4 2.9 46 33.9 Cities 5000 & Abv. 2257 243.7 122 13.2 913 98.6 44 4.8 638 68.9 Military Resvns. ---- 223 Appling -------------------- 6 Atkinson ------------------ 1 Bacon ----------------------- -----Baker ------------------------ ------ Baldwin ------------------ 125 41.4 14.1 761.7 USN Train. Sch. ------ Banks ----------------------- Barrow --------------------- 33 Bartow ---------------------- ------ Ben Hill ----------------- 1 Berrien -------------------- ------ Bibb ----------------------...----- 736 ll.5 252.6 6.9 878.5 H. Smart Airport 4 Cochran Field ------ ------ Camp Wheeler ---- 28 Bleckley -------------------- 19 196.8 Brantley ------------------- ------ Brooks -------------------- 3 14.6 Bryan ------------------------ 108 1717.6 Bulloch ---------------------- 17 65.4 Burke ------------------------ 6 22.6 Butts ------------------------ ---- Calhoun ----------------- 2 19.2 Camden ---------------------- 16.9 Candler ---------------------------- Carroll ---------------------. 12 35.1 Catoosa ------------------- 19 174.3 Fort Oglethorpe.... ll9 Charlton ---------------- 9 171.2 Chatham -------------------- ll5 97.5 USN Section Base _____ Fort Screven -----------Sav. Air Base______ ----- Chattahoochee ---------- ----- Fort Benning ------ ----- Chattooga --------------- 10 54.0 Cherokee ------------------ 181 899.3 Clarke ----------------------- 110 387.4 USN Pref. Sch..._ ---- Clay ------------------- ------ 9 216 22 151.8 3 42.3 8 98.8 3 40.8 20 121.9 1 11.5 4.0 1 6.5 ll 13.1 4 45.8 8 61.2 12 47.5 ll 75.7 6 39.0 55 65.6 7 14.6 1 9.6 28 13 134.6 3 43.7 5 24.4 18 286.3 50 192.2 25 94.3 3 32.7 2 19.2 9 152.3 17 49.8 1 9.2 6 55.1 3 106 1 19.0 8 152.2 35 29.7 138 ll7.0 4 14.1 1 19.5 10 54.0 20 99.4 17 59.9 2 28.3 2 17 6.9 1 14.1 2 12.2 11.5 4 24.4 4 27.6 6.5 3 3.6 80 95.5 6 2 5.9 2 18.4 1 19.0 6 5.1 1 9.6 16.9 2.9 3 27.5 1 19.0 42 35.6 3 10.6 1 5.4 ll 38.7 162 Georgia Department of Public Health NuMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIES, 1944 Area Menin&oeoceus Measles Meningitis Pneumonia Cases Rate Cases Rate Cases Rate Poliomyelitis Scarlet Fever Cases Rate Cases Rate Clayton --------------------- -----Clinch -------------------- ----Cobb --------------------- 66 Coffee ------------------- 5 A.A.F.F.T.D. -------- ------ Colquitt -------------------- 41 Spence Field -------- ----- Columbia -----------------------Cook ------------------------- 2 Coweta -------------------- ----Crawford ----------------- 3 Crisp ----------------------- 3 Dade -------------.,.-------- -----Dawson -------------------- 1 Decatur ---------------------- so A.A.F.B.F!y.Sch. 7 DeKalb ----------- 123 Lawson Gen. Hsp. 10 U.S.N. Air Base ----Dodge --------------------- 1 Doolt ----------------------- -----~ Dougherty -------------- 54 Turner Field -------- 8 Darr Aero Tech. ------ Douglas ------------------- 4 E a r l y ------------------------~ 2 Echols ------ -------------------~ Effingham ---------------- 11 Elbert ------------------------ 4 Emanuel -------------------- ------ Evans ------------------------ ------ Fannin ---------------------- 5 Fayette ------------------- 6 Floyd ---------..-------- 228 Battey Gen. Hosp. ------ Forsyth -------------------- 3 Franklin ------------------ -----Fulton --------------------- 599 Fort McPherson____ ----NAB-Ga. Tech____ ----- At!. Army Air B. ----- Gilmer --------------------- 1 Glascock ------------------- ----- Glynn ----------------------- 582 NAB-St. Simons _____ NAB-Glynco --- 1 Gordon ------------------ 96 172.4 23.2 124.2 16.8 42.1 17.1 22.3 359.8 141.5 4.8 189.0 39.8 10.7 114.0 20.4 33.9 73.4 406.1 26.5 152.5 11.1 2655.1 520.5 1 8.6 1 15.5 1 2.6 1 4.6 3 9.1 2 7.4 2 11.4 2 33.9 1 4.5 1------ 3 3.5 2 1 4.8 10 35.0 1 1 10.4 3 5.3 35 8.9 1 11.1 22 100.4 7 60.1 32 83.6 16 74.3 16 48.5 9 95.4 4 33.6 11 40.8 6 84.2 4 22.8 4 67.9 1 22.3 20 90.0 50 57.5 33 10 47.6 11 65.1 30 105.0 5 49.7 4 21.4 9 93.3 11 56.1 9 38.3 1 13.5 13 88.1 6 73.4 124 220.9 1 8.8 4 25.6 254 64.6 11.1 4 88.0 72 328.5 11 59.6 2 17.2 2 9.3 1 8.6 43 112.4 4 18.6 2 6.1 1 8.4 2 7.4 4 22.8 1 17.0 1 4.5 8 9.2 125 143.8 5 4 14.0 2 7.0 1 12.2 3 5.3 23 41.0 16 4.1 295 75.1 1 11.1 4.6 1 22.0 16 73.0 2 10.8 Preventable Diseases 163 NuMBER OF CASES AND CASE RATE PER 100,000 PoPuLATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1944 Area Meningococcus Measles Meningitis Pneumonia Cases Rate Cases Rate Cases Rate Poliomyelitis Scarlet Fever Cases Rate Cases Rate Grady -------- ----Greene ----------------- 15 109.4 Gwinnett ----------- 15 51.6 1 5.1 7.3 1 3.4 Habersham --------------- 2 13.5 Hall --------------------- 204 585.8 Hancock ------------- 2 15.7 Haralson ---------- 7.0 Harris ---------------- ---- Hart ------------------- ----- Heard ----------------- 11.6 Henry --------------- 1 6.6 Houston -------- 223 1972.9 2 13.5 1 2.9 Robins Field ------ 30 Irwin ---------------- 2 15.5 Jackson ------------- 142 706.9 Jasper ---------------------- 6 68.4 Jeff Davis ---------------- ------; Jefferson -------------- 12 59.9 Jenkins ----------------- 10 84.4 Johnson ----------------- 5 38.6 Jones ------------------- 11 132.0 Lamar --------------- ------ Lanier --------------- 1 17.8 Laurens --------------- --- Lee --------~-~----- 2 25.5 Liberty -------------- 4 46.5 1 9.9 Camp Stewart ---- 11 2 Lincoln ------------------ ___. Long --------------------------- Lowndes ---------- 13 40.8 Moody Field -- 4 Lumpkin -------------- 82 1317.7 16.1 Macon --------------- 18 112.9 ' Madison --------------- ------ Marion --------------- ---- McDuffie ---------- 10 91.9 Mcintosh -------------- 21 396.8 Meriwether ----------- 1 4.5 Miller --------------------- 1 10.0 Mitchell ----------------- ------ 3 12.9 Monroe ------------------- ---- Montgomery ------------ Morgan 31 ----~------------- 243.8 Murray -------------- 1 9.0 Mllllcogee ----------- 106 140.4 10 13.2 Newton ------------ 1 5.4 Oconee --------------- 2 26.4 5 25.4 11 80.2 10 34.4 3 20.3 15 43.1 11 86.2 6 41.7 6 52.5 12 77.4 7 81.3 9 59.5 19 168.1 10 5 38.7 8 39.8 7 79.8 10 113.1 7 34.9 28 236.4 5 38.6 5 60.0 12 118.9 17.8 13 38.7 6 76.6 11.6 30 24.5 18 56.5 1 16.1 14 87.8 5 37.2 5 71.9 8 73.5 7 132.3 23 104.3 4 40.0 10 43.0 8 74.4 6 62.1 11 86.5 11 98.8 173 229.2 6 32.3 3 39.6 1 5.1 7 51.1 14 48.1 2 5.7 52 149.3 7.0 8.8 8.8 2 7.7 5.0 4 35.4 1 11.4 7 34.9 1 8.4 12.0 3.0 2 23.3 1 24.5 12 37.7 1 3 27.6 1 4.5 4.5 4.3 9.3 8 23.8 6 7.9 36 47.7 164 Georgia Department of Public Health NUMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1944 Area Meningococcus Measles Meningitis Pneumonia Cases Rate Cases Rate Cases Rate Poliomyelitis Searlet Fever Cases Rate Cases Rate Oglethorpe -------------- 48 Pauldi Peach n g____-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-., ----- 19 Pickens ---------------- 78 Pierce ----------------------- 9 Pike --------------------------- 81 Polk -------------------------- 166 Pulaski ------------------- ---- Putnam --------------------- ----- Quitman ------------------- ---- Rabun --------------------- 12 Randolph ------------------ 9 Richmond --------------- 43 Oliver Gen. Hosp. ----Camp Gordon ----- ----Ga. Aero Tech.... ----Camp Hancock.... ----Daniel Field ------- ----- Rockdale ------------- 11 Schley ---------------------- 1 Screven --------------------- 20 Seminole ------------------ 1 Spalding ------------------ ---Stephens ------------------- ----- Camp Toccoa ------ ------ Stewart -------------------- ----Sumter -------------------- 12 Souther Field ----- ------ Talbot ---------------------- ---Taliaferro --------------- ----Tattnall -------------------- 1 Taylor --------------------- ----Telfair -------------------- 1 Terrell ---------------------- ------ Thomas --------------------- 26 Finney Gen. Hsp. ------ Tift --------------------Toombs ------------------ ----- Camp Toombs_____ ------ Towns ------------------------ ----- Treutlen ---------------- -----Troup --------------------- 91 Turner --------------------Twiggs --------------------- 1 Union ------------------ 20 Upson ----------------------- 17 Walker ----------------- 25 386.2 183.1 853.8 76.3 780.7 548.0 153.4 64.2 62.5 142.4 19.9 98.3 11.8 49.0 6.2 6.6 83.1 5.4 207.4 9.2 11.0 260.4 67.8 80.6 1 8.0 11 88.5 1 7.8 1 9.6 22 212.0 4 43.8 6 50.8 28 269.9 21 73.8 6 50.9 6 70.6 1 12.8 6 36.1 5 6.1 69 84.3 11 142.4 1 19.9 12 69.0 2 23.6 2 7.0 22 77.4 3 23.1 3 12.2 6 66.6 9 36.7 6 73.7 1 16.9 6.2 7 43.1 6 46.4 4 26.4 15 90.0 17 64.3 2 10.8 6.9 6 26.9 3 17.7 5 11.4 2 18.4 13.0 2 8.0 1 3.2 3 39.3 38 86.6 6 46.1 4 43.9 17 221.4 10 40.0 10 32.2 1 8.5 10.2 2 19.3 7 24.6 6.0 2 2.4 55 67.2 2 7.0 3 69.6 6 24.6 2 7.0 1 4.1 1 6.0 6.0 z 6.4 1 2 4.6 10 22.8 2 21.9 2 6.4 1 3.2 Preventable Diseases 165 NuMBER OF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASEs REPORTED IN GEoRGIA BY CouNTIES, 1944 Area Meningococcus Measles Meningitis Pneumonia Cases Rate Cases Rate Cases Rate Poliomyelitis Scarlet Fever Cases Rate Cases Rate Walton - 366 1761.6 Ware ------------------------ 9 32.2 Waycross A.A.Bse. 1 Warren --------------------- ----Washington ---------------- 56 231.1 Wayne ---------------------- ---Webster ---------------- 14 296.2 Wheeler ----------------- 8 93.7 White --------------------- 20 311.7 Whitfield - 350 1340.7 Wilcox ------------------ 26 203.8 Wilkes -------------------- 87 576.8 Wilkinson --------------- 8 72.6 Worth ------------------ 7 32.8 4.8 3.6 6 45.7 3.8 1 6.6 1 4.7 7 33.7 11 39.4 1 3 29.3 20 82.5 10 76.2 4 84.6 2 23.4 1 15.6 7 26.8 6 47.0 21 139.2 11 99.8 14 65.6 2 9.6 12 43.0 4 7 28.9 4 30.5 7 109.1 3.8 14 63.6 1 7.8 34 226.4 4.7 166 Georgia Department of Public Health NuMBER OF CAsEs AND CAsE RATE PER 100,000 PoPuLATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEoRGIA BY CouNTIEs, 1944 Area Whoopin.r Syphilis Tuberculosis Typhoid Fever Typhus Fever Cough Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate State Total ............13954 446.7 Rural ------3924 Cities 2500-5000 ...... 615 Cities 5000 & Abv. 8816 Military Resvns. ____ 599 190.3 453.3 952.1 Appling ------------- 35 Atkinson ------------- ...... Bacon ------------- ______ Baker -------------------- 1 Baldwin ------------- 84 USN Train. Sch. - 241.4 13.6 511.9 Banks --------------------- Barrow ------------ 3 Bartow ---------- 8 Ben Hill ----------- 1 Berrien ------------- 5 Bibb ------------------- 711 H. Smart Airpoi:i; 3 Cochran Field ___ ---- Camp Wheeler - 79 11.5 23.0 31.6 6.9 32.5 848.6 Bleckley ---------- 28 Brantley -------------- ---Brooks ------------- 61 Bryan ------------- 4 Bulloch -------- 91 Burke ------------ 240 Butts ----------------- 2 Calhoun -------- 81 Camden 1 Candler 1 Carroll 4 Catoosa ------ 7 Fort O.rlethorpe__ 175 290.0 297.6 63.6 349.9 905.0 21.8 776.0 16.9 11.0 11.7 64.2 Charlton ----- 1 Chatham --------2634 USN Section Base _ Fort Screven -- _ Sav. Air Base_ __ Chattahoochee ___ 2 Fort Benning __ 1 Chattooga ___ _ 19.0 2232.8 38.9 Cherokee - - - - 3 Clarke - - - - - 338 USN Pret. SehJ.__ - Clay --------- _ Clayton - - - - - 14.9 1190.2 2608 1098 164 1294 52 7 4 9 2 24 9 32 8 3 134 13 2 5 5 11 16 9 5 3 8 22 12 9 3 168 20 2 23 3 8 83.5 53.2 120.9 139.7 48.3 56.4 111.2 27.2 146.2 68.9 126.6 55.1 19.5 159.9 20.7 24.4 79.5 42.3 60.3 98.0 47.9 50.8 87.9 64.4 110.1 57.1 142.4 77.9 107.9 9.9 81.0 42.5 68.6 177 122 16 39 1 3 3 4 1 1 1 1 5 5 1 1 5.7 1182 37.8 5.9 548 26.6 11.8 166 122.3 4.2 459 49.6 9 36 248.3 14.1 4 56.4 2 24.7 13.6 3 40.8 1 7.7 11.9 3 11.9 20.7 9 62.0 4.8 59 70.4 1 5 51.8 1 14.6 4.9 9 43.9 15.9 4 63.6 3.8 38 146.1 3.8 10 37.7 13 124.5 7 76.9 2.9 1 2.9 1 19.0 4.2 141 119.5 27.0 5.0 1 5.0 4 14.1 14.2 1 14.2 792 25.4 509 24.7 20 14.7 254 27.4 9 20 138.0 21 128.0 2 15.3 25 98.9 6.5 47 56.1 9 9 93.2 1 4.9 1 a.s 1 3.8 1 9.6 1 11.0 30 25.4 30 149.1 19 66.9 Preventable Diseases 167 NuMBER OF CAsEs AND CAsE RATE PER 100,000 PoPULATION oF SPECIFIED NoTIFIABLE DisEASES REPORTED IN GEORGIA BY CouNTIES, 1944 Area Syphilis Cases Rate Whooping Tuberculosis Typhoid Fever Typhus Fever Cough Cases Rate Cases Rate Cases Rate Cases Rate Clinch ----------- 2 Cobb -------- 279 Coffee --------- 121 A.A.F.T.D. ------- Colquitt ----------- 115 Spence Columbia Field --- ____________ ., -__-_ ., Cook -------------------- 2 Coweta ---------------- 2 Crawford ----------------- Crisp ----------------- 95 Dade ----------------------Dawson ---------- 1 Decatur -------------- 3 A.A.F.B.Fly.Sch. 4 DeKalb ---------- 164 Lawson Gen. Hsp. 30 U.S.N. Air Base-- Dodge ---------- 47 Dooly -------------- 5 Dougherty ---------- 12 Turner Field -- 9 Darr Aero Tech..______ Douglas -------- 4 Early ---------- 4 Echols -------------- ----- __________ Effingham Elbert ---------,. --8- Emanuel ---------- 5 Evans ----------- ---- Fannin ---------- ---Fayette ------- 5 Floyd ----------- 230 Batte)' Gen. Hsp. 1 Forsyth ------- Franklin -----. 1 - - Fulton - .3865 Fort McPherson NAs-Ga. Tech_- At!. Army Air B. - Gilmer ------ _ Glascock ---- 1 Glynn - - - - - 20 NAB-St. Simona_ - NAs-Gl:vnco 1 Gordon ------ 10 31.1 729.0 561.7 348.4 16.8 7.4 541.6 22.3 13.5 188.6 223.6 29.6 42.0 39.8 21.4 82.9 21.8 61.2 409.7 6.4 983.7 22.0 91.2 54.2 4 62.1 29 75.8 6 27.9 13 39.4 2 21.2 8 67.1 18 66.7 4 56.1 21 119.7 4 67.9 24 107.9 66 64.4 18 11 52.3 14 82.9 31 108.6 1 4 39.8 5 26.8 5 51.8 7 36.7 7 29.8 1 13.5 10 67.8 5 61.2 38 67.7 1 1 8.8 9 57.6 489 124.5 2 22.2 1 22.0 35 159.7 16 86.7 15.5 1 2.6 2 9.3 1 15.5 4 10.5 9 41.8 3.0 . 20 60.6 1 10.6 5 18.5 1 17.0 7 58.7 22 125.4 2 44.7 12 54.0 1.2 6 6.8 2 9.5 3 29.8 2 10.7 1 6.1 2 8.6 1 6.8 1 1.8 2 17.7 15 3.8 24 114.2 13 77.0 12 42.0 2 17 91.0 8 82.9 4 17.0 10 135.1 1 12.2 70 17.8 4 44.4 1 22.0 1 4.6 1 5.4 29 132.8 1 26 67.9 5 23.2 6.7 40 179.9 8 9.2 1 4.8 1 10.4 15 76.5 2 8.6 3 26.5 1 6.4 31 7.9 2 22.2 4 18.2 168 Georgia Department of Public Health NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DisEASEs REPORTED IN GEORGIA BY CouNTIEs, 1944 Area Syphilis Cases Rate Whooping Tuberculosis Typhoid Fever Typhus Fever Cough Cases Rate Cases Rate Cases Rate Cases Rate Grady ---------------------- 88 Greene ...................... 46 Gwinnett .................. 22 44 7. 7 335.5 75.6 Habersham .............. 4 Hall ............................ 61 Hancock .................... 13 Haralson .................. 2 Harris ------------ 51 Hart ------------ -----Heard ----------------------- ----Henry ------------------------ 3 Houston -------------------- 8 Robins Field -------- 76 27.1 175.2 101.8 13.9 446.3 19.8 70.8 Irwin ------------------------ ------ J ackaon ------------------- ____ Jasper ------------------------ 2 Jeff Davia --------------- ---- Jefferson ----------- 125 22.8 623.8 Jenkins ------------ 123 1038.6 Johnson -------- 3 23.2 Jones -------- 26 312.1 Lamar -------- 2 19.8 Lanier --------- 1 17.8 Laurena ---- 188 569.4 Lea --------------- 3 38.3 Liberty ---------- 15 174.5 Camp Stewart .... 40 Lincoln ---------- ...... Long ------- 2 48.9 Lowndes -------- 5 15.7 Mood:v Field ........ 17 Lumpkin -------- ___ Macon -------- 19 Madison ------------- 2 Marion ------- 1 McDuffie --------- 1 Mcintosh --------- 8 Meriwether ------- 40 Miller ------------- 1 Mitchell ------------ 90 Monroe -------- 3 Montgomery ------ --- Morgan ----------- 1 Murray -------------- 1 Muscogee -------- 840 Newton ------------ 2 119.1 14.9 14.4 9.2 151.2 181.4 10.0 386.9 27.9 7.9 9.0 1112.7 10.8 Oconee ------------- ----- 6 30.5 15 109.4 22 75.6 11 74.5 12 34.5 7 54.8 4 27.8 4 35.0 3 19.3 3 34.8 5 33.1 13 115.0 7 2 15.6 10 49.8 3 34.2 5 56.6 21 104.8 10 84.4 5 38.6 10 120.0 8 79.3 2 35.5 27 80.3 6 76.6 18 151.3 2 1 14.2 1 24.6 30 94.2 2 32.1 12 75.2 6 44.7 2 28.8 5 46.0 3 66.7 14 63.6 3 30.0 12 61.6 10 93.0 6 51.7 u. 110.1 9 80.8 74 98.0 10 63.8 3 39.6 5 25.4 7.3 2 6.9 4 11.6 1 7.0 2 10.0 2 10.0 8.4 3 23.2 1 12.0 1 14.2 1 3.1 10 160.7 1 9.2 3 13.6 2 8.6 1 7.9 1 9.0 2 2.6 2 26.4 21 106.8 7.3 3.4 1 6.8 8 23.0 1 6.6 2 17.7 3 23.2 1 11.4 4 45.2 6 42.2 6 38.6 2 24.0 1 9.9 27 80.3 1 12.8 1 11.6 5 122.4 14 43.9 3 18.8 3 43.1 2 18.4 1 4.5 3 30.0 12 51.6 1 9.3 6 62.1 1 7.9 1 9.0 7 9.3 5.4 7.3 4 13.8 3 20.3 8.8 2 12.9 3 19.8 8.8 5.0 11.4 4 20.0 6 50.7 7 84.0 1 3.1 2 28.8 3 56.7 4 18.1 4 17.2 7.9 31 41.1 1 5.4 1 13.2 Preventable Diseases 169 NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1944 Area Syphilis Cases Rate Whoopinc Tuberculosis Typhoid Fever Typhus Fever Cough Cases Rate Cases Rate Cases Rate Cases Rate Oglethorpe 8.0 Paulding ----------------- ----- Peach ------------------------ 120 Pickens ---------------------- 2 Pierce ----------------------- 3 Pike --------------------------- 1 Polk -------------------------- 12 Pulaski --------------------- ----Putnam -------------------- 1 1156.3 21.9 26.4 9.6 42.2 11.7 Quitman ------------------- 2 58.2 Rabun ------------------------ ----Randolph ---------------- 1 6.0 Richmond ---------------- 493 602.2 Oliver Gen. Hoap. 22 Camp Gordon ---- 108 Ga. Aero Tech...._-- Camp Hancock -------- Daniel Field ------ 24 Rockdale -------------------- Schley -------------------- 3 Screven ------------------ 167 Seminole n- 2 Spa~ding ----- 126 Stephens ------------------ 1 59.6 820.5 23.6 443.3 7.7 Camp Toeeoa -- -- Stewart --------------- 3 28.3 Sumter -- 224 914.2 Souther Field --------- Talbot -------------------- 1 12.3 Taliaferro ------------- -----Tattnall ---------------- 4 24.6 Taylor --------------- 2 18.6 Telfair -------------------- 32 211.3 Terrell ---------------------- 82 491.8 Thomas -------------- 23 73.5 Finney Gen. Hsp. 5 Tift ------ 245 1317.3 Toombs --------------- 3 17.7 Camp Toombs ------- Towns ---------------- ---- Trent!en -------------- 1 13.1 --- Troup -------- 201 458.1 Turner ------------------- Twiggs -------------- 5 54.8 Union Upson ----------------------------. ------ 7 56.3 3 23.4 14 134.9 6 65.7 2 16.9 4 38.6 24 84.3 6 61.0 2 23.5 2 58.2 12.8 11 66.2 131 160.0 1 12.9 18 88.4 35 123.1 6 46.3 6 56.6 22 89.8 2 24,6 3 47.8 16 98.5 1 9.3 6 39.6 12 72.0 17 54.3 17 91.4 10 59.0 2 40.6 13.1 36 82.0 5 46.1 5 54.8 1 13.0 34 135.7 9.6 10.9 8.5 1 9.6 6 17.6 1 8.0 13 125.3 11 93.2 9.6 8 81.4 7.8 3 32.8 2 7.0 11.7 4 24.1 5 6.1 6 36.1 50 61.1 16 96.3 85 103.8 12.9 1 11.8 17 337.8 24 117.9 23 270.8 4 14.1 3 59.6 3 14.7 100 1177.6 3 10.6 2 18.9 5 20.4 4 37.7 22 89.8 2 8.2 1 6.0 2 6.4 3 16.1 21 129.3 9 83.6 18 118.9 40 289.9 15 47.9 1 22 118.3 12 70.8 2 31.9 6 19.2 8 18.2 4 52.1 1 4.0 2 26.2 2 18.4 3 32.9 3 12.0 31 70.6 9.2 170 Georgia Department of Public Health NUMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1944 Area Syphilis Cases Rate Tuberculosis Typhoid Fever Typhus Fever Cases Rate Cases Rate Cases Rate Whoopinc Couch Cases Rate Walker -------------------- 6 Walton -------------------- 62 Ware ------------------------- 47 Waycross A.A. B. 4 Warren ------------------- ----- Washington ----------- 94 Wayne ---------------------- 60 Webster ------------------- 2 Wheeler ------------------ 2 White -----------------------------Whitfield ---------------- 64 Wilcox ------------------------ 4 Wilkes --------------------- 63 Wilkinson -------------- 6 Worth ----------------------- 66 16.1 298.4 168.3 387.9 381.0 42.3 23.4 206.9 31.4 417.7 45.4 262.0 40 128.9 21 101.1 26 89.6 7 68.4 12 49.6 17 129.6 1 21.2 1 11.7 6 93.6 38 146.6 7 54.9 7 46.4 9 81.6 12 66.1 4.8 1 4.1 -21.2 1 11.7 2 6.4 8 38.6 13 46.6 2 9 37.1 14 106.7 8 93.7 1 4.8 4 14.3 1 4.1 7 64.9 26 203.8 1 6.6 69 391.1 1 9.1 1 9.1 2 9.4 11 61.5 2 9.4 Preventable Diseases 171 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, 1944 Area Diphtheria Gonorrhea Influenza Malaria Population Cases Rate Cases Rate Cases Rate Cases Rate TOTAL ---------------------925,970 147 15.9 4182 451.6 2766 298.7 Albany ------------- Americus --------- Athens -----... Atlanta (DeKalb) Atlanta (Fulton) 19,055 9,281 20,650 28,994 273,294 21 110.2 6 31.5 6 64.6 8 86.2 7 76.4 1 4.8 13 63.0 7 33.9 1 3.4 6 20.7 2 6.9 27 9.9 2634 963.8 1216 444.9 Augusta----- Bainbridge ------ Brunswick --------- Carrollton ----~ Cartersville --------- Cedartown ---------- College Park ------ Columbus ---------- Cordele -------------- Dalton ----------- Decatur ----Douglas ---- Dublin -------- East Point ----- Elberton -----.. Fitzgerald Gainesville -__-_-__-_-_-,. 65,919 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 7,388 10,243 6 7.6 442 670.5 183 277.6 15.7 2 31.5 1 15.7 1 6.7 12 79.8 2 32.2 4 64.4 1 16.1 4 65.1 2 32.6 1 11.1 25 277.0 115 1274.2 3 36.5 15 182.6 76 925.4 25 46.9 104 195.2 14 26.3 1 12.6 44 554.9 10 126.1 1 9.6 128 1225.1 6 47.9 2 12.1 9 54.3 1 6.0 75 1449.3 7 135.3 12.8 6 76.8 21 169.3 4 32.3 1 16.2 2 27.1 1 13.5 7 68.3 35 341.7 103 1005.6 Griffin ---------- Hapeville -------LaGrang~ ------ :Macon ----------:Marietta ------- :Milledgeville ------- Moultrie Newnan ----- Rome Savannah ----- Statesboro ------ Thomaston -----Thomasville ----Tifton ---------Toccoa ------Valdosta ----Wa:veross - - - - 13,222 5,059 21,983 67,865 8,667 6,778 10,147 7,182 26,282 95,996 6,028 6,396 12,683 5,228 5,494 15,595 16,763 3 22.7 107 809.8 4 79.1 3 69.8 4 18.2 31 141.0 24 41.5 32 65.3 7 80.8 27 311.6 10 147.5 5 49.3 16 167.7 1 7.6 29 573.2 11 50.0 8 13.8 2 23.1 17 250.8 8 78.8 2 7.6 30 114.1 54 205.5 258 268.8 756 787.5 11 218.8 1 16.6 1 15.6 3 46.9 1 7.9 8 63.1 7 65.2 15 286.9 1 19.1 3 64.6 2 36.4 6 38.5 8 61.8 15 96.2 3 17.9 42 260.6 62 369.9 51 5.6 4 1.6 4 6.1 1 16.7 1 6.7 3 38.2 2 3.8 1 12.6 5 80.2 3 3U 1 7.6 1 14.8 18 177.4 1 8.8 2 2.1 3 69.7 1 .., 172 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, 1944 Area Measles Cases Rate Meningococcus Meningitis Pneumonia Cases Rate Cases Rate Poliomyelitis Scarlet Fever Cases Rate Cases Rate TOTAL ------------------- Albany ------------ 41 Americus -------. 11 Athens --------------------- 6 Atlanta (DeKalb) .... 2 Atlanta (Fulton) .... 547 Augusta --------- 35 Bainbridge Brunswick ------ 516 Carrol,ton ----- 1 Cartersville ---- Cedartown ----- 122 College Park ............ Columbus ------- 74 Cordele --------~ Dalton ------------ Decatur --------- 9 Douglaa ---------- 4 Dublin ----------- East Point ...... 2 Elberton ---------- 2 Fitzgerald ........ Gainesville ----- 118 Griffin ----------. Hapeville u LaGrange ----- 17 Macon ---------- 302 Marietta ------~ 29 Mllledgeville _ 125 Moultrie -------- 19 Newnan ------ ---- Rome ------- Savannah 123 70 Statesboro ---' Thomaeton ----- Thomaeville 11 17 26 Tifton ------- ',l'oeeoa -____, Valdoata -------- 12 Wueroea 9 ~43.7 215.2 118.5 29.1 6.9 200.2 53.1 3432.0 16.1 1351.8 85.2 138.9 12.6 54.3 77.3 16.1 32.3 1152.0 77.3 521.9 334.6 1844.2 187.2 468.0 72.9 218.8 265.8 197.1 76.9 53.7 122 13.2 8 42.0 2 21.5 4 19.4 1 3.4 28 10.2 3 4.6 17 113.1 6 11.3 2 25.2 6.0 1 19.3 1 9.8 1 7.6 1 19.8 1 4.5 11 19.0 1 9.9 1 13.9 28 29.2 2 31.3 1 19.1 1 6.0 913 98.6 24 126.0 5 53.9 16 77.5 15 51.7 190 69.5 55 83.4 9 141.7 60 399.1 7 112.6 2 32.6 9 99.7 8 97.4 145 272.2 s 37.8 4 38.3 15 90.6 5 96.6 3 38.4 10 80.6 4 64.6 7 94.7 6 58.6 16 121.0 2 39.5 21 95.5 44 76.0 8 92.3 14 206.6 8 78.8 6 83.6 37 140.8 117 121.9 6 119.3 5 78.2 8 63.1 2 38.8 1 18.2 8 51.8 8 47.7 44 4.8 638 68.9 3 15.7 5.2 3 14.5 8 38.7 2 6.9 51 175.9 10 3.7 192 70.3 2 3.0 42. 63.7 1 6.7 2 32.2 12 79.8 16.1 12.2 3 5.6 12.6 2 12.7 1 11.1 s 36.5 23 43.2 11 105.3 55. 332.1 3 58.0 1 12.8 6 4U 1 9.8 2 15.1 1 4.5 3 5.2 2 29.5 1 13.9 2 7.6 2 2.1 3 40.6 18 175.7 1 7.6 14 276.7 9 40.9 76 181.3 82 369.2 4 59.0 2 19.'f 17 64.7 29 80.2 2 1&.8 9 57.7 12 71.8 Preventable Diseases 173 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, 1944 . Area Syphilis Cases Rate Whooping Tuberrulosis Typhoid Fever Typhus Fever Cough Cases Rate Cases Rate Cases Rate Cases Rate TOTAL ------------------- 8816 Albany ------------ 10 Americus ----- 28 Athens ----------- 41 Atlanta (DeKalb) ____ 5 Atlanta (Fulton) .... 3832 Augusta ------- 473 952.1 52.5 301.7 198.5 17.2 1402.2 717.5 Bainbridge. ---Brunswick -- Carrollton ____ Cartersville ---Cedartown ----- College Park ___ Columbus _______ Cordele 2 31.5 18 119.7 3 48.3 4 65.1 7 77.6 12.2 763 1432.1 62 781.9 Dalton Decatur Douglas Dublin ------------- East Point ---Elberton -------- 53 507.3 13 78.5 93 1797.1 13 166.4 1 8.1 Fitzgerald 13.5 Gainesville Griffin ----------- 44 429.6 101 763.9 Hapeville 19.8 LaGrange 100 454.9 Macon --------- Marietta -------- Milledgeville Moultrie ----------- 201 347.4 191 2203.8 77 1136.0 110 1084.1 Rome ------------- Savannah ..... Statesboro --- Thomaston ----- Thomasville ___ Tifton ------------Toccoa ----------- Valdosta ........_ Waycross ----- 47 178.8 2296 2391.8 26 517.1 18 141.9 132 2524.9 18.2 2 12.8 46 274.4 1294 26 11 18 16 410 123 13 19 5 13 10 12 69 13 18 21 3 16 12 4 4 8 24 3 17 119 18 15 9 10 17 131 4 25 14 8 16 20 139.7 136.4 118.5 87.2 55.2 150.0 186.6 204.7 126.4 80.5 211.7 110.8 146.1 129.5 164.0 172.3 126.8 58.0 204.8 96.8 64.6 54.1 78.1 181.5 59.3 77.3 205.7 207.7 221.3 88.7 139.2 64.7 136.5 79.6 390.9 110.4 153.0 102.6 119.3 39 4.2 459 49.6 254 2'1.4 8 42.0 3 32.3 12 129.3 10.8 2 9.7 7 33.9 2 6.9 1 3.4 4 1.5 53 19.4 30 11.0 4 6.1 49 74.3 70 106.2 8 125.9 18 119.7 4 44.3 12.2 1.9 16.3 1 12.2 5 9.4 11 138.7 11.1 23 43.2 1 6.0 2 38.6 3 40.6 9.8 4 6.9 1 11.5 9.9 2 12.1 4 77.3 17 217.6 8.1 6 81.2 8 78.1 4 30.3 19.8 50 86.4 2 23.1 7 69.0 3 18.1 2 38.6 4 64.6 2 15.1 24 109.2 19 32.8 25 288.5 21 309.8 4 4.2 130 135.4 11 218.8 1 15.6 2 15.8 1 19.1 3 46.9 11 86.7 11 210.4 1 6.4 12 76.9 9 53.7 2 7.6 9 9.o& 5 39.4 1 6.4 4 23.9 !-' -l PREVENTABLE DisEASEs REPORTED IN GEORGIA BY MoNTHs, 1944 """' Diseases Actinomycosis -------------------------------------------Acute lnf. Conjunctivitis___________________________ Anthrax -------------------------------------------------------- Chicken-pox ---------------------------------------------------Cholera --------------------------------------------- Dengue ---------------------------------------------- Diphtheria ---------------------------------------------------- Dysentery, Amebic ---------------------------------------Dysentery, Bacillary -----------------------------------Dysentery, Unspecified --------------------------------Gonorrhea ---------------------'----------------------------------Hookworm ------------------------------------------------------Influenza --------------------------------------------------------- Leprosy --------------------------------------------------- Lethargic Encephalitis -----------------------~---- Malaria ------------------------------------------------------- Measles --------------------------------------------------Meningococcus Meningitis ----------------Mumps --------------------------------------Paratyphoid Fever ------------Pellagra --------------- Pneumonia ------ Total Jan. Feb. Mar. 3 1- 1 101 1 2 - -' 2 1 993 248 123 124 - - -- - - 2- - 462 21 14 22 40 ---- --- 1 231 2 3 5 33 2 - - 8557 452 642 673 3372 242 241 341 8118 6010 851 295 --- --- -- - 4 --- 1- 416 12 6 14 6239 858 1646 1840 215 60 31 33 3026 323 555 666 160 3 1 2 159 14 16 15 2624 546 289 222 Apr. May -- 1 54 2 -- -- 129 70 -- -- --- 12 12 5 11 9 24 3 5 675 599 276 251 150 46 - -- 1 --- 20 19 1077 500 29 18 624 445 1 1 22 20 234 177 June --- --- 26 --- -- 13 5 65 10 667 255 75 ---- 67 166 6 169 6 15 119 July Aug. Sept. Oct. Nov. 3 6 15 6 1 ---- -- ---- ---- --- 5 4 12 17 77 -- - ---- ---- ---- -- 2 --- ---- --- 17 40 55 96 100 4 3 1 5 1 38 34 27 21 2 2 5 2 a- ---- 767 791 1054 775 646 261 342 387 299 315 37 71 116 123 101 - -- ---- ---- ---- ---- - 1 ---- 1 37 58 64 65 34 67 17 22 13 8 6 9 7 9 7 56 58 31 16 21 12 5 43 74 5 5 18 10 11 6 106 109 120 141 194 Dee. 6~ - c~ 158 - ~s --- 60 '1 t::::l ~ !..;.I. ~ ~ -1 ~ 816 c 162 "'tl !;:: 243 <::!"' ---- ~ - ::X:: ~ 21 !;I 26 ~ 11 63 7 8 267 PREVENTABLE DISEASES REPORTED IN GEoRGIA BY MoNTHS, 1944 Diseases Total Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dee. Poliomyelitis -----------------------------------------------------Puerperal Sepsis -----------------------------Rabies (in man) ------------------------------------------Rat Bite Fever.---------------------------------------- Rheumatic Fever ------------------------------ Rocky Mt. Spotted Fever________________________________ Scarlet Fever -----------------------------------------------Screw Worm Inf. (in man>----------------------~---Septic Sore Throat............-------------------------------SmallPOx -----------------------------------------------------Syphilis -------------------------------------------------------------Tetanus -------------------------------------------------------------- Trachoma -----------------------------------------------------Trichinosis --------------------------------------------------Tuberculosis ----------------------------------------------------- Tularemia ------------------------------------------Typhoid Fever -------------------------------Typhus Fever --------------------------Undulant Fever -------------------------Vincent's Infection ------------------Whooping Cough ------------------ T o t a l ...........- - - - - - - - - - - - - - - - - - 104 2 5 2 68 12 997 - 231 7 13964 47 1 ---- 2608 62 177 1182 169 157 - -792 55213 ------ ---- ---- 4 ---- 67 --- 13 1 1199 1 ------- 272 6 6 50 6 18 60 -- 10478 1 1 1 ---- 1 1 ---- ---- 6 8 ---- ---- 61 86 -- 22 13 1 ---- li48 1359 2 2 ---- -- - - 268 299 2 16 . 6 12 25 29 6 12 16 20 53 65 -- -- 6029 6177 --- ---- 6 29 24 21 13 6 4 ---- -- 1 ---- 1 1 ---- --- 1 ---- ---- ---- --- ---- 2 4 6 10 6 5 5 8 3 4 ---- 1 3 6 2 1 ---- ---- -~ 110 116 47 39 31 64 88 145 146 ~ ---- ---- ---- ---- ---- ---- ---- ---- - ~ ;<:I:>, 16 25 20 4 14 23 43 34 ---- ---- ---- ---- 1 2 ---- ---- 4 2 1o:l"1b' 1602 1216 1090 1343 996 1276 1009 963 864 t::l 3 7 4 6 2 7 5 6 3 ~.:: ___ ., 1 ---- ---- ---- --- ---- --- - t::l --- 287 ---- 221 ---- 217 ---- 197 ---- 204 ---- 192 ---- 127 ---167 --- 177 "~ ' "' 10 7 2 1 2 3 1 ---- 3 17 11 22 27 34 14 22 4 3 29 48 85 171 166 165 136 160 138 10 17 16 28 21 16 12 9 8 26 13 10 12 6 4 13 13 6 70 90 84 97 43 68 117 28 27 -- -- -- -- -- -- -- -- -- 6~ 8980 3281 3385 3123 3818 3269 3026 3242 1-' -.1 1:11 176 Georgia Department of Public Health INDUSTRIAL HYGIENE SERVICE Introduction During 1944, the Industrial Hygiene Service has continued to work with those plants producing war materials. The activities in such plants have been broader than might be termed industrial hygiene in that they attempt to bring to such employee groups an overall program of adult public health, so that the term industrial health may be more accurate in its interpretation than industrial hygiene. An attempt is made to correlate all health activities available in the State for the benefit of industry. Acknowledgement is made for the assistance of the U. S. Public Health Service, Division of Industrial Hygiene. During this period, probably the most important factor associated with the program included increase in requests for services and on the other hand, a marked decrease in available personnel. Sufficient number of plants have been surveyed to date so that currently a number of requests for resurveys and additional services are received. So many of these come in that roughly three-fourths of the time is spent on work with plants which have formerly been surveyed. This results in a minimum amo~t of time being available for contact and work with new plants. All of this indicates a great need for personnel both to replace that which has been lost and also to add to the industrial hygiene staff. Details of personnel requirement~ are discussed in a following section of this report. Federal Authorization and Liaison Activities As indicated in previous reports, the War Department, Navy, Maritime Commission, Public Health Service; War Manpower Commission, War Production Board, and other Federal Agencies have requested that specific health services be made available through the Georgia Department of Public Health to the employees of war production plants in this State. The Industrial Hygiene Service is still operating under this federal authorization and continues to assume the responsibility of assisting war production plants in matters pertaining to the health of their employees. Further, the Industrial Hygiene Service continues to function under the regulation adopted by the State Board of Health, whereby it is delegated the responsibility for the investigation of occupational diseases within the State and with conducting plant surveys in various industrial establishments. Confidential Nature of Reports and Findings The State regulation specifies that all reports shall be confidential records of the Board of Health and not open to public inspection. Due to the confidential nature of information obtained during plant surveys, all reports covering studies are submitted to plant managements and file Preventable Diseases 177 copies are kept under lock and key at all times in accordance with the . Espionage Act 50 U. S. C. 31 and 32. All personnel connected with the Industrial Hygiene Service are under oath to the War Department on confidential handling of documents and revelation of confidential information. Several agencies have unsuccessfully endeavored to by-pass this commitment to plant management as to the confidential nature of reports and to secure copies of reports directly from the Industrial Hygiene Service. A routine satisfactory to all parties concerned has been worked out with the U.S. Public Health Service, the War Production Board, and the War Manpower Commission. In those instances where copies of reports are desired by these agencies, the Industrial Hygiene Service submits extra copies to the plant management. A letter advising the plant of the federal agencies' request accompanies the report. A copy of the letter, but not the report, is sent directly to the federal agencies by the Industrial Hygiene Service. Management may forward the report to the federal agencies if it desires to comply with the request. Personnel At the beginning of the period covered in this report, personnel of the Industrial Hygiene Service included one medical director, one industrial hygiene physician, one consultant nurse, one industrial hygiene engineer, two chemists and three secretaries. At the termination of the period, this staff had been diminished to the point where existing personnel consisted of one medical director, one industrial hygiene engineer, one chemist, one nurse, and two secretaries. Obviously, such loss of personnel greatly cur tails the program and its activities. As mentioned above, complying with requests received leaves little time for promotional work and survey work in new plants. This is an unfortunate situation since the development of the industrial hygiene program with new plants is extremely vital. In recognition of this need, budgetary arrangements have been made for the employment of an additional industrial hygiene physician, engineer, chemist, and nurse. Every attempt is being made to secure the services of such personnel. However, the scarcity of qualified professional individuals undoubtedly will delay their employment. One secretarial vacancy was fiilled in September and a nurse was employed in October. Medical and Nursing Program Medical and nursing activities are concerned with the investigation of occupational diseases, the establishment of proper medical programs and facilities, the planning of adequate nursing services and the establishment of proper record keeping, including sickness absenteeism records within the industries; also with the promotion of public health measures in industrial establishments and correlation of industrial health activities 178 Georgia Department of Public Health with community health services. Programs which are especially emphasized include preplacement and periodic physical examinations of all individuals, special periodic examination of individuals who work in areas of environmental exposure, tuberculosis control, venereal disease control, immunizations, feeding, sanitation, dental hygiene, proper placement and medical supervision of handicapped workers, and health education. Engineering and Chemical Program Engineering personnel promote and carry out plant surveys in order to study processing methods and materials in their relation to the working environments. This is done by means of detailed plant surveys followed by accurate chemical determinations where indicated. Observed results are assembled and carefully analyzed. Following this, engineering reports are prepared in which observations are presented along with recommendations for the alleviation of environmental exposures. Professional engineering advice is rendered to the industries in the form of consultations on methods and procedures for the correction of hazards observed in the course of plant surveys. In addition, assistance is rendered in the development of proper sanitary facilities in the plants and in training individuals concerned with plant industrial hygiene and safety programs. Industrial Hygiene Laboratory Laboratory activities continued to play an important part in the engineering investigation of the industrial environment and evaluation of observed hazards. A well equipped laboratory provides facilities for the quantitative and qualitative evaluation of air contaminants such as dusts, fumes, gases, vapors, mists, smokes and the like. In addition to the study of processing materials and their by-products which are of a toxic nature, a certain amount of biochemical work is done on blood, urine and other biochemical samples taken in connection with the plant studies. Labora tory findings are correlated with the engineering and medical investigations so that actual hazards may be properly evaluated and that a more intelligent and comprehensive report may be submitted to the industry concerned. During this period, 627 samples were examined in the laboratory. In connection with laboratory activities, it should be pointed out that existing laboratory space is cramped both from the standpoint of working per sonnel and the proper use of certain pieces of laboratory equipment. Public Relations During the period covered in this report, 84 plants in 21 counties were visited. Also 523 conferences were held with 1165 individuals. 72 meetings were attended by Industrial Hygiene Service personnel. Talks by staff personnel were made at 55 of these meetings with an average of 67 persons in attendance. 1496 pieces of literature were distributed and one health film was shown. Staff personnef continued to present industrial hygiene Preventable Diseases 179 lectures at Emory University Medical School, Georgia University School of Medicine and Vanderbilt University. The medical director and industrial hygiene engineer attended the Annual War Conference on Industrial Health which was held in St. Louis in May. The medical director attended the Congress on Industrial Health of the American Medical Association in Chicago in February. He was also a guest speaker at the annual meeting of the Florida Tuberculosis Association in Jacksonville in June, to discuss the program of the Georgia Department of Public Health for control of tuberculosis in industry. Dr. Herman San Martin, Health Officer from Curico, Chile, was a distinguished. guest in August. In addition to visiting the office and laboratory, he made a field trip with the medical director. Harmonious working relationships are maintained with numerous federal, state, and private agencies, including U. S. Public Health Service, U.S. Army, U.S. Navy, U. S. Maritime Commission, War Food Administration, U. S. Department of Labor, U. S. Department of Commerce, War Manpower Commission, War Production Board, National Committee for Conservation of Manpower in War Industries, State Departments of Education, Labor, Agriculture, and Welfare, Rehabilitation Service, American Medical Association, State Medical and Dental Associations, State and local Tuberculosis Associations, National and local Chambers of Commerce, Manufacturers Associations, Labor Organizations, and others. Certain accomplishments with some of these organizations are given below. Cooperation is continued with the War Food Administration and activities in Georgia of certain of their industrial feeding experts are correlated with the Industrial Hygiene Service. This applies particularly to surveys of industrial feeding establishments and carrying out recommendations presented in reports covering such studies. Cooperative feeding surveys have been conducted in 20 industrial establishments in Georgia under this arrangement since its inception. Study and promotion of inplant feeding in all tire cord industries in the State is being initiated. The series of food poisoning outbreaks which occurred in Georgia during the year has stimulated the development of consulting service on feeding sanitation and food handlers classes. The food handlers schools which were originated by the Division of Sanitary Engineering have been made available to industries, and the services of a teacher supplied by the State Department of Education have been added. The food handlers schools are now a joint project of the Division of Sanitary Engineering, the Industrial Hygiene Service, and the State Department of Education working with and through the local Health and Education Departments, and with material assistance from the U. S. Public Health Service. State Nutrition Committee. The medical director is co-chairman of the sub-committee on feeding in industrial communities in the Extension School. 180 Georgia Department of Public Health War Production Board. The industrial hygiene engineer has participated in certain War Production Board sponsored activities including addresses at meetings held by this organization. At the present time the War Production Board is attempting to increase production in the following vital industries, namely, tire cord, forges and foundry, coal mining and superphosphate. Meetings are to be held and attended by industries in these groups. Meeting of the tire cord manufacturers has been held at which time the industrial hygiene engineer presented certain points covering industrial health and their relation to increased production. It is anticipated that similar talks will be presented when meetings of the other three industries are called. In addition to cooperating with the War Production Board in connection with these meetings, a summary of health hazards in these industries has been prepared and presented to this agency. As a sound step in attempting to increase the production within these industries, industrial hygiene surveys of such industries in this State are being scheduled and will be carried out at the earliest possible time. War Manpower Commission and War Production Board. The arrangement for transmission of confidential reports of the Industrial Hygiene Service to these agencies is given under "Confidential Nature of Reports and Findings." The Industrial Hygiene Service gives top priority for surveys and the other services to industries indicated by these agencies as being critical to the war effort. Georgia Federation of Labor. A resolution endorsing the program of the Georgia Department of Public Health for discovery and control of tuberculosis in industry and recommending routine chest x-ray examinations of employer and employee groups was adopted by the Federation at their annual meeting, May 18, 1944. Cooperation with U. S. Public Health Service, Maritime Shipyard Study. Assistance has been rendered to the Public Health Service and the Maritime Commission in conducting a detailed study of certain shipyards. This study is undertaken to evaluate health hazards associated with welding. Complete physical examinations are given to welders and these findings are correlated with engineering and laboratory studies of the working environment. The Industrial Hygiene Service made available for this study laboratory facilities. These facilities were used during the course of work with one yard in Georgia and one in Alabama. Navy personnel did actual analytical procedures, but such work was carried out in laboratories of the Industrial Hygiene Service. National Committee for Conservation of Manpower in War Industries. The medical director is serving as medical consultant on this committee in Georgia Medical Association of Georgia. The medical director is serving as secretary of the Industrial Health Committee of this organization. Legislation. The medical director is serving as medical advisor to the sub-committee of the Legislature headed by Mr. Cicero Kendrick, which Preventable Diseases 181 is drafting an amendment to the workman's compensation law to cover occupational diseases. Medical recommendations for items to be included in the law have been written and given to Mr. Kendrick after their approval by the Medical Association of Georgia had been secured. Southern Safety Council. Personnel of the Industrial Hygiene Service appeared on the program of the Sixth Annual meeting in Atlanta in March 1944. The determination of health hazards in industrial occupations and methods of overcoming them were discussed. Several industries have taken advantage of the services of the Georgia Department of Public Health as a result of this relationship. Field Activities The Service continues to render direct assistance to war plants manufacturing critical war materials including aircraft, ships, artillery shells, aircraft parts, ordnance materials, chemicals and the like. During the period covered in this report, 198 promotional visits were made, 20 plant surveys conducted, 116 miscellaneous services rendered. More specific information covering these activities is presented under sections on engineering activities, medical and nursing activities and also in the statistical summary. Medical and Nursing Activities Eighty-five field visits were made by the medical personnel and 7l field visits by the nurse, 120 cases of occupational diseases were investigated. 149 consultations with physicians and llO conferences with industrial nurses served the purpose of promoting better medical and nursing services in industry. Some of the activities worthy of special mention appear below. l. Active Participation in Work Shops in Health Education The medical director and consultant nurse have participated actively in work shop meetings attended by personnel of the Departments of Health and Education. The primary function of these meetings was to both correlate educational activities by the two departments and further to acquaint each department with the activities of the other. It is anticipated that the net results will be a closer correlation of the approaches used in public health education. This will afford an excellent opportunity for the presentation of material on health education both through school channels and to adult groups. 2. Food Poisoning Investigations A series of food poisoning or food infection outbreaks have been investigated, in several industrial feeding establishments including Reyn- 182 Georgia Department of Public Health olds Corporation Fuze Plant at Milledgeville, and Bell Aircraft Corporation at Marietta, causing hundreds of lost man-days of production. An extensive food infection outbreak of Salmonella typhi murium at Georgia State College for Women causing illness in over a third of the 900 students in one dormitory was also investigated and brought under control. Extensive changes in the physical layout, equipment and procedures were recommended where needed and most of the recommendations have been or are being complied with. These outbreaks have furnished great stimulus to the food handlers classes mentioned under "Public Relations." Dr. Watt of the U. S. Public Health Service made a special dysentery survey of all food handlers at Bell Aircraft Corporation following their first major food poisoning outbreak which was studied. The incidence rate of dysentery carriers was less than 3 per cent, which is not over the normal expectancy for an unselected group. 3. Tuberculosis Program in Savannah Army Service Force Depot A very satisfactory continuing program for discovery and control of tuberculosis was instituted in the Savannah Army Service Force Depot in cooperation with the local health department, Tuberculosis Association, U. S. Public Health Service and related agencies. 4. Industrial Nursing Organization The Industrial Nursing Section of the Georgia State Organization for Public Health Nurses was reactivated at the April meeting of the Georgia Public Health Association. In October 1944 they transferred their affiliation to the Georgia State Nurses' Association. Several local chapters have also been formed, the group in the Columbus area being the most active. 5. Graniteville Corporation Medical-nursing personnel have spent a great deal of time and effort in working out with the Graniteville Corporation in Graniteville, South Carolina, and with the South Carolina Industrial Hygiene Division, a comprehensive industrial medical plan. This is an inter-state project in view of the fact that two of the seven mills of the Company are located in Augusta, the remainder being in South Carolina. Considerable progress has been made, including the construction of adequate quarters for the central medical department and plans for the construction of new buildings for company owned and operated cafeteria, locker and shower rooms, first aid rooms and the like. 6. Winder Health Clinic A rather unique organization, formed for the purpose of answering the problem of adequate health service for small industry, is successfully functioning in Winder, Georgia. The six cooperating plants formed a Preventable Diseases 183 board of directors and, under written standing order of local physicians, employed the full-time services of an industrial nurse. The program includes pre-placement and periodical physical examinations, chest x-ray service, a first-aid room in each plant operated by trained first-aid workers, home visiting and counseling by nurse, and over-all coordination with the local health program. 7. Roster of Industrial Nurses A directory was prepared of all the industrial nurses known to he practicing within the State, including 218 nurses. The industrial hygiene consultant nurse has contacted all of these industrial nurses and promoted improvements in quarters, procedure, practices and the like. Engineering and Chemical Activities Engineering activities covered in this period include 43 field visits and 627 laboratory determinations. The work has been concerned with sanitation, ventilation, dust studies, organic solvents and detailed plant engineering surveys. In addition, certain field visits have included presentation and discussion of reports, presentation of group talks, conferences, promotional visits, special services, etc. L Study of Ground Waters in McDuffie County In connection with a study conducted by the Division of Dental Health Education, an examination of selected wells in McDuffie County was carried out. Examination of water from these wells was for the purpose of determining their fluoride content. For a number of years, rather accurate observations were made as to the condition of school children's teeth in McDuffie County and extremely low incidence of dental caries has been noted. Since the presence of fluorides in drinking water of children may affect the growth and structure of teeth, it was desirable to determine the concentration of fluorides in waters used by children included in the dental survey. Such samples were collected by the industrial hygiene engineer and examined in the laboratory. Findings were presented to the Division of Dental Health Education for their interpretation and use. 2. Cooperation With the Maritime Commission Continuing with our past cooperation with the U. S. Maritime Commission and Navy, detailed industrial hygiene surveys were conducted in two of the major shipyards of the State, Personnel from the Industrial Hygiene Section of the Maritime Commission participated in these surveys and copies of reports prepared by the Industrial Hygiene Service were submitted to the Maritime Commission. During the course of these surveys, observed hazards were evaluated and recommendations presented for their alleviation. 184 Georgia Department of Public Health 3. Ventilating System in Shipyard Welding School In a former report covering industrial hygiene survey of a Maritime Commission shipyard recommendation was made that ventilation be provided in the welding school conducted by the shipyard. At the request of the shipyard management, plans and specifications covering recommended procedures for such ventilation were prepared and submitted. It was anticipated that this information was to be used merely as a guide rather than working drawing for the actual installation, however, plans and specifications for this system were followed to the letter by the shipyard management and the installation made. Later measurements on this system indicate that it is operating satisfactorily. 4. Industrial Hygiene Program-Bell Aircraft Corporation Considerable amount of time has been spent with the Bell Aircraft Corporation by the engineering personnel. A complete industrial hygiene survey of this establishment has been conducted and one of our principal recommendations included in the report covered the establishment of an industrial hygiene program by the Bell Corporation. Specific recommendations were made as to the administration and details of such an industrial hygiene program. Since that time, much promotional work has been done in an effort to inaugurate this activity within the industry. Group talks have been made and conferences held in connection with the promotion of this activity. It is noted that the Bell Aircraft Corporation has followed recommendations of the Industrial Hygiene Service and at the present time, an industrial hygiene program is in operation. Personnel of the Service continued to advise on certain technical problems and administrative details. In the absence of a qualified industrial hygiene engineer employed by the plant, it is anticipated that personnel of the Service will continue to advise and serve in a consulting capacity on this project. As a result of promotional work outlined above, the Bell Corporation is setting up an industrial hygiene program. In addition, the company is attempting to employ either an engineer or a chemist for industrial hygiene work. Although certain facilities under such a proposed program will be made available for industrial hygiene activities, it is expected that personnel of this Department will continue to serve in an advisory and consulting capacity. 5. Storage Battery Plants Lead poisoning is one of the principal occupational diseases and is of extreme importance in the manufacture of storage batteries. During the period covered in this report, detailed industrial hygiene surveys of battery manufacturing plants in the area of Atlanta have been carried out. Some of these surveys were initiated by the Service, ~ereas others were conducted at the request of plant management. Excellent cooperation has been Preventable Diseases 185 received from these plants and it is believed that much has been done to alleviate possibilities of lead poisoning in these industries. It is worthy of note that one of the largest of these battery pia~ submitted the Service's report to their home office and in turn the home office presented copies to each of their branch plants throughout the country. Accompanying distribution of this report were instructions from the home office to contact the industrial hygiene division of their respective states and to have health studies conducted in each of the branch plants. Much favorable publicity was given the report and the activities of the Industrial Hygiene Service. 6. Promotional Work in the Granite Industries At the request of the major granite industries in the area of Elberton, a conference was held with these companies for the purpose of discussing the control of silicosis. Both labor and management in these plants are highly interested and desirous of having certain improvements made in the control of dust. Specific requests have been received from these plants for detailed engineering studies. Due to the shortage of personnel no commitment for such proposed studies has been made. In view of the fact that any recommendations made for the control of dust would involve local exhaust ventilation, the matter of priorities was taken up with the Atlanta Office of the War Production Board. At the time theWar Production Board indicated that applications for priority covering the procurement of ventilating equipment would he denied. It is highly interesting to note that one individual plant has gone ahead with the processing of application for priority rating. This Department has been advised by the War Production Board that every consideration will he given to this application. Further it seems that this may serve as a test case and i favorable decision is rendered it is likely that equipment might he made available for the other industries in the Elberton area. I priorities are granted, undoubtedly some time will he spent in conducting detailed surveys and obtaining field data on which specific recommendations covering exhaust ventilation might he made. 7. Industrial Waste Treatment Industries throughout the State are giving more consideration to the problem of treatment of industrial wastes. Although this may not follow directly in the realm of industrial hygiene, this subject is promoted wherever possible with the industries. Certain specific plants now have either plans or proposals for the construction of treatment units involving their particular wastes. As in the past, all matters pertaining to water supply, sewage disposal and industrial waste treatment are referred to the Division of Sanitary Engineering. 186 Georgia Department of Public Health 8. Safety Congress The State Department of Labor held a conference covering the subject of industrial accidents and safety. At this time personnel of the Industrial Hygiene Service presented papers covering nursing and sanitary requirements in industry. In addition they participated in panel discussions covering these topics. Much interest was developed from this meeting and the policy of promoting safety along with industrial hygiene in plant surveys is followed. WINDER MANUFACTURERS' HEALTH CLINIC 188 Georgia Department of Public Health TABLE I. NuMBER OF PLANTs SERVED BY THE INDUSTRIAL HYGIENE SERVICE PERSONNEL AND TYPES OF SERVICE RENDERED 1941 Total Number of Plants Visited______________ 20 1942 96 1943 1944 113 84 Number of New Plants (initial service during current year)--------------------------- 20 87 48 33 Number of Old Plants (service initiated in previous years) -------------------------------- 0 9 65 51 Number of Plants which received medical service -------------------------------------------------- 17 60 76 64 Number of Plants which received nurs- ing service -------------------------------------------- 11 43 64 17 Number of Plants which received engi- neering service ------------------------------------ 17 30 33 45 Number of Plants which received labora- tory service ---------------------------------------- 4 12 19 23 Number of Plants which received feeding service -------------------------------------------------- 0 0 8 20 Number of Plant Days Plants were visited 48 309 396 250 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 Requests ----------------------------------- 4 Total Employee Population of Plants________ 0 0 0 70 24 15 19 24 12 3 1 2 0 0 0 0 2 2 2 6 1 163,798 186,800 Number of Counties in which Plants were located ------------------------------------------------- 14 31 31 21 Preventable Diseases I89 TABLE II. SuMMARY OF MoNTHLY AcTIVITIES REPORTS OF INDUSTRIAL HYGIENE SERVICE PERSONNEL I. PUBLIC RELATIONS: Totals A. Conferences I. Number ---------------------------------------------------------------------- 523 2. Average attendance (not including I.H.S. personnel ------------------------------------------------------------------- 2 B. Meetings I. Number attended _____ --------------------------------------------------- 72 2. Number addressed ------------------------------------------------------ 55 3. Average attendance addressed____________________________________ 67 4. Number of films shown______________________________________________ 3 C. Literature distributed ------------------------------------------------------ I496 D. Radio talks ___________________________________________________________________:____ 1 E. Published articles ------------------------------------------------------------ 1 II. FIELD VISITS: A. Promotional visits ------------------------------------------------------------ I98 B. Special services ---------------------------------------------------------------- I16 C. Formal survey reports presented______________________________________ 20 III. ENGINEERING ACTIVITIES: A. Sanitation studies ----------------------------------------------------------- I7 B. Ventilation studies ------------------------------------------------------------ 32 C. Dust studies ------------------------------------------------------------------------ 24 D. Organic solvent studies ---------------------------------------------------- 26 IV. LABORATORY STUDIES: A. Samples collected -------------------------------------------------------------- 691 B. Physical and Chemical analyses made______________________________ 9?:7 C. Special studies ------------------------------------------------------------------ 7 V. MEDICAL AND NuRsiNG AcTIVITIES: A. Conferences with physicians___________________________________________ I49 B. Conferences with nurses____________________________________________________ llO C. Occupational disease cases reported________________________________ 408 D. Occupational disease cases investigated__________________________ 120 190 Georgia Department of Public Health SOCIAL HYGIENE Realizing that treatment alone is an unsatisfactory method of dealing with the problem of venereal disease, the Department, in December of 1942, obtained the services of a Social Hygiene Consultant, whose primary objective was to bring to the attention of the citizens of the state the social as well as the public health aspects of venereal disease. This was a community problem, in part, and education was to be the foundation of the fight against the menace. Too long, Georgia had been bound by tradition, prejudice, and taboo. Now facts were to be brought out into the open. Four main purposes of this educational program became the guide for action: l. To inform the public about the venereal disease problem in the state. 2. To aid in the recognition of the need for community action in combating syphilis and gonorrhea as the dangerous communicable diseases they are. 3. To direct attention to the medical and public health activities available in the state. 4. To promote parent-education and, from childhood on, incorporation of sound social hygiene education (including sex education) and training for marriage and parenthood, as a part of human relations education. During 1944 these purposes have been carried out in the following ways: meeting with adult groups in various parts of the state (men's service clubs, women's clubs, parent-teacher associations, church groups) telling them of the problem in the state and that "it does happen to us" even in the skeptical community. The Consultant has worked with high schools-talking to boys and girls on request from school authorities. Because of the need for a long range educational program, the interest of the State Superintendent of Education and allied workers in that field was enlisted. Through his cooperation steps have been taken to integrate social hygiene in the regular health education instruction in the public schools of the state. Heretofore, it has been set aside and given attention, if at all, on very rare occasion~ during the entire school year. The Consultant has worked with teachers during the school year and in summer schools and workshops, helping them with the knowledge and information necessary for such instruction. Preventable Diseases 191 Some of the activities of the Consultant have been as follows: 1. The organization of study groups for parents on social hygiene guidance. 2. Working with communities m organizing Community Health Councils. 3. Educational pamphlets and leaflets have been made available through the Social Hygiene office. 4. Participation in programs for the nursing personnel of the state. 5. The handling of all printed materials issued from the U. S. Public Health Service for distribution to some 25 military camps and bases in Georgia, and constant work with the Medical and Educational Personnel at these stations. 6. Responsibility for program for the annual Social Hygiene Conference held in Atlanta. While great gains have been made, there still remains much to be done. United effort is the center of great potential power. Out of a longrange educational program will come better health, better homes and better communities, and a better and stronger Georgia. WHOLESOME REcREATION FOR YouTH -. .A CoMMUNITY CoUNCIL GROUP ' Preventable Diseases 193 Below is a statistical report of the activities of the Social Hygiene Consultant during 1944. Meetings addressed -------------------------------------------------------------------- 50 Meetings attended other than addressed --------------------------------- 93 Estimated number of persons addressed ----------------------------------- 6,497 Conferences attended -------------------------------------------------------------- 123 Contacts ----------------------------------------------------------------------------------- 21 Films shown ------------------------------------------------------------------------------ 13 Exhibits displayed ------------------------------------------------------------------~--- 26 Memberships obtained for Georgia Social Hygiene CounciL. 8 Renewals obtained for Georgia Social Hygiene CounciL_________ 17 Films and Publications Reviewed_______________________________________________ 16 Social Hygiene Literature distributed________________________________________43,835 194 Georgia Department of Public Health TYPHUS FEVER CONTROL SERVICE The Typhus Control Service rendered service to cities, towns and rural communities in 51 counties, as compared with services rendered in 49 counties for the previous year. Of the total number of counties receiving assistance dpring 1944, 36 were organized health department counties and 15 were counties without full-time health departments. A total of 342 field visits was made by the staff personnel during the year. Permanent local Typhus Control Programs were in operation in the following listed cities: Columbus, Brunswick, Macon, Dublin, Atlanta, Savannah, Camilla, and Eastman. Local programs were established by the local health departments, with local personnel employed full-time for continuous service on a par with other local activities. A program in Colquitt County was in the process of being organized during December of 1944. This is the first county in the State to organize, as part of the local health department, a Typhus Control Service for the purpose of carrying on control measures in all municipalities and rural areas in the county. Inasmuch as the Typhus problem in southern Georgia is county-wide, involving. cities, towns and rural areas, Typhus Control Programs in the future should be established on a county-wide basis in counties with full-time health departments. In addition to the services rendered by the State Typhus Control Service, the United States Public Health Service, Typhus Control Unit, coop- Preventable Diseases 195 erated in the state-wide Typhus program, by rendering supervisory services in organizing and operating programs in the cities of Brunswick, Columbus and Macon. The United States Public Health Service furnished the local health departments supervisory personnel and certain equipment for training local health department personnel, so that the programs could be operated on a permanent basis. An analysis of the activities and accomplishments for the year is as follows: Administrative The activities of the Typhus Fever Control Service are directed from the central office in Atlanta by the Medical Director and the Engineer of the Division of Preventable Diseases. Field activities are conducted from the Macon office, which is located in the Persons Building. The professional staff of the Typhus Fever Control Service consists of sanitary engineering personnel. Medical assistance is provided by the medical staff of the Division of Preventable Diseases, Regional Medical Directors, and County Health Officers. Personnel The personnel of the Atlanta central office consisted of one Sanitary Engineering Director of the Service and one secretary. Personnel of the Macon field office consisted of one Sanitary Engineer, two Sanitarians and one stenographer. In view of the existing Typhus Fever problem in the State, it is clear that additional personnel is greatly needed, in order that services may be rendered to more communities throughout the Typhus area of the State. Due to the inability to obtain qualified Sanitary Engineering personnel for the duration of the War, efforts are being made to secure personnel on a War Emergency basis, so that a greater coverage of services may be rendered. Educational and Promotional The efforts of the Typhus Fever Control Service to conduct an intensified educational and promotional program are supported by the following accomplishments: During the year, 1,640 personal conferences were held, 12 meetings attended, 21 meetings addressed, with approximately 594 persons in attendance, and approximately 5,000 pieces of literature distributed. 196 Georgia Department of Public Health Investigations EPIDEMIOLOGY Routine epidemiologic 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 prevalence of Typhus Fever and the environmental conditions conductive to the animal reservoir (rat) and the transmitting agent (rat flea) of the disease. Investigation~> and recom mendations are supported by detailed reports that are submitted to the local sponsoring agency, such as the municipal government, local health department, or civic organization. Eight city-wide and two special investigations were made during 1944. City-wide investigations are made as the basis for the establishment of a complete Typhus Fever control program. 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 practices. Accomplishments, as indicated by the figures in the following paragraphs and in the statistical report, are based on the activities of personnel in the Typhus Control Service, and do not include a complete record of the accomplishments made by local health departments which are currently applying Typhus Control measures. Vent-Stoppage "Vent-stoppage," 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 "vent-stoppage," 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 rna terials and wage scale of labor. During the year, 1,594 business establishments were surveyed for "vent-stoppage" and 1,955 inspections were made of "vent-stopped" busi Preventable Diseases 197 ness establishments. In addition 2, 757 inspections were made of residences. Incomplete records show that about 522 business establishments were "ventstopped" and about 281 previously "vent-stopped" business establishments were repaired. Rat Extermination Twenty-eight rat extermination campaigns, employing the use of poison bai, were conducted in cities and towns. A total of 5,270 business establishments and residences was treated. In addition, rat trapping campaigns were conducted in the business district of eight cities and towns. Ordinances Typhus Control Ordinances were enacted by the cities of Macon, Brunswick, Dublin, Valdosta and Columbus. Local programs conducted in cities enacting ordinances have been readily accepted by the citizens, to the extent that the programs have been conducted successfully on a voluntary basis, without the necessity of the enforcement of ordinances. Refuse Collection and Disposal Practices Experiences have shown that open refuse dumps serve as a continuous reservoir for the distribution of the rat population. For a municipality to effectively control the Murine Typhus Fever problem, it is obvious that, not only must the business establishments be maintained free of rats, but a sanitary collection and disposal of refuse must he accomplished. The Typhus Control Service recommends the disposal of refuse, either by incineration, or by the sanitary landfill method. Due to the wartime shortage of materials required for incinerator construction, the War Production Board has not permitted the construction of any incinerators in Georgia, by municipalities, during the year, 1944. The Federal Government has, however, recognized the importance of controlling Typhus Fever in War areas of the State, and, consequently, has approved the purchase of equipment required for the operation of sanitary landfills. In those cases where the War needs justified such action, the Federal Government, acting through the Federal Works Agency, has given monetary grants to various local governments to assist in the purchase of equipment. Four local governments-namely, Muscogee County and the cities of Hinesville, Valdosta and Warner Robins, have started landfills with such Federal financial aid. The City of Thomasville has begun the operation of a sanitary landfill with city-owned equipment. Definite plans have been made by other cities to convert their open refuse dumps into sanitary landfills early in 1945. Extreme difficulties have been encountered by the cities in locating salable equipment, even after the War Production Board has authorized (Continued on Page 200) COUNTY Health Officer Non-Health Officer CITY Appling Bibb Bleckley Burke Chatham Clark Cobb Coffee Colquitt Crisp Decatur DeKalb Dodge Dougherty Fulton Fulton Glynn Grady Hall Jefferson Bacon Ben Hill Calhoun Carroll Carroll Cook Effingham Baxley Alma Fitzgerald Macon Cochran Waynesboro Edison Villa Rica Carrollton Savannah Athens Marietta Douglas Moultrie A del Cordele Bainbridge Stone Mtn. Eastman Albany Springfield Atlanta Rural Brunswick Cairo Gainesville Wadley TYPHUS FEVER CONTROL SERVICE ]AN. l, 1944 THROUGH DEc. 31, 1944 Educational :1; i> ~ .. . . 0:: . ..... .... ........ ... ... " " 'iiil .... ..... . :=: " 0:: .. biG> 0::"0":: bl .. 0:: .. ~:: ..... "" 'i!! .. 0:: =-< =-:;j ""~(,.) t"" Z< :; :a" Ill ~ I 10 57 38 23 12 51 2 3 22 5 14 15 18 3 11 7 32 17 16 15 193 13 59 26 18 62 6 32 1 16 14 32 86 2 29 451 12 5 27 1 2 3 1 2~l 2 48 2 1 150 1 15 1 10 1 12 16 Investiga tions f'i ........f~ .. ~~ ~" ,e. 0 'ii '2 Ul Control Measures Vent-Stoppa&"e Number of Establishments IRat Extermi-~Ordinances nation Enacted I I I I e~ I Sur- ve:ved StVopepnet d speInet-ed StoR!:e:-!e Poini&so' n-\ .b5l paired !-< ~. ..!..., .;, r"= ~ ".;, ~ r= ~ .;, r"= .l ~" .l r"= .;, ~" I~a!:1..l..... .:~1 ~ a..f, t! ....g..!. 0":: "=- ~ ,..aI:l.l u"o.:,: =~ . .. =- > January December, 1944 ~ ~ NEW CASES (Never previously treated) White Colored M F M F TOTAL January --- 31 30 70 81 212 February ------- 20 19 31 38 108 March ------- 29 31 67 114 231 April ----- 30 34 48 58 170 May ---------- 21 21 65 95 202 June ------------- 10 17 78 123 228 . July -------------------------- 20 21 41 63 145 August --------- 15 17 36 54 122 September --------- 19 22 52 95 188 October --------- 26 21 39 67 153 November -------- 11 10 19 66 106 December ------- 15 13 35 47 110 White M F 24 15 11 2 19 14 10 15 17 12 15 16 12 8 13 3 16 9 27 14 8 13 5 10 OLD CASES (Previously treated) Colored M F TOTAL 25 31 95 9 15 37 30 62 125 27 53 105 36 56 121 40 76 147 16 31 67 12 17 45 16 29 70 19 33 93 10 30 61 6 11 32 t;::, TOTAL REPORTED White Colored ..,'"1::1 I:! ..... M 65 31 48 40 38 25 F 45 21 45 49 33 33 M 95 40 87 75 101 118 F TOTAL 112 307 53 146 176 356 111 275 151 823 199 375 ;:1 -...;<:Is> c ;":':t::: o::::: 32 29 57 94 212 ::X:: 28 20 48 71 167 Q 35 31 68 124 258 ~ ;;::-- 63 35 68 100 246 19 28 29 96 167 20 23 41 68 142 TOTAL ------------- 247 256 571 901 2876 177 131 246 444 998 424 387 817 1345 2973 TABLE "B" SUMMARY REPORT OF CLINIC ACTIVITIES SYPHILIS January December, 1944 NEW CASES OF SYPHILIS ADMITTED TO CLINIC White Colored M F M F January ----------------- 29 February ------------- 46 Mareh ----,--~----------- 46 April ---------------------- 24 May--------------------------- 34 June ------------------------- 27 July --------------------- 34 August ---------------- 32 September --------------- 41 Oetober -------------------- 48 November ------------- 40 December -------- 43 TOTAL -------------------- 442 46 341 381 69 496 499 68 642 632 37 417 410 60 610 646 49 301 304 64 310 406 58 280 445 63 326 466 54 276 401 41 268 376 68 223 336 646 4,379 5,100 --- OLD CASES OF SYPHILIS DOSES ADMITTED TO CLINIC Total Under ADMINISTERED "'t:: ~ White M F Colored M F Total Admissions Treatment Heavy During Mo. Arsenicals Metals <::! .;~.::.,. !;) 114 127 1,071 1,066 3,174 24,681 34,294 34,498 0"' ~ 130 124 1,168 1,291 3,812 104 122 1,326 1,478 4,216 24,166 24,688 32,434 37,364 z: 30,993 35,069 t::1 149 109 1,366 1,233 3,746 184 133 1,633 1,634 4,824 126 110 1,105 1,176 3,197 22,766 23,801 21,261 30,210 36,196 31,033 28,610 ~ 34,237 ~ ~ 30,313 "' 96 111 931 1,090 3,032 19,928 32,839 27,791 119 104 1,246 1,363 3,637 18,904 30,347 27,242 103 121 1,066 1,199 3,374 18,206 26,287 27,311 119 128 1,226 1,207 3,467 18,094 24,162 26,006 127 128 1,020 1,234 3,223 17,662 25,068 24,385 94 102 676 849 2,390 14,639 18,473 18,335 1,464 1,419 13,821 14,810 42,081 ---------- 357,696 343,779 ~ ~ ..... 0 TABLE "C" GONORRHEA CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE By CUnlea January December, 1944 NEW CASES ADMITTED (Not ,previously treated) White Colored M F M F January ----- 87 113 187 151 February ___ 99 83 154 163 March -------- 104 132 216 281 April ------------ 63 119 131 138 May ------------ 97 116 196 225 June ----------. 61 91 127 101 July-------------- 84 151 234 252 August ------ 104 167 236 216 September _ 86 121 166 187 October ----- 115 148 224 242 November ____ 83 115 176 214 December ___ 89 131 160 162 TOTAL __1072 1487 2206 2282 OLD CASES ADMITTED (Previously treated) White Colored M F M F 24 21 80 79 6 4 17 19 19 23 76 66 6 5 20 13 15 23 75 89 5 9 10 6 13 14 68 20 14 16 65 33 9 9 21 7 18 21 53 109 6 34 36 ss __ 6 12 27 87 140 191 528 1116 CASES ADMITTED No Information as to previous treatment White Colored M F M F 2 25 2 16 3 12 2 18 -- 20 3 2 1 3 4 8 4 11 9 7 4 13 5 11 3 2 1 ---- 1 -- ---- NOT AVAILABLE - u. 96 so 52 <;"') (1) <:) ~ ~ Total Total t:;:, (1) Under Treatments Total Treatment During Admitted During Month Month ~;;....:,... (1) 781 1443 1367 .;:.s.. 677 937 1040 - .<:) 898 1162 1811 '"c;:j 632 872 1002 1247 1052 2388 ....I;: 0" 420 857 964 ~ 831 1546 1897 ~ 841 1576 2124 ;, 606 1156 1998 ~ ;:s-o 930 2162 702 1824 624 1934 8614 --- 14651 ABLE "D" TOTAL NEW VENEREAL DISEASE CASES REPORTED TO THE VENEREAL DISEASE CONTROL SERVICE January- Deeember, 1944 BY PRIVATE PHYSICIANS White Colored M F M F SYPHILIS .Pri. & See. ------------------------------------------------------ 206 Early Latent ---------------------------------------------------- 1 Late & Late LatenL____________________________________ 47 Congenital ------------------------------------------------------ 1 - - Prenatal....---------------------------------------------------------- --- TOTAL ----------------------------------------------------------- 255 GONOCOCCUS INFECTION Genito-urinary Opthalmia :to.'eo Not stated _:______________________________________________________ 208 -- TOTAL ------------------------------------------------------------ 208 OTHER VENEREAL DISEASES Chancroid ------------------------------------------- -- Granuloma lng. ------------------------------------------ 1 Lymphogranuloma -----------------.-------------------- ---- 203 3 49 9 4 -- 268 132 -- 132 3 - --- 358 1 212 10 ---- ~- 581 516 -- 516 14 - --- 642 3 449 3 ------ 1006 237 -~ 237 - -- TOTAL ---------------------------------------------------------- 1 3 14 - BY CLINICS, HOSPITALS OR OTHER INSTITUTIONS White Colored M F M F 121 162 669 800 120 314 1638 2727 172 143 1808 1327 20 17 151 138 ------- - ------- ------- 1 -- 433 636 4266 4993 - -1072 148 72206 2282 -- -- -- 1072 148 72206 2282 25 25 322 187 1 2 66 73 ---- ---- 54 26 26 27 442 286 TOTAL BY ALL SOURCES White .Colored M F M F -.~ .. 327 365 1027 1342 ~ <:! 121 317 1639 2730 ~ ;:I 219 192 2020 1776 E' 21 26 161 141 0" ---- -- 4 -- ------ 1~ - - t::::l 688 904 4847 5990 !;; ~ Q "~ ' "' 1280 1619 2722 2519 -- -- -- -- 1280 1619 2722 2519 12 28 336 107 2 2 66 73 ---- ---- 54 26 14 30 456 206 .1...:..-.....:..) t..-.:..). t-:) TABLE"E" FREE ANTISYPHILITIC DRUGS DISTRIBUTED Venereal Disease Control Service January- December, 19U NEOARSPHENAMINE .3 .u .6 .75 .9 January --------------------------------------------------- 265 February ------------------------------------------------- 65 1695 320 5530 4120 40 210 20 so March ----------------------------------------------------- 650 380 5290 -------- 170 April --------------------------------------------------------- 310 240 5985 -------- 70 May ------------------------------------------------------- 220 2175 4900 -------- 50 June --------------------------------------------------- 370 410 6020 -------- 50 July ------------------------------------------------------ 865 450 3740 -------- 180 August --------------------------------------------- 560 530 5151 ------ 10 September --------------------- 690 750 3380 ------- 260 October ----------------------------------------------- 90 1070 4940 ------- ------- November ---------------------- 160 480 3865 ------ 110 December -------------------------------------- 70 170 2405 10 20 TOTAL ------------------------------ 3815 8670 55326 70 1160 TOTAL NO. OF DOSES--------- 3815 8670 55326 70 1160 3.0 395 235 285 100 495 430 490 610 180 260 410 20 3910 19550 4.5 540 ---------------------- 50 -------- 880 400 100 -880 35 1000 3125 5960 6.0 1480 850 1680 880 590 1100 1270 380 400 640 300 370 9940 99400 10.8 650 100 200 50 1200 100 100 200 350 50 100 100 3200 57600 ~ <1> 0 ~ ARSENOXIDES ~ 45.0 - .045 -------- 2040 -------- 1220 -------- 1380 -------- 1160 -------- 3000 -------- 1830 -------- 1145 -------- 1190 ------- 840 .067 4140 2970 4890 4220 5050 4660 4760 3900 2160 .45 .67 t::::f <1> 150 90 ..,"1::1 2180 1210 .~... ;:! 90 110 310 470 2550 2870 2840 2530 -.";.:.s'. 0 "'tj 130 1730 ~ o 80 2360 0....". 130 1890 -------- 990 3790 -------- 1000 3590 -------- 1050 2830 ------- 16845 46960 70 1188 ::z:: 80 1227 <1> ~ 110 1360 ~ 1820 23915 ~ -------- 16845 46960 18200 239150 TABLE "F" FREE ANTISYPHILITIC DRUGS DISTRIBUTED Veaereal Disease Control Service Januai'J'- December, 1944 T~ar- saulide 3.0 January ----------------------------------- 20 February ---------------------------------- ---March ---------------------------------- ---April ------------------------------- ---May ----------------------------------------- ---June ----------------------------------------- ---- July ---------------------------------- ---August ---------------------------------------- 20 September ------------------------------ ---October ----------------------------------- ---November ------------------------------ ---December -------------------------------- --- TOTAL ----------------------------- 40 TOTAL NO. OF DOSES.. 40 Sulpharsphenamine Stovarsol 0.2 0.4 0.6 Tablets 130 70 10 2200 130 110 160 946 25 260 -60 -- 125 250 20 1200 145 15 70 700 180 90 100 2150 105 2090 90 850 100 40 130 1700 30 ------ ----- 2600 175 20 20 600 155 215 60 2200 10 10 ------ 100 1310 3110 600 15245 1310 3110 600 15245 FUADIN 5-cc ---------- 120 460 290 650 360 590 390 790 290 230 4170 4170 SULFATHIAZOLE BISMUTH Bottles of Tablets 40 tablets 30-cc 60-ec 63000 269 736 488 73000 144 472 1261 68000 328 344 677 50000 178 228 678 61000 155 389 702 73000 161 369 435 65000 281 193 1667 78000 70 313 405 31000 206 241 390 72000 457 263 409 74000 175 291 296 84000 150 200 719 782000 2574 4039 8027 782000 102960 121170 481620 Total No. doses of tryparsamide ----------------------------------------------Total No. doses of neoarsphenamine Total No. doses of arsenoxides Total No. doses of Sulpharsphenamine Total No. doses of stovarsol 40 251,551 105,155 5,020 15.245 Total N'o. doses of fuadin --------------------------------------------------------- 4,170 Total No. doses of sulfathiazole ----------------------------------------------- 884,960 Total No. doses of bismuth ----------------------------------------------------- 602,790 TOTAL --------------- ------------------------------------------------------------- 1,868,931 Total No. of frei antigeu.____________________________ -------------------- 1,030 Total No. of ducrey antigen............--------------------------------------- 4,050 (For larger ampoules, 0.6 considered dose) (l-ee ~onsidered dose) VACCINES FREI DUCREY Pkg. (10) Pkg. (50) 10 7 13 4 20 4 .".'.t;j (II 14 22 6 7 ~ ...(II ;:t 9 7 1:1 0"" 9 7 ~ 5 5 t:::l 10 11 ~:;; 7 7 (II 1:1 103 81 "'(II 1030 4050 "' 1..:.-.,.J. CiJ ..t.-...,.:1... TABLE "G" LABORATORY EXAMINATIONS FOR VENEREAL DISEASES Performed in Central Laboratory and Two Branch Laboratories GEORGIA DEPARTMENT OF PUBLIC HEALTH January- December, 1944 SEROLOGIC EXAMINATONS Number Number Percent TOTAL Positive Negative Positive Jauuary --~------------------------------------------- 36108 3722 32386 10.3 February ---------------------------------------------- 27309 3120 24189 11.4 March ------- 30150 3476 26674 11.5 April ------------------- 26093 4343 21750 16.7 May -------------------------------- 30241 3713 26528 12.3 June--------------- 29672 2969 26703 10.0 July --------------------- 27047 2948 24099 10.8 August ---------------------------------- 31002 3605 27397 11.6 September ---------------------------- 29561 3894 25667 13.1 October ---------------------------------------- 30112 8608 26504 11.9 November ------------------------------------ 27030 8350 23680 12.4 December -------------------------- 22088 2653 19435 12.0 TOTAL ---- 346413 41401 305012 12.0 DARKFIELi> EXAMINATIONS Number Number Percent TOTAL Positive Negative Positive 7 3 4 42.9 8 1 7 12.5 9 4 5 44.4 4 2 2 50.0 7 1 6 14.3 24 4 20 16.7 24 10 14 41.7 18 6 12 33.3 29 5 24 17.2 21 11 10 52.4 11 5 6 45.5 11 2 9 18.2 173 54 119 31.2 <;') c~ ~ ~ i EXAMINATION FOR GONOCOCCI t:::1 Number Number Percent .... TOTAL Positive Negative Positive 857 140 717 16.3 1121 166 955 14.8 ~ .;.:.I. 1336 186 1150 13.9 ~ 1089 174 915 16.0 1489 255 1234 17.1 ~ 1567 280 1287 17.9 167 49 118 29.3 5- 1454 261 1193 17.9 1298 226 1072 17.4 1581 324 1257 20.5 ~ 1732 262 1470 15.1 1512 263 1249 17.4 15203 2586 12617 17.0 TABLE "B" SUMMARY REPORT OF EDUCATIONAL ACTIVITIES Venereal Disease Control Service January- December, 1944 Meetincs Addressed No. Aud. January ----- 4 February ---- 4 March ------------ 29 April ---------- 24 May --------- 6 June ------- 13 July ------ 10 August ---- 4 September -- 2 October __ 16 November -15 December - ___ TOTAL __126 260 327 3480 5034 655 2183 2752 194 365 2547 2078 --- 19775 Meetings Attended (Not addressed) 10 11 18 20 13 10 --- ---- 1 --- 8 -- 91 FILMS No. Aud. 9 952 28 7172 38 6160 20 2748 12 8255 11 1546 13 1922 9 2622 9 941 23 13774 6 11142 14 9838 192 67072 No. of Clinic Visits 2 4 7 1 14 10 10 5 10 8 ---- 7 78 Memberships No. of Conferences 36 35 44 34 30 18 Exhibits Literature Distributed Distributed 1 2351 1 3534 1 4229 1 4650 ---- 5034 5 5977 Obtained for Ga. Social B:rclene Council "...t. t ~ :<:1s> ~ 0'" 11 1i> 9 t:l !;; --- <1> 2 3 1:1 "~ ' 28 3 15579 3 3 5397 12 4 2341 23 1 4709 16 4 2944 1 25 -- 1056 2 304 24 57801 -28 - !.:.-.-..:). Cl1 TABLE "I" VENEREAl, blsto:ASE SUSPECTS JlEPOR'U:o 'tO GEORGIA CLINICS FOR INVESTIGATION DURING 1944 TYPE OF SUSPECT Contacts of Members of the Armed Forces------------------------------------------------------------Syphilis-Complete Information Syphilis-Incomplete Information Gonorrhea-Complete Information Gonorrhea-Incomplete Information ----------------------------------------------------------------Other V- D--Complete Information Other V- D--Incomplete Information --------------------------------------------------------Contacts of Civilian Patients-------------------------------------------------------------------------- Syphilis-Complete Information Syphilis-Incomplete Information Gonorrhea-Complete Information Gonorrhea-Incomplete Information Other V. D--Complete Information ------------------------------------------------------------Other V. D--Incomplete Information_______________________________________________________________ Positive Laboratory Findings---------------------------------------------------------------------------------Selectees Army Separations -------------------------------------------------------------------------------------Premarital Tests ----------------------------------------------------------------------------Prenatal Tests -------------------------------------------------------------Miscellaneous TOTAL 6,606 348 463 1,936 3,269 168 331 13,683 4,265 3,108 2,766 2,661 508 386 14,443 11,895 340 11 16 2,181 FIRST SIX MONTHS 3,188 213 244 986 1,429 111 206 6,967 2,256 1,453 1,366 1,343 306 266 11.801 10,934 ------ 6 2 869 ~ ....... 0\ SECOND SIX ~ t1) MONTHS 0 ri~ 3,317 i:i' 135 t::::l t1) 219 "1::1 951 .~ ...... 1,830 ;3 67 126 6,716 2,009 1,666 1,411 1,308 t1) ;::s ...0 -~ !;:: 0"' -~ 203 ::X:: 130 2.646 t1) ;~.:;::... 961 340 6 14 1,326 TABLE "J" VENEREAL DISEASE SUSPECTS REPORTED FOR INVESTIGATION JannalT- June, 1944 PERCENTAGE LOCATED AND EXAMINED AND PERCENTAGE STILL PENDING AS OF SEPTEMBER 1, 1944 TYPE OF SUSPECT Contacts of Members of the Armed Forces Syphilis-Complete Information Syphilis-Incomplete Information Gonorrhea-Complete Information Gonorrhea-Incomplete Information -----Other V. D.-Complete lnformation_______________________..........................------- Other V. D.-Incomplete Information.......................------------------------- Contacts of Civilian Patients Syphilis-Complete Information Syphilis-Incomplete Information Gonorrhea-Complete Information Gonorrhea-Incomplete Information ------------------------------------------ Other V. D.-Complete Information_------------------------Other V. D.-Incomplete Information_____,________________....................................... Positive Laboratory Findings**---------------------- Total Reported for lnvesti&'ation 213 244 985 1,429 111 206 2,256 1,453 1,355 1,343 305 255 11,801 Located and Examined* No. % 120 56.3 48 19.7 543 55.1 302 21.1 74 66.7 34 16.5 1,482 66.7 594 40.1 837 61.8 459 34.2 176 57.4 85 33.3 7,304 61.9 Disposition Pendin&' as of September 1, 1944 No. % "tt ~ <:; 48 22.5 ...;~::, ~ 33 13.5 0"' 208 21.1 ~ 222 15.5 t::::l Nj 15 31 436 13.5 15.0 19.3 ~""'' """''' 386 26.5 268 18.7 367 27.8 62 20.3 89 34.9 3,250 27.5 Includes "Examined-Infected", "Already Under Treatment". "Examined-Not Infected", "Infected, Not Brought to Treatment." **Includes Selectees, Women Volunteers with Positive Teats, Premaritals, Prenatals, Army Separations, and Miscellaneous Positive Laboratory Findings. t-.:) ....... -.] ~ ...... TABLE "K" 00 VENEREAL DISEASE SUSPECTS REPORTED FOR INVESTIGATION July December, 1944 PERCENTAGE LOCATED AND EXAMINED AND PERCENTAGE STILL PENDING AS OF MARCH 1, 1945 TYPE OF SUSPECT Contacts of Members of the Armed Forces Syphilis-Complete Information Syphilis-Incomplete Information Gonorrhea--Complete Information Gonorrhea-Incomplete Information -------------------------------------------------------------Other V. D.--Complete Information_________________________________________________________ Other V. D.-Incomplete Information______________________________________________________________ Contacts of Civilian Patients Syphilis--Complete Information Syphilis-Incomplete Information Gonorrhea--Complete Information Gonorrhea-Incomplete Information ----------------------------------------------------------Other V. D.--Complete Information___________________________________________________________ Other V. D.-Incomplete Information________________________________________________________ Positive Laboratory Findings**------------------------------------------- Total Reported for Investi&"ation 135 219 951 1,830 57 125 2,009 1,655 1,411 1,308 203 130 2,646 Located and Examined* No. % 97 71.9 59 26.9 537 56.5 476 26.0 31 64.4 21 16.8 1,369 68.1 865 52.3 1,016 72.0 654 50.0 126 62.1 69 53.1 1,607 60.7 ~ Disposition Pendin&' as of March 1, 1945 ~ ~s No. % ~ ~ .1...:1.. 13 29 9.6 13.2 ;: ...:C;:bs 166 237 17.5 13.0 ~ 11 19.3 "'0 10 8.0 ~ 0" ~ 273 248 125 177 13.6 15.0 8.9 13.5 -::r:: ~ ;;:. 30 14.8 11 8.5 553 20.9 Includes .,Examined-Infected", "Already Under Treatment", "Examined-Not Infected". "Infected, Not Brought to Treatment." Includes Selectees, Women Volunteers with Positive Tests, Premaritals, Prenatals, Army Separations, and Miscellaneous Positive Laboratory Findinp. TABLE "L" ACTIVITY REPORT FOR SOUTREASTERN MEDICAL CENTER, 1944 Month 1944 Syphilis Alone or with other V. D. except II'Onorrhea January----------------- 62 Februar:v ------------------ 81 March --------------------- 128 April ----------------------- 73 May ------------------------- 62 June -------------------------- 106 July --------------------- 132 August------------------- 176 September ------------------- 197 October ----------------------- 177 November 162 December ---------------------------- 141 TOTALS ------------------1,496 RECAPITULATION: Total syphilis____ Total gonorrhea __ Other V. D._ _ _ 1824 1918 114 8866 Syphilis & G. C. toJI'ether with or without other V. D. 12 60 24 37 23 26 17 32 18 36 27 26 - 328 Gonorrhea alone or with other V. D. except syphilis 44 73 128 110 149 112 93 169 174 164 184 . -19-0 1,590 Other V. D. not in combination with syph. or G.C. 5 14 14 7 5 9 7 11 13 6 11 12 -- 114 Non V. D. 12 2 11 11 13 17 6 22 23 25 29 28 -- 199 TOTAL 135 220 "'t:j 305 ~ 238 <:! 252 (1) ~ 270 ~ 255 409 C"' ~ 425 408 t:::; ~ (1) 413 ~ 397 -- (1) "' 3,727 ~ ...... \0 ' ~ 0 TABLE "M" SYPHILIS BY STAGES- SOUTHEASTERN MEDICAL CENTER, 1944 1944 Primary and Secondary Early Latent Late Latent and Late January -------------------------------------- 10 43 10 February ----------------------------------------------- 18 79 30 March -----------------------------------------------,- 18 108 25 April ------------------------------------------ 22 71 15 May ------------------------------------------ 25 38 20 June ----------------------------------- 46 60 20 July ----------------------------------- 46 72 25 August ----------------------------------- 54 104 43 September ------------------------------- 86 90 34 October ----------------------- 68 101 35 November--------------------------- 56 102 29 December ---------------------------------------------- 67 71 28 TOTALS -------------------------------- 616 939 314. Congenital 0 3 0 2 2 6 2 6 5 8 2 1 37 Stall'e Unknown 11 1 1 ---- ------- 4 ------- 1 ------ 18 ~ c~ ~ TOTAL ~"' ~ ~ ...... 74 ~ ~ 131 152 110 85 132 149 207 215 213 ~ .,.~.. c -'"l:i !;:: 0"' -<"">' 189 1:1:: ~ 167 ~ ~ ~ 1824 Division of Malaria and Hookworm Service C. D. BoWDOIN, M.D.___________________________________________________________..Acting Director PAUL C. BEAVER, Pu.D.______________________________________________________..Assistant Director Division of Malaria and Hookworm Service The personnel of the Division for the first part of the year consisted of the Acting Director; two Field Biologists, one of which was Assistant Director in charge of field activities; a Field Nurse; a secretary and a clerk-typist. Effective May 15, the Acting Director resigned and the direction of the Division was taken over by the Director of the Division of Preventable Diseases. A temporary Biologist joined the staff for three months during the summer. ANTI-MALARIA ACTIVITIES Although the standard plan for county-wide malaria control was officially discontinued in 1942, three counties, Dougherty, Crisp, and Terrell, have to the present time continued with county-wide dusting programs. The Division assisted these counties, especially Dougherty and Cris~ by making entomological investigations on the basis of which control operations were largely directed. In response to requests for assistance in malaria control problems, other counties were served by special investigations. These investigations include: a follow-up of the 1943 malaria outbreak in the Doctortown vicinity of Wayne County; mosquito breeding in the vicinity of three proposed Boy Scout camps in Wayne County; mosquito breeding and control operation at a Boy Scout camp in operation in Worth County; mosquito control operations in the Albany area; a pest mosquito problem in the city of Hazlehurst; malaria cases and mosquito breeding in Wilcox County where the incidence of reported cases was unusually high in 1944; and A. quadrimaculatu.s surveys in the vicinity of towns and villages of Screven, Bulloch, Evans, Emanuel, and Candler Counties. In addition to responses to requests, three general additional types of investigations were carried out. Observations were made and data accumulated for investigations being continued throughout a period of several years; preliminary experiments were conducted and field observations were made on the general problem of choice of site for A. quadrimaculatu.s oviposition; and as a preliminary to a study of natural factors involved in the present low endemicity of malaria, conditions prevailing in a number of populated area in regions of former high endemicity were studied. MALARIA MORBIDITY AND MORTALITY This year there was a further reduction in the incidence of malaria in Georgia. Provisional statistics for the period through December 30 showed only 377 reported cases, at least 100 of which were military personnel in 224 Georgia Department of Public Health service hospitals. Deducting these cases, all of which probably were contracted outside of the State, we have less than 300 reported cases as compared with 491 and 981 for the years of 1943 and 1942 respectively. The seven counties reporting the greatest number of cases are: Wilcox, 44; Bulloch, 36; Brooks, 24; Seminole, 19; Colquitt, 18; Lee, 17; and Washington, 11. Only 26 deaths were attributed to malaria during the first 9 months of 1944. For the same period of 1943 and 1942 respectively the number of deaths were 25 and 46. Seminole County with 5 and Brooks with 2 are the only counties reporting more than 1 malaria death in this period. A limited number of thick blood film surveys were made in the fall of 1944. Localities were chosen which either had had a high incidence of positives on previous surveys or were known by entomological investigations to have relatively dense populations of the vector, A. quadrimaculatus. Out of a total of 5,644 films, 3,661 have been examined to date. Two were found to be positive for malaria. No previous survey of a like number of individuals in this region has ever given so few positives. In addition to the fall surveys, 253 slides taken on white school children in Decatur County in the Spring of 1944 were negative for malaria. SUMMARY BY COUNTIES OF 1944 FALL THICK BLOOD FILM EXAMINATIONS OF ELEMENTARY ScHOOL CHILDREN Count)- Slides Reeeived Colored White Baker** -------------- 1092 663 Berrien ---------------- 250 Brooks ---------------- 407 Calhoun -------------- 118 179 Crisp ------------------- 285 Dougherty ---------- 57 Early** -------------- 492 295 Grady ------------------ 94 80 Liberty ---------------- 296 Peach ------------------ 162 Sumter ---------------- 206 Telfair ---------------- 104 54 Terrell ---------------- 304 Wayne ---------------- 144 Wilcox ---------------- 362 Slides Examined Colored White 395 406 250 407 7 285 57 110 94 80 296 162 144 104 54 304 144 362 Positive Colored Wllite 2 TOTALS ------------ 3704 1940 2445 1216 2 GRAND ToTALs 5644 3661 2 **Emory University Project. Malaria and Hookworm Service 225 ANTI-HOOKWORM ACTIVITIES There has been no significant change in the general program of hookworm control in recent years. Emphasis is placed on hookworm disease as contrasted with hookworm infestation and the family rather than the individual is regarded as a case unit. The selective survey, based on actual or suspected anemia followed by stool examinations, is the usual casefinding method. General surveys were done in only three counties. To assist County Health Departments, the Divisional staff members participated directly in selective surveys in 20 counties. Active hookworm programs without direct participation were initiated in 10 other counties, and consultations on special problems were held in 12 additional counties. Educational programs in 5 counties were participated in by giving 8 addresses and 15 illustrated lectures on hookworm and sanitation. Several studies, some of which were begun in 1942 and 19~3, on hook worm control problems were completed in 1944. The more important of these are (1) the effects of iron supplements on the hemoglobin level ,in Atkinson County school children, (2) seasonal variation and age-sexhemoglobin correlations in Atkinson County school children, (3) selective S'!lrveys md non-hookworm anemias, and (4) field observations on the Standard Pit Privy in South Georgia. A follow-up of the Atkinson County hemoglobin studies using larger numbers of rural children and' a siiD;ilar sample of urban children is in progreSs. Other studies in progress aim at evaluating the selective survey technic, present standards of rural sanitation, and the efficacy of anthelmintic treatment at different seasons of the year. For consultation and inspection of field activities on hookworm investigations and control, visitors were received from Brazil, Columbia, Bolivia, China, Rockefeller, Foundation, and Western Reserve University. SuMMARY oF AcTMTIES BY CoUNTIEs FOR THE YEAR 1944 COUNTY Eclueational and Promotional Mtcs. Addrs. Attd. Made Exhibits Confs. Appling ---------------Atkinson -------------- 6 6 6 108 Bacon ------------------ 9 Baker ----------------- 2 Berrien ----------------- 3 Bibb ----------------- 1 Bleckley ----------- 1 Brantley ------------ 40 Brooks ---------------Bryan ----------- 4 z Bulloch ------------ 'I Burke ------------Calhoun ----------- z z Candler --------- 1 Charlton ----- 4 Chatham ----------- 27 Clinch ----------------- 1 1 17 Coffee --------------------Colquitt ------------ 1 39 1 Columbia -------------- 1 Crisp ----------- 1 ----- ----- 33 Decatur --------------- 2 Dougherty 2 ---- --- 32 Echols 3 Effingham 1 Emanuel ----------- 'I Evans --------------Fulton ------------ 3 z- '36 Glynn ----------------- a Grady -------------- a Houston ------- a Irwin ---------- z .....PitT. Hb. ---- 83 ----- 8016 ------ 11 ------ ----- ------ ----- ----- ---- ---- ----- ------ --------n-- -- ----- 1011 'fO --------- ----- -- 31 ----- - - ------ - u Hookw- Treat. Antllel Treated alatie Inn Epidemiolocical Senl- Home Malaria Spleen Visits Smears Palp. z ----- 4 ------ ----- ------ ---- ------ - ---- ---- ------ ----- ----- -------- ZliO ----- ------ --- ----- 87 ---- -------- --------- 16 - --------s-----a--8 ----- 8 -------- ----- ------ --- ---- ------- --- - 186 ------------6 1 10 -- -- ------ --"-- 1 ---- ------ ---------- - ----- -- 286 ----------- --- ----- ----- --- ---- -------- -- ------- ~ ~ Q'l Containers SoU Dlst. Colt. Samp. 31 44 ---- -- -.~ ---- ---- --- <1> 0 -- - --- -- ~s 814 --------z-o -- 86 81 ---------- - ----- - --- t::::l ~ ------ - ~ ;<:1s> ...0 -;"':t1 0" -g ----- - ----- -- ---- ~ ~ 94 1'7 - 6a SuMMARY OF AcTIVITIEs BY CoUNTIES FOR THE YEAR 1944 COUNTY Educational and Promotional Mta's. Addrs. Attd. Made Exhibit. Confa. Jeff Davia ----- --- --- ---- 10 Jefferson ----- ---- -- - 4 Jenkins - - - - - - ____ ---- - 9 Lamar -------------- ---- Lanier ---------------- ----- ------- ------ 1 1 Laurens ------------ ----- ----- --- 4 Lee -------------------- ---- --- ---- 3 Liberty ----------------- ----- ---- -- 18 Long ----------------- ----- ---- --- 26 Lowndes ------------ ----- Mcintosh ------------- ---- --- --- ------ 2 1 Mitchell -------- ---Montgomery ----------- ----- ---- -- - 1 1 Pierce -------------- -- 1 -- 1 Randolph ---------- ---- ---- 6 3 Richmond ----------- 1 ---- -- 4 Screven --------------- ____ --- ---- 1! St. Louis, Mo._______ 1 -- ---- --- Sumter ------------- ----- ---- --- 2 Tattnall -------------- ---- ----- --- 3 Telfair --------------- ---- --- 3 9 Terrell -------------- ---- ------ ----- 6 Thomas ------------- --Tift --------------- -- ------- ----- 13 4 --- Toombs ---------- Trotutlen ------- ---Ware ------- 1 Wayne ------ ----- Wilcox ------ ---- ------ - 1 ---- --------- 8 1 62 64 12 Wilkinson ------------ ---- -- Worth ---------- - - - TOTAL 9 --1 11 -- 16 1 2 674 u.. Pla7'. Exa-. ---- 16 Hookworm Treat. Anthel Treated mintie Iron Epidemioloaieal Bern- H-e Malaria Spleea VIsit. Smean PaJp. 10 ----- -- ----- 2 3 ----- -- ---- Containen Soil Dlst. CoiL Samp. 20 68 --- 28 ------------- ------- --70 -- -------- --- --- 81 11 16 38 ---- -- 18 ------14 18 1 ----42 --- ---- - --------- ---10 -- -------- 3 ------------------ --- -------- 1 ----84 ------ -------- --- --- --2 ----- - --- 272 ----------- - --------- 1 -- 233 ------------------- --- --------- -26 - 22 120 -------- - ------------------- -- - - ----1--4 --- - ----------- - - ----------------------- .~.. ~ l ~ ;Q.:.. ~ Q ~ ~ ~ F; ~ --------- 41 - -- -- 102 --- 10 --- ---- ----- ----- ----- 2 46 1 1 --- 1 1411 388 1 ------ --- - ---- 1114 3 - 1 3 -- - 6 -- fj -..) 98 4688 820 6 848 1627 -- 10011 160 6 ~ SuMMARY oF AcTIVITIEs BY CouNTIEs FOR THE YEAR 1944 ENTOMOLOGICAL SERVICES COUNTY Ponds Ponds Anoph. Species Found Adult Anoph. Inves. Dipped Neg. Aq. A c. Ap. Others Searches Neg. Q. Appling ------------------ -------- -------- -------- -------- -------- -------- -------- 1 1 -------- Atkinson ---------------- 6 3 2 1 1 -------- ------- 17 15 2 Ben Hill ---------------- 5 Berrien -------------------- 2 2 -------- 2 -------- -------- ------- 24. 2 22 2 -------- -------- 2 __,..____ -------- -------- -------- -------- Brantley ------------------ 4 1 1 -------- -------- -------- -------- 2 2 -------- B r o o k s ---------~--------- 2 2 1 1 1 1 ------- 1 1 -------- Bryan --------------------- -------- -------- -------- -------- -------- -------- ------~- 1 -------- 1 Bulloch ----------------- 15 -------- -------- -------- -------- ------- ------- 36 25 10 Burke ---------------------- 6 5 3 1 -------- -------- ------- -------- -------- ------- Candler -------~------~ 6 5 2 1 3 ------- ------- 3 2 1 Charlton --------------- -------- -------- -------- -------- ------- ------- ------- -------- ------ -------- Clinch ------------------ ------- -------- -------- -------- ------- ----- --- 2 -------- ------- Coffee ------------------ 7 2 1 -------- 1 ------- ----..- 4 -------- 3 Columbia ---------------- 14 1 1 -------- -------- -------- ----- 34 22 5 Crisp ----------------------- 235 96 49 37 25 4 ------ 313 133 159 Dooly ----------------------- 8 1 ------- 1 ------- -------- ------- 36 6 27 Dougherty ------------- 321 171 132 46 34 1 11 142 54 82 Emanuel ----------------- 38 36 22 9 8 6 ------- 10 8 2 Evan ----------- 25 18 10 6 1 6 ------ .4 4 .. Glynn -------------------- 2 Irwin------------------------ 4 1 4 1 ------- -------- 1 -------s __-_-_-_-_-_-.-. -------- ---- ------- 1 ........... 1 SANITARIAN SERVICES Sani SanI tary tary Speeiea Found Surveys Units 1\lap c. P. Others Premises Instld. Hours ~ .,. .Q.. ~ 5" .,. -------1 -------- -------- -------------- -------- 3 --------------- ------------- t:::l ---------------------- 2 --------------- -------- -------- -------- -------1 -------- -------- ---- -------- ------- ------ ~.g1.,=...1 --------------- 3 ------- 1 ------- 2 2 -------------- -----~~- ---------------------------- 2 ----------------------------- ---- -------------------- ---------------------- -~------ -----1 3 . 10 ------------------------ ------ -------------- -- ---------- .~... Q -- ---------2 -------- ""o ~ 0"' 5" l.:,.t: 1 26 7 34 -------- ------- -------- 597 --------------- ------------- 1=1 ~ ~ 16 16 ----- --- 17 7 5 129 SuMMARY oF AcTIVITIES BY CouNTIEs FOR THE YEAR 1944 ENTOMOLOGICAL SERVICES COUNTY Ponda Ponda Anoph. Species Fonnd lnYea. Dipped Nel'. Aq. Ac. Ap. Othen Jeff Davia --------- 28 7 6 1 1 --~-- -- Jenkins -------- 78 69 9 66 9 4 ---- Lee ----------------- 2 -------- ---- -------- -------- ----- ------- Liberty --------- 6 --- ----- ------ ------- ------- ---- Long --------------- 48 40 28 9 6 4 ----- Mcintosh ---------- 6 1 1 -------- -------- ------- ------- Pierce -------------Richmond --------- - - 5 -------- -------- ----- -------- ----- ----- 2 1 1 ---- -------- ---- Scr:even -------------- 102 79 32 30 50 13 ------ Sumter --------------- 45 8 2 4 1 2 ------ Telfair --------------- ------ ------- ------ -------- -------- -------- ------ Terrell ------ 8 --- -- ------ --- ----- ---- Thomas ----------- -------- ----- ----- ------ -------- ------- ---- Tift --------- 5 8 ----- 8 3 ---- -- ---- Washington ------- ----- ----- - - --- ---- ----- ------- Wayne ------ 6 8 3 -- --- ------- -- -- -- -- -- ---- ---- Wilcox ------------ 79 19 Worth ------------ 27 11 8 13 10 6 6 2 1 ---- TOTAL--- 1140 691 316 226 161 41 11 Adult Anoph. Searches Neg. Q. 7 4 1 127 14 112 1 --- ------- 2 ------- 2 27 9 14 5 ------- _______6. ------. -------- 2 1 ------- 8 5 1 196 97 86 7 ------- 7 2 1 1 ------- -------- -------- 4 2 2 2 ----- ------- 86 34 49 29 21 7 -4-0 -1-8 -1-9 1178 486 616 SANITARIAN SERVICES Sani Sani tary tar:r Species Found Surveys Units Map c. P. Others Premises lnstld. Hours .~.. 2 6 1 -------- 2 -~----- 5 -------- 2 6 -------- 1 -------------------- ------ -------177 -------------- ------- ----- -------- -------- --------------- ~ ~ ~ - - -------- -------- -------- -------- ----- ----- Q;.;... -------- ------- ----- ------- -------- :::; -------- 2 1 -------- -------1 -------------- --------------- -- ------ 0 ~ ,. 12 -------- 22 -------- ------------ 146 -------- ---------- ------ e...n ,. 1 -------- -------------- -------- ------- -------- 683 -------------- ---------- ~ F) -------- -------- ------- 2 17 10 4 4 4 -------- -------- 1 ----- 3 7 -- 2 ------- 51 121 117 11 1806 ---- 6 I>:) ~ Division of Tuberculosis Control H. C. ScHENCK, M.D.________________________________________________________________________Director CLARA B. BARRETT, M.D.____________________________________________________________________Clinician J. F. BuscH, M.D. ______________________________________________________________________________Clinician Division of Tuberculosis Control Considerable difficulty in the operation of the Division of Tuberculosis Control was encountered during 1944. These difficulties consisted principally of a shortage of personnel of all kinds in the Division, of nursing personnel in the field, and of transportation of people to clinic centers. However, in spite of these handicaps, a total of 10,232 x-ray pictures was made by our field clini.c unit, and 325 were made in our central office, and by these means 545 new cases of tuberculosis were found. In addition, 5,264 consultation films were interpreted, 3,175 of which were first or original examinations, out of which 301 new cases were discovered. This makes a total of 846 new cases of tuberculosis located by these means. In addition, 15,552 35-mm. photofluorographic chest pictures were made. The results of these were included in the interpretation of x-ray pictures as shown above and also in Table I. Distribution of clinics is shown in Table II. The following table with final figures for the year 1944 shows that there was a reduction of 197 in the number of deaths in 1944 as compared with 1943: Year 1943 __________l_____ 1944 - - - - - - - Total 1304 1107 NUMBER White Colored 499 805 419 688 Total 41.7 35.4 RATE White 24.5 20.6 Colored 74.2 63.4 Ninety-three, or 44% of these deaths occurred in nine counties in the State, as is shown by the table listed below: County 1943 1944 Bibb ------------ 56 55 Chatham ---------- 99 79 DeKalb ------------- 34 23 Dougherty----------- 24 14 F1oyd ------------ 20 13 County 1943 1944 Fulton ------------------ 261 238 Sumter ---------- 15 8 Troup ------------- 22 14 Walker ------------------- 20 14 Consultation service has more than doubled in 1944, as shown by the present figures of 5,264 against 2,087 for the year 1943. Much of this increase is due to the expanded service in some of the thirty counties in which fluoroscopic-radiographic machines were placed in 1942. Further increase in this service is to he expected. The artificial pneumothorax program was continued during 1944 at a cost of $24,119.00. An avesage of 379 patients per month was treated at an average cost of $5.30 per month per patient. The previous annual report of the number of patients treated was in error, inasmuch as 74 cases which had been discontinued were included in the report. On December 31, 1944, 448 patients were receiving treatment under this program. 234 Georgia Department of Public Health Photofluorographic x-ray pictures of rejected selectees are being received by the Division of Tuberculosis Control and an effort is made through the local public health organizations to have each case followed up. At the end of this division's report is a statistical report of the service rendered by the tuberculosis consultant nurse, the employment of whom was mentioned in the annual report for 1943. One of the important functions of this consultant nurse is to work out with local health organizations, welfare departments and other agencies the solution of difficult problem cases, particularly difficult public health menace cases. Another is to help develop standard services in local health departments. Following is a brief summary of the public health tuberculosis control activities carried on in organized counties in 1943 and 1944: 1943 Cases of tuberculosis admitted to service____________________ 6,058 Visits to tuberculosis cases, contacts and suspects_____________ 63,229 Visits to cases of tuberculosis_________________________ 17,624 Office visits by cases of tuberculosis___________________ 5,919 Office visits by tuberculosis cases, contacts and suspects___________ 23,458 Admission to Sanatorium Number completed tuberculin tests ---------------- 555 24,190 Number positive---------------------- 6,614 Contacts broken ------------------------- 1,343 Contacts partly broken------------------------------ 393 Relief secured-Number of cases----------------------------- 609 Tuberculosis Cottages built --------------------------------------- 16 1944 5,904 55,526 15,291 6,714 25,061 560 22,322 6,136 1,307 215 358 18 This summary shows that in spite of increased difficulties in carrying on routine services, the performance of these services in 1944 compares favorably with those of 1943. Plans for 1945 have for their aim greatly increased tuberculosis case finding and facilities for the care of patients who have tuberculosis. It is hoped that in 1945 six or more tuberculosis districts may he established, each furnished with x-ray equipment, such as stationary fluoroscopicradiographic apparatus to he located in health departments and tuberculosis clinic stations and photofluorographic miniature film apparatus for use likewise in health departments and large hospitals for mass case-finding purposes. It is hoped that each of these districts may have a consultant tuberculosis clinician, preferably with public health experience background, who would be responsible for the development of anti-tuberculosis measures within the area to which he may be assigned. It is hoped, too, that an expansion of hospital and sanatorium facilities can he brought about so that the terrible need of hospitalization for tuberculous patients requiring it may be met. Considerable aid for equipment and personnel is certain to be had through the Division of Tuberculosis of the United States Public Health Service. We also expect to develop and put in operation a central case Tuberculosis Control 235 register in the Division of Tuberculosis Control and to make it possible for similar registers to he established in each of the districts as they may he developed, and in each county health department as may he desired. TABLE I Following is a brief summary of clinics, surveys and interpretations of consultation x-rays in 1944: Kind of Clinic: No. of Clinics Clinie Da:ra No. of No. of X-ran CaaeaFoand % Regular - - - - - - - - 204 204 9073 479 College 14 x 17 -------- 4 4 92 1 (35 mm. survey) lndustrial14 x 17 ---------------- 3 4 447 0 (Not 35 mm. survey) Industrial 14 x 17 --------- 10 10 1067 35 (35 mm. survey) 14 x 17 x-rays made in Central Office ------------ 325 30 Total 14 x 17 films made______ 218 218 10557 545 X-rays sent in by doctors for interpretation_ ______ 3175 301 X-rays sent in by doctors on cases with previous diag- nosis and no change shown 1089 Total14 x 17 films interpreted and cases found________________ 218 218 14821 846 College 35 mm. survey x-rays made ---------------- 10 9 2389 Industrial plant 35 mm. survey x-rays made___________ 11 32 13163 * Per cent cases found as applied against total 2389 x-rayed. ** Per cent cases found as applied against total 13163 x-rayed. 5.3 .42 0.0 .27 . . 9.2 5.2 9.5 5.7 A grand total of 29731 x-rays were interpreted and 846 cases were found as a result. TABLE II DISTRIBUTION OF TUBERCULOSIS CLINICS Year 1944 In 96 counties in 197 clinics_____________________________________________ 9,073 In 10 counties in 10 clinics 35 mm. 14 x 17 follow-up industrial plants________ 1,067 In 3 counties in 4 clinics 35 mm. 14 x 17 follow-up colleges--------- 92 In 2 counties in 2 clinics 14 x 17 x-ray of industrial plant survey______ 447 Regular x-rays in office of patients referred by physicians_ _ _ _ _ _ __ 325 Total Number 14 x 17 x-rays made in State clinics___________________ 11,004 35 mm. photofluorographic surveys in 10 colleges representing 9 additional clinic days ---------------------------------------- 2,389 35 mm. photofluorographic surveys in 11 industrial plants representing 32 additional clinic days --------------------------------- 13,163 GRAND TOTAL OF X-RAY PICTURES MADE IN YEAR 1944_ _ 26,556 Consultation films interpreted.---------------------------- 3,175 TOTAL INTERPRETATIONS MADE IN 1944_______________________________ 29,731 236 Georgia Department of Public Health TABLE lli STATISTICAL REPORT OF SERVICES RENDERED BY TUBERCULOSIS CONSULTANT NURSE SociAL SERVICE WORK January-June July-Deeember Yearly 1944 1944 Total1944 1. Number of cases investigated_______________________________ 10 2. Number of visits to representative people regarding cases ----------------------------------- 34 3. Number of meetings held in the interest of patients --------------------------------------- 4 4. Number of problem cases for whom a satisfac. tory plan for care was worked out___________ 8 5. Number of problem cases for whom a satisfactory plan for care is being worked ouL______ 2 MAss SuRVEY WoRK 1. Number of mass survey organizational plans assisted with ------------------------- 5 2. Number of educational programs for survey promoted ----------------------------- 4 3. Number (approximately) literature distributed through industry ---------------------------5900 4. Number of mass x-ray surveys attended and assisted with --------------------------- DEVELOPMENT OF THE NuRSING SERVICE: 1. Number of visits made to regional offices_______ 4 2. Number of conferences held with health commissioners - - - - - - - - - - - - - - 6 3. Number of visits made to health departments_ 13 4. Number of conferences held with nurses______ 28 5. Number of conferences with lay people in the interest of tuberculosis controL_________ 16 6. Number of private physicians contacts__________ 5 7. Number of visits to Alto____________ 3 a. Number of conferences had with officials and patients --------------- 6 8. Number of conferences on rehabilitation____ 4 9. Number of surveys of tuberculosis services in urban centers made-------------- 1 EDUCATIONAL WoRK 1, Number of meetings attended____________ 8 a. Number of meetings participated in_____ 4 h. Number of talks made__________ 3 2. Number of programs planned for meetings___ 2 3. Number of program plans assisted with___ 2 4. Number of committee meetings attended.___ 3 5. Number of showing of films promoted______ 7 6 12 4 2 4 7,000 3 2 26 32 1 3 1 10 4 3 1 1 1 16 46 8 8 4 9 4 12900 4 7 8 39 60 16 5 4 9 5 1 18 8 6 3 3 3 8 State Tuberculosis Sanatorium H. C. SCHENCK, M.D._____________________________________________________________Superintenilent 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., MD. State Tuberculosis Sanatorium Despite the shortage of personnel the statistics show that there is very little difference between 1944 and 1943 in the number of admissions and discharges, x-ray, laboratory, and operating room procedures. There were only 4 less admissions and 78 less discharges in 1944 than in 1943. In some of the departments, as the statistics will show, the total number of procedures in 1944 exceed those of 1943. We call attention with considerable pride to the fact that only 709 pleural irrigations were necessary in 1944 as compared with 1800 in 1943, and only 626 thoracentesis were done in 1944 as compared with 1301 during 1943. Thus it is obvious that serious tuberculous complications of the pleura were reduced about 60%. This is explained by the fact that pneumoperitoneum at this sanatorium bas almost replaced pneumothorax as a collapse measure. We find that the therapeutic results of pneumonperitoneum are equally as satisfactory, if not more so, than pneumothorax and that only about 2% of all pneumoperitoneum patients develop serious complications. During the year a Patients' Personnel Department consisting of two members was established. A member of this department sees all new patients immediately after admission in an effort to help the patient orient him or herself, and to counsel them on following the advice of their doctor rather than being guided by hearsays. The members of this department are doing a good job helping patients during their stay in the sanatorium along the lines of welfare, morale, education, pre-rehabilitation, and miscellaneous. Before Dr. Schenck left the Sanatorium he had added a Nutritionist to the Staff. Her chief duties are to supervise the serving of all food to patients, to plan all special diets, to lecture patients on the value of food and what a balanced diet consists of, to check the weight of patients following each weigh day and to carry out many other important things that naturally fall under the duties of a Nutritionist. On August 1, Dr. Robert Major was added to the staff as visiting hronchoscopist. The purpose of this was twofold. First, it was to meet the immediate needs of a hronchoscopic service, and second it was to train one of the staff men to a point where he could take over this type of work, and thereby provide the sanatorium with a hronchoscopist whose services would he available at any and all times. Realizing the need for blood transfusions in many patients, particularly those receiving major surgery, we installed a 24-unit blood hank. We are now prepared to store both whole blood and plasma. This equipment was installed on the assumption that a sufficient number of persons visiting the sanatorium, especially relatives of patients, would donate sufficient blood to meet our needs without charge. We felt that this procedure of collecting blood would often obviate the necessity of getting professional donors who are not always available during an emergency. So far our needs for both whole blood and plasma have been met. 240 Georgia Department of Public Health CoMPARISON OF NuMBER OF PATIENTS ADMITTED IN YEARS OF 1943 AND 1944 194S 1944 White Men ---------------------------------------------------------------------- 214 243 White Women ------------------------------------------------------------------ 203 191 White Boys ----------------------------------------------------------------------- 2 0 WCohliotreedGiMrlesn--_-_-_-:-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 657 700 Colored Women ------------------------C---------------------~----------------- 65 52 Colored Boys ---------------------------------------,--------------------------- 3 0 Colored Girls ------------------------------------------------------------------ 1 0 TotaL~--------'------------------~----------------------------------~-------- 560 556 CoMPARISON OF NuMBER OF PATIENTs DISCHARGED IN YEARS oF 1943 AND 1944 1941 1944 White Men --------------------------------------------------------------~---- 288 220 White Women -------------------~--------:_______________________________________ 229 217 ~!: ~fJ: ~~~~~~~~~=~~~~~~~~~~~~~~~~=~~~~~~~~~~~~~~~~~~=~~~~~~~~~~~~~~~~~~~~~~~ 12 12 2 2 Colored Men ---------------------------------------------------------------------- 61 Colored Women --------------------------------------------------------- 66 74 . 65 Colored Boys ------------------------------------------------------------------- 1 Colored Girls ----------------------------------------------------------------- 0 8a TotaL____________________________________________________________________ 669 591 ADMISSIONS AND DISCHARGES JANUARY 1, 1944- DECEMBER 31, 1944 Patients Patients Remaininll' Admitted 1231-43 Jan.-Dee. '44 White Men ------------------ 138 243 White Women ----------- 181 191 White Boys ---------------- 2 0 White Girls ----------------- 2 0 Colored Men ------------- 55 70 Colored Women ---------- 64 52 Colored Boys -------------- 8 0 Colored Girls _____________ 3 0 iTnT1reo9at4ate4l d 381 372 2 2 125 116 8 3 Patients Dlaeharaed Jan.-Dee. '44 220 217 2 2 74 65 8 3 RPeamtieanintslq 12-31-44 161 155 0 0 51 51 0 0 TotaL_______________ 453 556 1009 591 418 Tuberculosis Sanatorium 24I AcE AND SEx OF PATIENTS DiscHARGED FRoM JANUARY 1, 1944DECEMBER 31, 1944 Aae Groups 1-I0 -------------~---------------------------------------------------1I-20 -----------------------------------------------------------------21-30 -------------------------------------------------------------------31-40 ---------------------------------------------------------------------41-50 -------------------------------------------------------------------51-60 ----------------------------------------------"---------------------61-70 ---------------------------------------------------------------------.71-80 --------------------------------------------------------------------- Total_____________________________________________________________ Male 6 17 36 60 34 11 4 0 168 J!'eaala 1 26 56 34 20 8 3 0 148 ADMISSION CLAssiFICATION oF WHITE PATIENTS January 1, 1944- December 31, 1944 .Jaa.Jane .Jal7-Dee Total Far-advanced --------------------------------------- 70 Moderately advanced ---------------------------- 80 Minimal ------------------------------------------- 15 !il~-:~~~~~~~=~~~~~~~~~~~~~~~~~~~~=~~~~~~=~ 1 0 0 Non-tuberculous -------------------------------- 12 .Tuberculous Pleurisy --------------------------- 0 Undiagnosed ------------------------------------- 30 Pulmonary the's apparently healed____ 0 79 149 86 166 10 25 0 1 0 0 5 5 10 22 0 0 36 66 1 1 TotaL___________________________________________ 208 227 435 ADMissiON CLAsSIFICATION OF CoLoRED PATIENTS January 1, 1944- December 31, 1944 Jan.-June July-Dee. Total Far-advanced --------------------------------------- 32 15 47 Moderate!y-advanced ---------------------------- I6 23 39 Minimal ---------------------------------------------- 3 3 6 Primary Type ---------------------------------------- 0 1 I Miliary ----------------------------------------------- 0 0 0 Suspicious -------------------------------------------- 2 0 2 Non-tuberculous ------------------------------------ 0 2 2 Tuberculous Pleurisy ---------------------------- 3 0 3 Possible Silicosis --------------------------------- 1 0 I Undiagnosed ---------------------------------------- 13 7 20 TotaL_______________________________________ 70 51 I21 242 Georgia Department of Public Health DISCHARGE CLASSIFICATON OF WHITE PATIENTS JANUARY 1, 1944 DECEMBER 31, 1944 App, App. HeaL Arrest. Arr. Far advanced _____ 0 1 4 Moderately advanced 2 6 17 MPriniimm~al fyp;-==::= 1 3 5 0 7 1 Suep1c1ous ------ 0 0 0 Non-tuberculosis ____ 0 0 0 Tuberculous Pleurisy 1 0 0 Undiagnosed---- 0 0 0 Nou-tuherculous lung abTscOeT8A8L_-_-_-__-_-_-_-__- 0 7 0 12 0 29 Not Qales. Imp. Unlmp. C011111cL Died 17 57 45 1 37 52 65 29 2 4 5 9 3 0 0 0 0 0 0 0 0 11 4 0 0 1 17 11 1 1 0 1 0 0 0 0 2 5 11 0 0 0 1 0 1 75 162 96 15 43 Total 162 117 30 4 15 31 2 18 2 441 DISCHARGE CLASSIFICATION OF COLORED PATIENTS JANUARY 1, 1944 DECEMBER Sl, ltU App. App. Heal. Arreat. Arr. Fat advanced _ _ 0 Moderately advanced 0 Minimal 0 Primary Type - - 0 Suspiciou 0 Non-tuberculous _ 0 Tuberculous Pleurisy 0 Undiagnosed - - - 0 Non-tuberculous lung absce88 - - - 0 ToTAI 0 0 3 0 19 0 13 0 6 0 0 0 0 0 0 0 0 0 0 0 41 Not Qal-. Imp. Unlmp. CoulL Died Total 2 15 20 9 22 7 2 2 0 1 2 0 0 0 0 0 1 6 0 1 0 0 1 0 0 10 50 1 2 60 0 0 17 0 0 9 0 0 0 0 2 9 0 0 1 203 0 1 0 14 45 33 0 0 1 3 14 150 Tuberculosis Sanatorium 243 COMPARATIVE X-RAY REPORT OF THE YEARS 1"3 AND 19U 1943 1944 Fluoroscopies (Colored and White)---------------------- 12,517 12;532 X-rays --------------------- Flats ----------------------------------- SBtuecrkeyoss _____:____-__-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-__-_-_- 4,486 4,304 32 6 3,727 3,638 0 2 G. I. ---------------------------- 45 5 Bone Plates -------------------------------------- 68 44 Fetus ----------------------------------- 0 5 Sinus X-rays ----------------------------------------- 3 4 Fluid X-rays ----------------------------------------- 0 0 PKoidrtnaebyleXs -rays ------------------~-------- _______________________:______________ 8 20 0 10 Mastoid X-rays ----------------------'____ 0 1 Lateral Cheat X-rays ----------------------------- 0 0 1Skull X-rays ------------------------------- 0 0 Photo Roentgenoscope ----------------------------------------- 0 0 ()blique X-rays ------------------------------------------------- Lipiodol ----------------------------------------- Coccyx ------------------------------------------------- :8. M. R. ------------------------------------------------E. K.. G. -------------------------------------------- WHhioteusAe dPualttsi:ents _____________________________________________________:__ Consultation Patients ---------------------------------------------------White Children: House Patients -------------------------------------------------------Consultation Patients ------------------------------------------- 0 0 0 2 6 2,220 1,247 63 140 0 16 2 4 4 1,805 1,029 7 95 Colored Adults: House Patients ----------------------------------------------------- 651 566 Consultation Patients ---------------------------------------------- 134 162 Colored Children: House Patients ------------------------------------------------------ 30 34 Consultation Patients ---------------------------------------------- 1 10 Lipiodol Injections: House Patients ------------------------------------ 14 8 Consultation Patients ------------------------------------ 2 11 Sinus X-rays: House Patients -------------------------------- 0 0 Consultation Patients ------ 0 1 In the clinic at the Sanatorium 26 new cases of pulmonary tuberculosis were found from January 1, 1944 through December 31, 1944. Four hundred and twenty-six of the consultation x-rays sent in by outside phy. sicians, from January 1, 1944 through December 31, 1944 were positive. 244 Georgia Department of Public Health CLINICAL LABORATORY PROCEDURES OF YEARS 1U3 AND 1Uf SmAecairds. Fast Sputum Direct______________________________ Acid Fast Sputum Concentrated..-----------------------Acid Fast Pleural Fluid---------------------------Acid Fast Miscellaneous ---------------------Gram Stain ----------------------------------Fontana -------------------------------------------------- Cultures: Acid Fast -------------------------------------Nutrient -------------------------------------------Sabouraud -------------------------Loffler's --------------------------------------------------- Blood: Count --------------------------------------------------Sedimentation -------------Kahn ----------------------------------------Coagulation --------------------------------Typing --------------------------Crossmatching --------------------------------------Blood Chemistry ------------------------------------------ Miscellaneous: Urinalysis -------------------------------------------------.Feces -----------------------------------------------Animal Inoculation S.B.H. -----------------------------Spinal Fluid Examination -------------------------------------Gastric Analysis -------------------------------------------Gastric Lavage ---------------------------------------Milk Bacteria Count ----------------------------------------Blood Agar Throat Culture__________________________________________ Malaria Smear -----------------------------------Agglutination S.B.H. ------------------------------------Vaccine ------------------------------------------------------------Pasteurization test ---------------------------------Diphtheria ----------------------------------------------------------------- 1141 3,043 198 29 7 22 13 225 30 114 10 843 875 573 100 52 33 80 8,531 25 97 5 8 0 30 24 3 0 0 0 0 ToTAL------------------------------------------------------------------- 14,970 ltU 3,884 19 69 61 65 151 170 18 229 12 849 870 750 101 38 23 25 6,338 15 234 8 9 71 16 0 0 6 1 1 1 14,034 Tuberculosis Sanatorium 245 COMPARATIVE OPERATING ROOM REPORT OF YEARS 1943 AND 1944 Apicolyses-Attempt ----------------------------Apicolyses -------------------------------------Bronchoscopic Examinations --------------Irrigation of Pleural Space ------------------------- Oleothorax, Avg. No. Pts. Rec----------------Oleothorax, Initial ----------------------Oleothorax, Refills -------------------Oleothorax, Discontinued ---------------------------Oleothorax, Pts. Discharged-------------Oleothorax, Avg. No. Out-Pts. Rec----------------- Oleothorax, Out-Pt. Refills ----------------------------- Phrenicotomies --------------------- Phrenicotomies, Out-Pts. -----------------------Pneumolyses ----------------------------------- First Stage ----------------------------Second Stage -----------------------Pneumoperitoneum, Initial -------------- Pneumoperitoneum, Avg. No. Pts. Rec--------Pneumoperitoneum, Pts. Adm. With_____________ Pneumoperitoneum Refills --------------Pneumoperitoneum, Pts. Discharged -----------Pneumoperitoneum, Patients Discontinued-----------Pneumoperitoneum, Avg. No. Out-Pts. Rec,___________ Pneumoperitoneum, Out-Patient Refills ---------Pneumothoraces, Initial - - - - - - - - - - - - - Pneumothoraces, Successful --------------Pneumothoraces, Unsuccessful -----------Pneumothorax, Avg. No. Pts. Rec. -----------Pneumothorax, Refills ----------------Extrapleural Pneumothorax ------------Pneumothorax, Patients Adm. With_______________ Pneumothorax, Patients Discharged -------------Pneumothorax, Patients Discontinued ----------Pneumothorax, Avg. No. Out-Pts. Rec,________________ Pneumothorax, Out-Pt. Refills -----------Removal of Air -------------------Removal of Oil ----------------------Thoracenteses --Oil Injections -------------------Thoracoplasties First Stage ------------------Second Stage -------- Third Stage -----Third Stage Anterior Fourth Stage-----Fourth Stage Anterior Fifth Stage ------------------------Sixth Stage Sixth Stage Anterior -----------------Seventh Stage - - - - - - - - - - - - - - - - - Schede - - - - - Revision -:-::-----:-.::----:-::----------- Invision and Drainage of Lung AbscesseB-Incision and Drainage of Pleural Cavity_________ 1943 1 0 24 1,800 3 0 128 0 0 0 0 243 1 7 0 0 224 170 1 8,496 111 41 2 24 84 56 11 140 5,590 0 13 78 40 5 67 45 1 1,301 0 31 19 15 2 9 0 6 2 0 1 0 0 0 0 1944 0 0 43 709 32 2 69 0 0 1 1 306 0 0 0 0 326 2,736 2 11,276 220 37 20 65 41 44 3 971 2,937 1 18 37 34 2 4 89 1 626 3 28 24 18 0 15 0 2 1 0 0 1 1 0 0 246 Georgia Department of Public Health COMPARATIVE OPERATING ROOM REPORT OF YEARS liU AND ltt 1941 Injection of Intercostal Nerve____________________________ 0 Instillation of Continuous Irrigation_______________________ 0 Lobectomies ------------- 0 Removal of Transverse Process_____________ 1 Rib Resection - - - - - - - 0 Secondary Closure of Thoracoplasty Wound__________ 1 Thoracotomies _______________________: 1 Tube Inserted in Pleural CavitY-------------------------- 0 Deaths During Surgical Procedures: Other Surgical Procedures: Appendectomies --------------------------------------------- 4 Blood Transfusions ------------------------------------ 20 Lumbar Punctures --------------------------------------- 7 Dilation and Currettage ----------------------------------------- 2 Myringotomies ----------------------------------------- 1 Removal of Cysts -------------------------------- 0 Laparotomy -------------------------------------- 0 Removal of Growth from Breast_________________________________________ 1 Removal of Lympth Gland------------------------------------------ 1 Removal of Lympth Node----------------------------------- 1 Therapeutic Abortions ---------------------------------------- 1 Other Operating Room Procedures: Antiluetic Treatments, Avg. Pts. Rec._______________________________ 22 Antiluetic Treatments Given ------------------------------------- 781 Antiluetic Patients Discharged --------------------------------------- 0 Antiluetic, Initial ----------------------------------------- 0 Incision and Drainage of Abscesses________________________ 13 I. V. Injections-------------------------------------- 121 Gastric Lavages -- ------------------------------------- 53 Oxygen Lavages ------------------------------------------- 9 Laceration of Ankle Repaired_____________________________ 0 Paracenteses ------------- 15 Excision of Fumucle --------------------------- 1 Laceration of Scalp Sutured________________ 0 Dilation of Vaginal Abscess ----------------------- 0 Incision Scraped and Sutured________________ 0 Pelvic Examination ------------------------ 18 Rectal Examination ----------------------- 1 Skin Tests -------------------------------------- 189 Postmortem ----------------------------------- 0 ltU 0 0 0 0 0 0 3 0 5 16 3 0 0 3 1 0 0 0 0 248 833 3 3 3 228 81 23 0 4 0 1 1 1 23 2 205 1 Tuberculosis Sanatorium 247 COMPARATIVE OPERATING ROOM REPORT OF YEARS 1943 AND ltU 193 Bladder Irrigation ------------------------------------------------------ 0 Wound Dressings ------------------------------------------------------ 0 Tetanus Antitoxin --------------------------------------- 1 Typhoid Shots ----------------------------------- 0 Biopsy ------------------------------------ 0 Blood Injected Into Pleural Space------------------------------ 0 Peri Rectal Abscess -------------------------------------- 0 Surgical Dressings ------------------------------------------------------ 0 Asthma Vaccine ------------------------------------------------- 0 Monaldi ---------------------------------------------------------- 0 Toe Nail Removed ---------------------------------------------------- 0 Herniaotomy --------------------------------------------------------- 0 Head Sutured ------------------------------------------------------- 0 Cavity Reading -------------------------------------------------- 0 Pneumothorax Pressure Reading --------------------------------------- 0 Pneumoperitoneum Pressure Reading ------------------------------- 0 ToTAL OPERATING RooM PRoCEDURES____________________________ 20,098 19U 1 686 2 63 2 1 2 1,158 1 3 1 2 1 1 1 1 19,955 248 Georgia Department of Public Health COUNTIES REPRESENTED BY DISCHARGES (BOTH RACES) FROM JANUARY 1, 1943 DECEMBER 31, 1944 Appling ---------------------------- 0 Atkinson ---------------------------- 1 Bacon -------------------------------- 2 Baker -------------------------------- 2 Baldwin -------------------------- 6 Banks ------------------------------ 1 Barrow ------------------------------ 1 Bartow --------------------------- 1 Ben Hill ------------------------ 1 Berrien -------------------------- 1 Bibb --------------------------------- 12 Bleckley --------------------------- 0 Brantley --------------------------- 0 Brooks -------------------------------- 2 Bryan ------------------------------- 0 Bulloch ------------------------------ 2 Burke -------------------------------- 4 Butts --------------------------------- 1 Calhoun ----------------------------- 0 Camden ------------------------- 0 Candler ------------------------- 1 Carroll ---------------------------- 4 Catoosa ------------------------------ 2 Charlton ------------------------ 0 Chatham -------------------- 10 Chattahoochee ------------ 0 Chattooga ----------------- 5 Cherokee ---------------- 5 Clarke ------------------------------ 5 Clay ------------------------------ 0 Clayton --------------------------- 0 Clinch ---------------------------- 0 Cobb ------------------------------ 4 Coffee -------------------------- 2 Colquitt ------------------------ 5 Columbia ---------------------- 0 Cook ----------------------------- 0 Coweta --------------------------- 4 Crawford ----------------------- 0 Crisp ------------------------------ 4 Dade ---------------------------------- 0 Dawson --------------------------- 0 Decatur --------------------------- 2 DeKalb -------------------------- 13 Dodge ------------------------------- 1 Dooly ------------------------------- 3 Dougherty ----------------------- 10 Douglas ---------------------------- 2 Early -----------------------------"--- 0 Echols ------------------C------------ 0 Effingham -------------------------- 0 Elbert ------------------------------ 5 Emanuel ---------------------------- 0 Evans ------------------------------- 1 Fannin --------------------------- 2 Fayette -------------------------- 0 Floyd ------------------------------ 13 Forsyth ---------------------------- 1 Franklin -------------------------- 1 Fulton ----------------------------- 18 Gilmer ------------------------- 2 Glascock ------------------------- 0 Glynn -------------------------------- 4 Gordon ---------------------------- 4 Grady ------------------------------ 3 Greene --------------------------- 3 Gwinnett --------------------------- 5 Habersham ---------------------- 4 Hall ---------------------------------- 9 Hancock --------------------------- 0 Haralson -------------------------- 0 Harris ---------------------------- 4 Hart -------------------------------- 0 Heard ------------------------------- 0 Henry ------------------------------- 2 Houston ----------------------- 1 Irwin ------------------------ 1 Jackson ---------------------- 2 Jasper ------------------------------ 0 Jefl Davis -------------------------- 0 Jefferson ------------------------- 2 Jenkins ---------------------------- 3 Johnson --------------------------- 0 Jones -------------------------------- 1 Lamar -------------------------------- 2 Lanier ------------------------------- 0 Laurens ------------------------------ 3 Lee ------------------------------------ 0 Liberty ---------------------------- 2 Lincoln ------------------------------ 0 Tuberculosis Sanatorium 249 COUNTIES REPRESENTED BY DISCHARGES (BOTH RACES) FROM JANUARY 1, 1943 - DECEMBER 31, 1944 Long ---------------------------------- 0 Lowndes ---------------------------- 4 Lumpkin ---------------------------- 1 McDuffie --------------------------- 1 Mcintosh -------------------------- 1 Macon -------------------------------- 2 Madison ---------------------------- 2 Marion ------------------------------ 1 Meriwether ------------------------ 0 Miller -------------------------------- 0 Mitchell ------------------------- 1 Monroe ----------------------------- 2 Montgomery -------------------- 0 Morgan ----------------------------- 0 Murray ------------------------------ 1 Muscogee -------------------------- 4 Newton ------------------------------ 3 Oconee ------------------------------ 0 Oglethorpe ------------------------ 0 Paulding ---------------------------- 1 Peach -------------------------------- 2 Pickens ------------------------------ 0 Pierce -------------------------------- 2 Pike ------------------------------------ 2 Polk -------------------------------- 2 Pulaski ------------------------------ 2 Putnam ---------------------------- 0 Quitman -------------------------- 1 Rabun ------------------------------ 1 Randolph -------------------------- 2 Richmond ------------------------- 1 Rockdale ------------------------- 1 Schley -------------------------------- 0 Screven ------------------------------ 2 Seminole ---------------------------- ~ Spalding ---------------------------- 5 Stephens ---------------------------- 0 Stewart ------------------------------ 0 Sumter ----------------------------- 0 Talbot -------------------------------- 0 Taliaferro ------------------------- 1 Tattnall ------------------------------ 1 Taylor -------------------------------- l Telfair ----------------------------- 1 Terrell ----------------------------- 0 Thomas ------------------------------ 1 Tift ----------------------------------- 1 Toombs ------------------------------ 2 Towns ------------------------------- 0 Truetlen ---------------------------- 0 Troup ------------------------------- 6 Turner ------------------------------ 2 Twiggs ---------------------------- 1 Union -------------------------------- 0 Upson -------------------------------- 4 Walker ------------------------------ 9 Walton ------------------------------ 1 Ware ---------------------------------- 7 Warren ------------------------------ 0 Washington ---------------------- 1 Wayne -------------------------------- 2 Webster ------------------------------ 1 Wheeler ---------------------------- 1 White -------------------------------- 0 Whitfield ---------------------------- 7 Wilcox ------------------------------ 0 Wilkes ------------------------------- 0 Wilkinson ------------------------- 1 Worth -------------------------------- 1 Division of Laboratories T. F. SELLERS, M.D-------------------------------------______________________________________J)irector E. J. SuNKES, Da.P.H.________________________________________________________Assistant Director JANIE MoRRis, M.S., Chief Bacteriologist__________________________________Culture Unit MADGE REYNOLDS, A.B., Chief BacteriologisL____________________Microscopy Unit E. L. WEBB, A.B., Chief SerologisL______________________________________Serology Unit M. M. HARRis, PH.D., Director_______________________Waycross Branch Laboratory ELIZABETH BUTT, A.B., Acting Director___________.Albany Branch Laboratory Division of Laboratories For the first time in many years, the specimen load of the Division of Laboratories showed a decrease from the previous year. During 1944. there were examined 466,973 specimens, a8 compared with 670,349 in 1943. See Diagram I. This was a loss of 203,378, or 30.3 per cent This decrease was due chiefly to a decline in syphilis serology specimens from 522,187 in 1943 to 346,413 in 1944. See Diagram II. DIAIIIAIII l GROWTH OF LABORATORY WORK 1920-1944 515.004. 45.110 1111!6 254 Georgia Department of Public Health -- ,._ -- .....- ....- :. - --ru" DIAGRAM 8 GROWTH OF LABORATORY WORK BY UNITS QMICAOSCOPY .CULTURE .SEIIOLOGY /920-1944 ._. 0 A definite decrease in specimens submitted for malaria examination also occurred. The most marked gain occurred in the number of specimens examined for gonorrhea. See Table I. / 'I Laboratories 255 TABLE I COMPARATIVE CLASSIFICATION OF SPECIMENS 1944 1943 1944 1943 Increase or Decrease Tuberculosis -------------------- 18,429 Diphtheria ---------------------- 3,071 Gonorrhea ---------------------- 16,333 Malaria ---------------------------- 9,379 Intestinal Parasites __________ 22,495 Rabies ----------------------------- 1,256 Miscellaneous --------------cC-- 4,268 Agglutination Series ______ 10,602 Blood Cultures ---------------- 9,210 Stool & Urine Cultures~"-- 10,018 Syphilis Serology ____________346,413 Water ------------------------ 15,499 GRAND ToTALS........466,973 MICROSCOPY ------------ 75,231 CULTURE ------------------ 29,830 SYPHIUS SEROLOGY 346,413 WATER ---------------------- 15,499 Unsatisfactcry MICROSCOPY -----------CULTURE -----------------SEROLOGY ---------------- 755 76 9,827 19,413 2,785 ll,784 ll,951 23,779 1,238 2,807 10,943 9,514 9,420 552,187 14,528 670,349 73,757 29,877 552,187 14,528 643 149 18,726 984 + 286 + 4,549 2,572 1,284 + 18 + 1,461 341 304 + 597 -205,774 + 971 -203,376 + 1,474 47 -205,774 + 971 + ll2 73 8,899 -5.1% +10.3% +38.6% -21.5% -5.4% + 1.5% +52.1% -3.1% -3.2% + 6.3% -37.3% + 6.7% -30.3% + 2.0% -0.2% +-37.3% 6.7% The decrease in specimen load was felt in all 3 laboratories, being most marked in the Central Laboratory. See Table 2. 256 Georgia Department of Public Health TABLE 2 SPECIMEN LoAD BY LABORATORIES 1944 1943 Increase or Deer. Spec. PerCent Central Laboratory, Atlanta._________ 320,631 506,199 -185,568 -36.7 Southwestern Branch, Albany________ 66,317 68,440 - 2,123 -3.1 Southeastern Branch, Waycross____ 80,024 95,710 - 15,686 -16.4 GRAND ToTALs____________________ 466,972 670,349 -203,378 -30.3 The diagrams that follow give a further analysis of the work, while Table 3 gives a consolidated report for 1944. Laboratories TABLE 3 CoNSOLIDATED REPORT FOR 1944 Tuberculosis--Microscopic ---------------------------------Tuberculosis--Culture -----------------------------------------Tuberculosis--Animal Inoc. -------------------------------- Total 16,726 1,616 87 Diphtheria ---------------------------------~-------------------------- 3,071 Gonorrhea-Microscopic -------------------------------------- 14,133 Gonorrhea--Culture -------------------------------------------- 2,200 Malaria ------------------------------------------------------------------ 9,379 Intestinal Parasites--eggs ------------------------------------ 20,022 Intestinal Parasites--amebic dysentery______________ 441 Intestinal Parasites--egg counts________________________ 2,032 Rabies--Microscopic -------------------------------------------- 1,134 Rabies--Animal Inoculation ------------------------------ 122 Miscellaneous -------------------------------------------------------- 4,268 ToTAL FOR MicRoscopy_______________________________ _ 75,231 Agglutinations -----------------------------------------------------Typhoid Fever -------------------------------------------------Typhus (Brill's) Fever-------------------------------------- Brucellosis -------------------------------------------------------Tularemia ---------------------------------------------------------- 10,602 Blood Cultures ------------------------------------------------------ 9,210 Eberthella typhosa -------------------------------------------Salmonella -------------------------------------------------------Brucella -----------------------------------------------------------Others ---------------------------------------------------------------- Stool and Urine Cultures______________________________________ 10,018 Eberthella typhosa ------------------------------------------Salmonella -------------------------------------------------------Shigella -------------------------------------------------------Others -------------------------------------------------------------- ToTAL FOR CULTURE_____________________________________ _ 29,830 Syphilis Serology -------------------------------------------------- 346,413 Water ------------------------------------------------------------------- 15,499 GRAND ToTAL ------------------------------------------------ 466,973 257 Positive 1,509 145 21 310 2,249 599 41 5,588 15 532 43 92 705 163 46 93 14 53 10 142 200 135 0 258 Georgia Department of Public Health DIAGRAM Dr SPECIMEN LOAD BY LABORATORIES 1944 CENTRAL 320,632 68.7'\ SEROLOGY 346,413 74.2'\ DIAGRAM Ill' SPECIMEN LOAD BY UNITS 1944 Laboratories 259 DIAGRAM "'I' SPECIMEN LOAD BY UNITS IN EACH LABORATORY 1944 CENTRAL LABORATORY ALBANY LABORATORY WAYCROSS LABORATORY 260 Georgia Department of Public Health DIAGRAM 'Ill SPECIMEN LOAD BY TYPES 1944 SPECIMEN LOAD HANDLED IN EACH LABORATORY CENTRAL 245.723 71.0% SEROLOGY CENTRAL 42,111 &6.9"4 CENTRAL 16,599 55.6% MICROSCOPY CULTURE Laboratories 261 DISCUSSION OF WORK BY LABORATORIES Central Laboratory The Central Laboratory examined 320,632 specimens during 1944, which was 68.7 per cent of the total specimen load for the Division of Laboratories. Included in this total were 15,499 water samples examined by the Water Unit. The complete activities of this Unit are covered in the report of the Division of Public Health Engineering. The Industrial Hygiene Laboratory, whose activities are reported by the Division of Industrial Hygiene, handled 691 specimens. The Microscopy Unit handled 42,811 specimens, or 17.4 per cent of the total specimen load for the Central Laboratory. This was an increase of 978. Examinations for gonorrhea and miscellaneous tests showed considerable increases, while distinct losses occurred in tests for tuberculosis and malaria. The Culture Unit load was 16,599 specimens or 5.1 per cent of the total specimen load, and remained rather stable, compared with the previous year's work. Increases occurred in the agglutination series and blood cultures, while there was a decrease in stool and urine cultures. The Serology Unit examined 245,723 specimens, or 76.6 per cent of the total Central Laboratory specimen load. This was a decrease from 1943 of 187,492 specimens-21,682 were routine and 165,810 from military agencies. See Tables 4 and 5. 262 Georgia Department of Public Health TABLE 4 REPORT OF CENTRAL LABORATORY FOR 1944 Total Tuberculosis--Microscopic -------------------------------- 12,091 Tuberculosis-Culture ------------------------------------------ 1,431 Tuberculosis--Animal lnoc. -------------------------------- 87 Diphtheria ----------------------------------------------------------~ 2,480 Gonorrhea-Microscopic ------------------------------------ 8,657 Gonorrhea-Culture -------------------------------------------- 1,980 Malaria ------------------------------------------------------------------ 3,256 Intestinal Parasites-Eggs ---------------------------------- 7,884 Intestin al Parasites-Amebic Dysentery______________ 322 Intestinal Parasites-Egg Counts ----------------------- 340 Rabies--Microscopic ------------------------------------------ 945 Rabies--Animal Inoculation ------------------------------ 122 Miscellaneous -------------------------------------------------------- 3,216 TOTAL FOR MICROSCOPY________________________________ 42,811 AggIutinations ----------------------------------------------------Typhoid Fever -------------------------------------------------Typhus (Brill's) Fever -------------------------------------Brucellosis -------------------------------------------------------Tularemia ---------------------------------------------------------- Blood Cultures -----------------------------------------------------Eberthella typhosa -------------------------------------------Salmonella -------------------------------------------------------Brucella -----------------------------------------------------------Others ---------------------------------------------------------------- 5,939 5,205 Stool and Urine Cultures -------------------------------------Eberthella typhosa -------------------------------------------- Salmonella -------------------------------------------------------Shigella -------------------------------------------------------------Others --------------------------------------------------------------- ToTAL FOR CuLTURE______________________________________ 5,455 16,599 Syphilis Serology -------------------------------------------------- 245,723 Water -------------------------------------------------------------------- 15,499 GRAND TOTAL ---------------------------------------------- 320,632 Positive 1,131 125 21 218 1,302 582 25 1,182 7 54 334 98 35 61 7 46 8 123 152 94 0 Laboratories 263 TABLE 5 COMPARATIVE CLASSIFICATION OF SPECIMENS 1944 1943 CENTRAL LABORATORY 1944 Tuberculosis ------------------------ 13,609 Diphtheria --------------------------- 2,480 Gonorrhea ---------------------------- 10,637 Malaria ------------------------------ 3,256 Intestinal Parasites ____________ 8;546 Rabies -------------------------------- 1,067 Miscellaneous ---------------------- 3,216 Agglutination Series __________ 5,939 Blood Cultures -------------------- 5,205 Stool and Urine Cultures____ 5,455 Syphilis Serology ________________245,723 Water ---------------------------------- 15,499 GRAND ToTALS ________________320,632 MICROSCOPY ---------------- 42,811 CuLTURE ______________________ 16,599 SYPHILIS SEROLOGY ____245,723 WATER ---------------------- 15,499 Unsatisfactory MICROSCOPY ---------------CULTURE -------------------SEROLOGY -------------------- 582 38 7,350 1943 15,785 2,136 7,114 5,271 8,797 1,079 1,651 5,828 5,155 5,640 433,215 14,528 506,199 41,833 16,623 433,215 14,528 516 67 15,535 Increase or Deer. 2,176 + 344 + 3,523 2,015 251 12 + 1,565 + Ill + 50 185 -187,492 + 971 -185,567 + 978 24 -187,492 + 971 -13.8 +16.1 +49.5 -38.2 -2.9 - 1.1 +94.8 + .2 + 1.0 -3.3 --43.3 + 6.7 -36.7 + 2.3 - .1 --43.3 + 6.7 + 66 29 8,185 Branch Laboratories The Branch Laboratories at Albany and Waycross handled 146,341 specimens during 1944 as compared with 164,150 during 1943, a decrease of 17,809. This constituted 28.3 per cent of the total specimen load, as compared with 24.4 per cent in 1943. The Albany Laboratory examined 66;317 specimens, contrasted to 68,440 in 1943, a loss of 2,123 or 3.1 per cent. This decrease occurred chiefly in serology, which showed a loss of 2,605 specimens (5.6 per cent) . Microscopic examinations decreased by 60, although marked gains were noted in the examinations for tuberculosis (17 per cent), and intestinal parasites (22 per cent). The culture load showed a gain of 542, due to an increase in stool and urine cultures (46 per cent). See Tables 6 and 7. The Waycross Laboratory handled 80,024 specimens during the year, compared to 95,710 in the preceding year, a decrease of 15,686. The drop in syphilis serology from 72,550 in 1943 to 56,873 in 1944, resulting from 264 Georgia Department of Public Health a marked decrease in the number of blood specimens submitted from the Brunswick Ship Yard area, accounts principally for the decrease in the specimen load of this laboratory, although there was also a decline of 565 (12 per cent) in culture specimens. Microscopy increased by 555 specimens (3.2 per cent) . TABLE 6 REPORT OF ALBANY BRANCH LABORATORY FOR 1944 Total Tuberculosis--Microscopic --------------------------------- 1,755 Diphtheria ------------------------------------------------ 298 Gonorrhea-Microscopic ---------------------------------- 2,179 Gonorrhea-Culture -------------------------------------------- 11 Malaria ------------------------------------------------------------- 3,614 Intestinal Parasites-Eggs --------------------------------- 5,487 Intestinal Parasites--Amebic Dysentery______________ 55 Rabies--Microscopic ------------------------------------------ 146 Miscellaneous ------------------------------------------------------- 676 ToTAL FOR MicRoscoPY ---------------------------------- 14,221 Agglutination Series -------------------------------------------- 3,139 Typboid Fever -------------------------------------------------Typhus (Brill's) Fever ----------------------------------Brucellosis ------------------------------------------------------Tularemia -------------------------------------------------------Blood Cultures ---------------------------------------------------- 2,535 Eberthella typhosa -----------------------------------------Salmonella ---------------------------------------------------Brucella ----------------------------------------------------------StoOotlhearnsd -U---r-i-n--e----C---u--l-t-u--r-e--s-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_--_ 2,605 Eberthella typhosa -------------------------------------------Salmonella -------------------------------------------------------Shigella --------------- __ ------------------------------------------ _ Others ----------------------------------------------------------ToTAL FOR CuLTURE -------------------------------------------- 8,279 Syphilis Serology ------------------------------------------------ 43,817 GRAND ToTAL __ --------------------------------------------- 66,317 Positive 189 44 284 4 7 1,587 2 84 32 231 44 8 25 6 5 0 15 44 31 Laboratories 265 TABLE 7 COMPARATIVE CLASSIFICATION OF SPECIMENS 1944- 1943 ALBANY BRANCH LABORATORY 1944 1943 lnerease or Deer. Tuberculosis -------------------------- 1,755 Diphtheria ---------------------------- 298 Gonorrhea ----------------------------- 2,190 Malaria ---------------------------------- 3,614 Intestinal Parasites ________________ 5,542 Rabies -------------------------------- '146 Miscellaneous ------------------------ 676 Agglutination Series ------------ 3,139 Blood Cultures ---------------------- 2,535 Stool and Urine Cultures________ 2,605 Syphilis Serology ---------------- 43,817 GRAND ToTALs ------------------ 66,317 MICROSCOPY ------------------ 14,221 CULTURE ------------------------ 8,279 SEROLOGY ---------------------- 43,817 Unsatisfactory MICROSCOPY ------------------ 87 CuLTURE ------------------------ 20 SEROLOGY ---------------------- 1,065 1,499 148 2,354 5,182 4,538 liS 445 3,320 2,643 1,774 46,422 68,440 14,281 7,737 46,422 83 27 1,430 + 256 + 150 - 164 -1,568 +1,004 + 31 + 231 - 181 - 108 + 831 -2,605 -2,123 60 + 542 -2,605 +4 7 365 + 17.1 +103.5 - 7.0 - 30.3 + 22.1 + 27.0 + 51.9 - 5.5 - 4.1 + 46.8 - 5.6 -31.0 4.2 -+ 7.0 5.6 266 Georgia Department of Public Health TABLE 8 REPORT OF WAYCROSS BRANCH LABORATORY FOR 1944 Total Tuberculosis-Microscopic --------------------------------~ 2,880 Tuberculosis-Culture --------------------------------------~ 185 Diphtheria ------------------------------------------------------------ Gonorrhea-Microscopic -------------------------------------Gonorrhea-Culture -------------------------------------------- Malaria ------------------------------------------------------------------ Intestinal Parasites--Eggs ---------------------------------Intestinal Parasites--Amebic Dysentery____________ Intestinal Parasites-Egg Counts________________________ 293 3,297 209 2,509 6,651 64 1,692 Rabies--Microscopic -------------------------------------------- 43 Miscellaneous -------------------------------------------------------- 376 TOTAL FOR MICROSCOPY------------------------------------ 18,199 Agglutination Series -------------------------------------------Typhoid Fever -------------------------------------------------Typhus (Brill's) Fever------------------------------------Brucellosis ------------------------------------------------------Tularemia -------------------------------------------------------- 1,524 Blood Cultures -----------------------------------------------------Eberthella typhosa -------------------------------------------Salmonella ----------------------------------------------------Brucella ---------------------------------------------------------Others --------------------------------------------------------------- Stool and Urine Cultures_____________________________________ Eberthella typhosa ------------------------------------------Salmonella -------------------------------------------------------Shigella -----------------------------------------------------------Others --------------------------------------------------------------- 1,470 1,958 ToTAL FOR CuLTURE -------------------------------------------- 4,952 Syphilis Serology ----------------------------------------------- 56,873 GRAND TOTAL ------------------------------------------------ 80,024 Positive 189 20 48 663 13 9 2,819 6 20 6 140 21 3 7 2 2 2 5 4 10 Laboratories 267 TABLE 9 COMPARATIVE CLASSIFICATION OF SPECIMENS 1944- 1943 WAYCROSS BRANCH LABORATORY 1944 Tuberculosis -------------------------- Diphtheria ---------------------------- Gonorrhea ------------------------------ Malaria --------------------------------Intestinal Parasites ______________ 3, 065 293 3,506 2,509 8,407 Rabies ----------------------------------- 43 Miscellaneous ----------------------- 376 Agglutination Series ____________ 1,524 Blood Cultures ---------------------- 1,470 Stool and Urine Cultures________ 1,958 Syphilis Serology ------------------ 56,873 GRAND ToTALs __________________ 80,024 MICROSCOPY ------------------ 18,199 CULTURE ------------------------ 4,952 SEROLOGY ---------------------- 56,873 Unsatisfactory MICROSCOPY -----------------CULTURE ----------------------SEROLOGY ---------------------- 86 18 1,412 1943 2,129 501 2,316 1,498 10,444 44 711 1,795 1,716 2,006 72,550 95,710 17,643 5,517 72,550 44 55 1,761 Increase or Deer. + 936 208 ++ 1,190 1,0ll - 2,037 1 335 271 246 48 -15,677 -15,686 + 556 565 -15,677 + 42 37 349 +44.0 -41.5 +51.4 +67.5 -19.5 -2.3 -47.1 -15.1 -14.3 -2.4 -21.6 +-16.4 3.2 -10.2 -21.6 DISCUSSION OF WORK BY UNITS MICROSCOPY UNIT Tuberculosis- Included in the examination for M. tuberculosis were microscopic examinations and cultures and animal inoculations made on microscopically negative or doubtful specimens. Cultures were made in both the Central and Waycross Laboratories, while the Central Laboratory alone handled all animal inoculations. During 1944 there were made 18,429 tests for M. tuberculosis, a decrease of 5.0 per cent from 1943, shown in Table l. An analysis of this work is given in Tables 10, ll and 12. Due to the increased cost and the difficulty of securing guinea pigs, it became necessary to curtail sharply animal inoculation tests for M. tuberculosis. As a substitute, in many cases, 5 tubes of Petragnani media were inoculated and the animal inoculation test omitted. Experience has shown that this procedure gives comparable, if not superior, results. When cultures alone are made, only 3 tubes of Petragnani are inoculated. 268 Georgia Department of Public Health EXAMINATIONS FOR M. TUBERCULOSIS- 1944 TABLE 10 Microscopic Central 1944 ---------------- 12,091 1943 ----------------------- 14,308 - Cultures 1944 -----------------------1943 ------------------------ 2,217 1,431 1,208 Animal Inoc. + 123 1944 ------------------------ 87 1943 ------------------------ 269 - 182 Totals 1944 ------------------------ 13,609 1943 ----------------------- 15,785 - 2,176 (13.8%) Albany 1,755 1,499 + 256 1,755 1,499 + 256 (17.1%) Waycross 2,880 1,988 + 892 185 141 + 44 3,065 2,129 + 936 (44.0%) Totals 16,726 17,795 - 1,069 1,616 1,349 + 267 87 269 - 182 18,429 19,413 - 984 (5.1%) TABLE II ANALYSIS AUXILIARY TuBERCULOSIS EXAMINATIONS TYPE SPECIMEN CULTURES Central Total Pos. WaycroBS Total Total Pos. Total ANIMAL INOCULATIONS CENTRAL LABORATORY Micro Animal Culture Pos. Total NeJr. Pos. NeJr. Poo. Ne~r. Poe. Sputum ---------------------------- I,I80 8I I78 20 I,3S8 101 I3 I3 ---- II 2 II 2 Pleural Fluid _______________ 84 19 s 89 I9 22 2I I IS 7 I7 5 Urine ---------------------- -- -- 23 2 ~--- Gastric Lavage ____________ liS I9 23 liS 2 I9 II 27 II 26 ---- I II 20 ---- 7 II 22 ---s- o~ - 0 Synovial Fluid __________ 6 Spinal Fluid ______________ 6 l Peritoneal Fluid ____________ 3 I 6 6 I 4 ---- I I 4 I I __.. _ I --- ---- I 4 ---- 4 ---- I I 4 ---- ---- ---- i .~.- Pus ---------------------------------- lO 3 IO 33 I 2I 2 I 2 Feces ----------------------------- I Fluid from Gland____________ I I ---- 2 ---- 1 TOTALS --------- ------- I,429 I2S I8S 20 I,6I4 I4S 82 78 4 63 I9 68 14 Cultures for Pathogenicity _______ __ TOTAL EXAMINATIONS ___________ s ---- ---- 3 2 87 78 4 66 21 68 14 NOTE: Culture report includes apeeimena cultured only and those cultured in conjunction with animal inoculation. An analysis of the latter findinp is included under "Animal Inoculations." to-.::-1 ~ 270 Georgia Department of Public Health TABLE 12 MicRoscoPIC ExAMINATIONs FORM. TuBERCULOSis fiVE YEAR PERIOD 1940- 1944 1940 Number Examined __________ 10,385 Number Positive ______________ 975 Per Cent Positive_____________ 8.4 1941 13,008 1,063 8.2 1942 14667 1,256 8.6 1943 17,795 1,590 8.9 1944 16,726 1,509 9.0 Diphtheria- Diphtheria examinations increased from 2,781 in 1943 to 3,071 in 1944, a gain of 290. While the total positive specimens decreased from 446 to 310, positive diagnostic cultures increased from 231 to 263. This gain was distributed among the several laboratories as follows: Central, 200 positives, an increase of 25; Albany 28 positives, an increase of 23; Waycross 35 positives, a decrease of 16. See Table 13. TABLE 13 CLASSIFICATION OF DIPHTHERIA EXAMINATIONS 1944 Diagnostic -----------------------Release and Carrier__________ Virulence -------------------------- Total 2,874 186 ll ToTALS ------------------ 3,071 Positive 263 42 5 310 Negative 2,595 142 6 2,743 Doubtful 16 2 18 Gonorrhear- Examinations for N. gonorrhoeae showed an increase of 38.6 per cent as compared with the preceding year. In 1944 there were 16,333, while in 1943 there were only 11,995-an increase of 4,338. Microscopic examinations showed a gain of 2,349 (3.2 per cent) while cultures increased 1,989 (6.7 per cent). Gonococcus culturing was instituted in the Central Laboratory in 1943 when 211 specimens were cultured. It was introduced in the Waycross Laboratory in March of the current year and in the Albany Laboratory in October. The response to the Branch Laboratory service has been poor so far, possibly due chiefly to the necessity of carrying the culture specimens promptly to the laboratory. Most of the specimens cultured in the Central Laboratory were received from nearby venereal disease clinics. Most of those cultured in the Waycross Laboratory were Laboratories 271 submitted by Health Officers from food handlers, accounting for the small number of positives. An analysis of the examinations for N. gonorrhoeae is given in Tables 14 and 15. TABLE 14 MicRoscoPIC ExAMINATIONs FOR N. GoNORRHOEAE FIVE YEAR PERIOD 1940- 1944 Number specimens Number positive Per cent positive 1940 8,248 1,818 22.0 1941 9,882 1,929 19.5 1942 9,813 1,593 16.2 1~43 11,784 1,642 13.9 1944 14,133 2,249 15.9 TABLE 15 CLASSIFICATION OF ExAMINATIONs FOR N. GoNORRHOEAE- 1944 Microscopic Central Number specimens ---------------Number positive -----------------Per cent positive ------------------Culture Number specimens -------------- Number positive -----------------Per cent positive____________________ 8,657 1,302 15.0 1,980 582 29.4 Albany 2,179 284 13.0 11 4 36.4 Waycross 3,297 663 20.1 209 13 6.2 Total 14,133 2,249 15.9 2,200 599 27.2 'Malaria- Malaria examinations showed a decline of 21.5 per cent in 1944. Only 41 blood films showed malarial parasites, and 9 of these were from ex-servicemen returned from overseas. Of the 41 positive specimens, 30 were P. vivax (tertian) and ll were P. falciparum (aestivo-autumnal). Limited malaria surveys were instituted during the latter part of the year .by the Division of Malaria and Hookworm Service. Of the 3,848 films examined, none were positive. See Tables 16 and 17. TABLE 16 EXAMINATIONS FOR MALARIA- 1944 Number of speci.mens*________ Number positive -----------------*Includes survey specimens Central 3,256 25 1,275 Albany 3,614 7 1,036 Waycross 2,509 9 1,537 Total 9,379 41 3,848 272 Georgia Department of Public Health TABLE 17 EXAMINATIONS FOR MALARIA FIVE YEAR PERIOD 1940-1944 1940 1941 1943 Number specimens __________ 36,081 33,157 19,189 Number positive ______________ 1,137 555 290 Increase or Decrease Over Preceding Year Number specimens __________ -613 -2,934 -13,968 Number positive -------------- +57 -582 -265 1941 11,951 77 -7,238 -213 19U 9,379 41 -2,572 -36 Intestinal Parasites- Examinations for intestinal parasites decreased from the preceding year by 1,284 or 5.4 per cent. Examinations for eggs decreased 750 or 3.6 per cent, while egg counts showed a loss of 975 or 32.4 per cent. In the Way- cross Laboratory, where most of the survey specimens collected by or under the direction of the Division of Malaria and Hookworm Service are handled, intestinal parasite examinations, including egg counts, showed a drop of 40 per cent. See Tables 18, 19 and 20. TABLE 18 INTESTINAL PARASITE EXAMINATIONS -1944 Eggs Central Positive 1,182 Negative ---------- 6,702 Total ---------------- 7,884 Egg Counts ________ 340 Amebic Dysentery Positive --------- 7 Negative ---------- 315 Total -------------- 322 Albany 1,587 3,900 5,487 2 53 55 Waycross 2,819 3,832 6,651 1,692 6 58 64 Total 5,588 14,434 Grand Total 20,022 2,032 15 426 441 GRAND ToTAL ________ -------------------------------------------------------------------- 22,495 Laboratories 273 TABLE 19 INTESTINAL PARASITE EXAMINATIONS FIVE YEAR PERIOD 1940-1944 1940 1941 194:11 1941 Total-Eggs ________________ 57,512 49,352 28,415 20,772 Increase or Decrease ____ -13,771 - 8,160 -20,937 - 7,643 Egg Counts----------------Increase or Decrease____ Amebic Dysentery ________ 3,197 793 3,854 2,469 3,007 +657 -1,385 +538 581 679 429 Increase or Decrease ____ --85 -212 +98 -250 1944 20,022 -750 2,032 -975 441 +12 TABLE 20 CLASSIFICATION OF INTESTINAL PARASITE FINDINGS -1944 Single Infection Worms for Identification___________________________________________________ 10 Hookworm ---------------------------------------------------------------- 5,267 Dwarf Tapeworm --------------------------------------------------------- 31 Round Worm --------------------------------------------------------------- 82 Whip Worm -------------------------------------------------------------- 13 Pin Worm --------------------------------------------------------------------- 70 Others ---------------------------------------------------------------------------- 10 Double Infection Hookworm and Pin Worm__________________________________________ 24 Hookworm and Dwarf Tapeworm_____________________________________ 11 HHooookkwwoorrmm aanndd WRohuinpdWWoormrm__._._.._._-_-_-_--_-_-_-_-_-_-_--_-_-_-_-_-_-_--_-_-_-_-_-_-_--_-_-_-_-_-_-_--_ 48 5 Hookworm and Rat Tapeworm_________________________________________ 2 Roundworm and Pin Worm.--------------------------------~------------ 1 Triple Infection ----------------------------------------------------------- 0 Total Specimens Positive for Ova of Hookworm_______________________ 5,357 Round Worm ----------------------------------------------------- 131 Pin Worm ----------------------------------------------------------- 95 Whip Worm ----------------------------------------------------------------- 18 Dwarf Tapeworm -------------------------------------------------------------- 42 Others ----------------------------------------------------------------------- 10 274 Georgia Department of Public Health MAP SHOWING ANIMAL HEADS MICROSCOPICALLY POSITIVE FOR RABIES 1944 RICHMOND COUNTY- AUGUSTA LAB' 15 MUSCOGEE COUNTY-COLUMBUS LAlli. 4 CHATHAM COUNTY-SAVANNAH LAB. 64 TOTAL-CITY LABORATORIES B3 TOTAL-STATE LABORATORIES "liZT GRAND TOTAL 610 DOCS MOT INCLUDC I EXAMhriATIOIIS f>' MCADS FROM OUT o; STATE Laboratories 275 Rabies-Microscopic Examinations The widespread incidence of rabies is indicated by the finding of 651 rabid animals by brain examination and mouse passage. In the State Laboratories, 532 heads were found positive by microscopic examination and 36 by mouse passage. In municipal laboratories, 83 were found positive by microscopic examination. During the year 5 heads submitted from other states were examined for rabies. Map l shows the source of all heads .found positive by the several state and municipal laboratoriea. Rabies among wild foxes remains a serious problem. Of 63 fox heads examined in the State Laboratories, 60, or 95.2 per cent, were positive. In the Albany Laboratory 24 of the 25 fox heads examined were positive. The single negative was a pet fox. These heads were received from 19 counties. The spread of this disease to other predatory animals is indicated by positive findings in a bob cat, which severely injured a young boy, and reports of attacks on humans and livestock by other bob cats which were killed but not examined. See Tables 21, 22, 23 and 24. TABLE 21 CLASSIFICATION OF ANIMAL HEADS- 1944 ExAMINED MICROSCOPICALLY FOR RABIEs--STATE LABORATORIES CENTRAL ALBANY WAYCROSS TOTALS ANIMAL Specimens P011. Specimens Pos. Specimens Poe. Specimens Poa. Dog _ _ 676 348 89 44 27 15 792 407 Cat _ _ _ 167 31 18 6 9 2 194 39 Cattle 32 12 12 10 44 22 Mule&Horse 5 1 5 1 Hog - - - 7 1 1 3 11 1 GFooat x_-_ -- 36 1 34 25 24 2 1 2 63 60 1 2 1 Squirrel_. 9 1 10 Rat--- 3 3 Rabbit __ 6 6 Chicken_ 1 1 Bob Cat _ 1 1 1 1 FCeorornet _ _ 1 1 1 1 ToTALS -945 428 146 84 43 20 1,134 5S2 276 Georgia Department of Public Health TABLE 22 CLASSIFICATION OF ANIMAL HEADS -1944 EXAMINED MICROSCOPICALLY FOR RABIEs-MUNICIPAL LABORATORIES COLUMBUS ANIMAL Specimens Pos. Dog ----- 16 4 Cat ------ 4 Fox--- Rat--- Horse--- Squirrel -- 1 ToTALS_ 21 4 MACON Specimens Pos. 10 3 SAVANNAH Specimens Pos. 91 57 15 7 1 AUGUSTA Specimens p- 22 13 12 2 1 1 13 107 64 36 15 TABLE 23 ANIMAL HEADS EXAMINED FOR RABIES 1940- 1944 EXAMINED MICROSCOPICALLY-STATE LABORATORIES Number Heads Examined_ _ 1,252 Positive for Negri Bodies___ 496 Percentage Positive ------- 39.6 1941 1,090 492 45.1 1942 1,050 488 46.5 1943 1,085 529 48.8 1944 1,134 532 47.0 TABLE 24 EXAMINATION oF Fox HEADs FOR RABIES-BY CouNTIES 1944 COUNTY CENTRAL Pos. Ne&'. Atkinson 1 Ben Hill ___ 3 Berrien - - - 1 Bibb 1 Bleckley 2 Coffee ____ 2 1* Crisp ------- Dodge ----- 7 Dooly --.-- 3 Irvin ---- 3 Laurens ------ 1 1 Macon Marion ------ - 1 Monroe Polk _ _-_- 1 2 Turner-- 1 Walker 1 Wilcox _____ 4 Worth -------- ToTALS _33 3* * 1 Unsatisfactory ALBANY Pos. Ne&'. 1 15 1 1 1 2 4 24 1 WAYCROSS Pos. Ne&'. 1 1 2 TOTALS Pos. Ne&'. 2 3 1 1 1 2 3 1* 15 1 7 3 3 1 1 1 1 1 2 2 1 6 4 59 4* Laboratories 277 Rabies-Animal Inoculation There were 122 specimens subjected to mouse passage during the year, as compared to 153 in 1943. An analysis of this work is given in Table 25. TABLE 25 ANIMAL INOCULATION FOR RABIES Type Specimen Micro.Mouse- Dog - 48 Cat ---------- 13 Fox --------- 2 Cow - - - - - - 3 Mule and Horse __ 1 Racoon Chicken - - - - - 1 Pig------ 1 Squirrel 1 Rat 1 Bob Cat ------- ToTALs_____ 71 Micro.Mouse+ 27 3 5 1 36 Micro. ? Mouse- 7 1 1 9 Mouse & Micro. Uno. Micro.+ Mouse+ Cheeks 2 1 1 1 1 Total 85 18 3 8 2 1 1 1 1 1 1 2 4 122 In addition to the routine testing done in the Animal Laboratory, 6 special tests were made, consisting chiefly of inoculations of salivary glands, removed from rabid animals to determine the presence or absence of rabies virus. Miscellaneous- Table 26 shows the miscellaneous examinations made during the year. Positive findings (Table 26) in certain of these examinations follow: Vincent's Organisms-positive 167 Central 68; Albany 88; Waycross ll These figures do not include positive findings obtained on smear examinations for C. diphtheriae. Trichomonads (T. vaginalis) -positive 81. Central 58; Albany 23. These figures do not include positive findings obtained on smear examinations for N. intracellularis. B. ducrey (chancroid)-positive 20 Central 5; Albany 15 Tr. pallidum (darkfield)-positive 54 Central46; Waycross 8 Meningitis-positive 26 278 Georgia Department of Public Health Central Albany Waycr- Tetal N. intracellularis ------------------ 15 H. influenzae ------------------------ 3 1 Type undetermined -------------- TOTALS -------------------------- 3 16 3 18 2 6 2 2 7 26 During the year, 114 positive heterophile tests for glandular fever were obtained. Of these, 110 were in the Waycross Laboratory, where this test is routinely performed and 4 in the Central Laboratory. About half of the specimens were received from the Atlanta area, and the remaining 50 per cent from the Army Air Base in Waycross and the U. S. Naval Station in Brunswick. Included in the miscellaneous examinations made in the Albany Laboratory, were 47 sterility tests on plasma submitted from blood banks and 94 milk samples collected during a special investigation. In the Central Laboratory, 53 examinations for Donovans bodies (Lymphogranuloma inguinale) were made of which 18 were positive and 6 doubtful. TABLE 26 CLASSIFICATION OF MISCELLANEOUS EXAMINATIONS Vincent's --------------------------------------------------------- 375 Trichomonads --------------------------------------------------------- 426 Chancroid (B. ducrey) ----------------------------------------- 76 Darkfield (Tr. pallidurn) -------------------------------------------- 173 Spinal Fluids for Meningitis ------------------------------------- 48 Examinations for Type of Organisms________________________ 166 Cultures ------------------------------------------------------------------------ 323 Glandular Fever (Heterophile Antibody Test)--------- 234 Unclassified ----------------------------------------------------------------- 2,447 ToTAL ------------------------------------------------------------------- 4,268 Culture Unit Under this heading are included blood and stool cultures, agglutination tests for typhoid, typhus, undulant fever and tularemia, as well as a miscellany of special bacteriology. The number of specimens submitted during the year for agglutination or cultural studies was approximately the same as during the preceding year, there being 48 fewer such specimens in 1944. Decreases were noted in positive findings for the various fevers with the exception of agglutinations and blood cultures for Brucellosis and stool and urine cultures for members of the Salmonella group. See Tables 27, 28 and 29. Laboratories 279 TABLE 27 PosiTIVE AGGLUTINATION TEsTs 1940 1941 1942 1943 1944 Typhoid -------------------------- 369 ll6 Ill 106 92 Endemic Typhus (Brill's) 429 651 796 839 705 Brucellosis ---------------------- 153 ll5 153 96 163 Tularemia ------------------------ 97 63 78 84 46 TABLE 28 PosiTIVE BLooo CuLTURES 1940 1941 1942 1943 19U E. typhosa ----------------------- 265 182 184 ll5 93 Salmonella -------------------- 9 9 15 19 14 Brucella -------------------------- 22 43 38 30 53 Other Organisms ___________ 25 25 21 16 10 TABLE 29 PosiTIVE STOOL AND URINE CuLTURES 1940 1941 1942 1943 1944 Eberthella typhosa __________ 360 266 500 162 143 Salmonella ---------------------- 3 5 28 52 200 Shigella ---------------------------- 136 206 240 203 135 Other Organisms ____________ 5 2 An increase in Brucellosis is indicated by laboratory findings of 163 positive agglutination tests in 1944, contrasted with 96 in 1943 and 54 positive blood cultures in 1944, compared with 30 in 1943. Isolations of Brucella were obtained both in clot cultures and in the tryptose broth cul- tures. The latter are made when the agglutination titre is sufficiently strong to suggest a diagnosis of Brucellosis. A classification of these findings is given in Tables 30 and 31, while Table 32 shows the incidence of individ- uals with positive blood cultures during the past 5 years. . 280 Georgia Department of Public Health TABLE 30 BRUCELLA IsoLATIONS- 1944 Central Albany Wayerou Total Br. abortus ------------------------------ 15 15 Br. suis -------------------------------------- 31 5 2 38 Double Infection ---------------------- 1 1 TOTALS ------------------------------ 47 5 2 54 TABLE 31 BRUCELLA IsoLATIONs - 1944 SHOWING TYPE OF CULTURE POSITIVE CENTRAL ALBANY Tryptose Broth outfit only* Clot culture only 4 abortus 19 suis 2 suis 24 1 mixed 7 5 abortus 3 suis 2 suis Both Tryptose Broth & Clot Total by Clot 3 abortus 8 5 suis 15 8 abortus 2 suis 7 suis Total by Tryptose 32 7 abortus 3 suis Broth 24 suis 1 mixed *This outfit was not used in the Waycross Laboratory. WAYCROSS 2 SUIS 2 suis Laborato,ries 281 TABLE 32 UNDULANT FEVER IN GEORGIA 1940- 1944 INCIDENCE OF INDIVIDUALS WITH PosiTIVE BLooD CuLTUREs AND NuMBER oF IsoLATIONS YEAR 1940 1941 1942 1943 1944 Individuals 20 32 35 26 43 TOTALS ------------------ 155 Isolations 22 42 38 30 54 185 Sais Abortus 20 2 34 8 31 7 20 10 37 15 (I mixed infection) 142 43 During 1944, 243 isolations of E. typhosa made from 152 individuals were typed by the application of bacteriophage. An analysis of this work is given in Table 33. TABLE 33 ISOLATIONS OF E. TYPHOSA-1944 CENTRAL ALBANY WAYCROSS Total Total Indi Others Type Blood Feees Blood Feees Blood Feces Blood Feees Yidaals Ind. laol. cA 5 29 4 3 1 7 10 8 4 4 10 32 28 19 14 29 E 29 27 3 3 2 3 34 33 48 5 6 F 351 2475 J 1 11 Beta, Gamma and W forms 17 51 9 5 26 56 41 4 5 TOTALS ---- 61 123 25 15 7 5 93 143 152 9 11 GRAND ToTALs 247 161 Isolations made in other laboratories from Georgia patients not included in the above tabulation are 17 typings made for the Fourth Service Command Laboratory. The typing of E. typhosa by application of bacteriophage was instituted in the Culture Unit of the Central Laboratory in 1941. Since then, a total of 1,487 isolations from 852 individuals has been studied. An analysis of this work is given in Table 34. 282 Georgia Department of Public Health TABLE 34 BACTERIOPHAGE TYPING OF E. TYPHOSA 1941 . 1944 (Figures given opposite type represent number of cultures typed. Figures in parentheses represent number of persons from whom types were isolated.) Type 1941 Ac 95 (57) 70 (39) E 68 (54) F 5 (4) H J 11 (10) Beta, Gamma and W. Forms 73 (44) ToTALs _________ 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) 1944 42 (28) 33 (29) 67 (48) 11 (5) 1 (1) Totals 560 (261) 242 (150) 275 (191) 35 (23) 9 (3) 26 (22) 82 (41) 327 (193) 236 (152) 1,487 (852) The above figures represent total examinations which include a number of repeat examinations on carriers. While typhoid fever continues to decline, more attention is being given to the Salmonella and Shigella infections. Our laboratories are well equipped for the critical identification of these groups. During the past year, 221 isolations of members of the Salmonella group were made. A classification of these findings is given in Table 35, while Table 36 gives a composite report for the period, 1941-1944. SECTION MICROSCOPY UNIT CENTRAL LABORATORY SECTION CULTURE UNIT CENTRAL LABORATORY Georgia Department of Public Health TABLE 35 SALMONELLA IsoLATIONS -1944 Group Type CENTRAL ALBANY WAYCROSS Other Labs. Total Total Blood Feees Blood Feees Blood Feees Blood Feees Isol. Ind. A S. paratyphi A. 2 21 S. paratyphi B. 2 2 S. typhi murium 131 B S. derby 5 S. sandiego 1 S. california S. bredeney 12 26 3 1 2 93 2 3 162 120 196 11 11 111 S. cholerae suis 3 1 1 1 1 1 88 c S. oranienburg S. montevideo 3 41 12 86 32 S. newport 2 1 31 S. muenchen 2 22 S. litchfield 1 11 D S. panama 1 11 S. anatum S. newington 1 1 1 2 33 22 S. worthington Others S. minnesota 3 11 31 22 ToTALS------ 6 152 6 44 2 3 3 5 221 162 Laboratories 285 TABLE 36 SALMONELLA TYPES IsoLATED IN GEoRGIA 1941 - 1944 Group Salmonella 1941 Total No. From Total No. 1942 1943 1944 Isolations Blood Stool Individuals A paratyphi A 1 1 4 2 8 8 5 B paratyphi B 5 8 20 9 42 22 20 25 typhi murium _ 14 10 162 186 2 184 138 derby 2 1 9 12 12 9 bredeney 1 1 2 1 1 2 san diego 1 1 1 1 california 1 1 1 1 c cholerae suis 2 6 5 8 21 15* 6 21 oranienburg 1 3 6 8 18 6 12 13 bareilly 1 1 1 1 montevideo 1 3 2 3 9 2 7 8 tennessee 2 2 1 1 1 georgia 1 1 1 1 newport 1 1 3 5 5 3 muenchen 3 2 5 5 3 litchfield 1 1 2 2 2 D sendai 1 panama 1 1 1 1 9 1 11 3 8 4 E give ana tum meleagridis newington 1 1 2 5 3 10 1 1 2 2 2 1 1 10 10 2 2 2 2 Others poona worthington minnesota 3 3 3 2 3 3 3 1 2 2 1 1 2 ToTALs________ 14 44 72 221 351 62 289 259 * One isolation was made from pus from knee. 286 Georgia Department of Public Health A classification of the Shigella isolations is given in Table 37. Of unusual interest was the isolation of Sh. paradysenteriae P 288. This finding has been reported in medical literature and, to our knowledge, is the first to be reported in this country. . Included in the miscellaneous blood culture findings were the following: Central Wa:rcroaa Streptococcus hemolyticus ---------------------------- l Streptococcus viridans ---------------------------------- l Streptococcus, unclassified ---------------------------- l Diplococcus pneumoniae -------------------------------- l Staphylococcus aureus ------------------------------------ l Staphylococcus albus -------------------------------------- l Laboratory studies of several outbreaks of food infection were made by the Culture Unit of the Central Laboratory. Worthy of special mention were a Staphylococcus exterotoxin outbreak in a large aeroplane manufacturing plant and a Salmonella typhi murium epidemic in a girl's college. TABLE 37 SHIGELLA IsoLATIONS -1944 Tnoe Central Flexner v 11 w 20 y vzz 1 1 103 11 Total Flexners ________ 44 Newcastle 88___________ 10 Unclassified ----------- 2 P288 ------------------- 1 p 274 ------------------ 2 Sonne ---------------- 24 Dispar -------------- 3 Alkalescens 18 ToTALS ------- 104 Albany 4 10 2 2 2 20 5 Wa:rcroas 1 1 2 6 1 1 2 31 7 Others 1 1 2 3 1 2 8 * Isolations made in other laboratories, typed in. Central Laboratory. Total 16 32 3 2 1 14 68 18 3 1 2 32 4 22 150 Laboratories 287 Syphilis Serology Syphilis serology showed a considerable decrease for the year. In 1943 blood speimens examined for evidence of syphilis totaled 552,187 while only 346,413 were handled in 1944-a decrease of 205,774 or 37.3 per cent. This was chiefly due to the discontinuation of syphilis serology for the Selective Service Boards in February, 1944. Thereafter this function was transferred to the Fourth Service Command, leaving to the State Laboratories only a certain amount of recheck and demobilization work. Thus, while 184,681 such tests were made for military agencies in 1943, only 18,871 were examined in 1944-:--a decrease of 165,810. During the year, 10,539 specimens were examined for Selective Service Boards and 8,332 from Separation Centers. These were all handled in the Central Laboratory. A second cause for the decline in syphilis serology was the decrease in the number of specimens received from war plants. In the Waycross area where blood specimens were examined for the Brunswick Shipyard area, the syphilis serology load dropped from 72,550 in 1943 to 56,873 in 1944, a decrease of 22 per cent. The routine volume in all 3 laboratories decreased by 40,000 specimens, compared with the preceding year. Serology specimens represented 74.2 per cent of the entire laboratory volume, compared to 82.3 per cent in 1943. Of the specimens examined, 12.0 per cent were reported positive, as compared to 13.2 per cent in 1943. See Table 38 for an analysis of this work. TABLE 38 CENTRAL ALBANY WAYCROSS TOTAL BLOOD 1944 -------------- 244,878 1943 ---------'--- 432,413 43,593 46,281 56,790 72,491 345,261 551,185 -187,535 SPINAL FLUIDS 1944 - - - - - - - - 845 1943 ------------ 802 .-2,688 224 141 -15,701 83 59 -205,924 1,152 1,002 +43 BLOOD AND SPINAL FLUIDS 1944 ---------------- 245,723* 1943 ------------ 433,215** +83 43,817 46,422 +24 56,873 72,550 +ISO 346,413 552,187 -187,492 -2,605 -15,677 -205,774 Includes 10,539 Selective Service Specimens and 8,332 Separation Center specimens. Includes 184,681 Selective Service Specimens. 288 Georgia Department of Public Health In the syphilis serology research laboratory of the Central Laboratory, the following recognized serologic procedures were applied to specimens, listed below, collected following either conflicting resu!ts on previous specimens or in instances where physicians had reason to question the specificity of the routine tests: Kolmer Complement-Fixation ------------------------------------------ 86 Kline Exclusion --------------------------------------------------------------- 7 Kline Diagnostic -------------------------------------------------------------- 73 Mazzini --------------------------------------------------------------------------- 72 Eagle Flocculation ----------------------------------------------------------- 56 Hinton Flocculation ---------------------------------------------------------- 48 Kahn Verification -------------------------------------------------------------- 45 During the year 2 new serologic tests were introduced--the Micro-Kahn test and the Quantitative Kahn test. The Micro-Kahn, after having been run in parallel with the Standard Kahn test on 1,000 specimens with comparable results, was placed in use in all three laboratories, to be employed on specimens from small children or in instances where it is very difficult to secure ample specimens from adults. During the year, 267 such specimens were examined by the application of this test. The Quantitative Kahn test was introduced but has not been adopted as a routine procedure. It was performed on 350 specimens by special arrangement. Like the Micro-Kahn test, it is much more time consuming than the Presumptive or Standard Kahn procedures and its employment will have to be limited under the present circumstances. During the year, the Central Laboratory again participated in the syphilis serology evaluation study conducted by the U. S. Public Health Service. All recognized serology diagnostic tests and the Presumptive Kahn tests were performed on 216 specimens from syphilitic and 161 specimens from non-syphilitics. Creditable rating in sensitivity and specificity were achieved in all tests, with the exception of the standard Kahn test. It is felt that the rather low sensitivity rating in this test was due to the use of an antigen of low sensitivity rather than to performance. Table 39 shows the comparative ratings with the laboratories o the author serologists. Laboratories 289 TABLE 39 NATIONAL SEROLOGY EVALUATION STUDY- 1944 Georaia Labor&tcltT Sensitivity Speelfleity Aathor Serololiot Lab.,ratcltT Senlltlrity Speeiflclty Kahn Presumptive --------------------- 83.3 Kahn Standard ---------------------------- 66.9 Kline Diagnostic ------------------------ 75.2 Kolmer Complement-Fixation____ 81.9 Eagle Flocculation ---------------------- 79.6 Hinton Flocculation ____________________ 85.7 Mazzini ---------------------------------------- 80.7 98.8 100.0 99.4 99.7 100.0 100.0 99.0 88.8 98.5 82.1 100.0 82.2 100.0 85.5 99.4 87.4 98.5 87.0 97.8 87.7 99.7 An intra-state serology evaluation study was conducted during the year with 22 participating laboratories, including the 3 state laboratories. One hundred and twenty specimens, consisting of an equal number of known positive sera, were submitted in the study. Approval was give to 15 of the 19 laboratories in accordance with the provisions of the State prenatal law. Assistance was offered to the 4 laboratories which were not approved. By reciprocal agreement with the Fourth Service Command Laboratory, all Army Post laboratories in the State, certified by them for acceptable performance of the serologic tests for syphilis, were approved in accordance with the provisions of the State prenatal law. Biologics and Drugs b Table 40 shows the distribution of biolqgics and drugs during 1944, while Table 41 lists those showing the most marked increase or decrease as compared with the preceding year. During 1944 the following were added to the list distributed: tetanus, toxoid, fuadin, lygranum, ducrey vaccine, Pandy's solution, procaine solution and clinitest tablets. With the exception of tetanus toxoid, these products were furnished only to state supervised clinics. Penicillin was furnished only to the Rapid Treatment Centers at Augusta and Savannah. 290 Georgia Department of Public Health Laboratories 291 TABLE 40 BIOLOGIC PRODUCTS AND DRUGS DISTRffiUTED PRODUCT Central Albany Wa:reroM Sera arul Vaccines Diphtheria Antitoxin, units______________ Diphtheria Toxoid, cc. -------------------Diphtheria Schick Tests, tests__________ Ducrey Vaccine, cc. ------------------------Meningococcus Antitoxin, units ______ Pertussis Vaccine, cc. vials_______________ Smallpox V~ccii_Ie, po~nts________________ Tetanus Antitoxm, umts___________________ Tetanus Toxoid, cc. --------------------Tuberculin, Diluted, cc. ---------------Tuberculin, PPD, tests -----------------Typhoid Vaccine, cc._____________________ Antirabic Treatments 1 (Persons treated) --------------------- 37,016,000 83,415 44,650 380 80,000 83,940 103,940 5,287,500 260 12,810 1,030 470,130 2,784 3,074,000 5,125 1,140 146 4,520 153,000 37,420 951 3,231,900 6,530 2,030 1,573 6,610 321,900 32,185 405 Drugs Arsenicals, ampules 2 -----------------------Bismuth Subsalicylate in Oil, cc.3 ____ 203,470 611,190 Blatid's Pills, 5 gr. -------------------------Brewers Yeast, pounds ------------------ 19,876 Clinitest, tablets ----------------------------- 14,300 Distilled Water, cc.' ---------------------- 3,385,570 Fuadin, ampules ---------------------------Hexylrescorcinol Crystoids, vials____ 8,960 36 Lygranum, tests -------------------------------Pandy's Solution, oz. -------------------- 1,120 132 Penicillin, units, -----------------------------1,140,000,000 Procaine Solution, cc. ------------------------ 200 Silver Nitrate, ampules ---------------------Stovarsol, tablets, 0.25 gm._______________ 64,505 16,145 Sulfathiazole, tablets, 0.25 gm._______ 886,960 Tetrachlorethylene, 8 minim capsules 8,371 985 540 482,330 1,660 80 3,700 297,160 3,985 1 The figures given for the Branch Laboratories do not represent complete treatments. Four vials of vaecine 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 10 cc. and 100 cc. bottles. 3 Equivalent to 609,342 doses of 0.6 gms. or less. ' Distributed in 10 cc. and 100 cc. bottles. 292 Georgia Department of Public Health TABLE 41 BIOLOGics SHOWING MARKED INCREASE oR DECREASE OvER 1943 DISTRIBUTION PRODUCT 1944 1943 Inereaae er Deer- Tetanus Antitoxin, units ____________ Smallpox Vaccine, points____________ Tuberculin, Diluted, cc.______________ Pertussis Vaccine, cc. vials________ 5,287,500 2,546,500 103,940 113,170 12,810 18,545 83,940 67,100 +2,741,000 9,230 + 5,735 16,840 Silver Nitrate, ampules_______________ 64,505 74,891 10,386 Tetrachlorethylene, 8 minim capsules____________________ 8,371 14,827 6,456 Sulathiazole, tablets, 0.25 gm.____ 886,960 1,051,760 164,800 Stovarsol, tablets, 0.25 gm.__________ 16,145 27,835 11,690 Penicillin, units __________________________1,140,000,000 + 1,140,000,000 Human Antirabic Treatments During the year, 2,784 human antirabic treatments were distributed, contrasted with 2,296 in 1943-representing an increase of 488. These were sent to 134 counties, as compared to 138 counties in the preceding year. See Map 2. There were a number of counties which received an unusually large number of treatments. These included Fulton, 231; Chatham, 174; Catoosa, 108; Richmond, 93; Walker, 97; DeKalb, 77; Cobb, 77; Thomas, 76; and Bibb, 73. This was due chiefly to a high incidence of rabies in these counties. However, in Catoosa County, 91 treatments were supplied to patients exposed to 2 rabid dogs, which ran amuck on a Military installation. A comparison of treatment distribution and human mortality during the past 5 years is given in Table 42, while Table 43 gives a classification according to type during the past 2 years. LQboratories 293 MAP SHOWING DISTRIBUTION OF HUMAN ANTIRABIC TREATMENT 1944 TOTAL NUMBER - 2,784 CHATHAM COUNTY 174 FULTON COUNTY - !21 CATOOSA COUNTY 108 RICHMOND COUNTY 93 294 Georgia Department of Public Health TABLE 42 ANTIRABic ThEATMENTS AND RABIEs MoRTALITY 1840 1tU 1942 1941 Human Treatments -------- Human Deaths During or After Treatment________________ Human Deaths Without Treatment Total Deaths -------------------------- 1,903 1 1 2,262 2,130 2,296 2 2* 1 2** 2 4 4 1 One patient bitten. in Georgia, treated and died in South Carolina. Diagnosis doubtful in one cue. 194, 2,784 2 2 4 TABLE 43 CLASSIFICATION .ANTIRABIC TREATMENTS BY TYPE T7Pe Treatment 19U Number Per Cent Precautionary ------ 1,254 45.0 Mild ------------ 1,366 49.1 Intensive -------- 135 4.9 Drastic -------------o-- 29 1.0 ToTALS ------------ 2,784 1941 Number Per Cent 995 43.3 1,174 51.1 109 4.8 18 .8 2,296 Human Cases of Rabies- Four human cases of rabies were reported during the year. Diagnosis in each case was based on clinical symptoms alone. Complete case histories were obtainable for only 3 cases. These are given below. CASE 1-Mrs. M. F., white, female, residing in Jackson (Butts County) Georgia. Bitten by a clinically rabid dog about December 5 or 6, 1943, receiving a scratch on the dorsal surface of the left hand at the base of the little finger. Antirahic treatment was not given. Characteristic symptoms of rabies developed on February 2, 1944---approximately 59 days after exposure. Patient died on February 6, 1944. CASE 11-J. E. C., white, male, age 2, residing on Route 4, Dalton, (Whitfield County), Georgia. Bitten February 18, 1944, by a clinically rabid dog, receiving one superficial puncture and 3 scratches on the right cheek and forehead under the right eye and possibly on nose. Intensive antirahic treatment was instituted on the following day. Symptoms suggestive of rabies developed on arch 5-15 days after exposure, hut these Laboratories. 295 symptoms were not characteristic until the morning of March 9. The patient expired that night. CASE Ill-S. E., colored, female, age 16 months, residence RFD, Ft. Valley (Peach County) Georgia. Bitten April21, 1944, by a dog clinically diagnosed as rabid. Patient received 10 puncture wounds, several described as severe, on the right face, neck, hand and hack. Drastic antirahic treatment was instituted on April 22, 1944, and completed on May 6, 1944. This patient died in May, 1944, of symptoms suggestive of rabies. Repeated attempts to obtain a case history were unsuccessful. CASE IV-R. L. D., white, male, age 5, of Carrollton (Carroll County) Georgia. Bitten about May 3, 1944, by a clinically rabid dog receiving 1 puncture and 1 laceration on the right ear. Antirahic treatment was not given. Characteristic symptoms of rabies developed on June 10, approximately 38 days after exposure. Patient died on June 15, 1944. TABLE 44 DISTRIBUTION OF SPECIMEN OUTFITS BY LABORATORIES -1944 Central Albany Wayeros1 *Keidel Tubes -------------------------------------------- 2ll,678 Sterile Corked Vials ---------------------------------- 139,762 *Darkfield Outfits ------------------------------------ 390 Throat Culture Outfits -------------------------------- 3,599 Intestinal Parasite Outfits, Routine____________ 7,413 *Intestinal Parasite Tins; Survey______________ 8,886 Slide Outfits ------------------------------------------------ ll,778 Slides ---------------------------------------------------------- 7,128 Sputum Outfits ------------------------------------------ 18,006 Stool Culture Outfits --------------------------------- 6,654 Needles 19 Gauge, 2 inch -----------------------------22 Gauge, 12 inch____________________________ 452 85 24 26 Gauge, Gauge, % % inch inch -a--n--d------2----i-n--c--h--_-_-_-_-_-_-_-_ 125 154% 12,933 26,748 60 236 3,555 3,376 1,456 2,616 1,698 1,897 2,904 18,774 82 440 1,ll9 5,176 1,250 2,234 3,852 2,686 Syringes 1 cc. Tuberculin ------------------------------ 45 2 cc. Hypodermic ---------------------------- 478 5 cc. Hypodermic -------------------------- 92 10 cc. Hypodermic ---------------------------- 409 statiatiel for Central Laboratory includes items sent to tbe Albany and Wayerosa Branch Laboratories. 296 Georgia Department of Public Health TABLE 45 MEDIA AND VACCINE UNIT Media-in ccs. Central Meat Infusion Double ------------------------------------- 100,000 MBeeeaft EInxfturasicotnBBrortoht_h_-_-_--_-_-_--_-_-_--_-_-_--_'_--_-_-_--_-_-_-- 27,600 68,000 Pork Infusion Broth ------------------ 35,000 Tetrathionate Broth -------------------------- 14,600 Tryptone Broth ----------------------------------- 1,700 Tryptose Phosphate Broth ------------------------------------ 13,000 Sugar Broth ------------------------------------------- 7,400 Miscellaneous Broths ------------------------------ 10,900 Meat Infusion Agar ------------------- 132,000 Beef Extract Agar ---------------------------- 1,000 CDhesoocxoylactheolAatgeaCr it-rl-j-.t-e--A--g-a-r-_-__-_-__-_-_-__-_-__-_-_-__-_-__-_-__-_-_-__-_-__-_-_ 6,800 13,000 EKnlidgole'sr'sStTocrikpleAgSaurg-a-r---I-r--o-n----A---g-a--r-_--_-_-_-_--_-_-_-_--_-_-_-_--_-_-_--_-_ 17,000 13,900 MacConkey's Agar ----------------------------------------------- 11,750 Peizer's Stock Agar--------------------------------------- 17,500 Pork Infusion Agar---------------------------------- 14,000 S. S. Agar ------------------------------------------------- 19,250 Wilson Blair Agar ---------------------------------------- 96,500 Tryptose Agar ------------------------------------------ 11,000 Miscellaneous Agars ---------------------------- 77,810 Conradi's Bile ----------------------------------------------- 106,000 Fryes Medium ------------------------------------------------------ 1,000 Loeffler's Blood Serum ----------------------------- 7,528 Petragnani's -------------------------------------------- 26,000 Thioglycolate -------------------------------------------- 500 Miscellaneous Media ---------------------------------- 12,450 Albany Wayerou 4,700 1,200 9,500 4,650 20,750 14,250 9,900 9,450 1,500 15,100 54,075 300 52,500 4,400 2,800 --8,500 500 4,500 5,300 1,800 2,500 2,200 32,000 37,000 9,500 SOLUTIONS AND INDICATORS Indicators for Media -----------------------------Dyes' for Media ------------------------------ __ Bismuth Sulfite Mixture_____________________ Glycerine Salt Solution_______________________________ Salt Solution ------------------------------------------Silver Nitrate Solution -------------------------------Reagents for Media ---------------------20 Per Cent Dextrose ------------------------------Miscellaneous Solutions ------------------ 300 900 14,500 66,000 583,000 34,700 24,547 1,500 17,550 14,000 39,300 25,000 135,000 1,500 (The following media were prepared In the Engineering Laboratory) Lactose Broth ------------------------------- 1,800,000 cc. Endo Medium -------------------------- 40,000 cc. Brilliant Green Lactose Bile Broth______________ 114,000 cc. Nutrient Agar --"E. C." Medium___ ---------------- 11,000 cc. 31,000 cc. V. P. and M. R. medium 1,000 cc. lndol Medium - 500 cc. Glucose Agar 1,000 cc. Fuchsin Dye Solution - - - - - - - - - 200 cc. Koser's Citrate Medium ------------------------ 100 cc. Laboratories 1% SILVER NITRATE Number ampules made ----------------------------------------- Number ampules filled --------------------------------------Number ampules distributed-------------------------------- 1944 78,000 62,500 68,000 STERILE DISTILLED WATER Water filled, cc. -------------------------------------------3,664,400 Water distributed, cc. _________________________3,674,400 DILUTED TUBERCULIN (OLD) Tuberculin diluted, cc. ------------------------ 11,250 Tuberculin distributed, cc. ----'------------------- 11,435 297 1943 80,000 92,500 96,250 bereaae or Decrease -2,000 -30,000 -28,250 5,426,900 -1,762,500 5,507,800 -1,833,400 19,000 18,870 -7,750 -7,435 Research In addition to the routine activities covered in this report, several research projects were instituted during the past year. In the Waycross Laboratory a study was made of concentration methods for the demonstration of tubercle bacilli. In the Central Laboratory, a study of new media used in the cultivating of the gonococcus was completed. Investigation of a complement fixation test for malaria was made and the conclusion reached that the test in its present state is not practical. The complement fixation test for typhus was instituted during the year. While not superior to the Weil Felix reaction for diagnostic purposes, there is hopeful evidence that this test will be of great value in differentiating between typhus and Rocky Mountain spotted fever. Of the latter, at least 10 cases were reported during the year. Seminars During the year, a program of seminars was instituted and proved to be most beneficial. The majority of papers presented were prepared by various members of the technical staff. Several visitors from foreign countries also participated. These seminars not only have an educational value, but also provide the opportunity to the technical staff of developing the ability to prepare and present papers. Personnel The difficulty in maintaining an adequate staff of qualified technical personnel, which has been so pressing during the past few years, was again felt during 1944. However, some improvement was apparent, chiefly as a result of an increased number of applicants for training. Fortunately, a number of capable trainees were trained sufficiently to replace most of the technical personnel who left the service. The high turnover in unskilled personnel continued, and it was exceedingly difficult to obtain satisfactory 298 Georgia Department of Public Health dieners and porters. During the year, there were 34 resignations and 35 appointments. These were classified as follows: Dieners 11 Porters 4 RESIGNATIONS Technical 11 Clerical 8 Total 34 APPOINTMENTS 13 4 13 5 35 At the close of the year, there were 83 employees in the Division of Laboratories classified as follows: technical 41; clerical 19; dieners and porters 23. There were 13 vacancies on the technical staff and 7 on the clerical-making a total of 20. Visitors Registered in the Laboratory Guest Book lor 1944 are the names or records of 426 visitors. This compares with 371 in 1943. They were classified as follows: 1. Students and teachers from schools and colleges including student nurses, 288. 2. Military personnel, 57. 3. From foreign countries, including Surinam, Ecuador, Costa Rica~ China, British Honduras, Venezuela, Brazil, Chile, Peru and England, 14. 4. Others, 67. Unsatisfactory Specimens In our report for 1943, we stated that 19,518 unsatisfactory specimens had been rejected by the Laboratory during the year. Ninety per cent of these were blood samples which had spoiled in transit. During 1944 there were only 10,658 unsatisfactory specimens. Of these 755 were received for microscopic examinations, 76 for culture and 9,827 for syphilis serology. This marked improvement is no doubt due to prompt shipment of specimens by the sender and, in the Central Laboratory, the collection of specimens from the Post Office on Saturday night. These are immediately refrigerated, thus preventing spoilage of numerous blood specimens. Division of Information and Statistics RICHARD BREWER------ _.Director LEALoN M. LAcy________________Office Supervisor FRANK M. WooDRUFF _Field Agent Division of Information and Statistics The Division of Information and Statistics is responsible for the filing of a certificate for each birth or death occurring in the State of Georgia and the training and supervision of the large field force of local registrars required to collect vital statistics in the counties. Under the provision of the new Vital Statistics Act passed by the 1945 Legislature and signed by the Governor on March 8, 1945, the Division will also have the responsibility of recording each marriage and divorce in the State of Georgia. CuRRENT BIRTH CERTIFICATES. The new Vital Statistics Act provides for a radical change in the method of filing current birth certificates. Under the old procedure the physician or midwife filled out a birth certificate, signed it, and filed it with the local registrar. The local registrar entered the information in his record book, made a copy for the county ordinary or the county health officer and forwarded the original certificate to the Division of Information and Statistics. Under the new procedure the parent will file a birth certificate with the local registrar who will transmit it directly to the Department. The Department will make a copy of the record and send it to the proper county so that the local record shall be exactly the same as the State record. At the same time the doctor or midwife shall fill out a medical report of the birth which shall contain all the medical information required on the present birth certificate and such additional information as the Board may direct. This report will go directly from the doctor to the Health Department and is a confidential report not open to public inspection. In this manner it is hoped that m-ore accurate medical information may be obtained. DEATH CERTIFICATES. Death certificates, under the new Vital Statistics Act, will be filed in the same manner as in the past. The undertaker secures the personal information about the person and fills that in on the certificate and presents it to the physician for the medical certification of the cause of death. The certificate is then sent to the local registrar who forwards it to the Department in the same manner as the birth certificate. STILLBIRTHS. The new Georgia Law provides for a stillbirth certificate to take the place of the old form in which a birth and a death certificate was filed for each stillbirth. This is considered to be a considerable improvement over the old manner. AMENDMENTS AND CORRECTIONS. Another important change in the new Vital Statistics Act is the provision that all corrections and amendments shall be made by a court order through the Court of Ordinary in the various counties. The old system of reporting by the doctor or midwife left too many inaccuracies and as a result the Department has been deluged by the number of requests for corrections of various certificates. Since we have no legal basis for making such corrections, it was necessary that some provision be made so that these corrections may be handled on a legal basis 302 Georgia Department of Public Health without too much trouble to the individuals involved. This procedure seems to point the way for handling this type of business. The new Vital Statistics Act also provides that the fees received by the Division of Information and Statistics be used by the Department for the promotion of Vital Statistics work in the State of Georgia. DELAYED BIRTH CERTIFICATES. The number of delayed birth certificates filed by the county Court Order procedure rose from 22,699 in 1943 to 32,510 in 1944. 42,016 certificates were placed on file by the regular State procedure during 1944 as compared with 46,282 filed in 1943. This gives an over-all increase of 2,709 certificates in the State as a whole over 1943. CERTIFIED CoPIES. During 1944 the number of certified copies of birth certificates declined to 47,547 as compared with 64,781 certified copies issued for the year of 1943. The number of certified copies of death certificates rose from 716 in 1943 to 965 in 1944. STATISTICS BIRTH RATE. There was a decrease of 1.7 per cent in the birth rate in 1944. The rate dropped from 25.1 in 1943 to 24.7 in 1944. The number of live births registered in 1943 was 78,327 as compared with 77,018 in 1944. STILLBI.RTHS. There is a continued decline in the rate of stillbirths of 3.7 per cent. The number of stillbirths reported in 1944 was 2,523 as compared with 2,664 in 1943. INFANT MoRTALITY. There was a further drop in the infant mortality rate in 1944 to 44.1 per 1,000 as compared wit,h 46.7 in 1943. A decrease of 5.6 per cent. MATERNAL MoRTALITY. A decrease of 7.3 per cent was shown in maternal mortality when the rate dropped from 3.9 in 1943 to 3.6 in 1944. CAUSE OF DEATH TYPHOID FEVER. There was a slight increase in the death rate from this disease from 0.7 in 1943 to 0.8 in 1944 or 4.1 per cent. TYPHUS FEVER. Typhus fever is still on the increase as 63 persons died in 1944 as compared with 57 deaths in 1943. This is an increase at the rate of 10.4 per cent. MALARIA. A decrease of 8.5 per cent is shown in the death rate of Malaria. In 1944, 34 deaths were reported against the 37 reported in 1943. SMALLPOX. The deaths and death rate on smallpox are nil. Information and Statistics 303 DISEASES OF CHILDHOOD. 0 childhood diseases deaths from measles increased at the rate of 152.3 in 1944. In 1943 the number of deaths reported was 27 as compared with 68 in 1944. Scarlet fever is on the downward trend as a decrease of 68.4 is shown. Only 2 deaths were reported in 1944 as compared with 6 in 1943. A decrease of 61.8 per cent is shown in whooping cough with a comparison in number of 65 deaths in 1944 and 170 deaths in 1943. DIPHTHERIA. The number of deaths from this disease dropped from 47 in 1943 to 40 in 1944. The rate decreased from 1.5 in 1943 to 1.3 in 1944, or 14.7 per cent: INFLUENZA. There is a marked increase in the number of deaths from influenza from 624 in 1943 to 742 in 1944. The rate increased 18.9 per cent. DYSENTERY. The deaths and death rates from this condition show a decrease of 20.2 per cent, a rate of 2.0 in 1944 as compared with 2.5 in 1943. The number of deaths dropped from 79 in 1943 to 63 in 1944. PoLIOMYELITIS. The death rate from this disease is on the increase as 0.3 is shown in 1944 and 0.1 in 1943 or an increase of 2ll.1 per cent. In 1943 only 3 deaths were reported while 9 were reported in 1944. LETHARGIC ENcEPHALITIS. Deaths from this disease are on the decrease as a drop in the number of deaths is shown from.5 in 1943 to 4 in 1944. The rate dropped from 0.2 in 1943 to 0.1 in 1944 or 25.0 per cent. MENINGococcus MENINGITIS. In 1944 a marked increase of 80.8 was shown in the death rate from this cause. The rate in 1943 climbed from 1.0 to 1.8 in 1944. The number of deaths reported in 1943 were 31 as compared with 56 in 1944. TuBERCULOSIS, ALL FoRMs. A decrease is shown in the death rate from this cause from 41.7 in 1943 to 35.4 in 1944 or a decrease of 15.1. In 1943 the number of deaths reported was 1,304 as compared with 1,107 in 1944. SYPHILIS. A decrease in the reported death rate from syphilis continued through 1944. There was a 14.5 per cent decrease or a rate of 13.9 in 1943 as compared with ll.7 in 1944. The number of deaths reported in 1944 was 372 against 435 in 1943. CANCER. An increase of 7.6 is shown in the death rate from cancer when the rate climbed from 67.1 in 1943 to 72.2 in 1944. The number of deaths increased from 2,097 in 1943 to 2,256 in 1944. DIABETES MELLITUS. The death rate from this cause is on the downward trend as a 12.9. per cent decrease is shown. In 1943 the number of deaths reported was 430 as compared with 375 in 1944. 304 Georgia Department of Public Health PELLAGRA. The number of deaths from pellagra decreased from 175 in 1943 to 134 in 1944. The rate of 4.2 compared with 5.6 in 1943. CEREBRAL HEMORRHAGE, EMBOLISM AND THROMBOSIS. The deaths from this condition decreased from 2,945 in 1943 to 2,974 in 1944. The rate in 1943 was 94.3 as compared with 95.2 in 1944. HEART DISEASES. The leader in the cause of death in Georgia, as well as the Nation, took 5,678 lives in 1944 a slight decrease of 1.7 over the 5,775 deaths in 1943. The rate dropped from 184.9 in 1943 to 181.8 in 1944. PNEUMONIA. Very recent years have shown a steady, slight decrease in deaths from pneumonia which continues on through 1944. The rate dropped from 55.5 to 50.6 in 1944. The number of deaths in 1943 was 1,734 as compared with 1,581 in 1944. DIARRHEA AND ENTERITIS (-2 Yrs.) . The number of deaths from this condition increased from 292 in 1943 to 340 in 1944. The rate increased from 9.3 to 10.9 in 1944 or 16.5 per cent. CIRRHOSIS OF LIVER. A slight increase was shown in the deaths from this cause as the rate rose from 4.9 in 1943 to 5.6 in 1944 or 15.2 per cent. APPENDICITIS. Deaths from appendicitis are slightly on the decrease according to reports in 1944. In 1943 the number of deaths fell from 188 to 159 in 1944 a decrease of 15.3 per cent. NEPHRITIS. Although deaths from this cause is next to the leading cause of deaths, it is still slightly on the decrease. The rate dropped from 100.5 in 1943 to 92.9 in 1944 or 7.6 per cent. The number of deaths reported in 1943 was 3,139 as compared with 2,901 in 1944. MALFORMATION AND EARLY INFANCY DISEASES. Deaths from this cause is on the downward trend as a drop of 9.4 per cent is shown. In 1943 the number dropped from 2,048 to 1,855 in 1944. The rate fell from 65.6 in 1943 to 59.4 in 1944. SUICIDE. The number of suicidal deaths rose from 165 in 1943 to 185 in 1944. The rate increased from 5.3 in 1943 to 5.9 in 1944 or 12.1 per cent. HoMICIDE. A very slight increase of 3.6 per cent is shown in deaths hy homicide. In 1943, 438 deaths were reported as compared with 454 in 1944. - MoTOR-VEHICLE AcCIDENTS. There was a slight increase in the death rate from 19.4 in 1943 to 20.6 in 1944 or 6.3 per cent. The number of deaths reported in 1943 was 606 as compared with 644 in 1944. ALL OTHER AcciDENTS. A decrease is shown in the number of deaths from other accidents in the rate of 42.2 in 1943 against 43.8 in 1944. There was a decrease of 48 in the number of deaths. Information and Statistics 305 UNKNOWN AND ILL-DEFINED CAUSES. The death rate from ill-defined causes dropped 3.8 per cent or from 34.1 in 1943 to 35.4 in 1944. The number of deaths reported in 1943 was 1,065 as compared with 1,106 in 1944. ALL OTHER CAUSES. The crude death rate, or deaths from all causes dropped from 130.4 in 1943 to 127.2 in 1944 or 2.4 per cent. The number reported in 1943 was 4,072 as compared with 3,973 in 1944. 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 AND THE PER CENT INCREASE OR DECREASE IN THE RATES, IN GEORGIA: 1943 AND 1944 1943 and 1944 rates based on the 1940 Census Enumerated Population. These figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurring in other states. Cause of Death Number 1944 ALL CAUSES --------------------------- 27,987 Typhoid fever ---------------------------- 23 Typhus fever ---------------------------------- 61 Malaria ------------------------------ 35 Smallpox --------------------- Measles -------------------- 68 Scarlet fever ------------------- 2 Whaoping cough ----------------------------- 65 Diphtheria ------------------------------- 36 Influenza Dysentery ---------------------------- 728 ----------------- 62 Poliomyelitis ------------------------------------ 9 Lethargic encephalitis ------------------------------ 2 Meningococcus meningitis ------------------- 50 Tuberculosis, all forms ----------------------- 1,078 Syphilis ------------------------------- 364 Cancer -------------------------------------- 2,216 Diabetes mellitus --------------------------- 366 Pellagra ---------------------------------------------- 134 Cerebral hemorrhage, embolism and thrombosis 2,891 Heart diseases ----------------------------------------- 6,545 PDniaerurmheoaniaand---e-n-t-e-r-i-ti-s---(---2---Y--r-e-.)-_-_-_-_-_-_-_-_-_-__-_-_-_- 1,527 330 Cirrhosis of liver -------------------- 152 Appendicitis -------------------------------- 171 Nephritis ---------------------------------- 2,824 Malformation and Early Infancy Diseases_______ 1,795 Suicide ------------------------------------------- 182 Homicide ------------------------------------------- 442 MAloltoort-hveerhicalceciadcecnitds.e_n_t_s__-_-_-_--_-_-_--_-_-_--_-_-_--_-_-_--_-_-_--_-_-_--_-_-_- 624 1,315 Unknown and ill-defined causes_____________ 1,048 All other causes ------------------------------------------- 3,842 Live births --------------------------------------------- 75,002 Stillbirths ------------------------------------ 2,445 Infant Mortality -------------------------------- 3,293 Maternal Mortality --------------------------------- 263 1943 29,488 23 67 37 27 6 170 47 624 79 3 5 31 1,304 435 2,097 430 175 2,945 5,775 1,734 292 152 188 3,139 2,048 165 438 606 1,319 1,065 4,072 78,327 2,664 3,661 303 Per Cent Rate Increase or 1944 1943 Decrease - 896.0 944.0 6.1 0.7 0.7 2.0 1.1 - 1.8 + 7.1 1.2 6.1 2.2 0.1 2.1 1.2 23.3 2.0 0.3 0.1 1.6 34.5 11.7 70.9 11.7 . 4.3 92.5 177.5 48.9 10.6 4.9 5.5 90.4 67.5 5.8 14.1 20.0 42.1 33.5 123.0 24.0 32.6 43.9 3.5 0.9 0.2 5.4 1.6 20.0 2.5 0.1 0.2 1.0 41.7 13.9 67.1 13.8 5.6 94.3 184.9 56.5 9.3 4.9 6.0 100.5 65.6 5.3 14.0 19.4 42.2 34.1 130.4 25.1 34.0 46.7 3.9 +152.3 - 68.4 - 61.8 - 23.3 + 16.7 -21.4 +211.1 - 62.5 + 61.6 - 17.8 - 16.8 -+ 5.7 14.9 -23.6 1.8 -- 4.0 - 11.9 + 18.1 - 9.0 10.0 -- 12.4 + 10.2 + + 0.9 s.o o.s 1.6 &.6 4.2 4.2 6.1 9.8 306 Georgia Department of Public Health DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS AND STILLBIRTHS WITH RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1944 INCLUSIVE Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1989 1940 1941 1942 1943 1944 Infant Mortality 6,306 4,905 4;937 6,384 5,674 4,704 4,406 4,678 4,876 4,464 4,713 4,234 4,097 4,079 5,086 4,316 4,319 3,968 4,362 3,817 3,737 3,956 3,669 3,661 3,293 Number Maternal Mortality Stillbirths 668 3,389 568 3,820 668 3,862 573 3,968 708 3,864 641 3,466 486 2,972 678 3,836 622 3,478 649 3,641 668 3,796 616 3,678 620 3,847 463 3,700 506 4,120 468 3,987 491 3,666 471 3,677 421 8,390 356 3,228 342 3,078 315 2,903 299 2,786 303 2,664 263 2,446 Infant Mortality 88.3 73.9 76.9 84.6 89.6 78.9 87.2 73.6 80.9 76.3 78.1 68.5 64.3 67.2 78.7 68.2 70.1 62.0 67.7 58.8 57.8 58.3 49.3 46.7 43.9 Rate Maternal Mortality Stillbirths 9.3 66.4 8.6 67.6 10.1 69.8 9.0 62.2 11.2 81.0 10.8 68.0 9.6 68.9 9.3 61.6 10.3 67.7 9.4 60.15 10.9 62.9 10.1 69.6 9.7 60.4 7.6 60.9 7.8 63.8 7.2 63.0 8.0 158.15 7.4 67.4 6.6 62.7 6.5 411.'1 6.3 47.6 4.6 41.8 4.1 ss . 3.9 84.0 3.6 a:u Information and Statistics 307 BmTHS AND DEATHs (ExcLUsiVE oF STILLBIRTHS) WITH RATES PER 1,000 PoPULATION AND BIRTHS PER 100 DEATHS, IN GEORGIA: 1920-1944 Year Number Births Deatha 1920 1921 - 60,061 66,378 1922 65,082 1923 63,681 1924 63,386 1925 59,610 192. 60,493 1927 62,246 1928 60,269 1929 - - - - - - - 68,621 1980 ----------- 60,818 1981 ------------ 61,774 1932 - - - - - - - - 63,690 1983 --------- 60,744 1984 --------- 64,616 1986 - - - - - - - - 63,290 183. --------- 61,617 1887 ----------- 64,012 1938 --------- 64,807 - - - - - - 1939 ------------ 64,910 1940 64,696 11!41 - - - - - - - 67,786 1842 -------------- '12,189 1943 --------------- '18,327 19.4 75,002 32,243 29,552 31,714 34,082 34,797 31,278 29,906 31,869 36,086 36,340 36,188 32,989 82,122 31,184 36,590 34,313 37,293 34,411 83,617 33,617 32,286 81,579 28,807 29,488 27,987 Rate Births Deaths 20.7 11.1 22.9 10.2 22.5 10.9 22.0 11.8 21.8 12.0 20.6 10.8 17.4 10.3 21.4 11.0 20.7 12:4 20.1 12.2 20.7 12.1 21.0 11.2 21.6 10.8 20.4 10.6 21.6 11.8 20.9 11.3 20.2 12.2 20.8 11.2 20.7 10.8 20.8 10.2 21).7 10.3 21.6 10.0 23.1 9.2 26.1 9.4 24.0 9.0 Birtha Per 100 Deatha 186 226 205 187 182 191 169 196 167 166 171 187 198 186 182 184 146 186 191 204 280 216 261 266 218 308 Georgia Department of Public Health TABLE 1 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 AND THE PER CENT INCREASE OR DECREASE IN THE RATES, IN GEORGIA: 19<&3 AND 19U Cause of Death Number 1944 1943 ALL CAUSES - - - - - - - - - - 28,803 Typhoid fever - - - - - - - - 24 Typhus fever - - - - - - - - - - - - - - 63 Malaria 34 Smallpox Measles --------------- 68 Searlet fever 2 Whooping Cough --------- 65 Diphtheria ------------------ 40 Influenza 742 Dysentery - - - - - 63 Poliomyelitis ------------------- 9 Lethargic encephalitis ---------- 4 Meningococcus meningitis ---------- 56 Tuberculosis, all forms ----------- 1,107 Syphilis --------- - - - - - - 372 Cancer ------ 2,256 Diabetes mellitus ------- 375 Pellagra 131 Cerebral hemorrhage, embolism and thrombosis 2,974 Heart diseases --------------------- 5,678 Pneumonia --------------------------Diarrhea and enteritis, under 2 Yrs._________ Cirrhosis of liver_____________________ 1,581 340 175 Appendicitis -------------------------- 159 Nephritis --------------------- 2,901 Malformation and early infancy diseases_________ 1,855 Suicide 185 Homicide ------------------------ 454 Motor-vehicle accidents ------------------ 644 All other accidents --------------- 1,367 Unknown and ill-defined causes______________________ 1,106 All other causes --------------- 3,973 LIVE BIRTHS___ ----------- 77,018 STILLBIRTHS ------------------- 2,523 INFANT MORTALITY----------------------- 3,398 MATERNAL MORTALITY------------- 276 29,488 23 57 37 27 6 170 47 624 79 3 5 31 1,304 435 2,097 430 175 2,945 5,775 1,734 292 152 188 3,139 2,048 165 438 606 1,319 1,065 4,072 78,327 2,664 3,661 303 Rate 19U 19U PerCent Incr- or Decrease 922.1 0.8 2.0 1.1 1144.0 0.7 1.8 1.2 - 2.3 + 4.1 + 10.4 - 8.6 2.2 0.1 2.1 1.3 23.8 2.0 0.3 0.1 1.8 35.4 11.9 72.2 12.0 4.2 95.2 181.8 50.6 10.9 5.6 5.1 92.9 59.4 5.9 14.5 20.6 43.8 35.4 127.2 24.7 32.8 44.1 3.6 0.9 0.2 5.4 1.5 20.0 2.5 0.1 0.2 1.0 41.7 13.11 67.1 13.8 6.6 114.3 184.9 55.5 9.3 4.9 6.0 100.5 65.6 5.3 14.0 19.4 42.2 34.1 130.4 25.1 34.0 46.7 3.9 +152.3 -68.4 -61.8 -14.7 + 18.9 -20.2 +211.1 -25.0 + 80.8 -15.1 -14.6 + 7.6 -12.9 -25.2 + 1.0 - 1.7 - 8.8 + 16.5 + 15.2 -15.3 - 7.6 - 9.4 + 12.1 + + ++ 3.6 6.3 3.6 3.8 2.4 1.7 3.7 5.6 7.3 NOTE: Figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurring in other states. Information and Statistics 309 TABLE 2 DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS AND STILLBIRTHS WITH RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1944 Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 Infant Mortality 5305 4905 4937 6384 6674 4704 4405 4678 4875 4464 4713 4234 4097 4079 5086 4316 4319 3968 4362 3817 8787 3956 3669 8661 3398 Number Matemal Mortality 558 568 658 573 708 641 486 678 622 549 658 616 620 463 605 458 491 471 421 366 842 316 299 803 276 Stillbirths 3389 3820 3862 3958 3864 3456 2972 3836 3478 3541 3796 3678 3847 3700 4120 3987 3666 3677 3390 3228 3078 2903 2786 2664 2623 Infant Mortality 88.3 73.9 75.9 84.5 89.5 78.9 87.2 73.6 80.9 76.3 78.1 68.5 64.3 67.2 78.7 68.2 70.1 62.0 67.7 68.8 57.8 58.3 49.3 46.7 44.1 Rate Matemal 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 6.5 6.8 4.6 4.1 3.9 3.6 Stillbirths 66.4 57.6 69.3 62.2 61.0 68.0 68.9 61.6 67.7 60.6 62.9 69.6 60.4 60.9 63.8 63.0 59.6 57.4 62.7 49.7 47.6 42.8 88.6 84.0 32.8 310 Georgia. Department of Public Health 1'ABLll i BIRTHS AND DEATHS (ExCLUSIVE OF STILLBIRTHS) WITH RATES PER 1,000 POPULATION AND BIRTHS PER 100 DEATHS, IN GEORGIA: 1920-1944 Year Namber Births Death 192() - - - - - - - - 60,061 1921 66,378 1922 --------- 65,082 1923 63,681 1924. --------~ 63,386 1925 - - - - - - - - - 59,610 1926 50,493 1927 --------- 62,246 1928 -- 60,259 1929 58,521 1980 --------- 60,318 1931 - 61,774 1982 68,690 1933 - - - - - - - 60,744 1934 64,615 1935 63,290 --------------~ 1936 - - - - - - - - - 61,617 1937 ------------------- 64,012 1938 --------------- 64,307 1989 ------------- 64,910 1940 ----------- 64,696 1941 --------------- 67,786 1942 ------------- 72,189 1943 ------------- 78,327 1944 --------------------- 77,018 32,243 29,552 31,714 34,082 34,797 31,278 29,906 31,869 36,085 35,340 36,188 32,989 82,122 31,184 35,590 34;313 37,293 34,411 33,617 31,866 32,286 31,679 28,807 29,488 28,803 Rate Birtho Death 20.7 11.1 22.9 10.2 22.5 10.9 22.0 11.8 21.8 12.0 20.5 10.8 17.4 10.3 21.4 11.0 20.7 12.4 20.1 12.2 20.7 12.1 21.0 11.2 21.5 10.8 20.4 10.5 21.5 11.8 20.9 li.3 20.2 12.2 20.8 11.2 20.7 10.8 20.8 10.2 20.7 10.3 21.6 10;0 23.1 9.2 25.1 9.4 24.7 9.2 Births Per 100 Deaths 186 225 205 187 182 191 169 196 167 166 171 187 198 195 182 184 166 186 llil 204 200 215 26i 266 267 Information and Statistics 311 TABLE 4 DEATHS UNDER ONE YEAR oF AcE, MATERNAL DEATHs, ILLEGITIMATE BIRTHS (ExcLUSIVE oF STILLBIRTHS) AND STILLBIRTHs WITH RATEs PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1944 Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1930 1931 1932 1933 1934 1936 1936 1937 1938 1939 1940 1941 1942 1943 1944 INFANT MORTALITY NUMBER RATE Total White Col. Total White Col. 6306 4906 4937 6384 6674 4704 4406 4678 4876 4464 4713 4234 4097 4079 6086 4316 4319 3968 4362 3817 8737 3966 3669 8661 3398 2961 2606 2609 2938 2989 2486 2299 2334 2674 2343 2468 2137 2122 2119 2628 2227 2114 2014 2267 1960 1861 1988 1766 1911 1961 2344 2299 2428 2446 2686 2218 2106 2244 2301 2121 2246 2097 1976 1960 2458 2089 2205 1964 2086 1867 1886 1967 1803 1760 1637 88.3 73.9 76.9 84.& 89.6 78.9 87.2 73.& 80.9 76.3 78.1 68.5 64.3 67.2 78.7 68.2 70.1 62.0 67.7 68.8 67.8 68.3 49.3 46.7 44.1 71.1 &8.6 69.1 68.4 72.2 66.0 71.3 &9.4 67.6 65.5 66.6 66.9 56.6 69.4 68.6 69.6 68.2 62.7 68.7 60.4 47.6 48.2 38.9 38.1 36.6 127.1 106.3 107.4 108.3 122.0 103.9 116.3 97.7 104.0 93.1 96.& 86.6 77.6 78.2 93.6 80.6 87.2 76.6 81.1 71.6 73.1 74.2 66.8 62.1 69.4 MATERNAL MORTALITY NUMBER RATE Total White Col. Total White Col. 568 267 291 11.3 6.4 16.8 668 266 302 8.6 6.0 13.8 668 316 342 10.1 7.4 16.1 &73 288 286 9.0 7.0 12.6 708 362 346 11.2 8.7 16.7 641 299 842 10.8 7.8 16.0 486 222 263 9.6 6.9 14.4 678 291 287 9.3 7.4 12.6 622 312 310 10.8 8.2 14.0 649 284 265 9.4 7.9 11.6 668 361 297 10.9 9.7 12.8 616 322 294 10.0 8.6 12.1 620 310 310 9.7 8.1 12.2 463 227 236 7.6 6.4 9.4 606 262 243 7.8 6.8 9.2 468 230 228 7.2 6.2 8.8 491 261 240 8.0 6.9 9.6 471 240 231 7.4 6.3 8.9 421 198 223 6.6 6.1 8.7 366 176 181 6.6 4.6 7.0 342 146 196 6.3 3.8 7.6 316 133 182 4.6 3.2 6.9 2U9 146 163 4.1 3.2 6.7 303 160 163 3.9 3.0 6.4 276 122 154 3.6 2.6 6.6 Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1930 1931 1932 1933 1934 1936 1936 i937 1938 1939 1940 1941 1942 1943 1944 ILLEGITIMATE BIRTHS NUMBER RATE Total White Col. Total White Col. 2696 3077 3606 4046 4089 4014 3166 4089 3868 4061 4141 4429 6126 6101 6089 6031 4878 4739 4724 4960 6046 6134 6038 4911 4766 474 2221 44.9 11.4 120.4 616 2561 46.4 11.6 117.4 600 3106 66.4 11.8 137.4 643 3602 63.6 13.2 166.0 674 3616 64.6 13.9 169.7 634 3480 67.3 14.0 163.0 461 2694 62.5 14.3 147.6 637 3462 66.7 16.2 160.3 482 3386 64.2 12.6 153.0 616 3646 69.4 14.4 166.7 612 3629 68.7 13.8 166.1 647 3882 71.7 14.6 160.1 600 4626 80.6 16.7 177.6 682 4619 84.0 16.3 180.4 661 4438 78.8 17.0 168.9 643 4388 79.6 17.2 169.1 698 4280 79.2 16.6 169.2 626 4213 74..0 13.8 163.1 680 4144 73.5 16.0 161.3 696 4364 76.4 16.3 167.9 665 4481 78.0 14.6 173.8 607 4627 76.7 14.7 170.8 678 4460 69.8 12.8 166.2 637 4374 62.7 10.7 165.2 673 4182 61.7 11.6 161.8 STILLBIRTHS NUBER RATE Total White Col. Total White Col. 3389 1608 1781 66.4 38.6 96.6 3820 1720 2100 67.6 38.6 96.2 3862 1716 2146 59.3 40.4 ' 94.9 3968 1802 2166 62.2 43.9 96.4 3864 1676 2189 61.0 40.6 99.6 3466 1436 2020 68.0 37.5 94.6 2972 1246 1726 68.9 38.7 94.6 3836 1604 2232 61.6 40.8 97.2 3478 1335 2143 67.7 35.0 96.6 3641 1374 2167 60.6 38.4 96.2 3796 1464 2342 62.9 39.2 100.7 3678 1424 2264 69.6 37.9 93.0 3847 1492 2366 60.4 39.0 92.4 3700 1382 2318 60.9 38.7 92.6 4120 1673 2447 63.8 43.6 93.1 8987 1632 2466 63.0 41.0 94.6 3666 1467 2209 59.6 40.1 87.3 3677 1499 2178 57.4 39.3 84.3 3390 1386 2004 62.7 35.9 78.C. 3228 1337 1891 49.7 34.3 72.8 3078 1326 1762 47.6 34.1 67.9 2903 1276 1627 42.8 30.9 61.4 2786 1268 1618 38.6 28.1 66.2 2664 1238 1426 84.0 24.7 60.6 2623 1137 1386 32.8 23.0 60.3 312 Georgia Department of Public Health DEATHS AND BIRTHs (ExcLUSIVE OF STILLBIRTHs) AND RATES PER 1,000 PoPULATION, IN GEORGIA: 1920-1944 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 1944 BIRTHS NUMBER RATE Total White Col. Total White Col. 60061 66378 65082 63681 63386 69610 50493 62246 60259 68521 60318 61774 63690 60744 64615 63290 61617 64012 64307 64910 64696 67785 72189 78327 77018 41618 44555 42475 41088 41379 38254 32226 39281 38136 35761 37064 37531 38209 35692 38333 37345 36320 38181 38613 38923 38911 41277 45192 60149 49464 18443 21823 22607 22593 22007 21356 18267 22965 22124 22770 23254 24243 25481 25052 26282 25945 25297 25831 25964 25987 25784 26508 26997 28178 27554 20.7 22.9 22.5 22.0 21.8 20.6 17.4 21.4 20.7 20.1 20.7 21.0 21.5 20.4 21.6 20.9 20.2 20.8 20.7 20.8 20.7 21.6 23.1 25.1 24.7 24.6 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 24.3 16.4 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 25.4 DEATHS NUMBER RATE Total White Col. Total White Col. 32243 29552 31714 34082 34797 31278 29906 31869 36085 35340 36188 32989 32122 31184 35690 34313 37293 34411 33617 17212 15439 16540 17763 17750 15860 16141 16230 18642 18245 18036 17012 16813 16847 19157 18677 20156 18493 18109 15031 14113 15174 16319 17047 15418 14765 15639 17443 17095 17162 15977 15309 14337 16433 15636 17137 15918 15508 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 10.1 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 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 16.6 14.3 13.9 31856 17486 14370 10.2 32285 17313 14972 10.3 31579 16717 14862 10.0 28807 15820 12987 9.2 8.7 12.8 8.6 13.8 8.1 13.7 7.8 120. 29488 16414 13074 9.4 8.1 12.0 28804 16118 12685 9.2 7.9 11.7 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 19" TYPHOID NUMBER RATE Total White Col. Total White Col. 649 274 275 19.0 16.2 22.9 798 361 447 27.5 20.5 37.7 714 326 388 24.6 18.9 33.1 601 244 357 20.7 14.0 30.8 681 292 389 23.5 16.7 33.9 676 264 411 23.3 14.9 36.2 619 191 328 17.9 10.7 29.3 663 285 368 22.5 15.9 33.2 444 182 262 15.3 10.0 23.9 340 140 200 11.7 7.7 18.5 600 207 293 17.2 11.2 27.3 513 201 312 17.6 10.8 28.9 363 133 230 - 12.3 7.1 21.2 251 105 146 8.4 5.5 13.4 316 110 206 10.5 5.8 18.8 261 100 161 8.6 5.2 14.6 196 68 127 6.4 3.5 11.5 139 54 85 4.5 2.7 7.6 121 51 70 3.9 2.6 6.2 83 38 45 2.7 1.9 4.0 68 27 41 2.2 1.3 3.8 55 22 33 1.7 1.1 3.0 24 6 18 0.8 0.3 1.7 23 8 15 0.7 0.4 1.4 24 9 15 0.8 0.4 1.4 TYPHUS FEVER NUMBER RATE Total White Col. Total White Col. 2 1 1 0.1 0.1 0.1 2 2 0.1 0.1 2 2 0.1 0.1 3 3 0.1 0.2 1 1 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 i.2 63 45 18 2.0 2.2 1.7 Information and Statistics 313 DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1944 Year 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1938 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 MALARIA NUMBER RATE Total Whita Col. Total White Col. 559 242 317 19.3 14.3 26.4 468 195 273 16.2 11.4 23.0 584 256 328 20.2 14.8 27.9 489 201 288 16.9 11.6 24.8 440 181 259 15.2 10.3 22.6 285 102 183 9.8 5.8 16.1 288 107 181 9.9 6.0 16.2 296 113 183 10.2 6.3 16.5 582 253 329 20.0 14.0 30.1 677 322 355 23.3 17.6 32.8 442 186 256 15.2 10.1 23.9 307 119 188 10.5 6.5 17.4 316 136 180 10.7 7.2 16.6 364. 193 171 12.2 10.2 15.7 418 212 206 13.9 11.1 18.8 387 186 211 12.8 9.1 19.2 606 321 285 19.8 16.5 25.7 235 113 122 7.6 5.8 11.0 146 63 83 4.7 3.2 7.4 101 40 61 3.2 2.0 5.4 89 35 54 2.8 1.7 5.0 75 29 46 2.4 1.4 4.2 76 24 52 2.4 1.2 4.8 37 15 22 1.2 0.7 2.0 34 12 22 1.1 0.6 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 8.6 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 68 49 19 2.2 2.4 1.8 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 1944 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 2 1 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 0.8 1.1 0.2 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 1 0.1 0.04 0.1 WHOOPING COUGH NUMBER RATE Total White Col. Total White Col. 373 240 133 12.9 14.2 11.1 183 93 90 6.3 5.4 7.6 130 51 79 4.5 3.0 6.7 254 116 138 8.8 6.7 11.9 435 203 232 15.0 11.6 20.2 313 167 146 10.8 9.4 12.9 141 74 67 4.9 4.2 6.0 229 118 111 7.9 6.6 10.0 163 99 64 6.6 5.5 6.9 280 171 109 9.6 9.4 1G.l 257 121 136 8.8 6.6 12.7 113 59 54 3.8 3.2 6.8 112 52 60 3.8 2.8 6.6 223 116 107 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 6.6 108 52 56 3.5 2.6 6.2 140 69 71 4.6 3.4 6.li 101 35 66 3.2 1.7 6.1 170 76 94 5.4 3.7 8.7 65 25 40 2.1 1.2 3.7 3i4 Georgm Department of Public Health DEATHs AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAUsEs, BY CoLoR, IN GEORGIA: 1920-1944 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 1944 Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1930 1931 1932 1933 1934 1936 1936 1937 1938 1939 1940 11141 1942 1943 1944 DIPHTHERIA NUMBER RATE Total White Col. Total Wblte Col. 401 283 118 13.8 16.7 9.8 416 294 121 14.3 17.2 10.2 411 277 134. 14.2 16.1 11.4 zn 199 75 9.6 11.4 6.6 230 167 63 7.9 9.5 6.6 186 119 66 6.4 6.7 6.8 261 199 62 8.6 11.2 4.6 272 187 86 9.4 10.4 7.7 240 177 63 8.3 9.8 6.8 183 139 44 6.3 7.6 4.1 136 102 33 4.6 5.6 8.1 158 122 36 6.4 6.6 3.3 169 139 30 6.7 7.4 2.8 187 152 35 6.3 8.0 3.2 188 162 86 6.3 8.0 3.3 161 116 45 5.3 6.0 4.1 123 83 40 4.0 4.3 3.6 108 66 42 3.5 3.4 3.8 106 74 32 3.4 3.7 2.9 95 65 so 3.0 3.3 2.7 69 44 15 1.9 2.2 1.4 63 36 27 2.0 1.7 2.5 55 42 13 1.8 2.1 1.2 47 32 16 1.5 1.6 1.4 40 84 6 1.3 1.7 0.6 DYSENTERY NUMBER RATE Total White Col. Total White Col. 170 116 54 5.9 6.8 4.6 146 88 58 5.0 5.1 4.9 112 69 43 3.9 4.0 3.7 161 90 61 5.2 5.2 5.3 187 104 83 6.6 5.9 7.2 194 119 75 6.7 6.7 6.6 207 129 78 7.1 7.2 7.0 277 172 105 9.5 9.6 9.5 304 189 115 10.5 10.4 10.5 204 99 105 7.0 5.4 9.7 805 168 147 10.6 8.6 13.7 177 86 91 6.0 4.6 8.4 141 86 56 4.8 4.5 5.2 163 86 67 5.1 4.5 6.1 219 123 96 7.3 6.4 8.8 163 86 77 5.4 4.5 7.0 156 78 78 5.1 4.0 7.0 130 67 63 4.2 3.4 5.7 192 107 85 6.2 5.4 7.6 127 66 62 4.1 3.8 5.5 126 67 59 4.0 3.3 5.4 109 52 57 3.5 2.5 5.2 86 43 43 2.8 2.1 4.0 79 42 37 2.5 2.1 8.4 63 24 39 2.0 1.2 3.6 INFLUENZA NUMBER RATE Total White Col. Total White Col. 2581 278 1014 1600 886 1384 1493 971 2041 2543 964 1301 1170 1237 1009 1357 1842 1436 802 960 924 994 482 624 742 1516 159 615 880 612 773 800 480 1204 1450 532 703 694 694 563 781 1058 739 393 496 603 483 200 319 342 1065 119 399 620 374 611 693 491 837 1093 432 598 476 643 446 676 784 697 409 466 421 511 282 305 400 89.1 9.6 35.0 61.7 30.5 47.7 51.4 33.4 70.2 87.6 33.1 44.3 39.6 41.5 33.6 44.8 60.3 46.7 26.9 30.4 29.6 31.6 16.4 20.0 23.8 89.4 9.3 35.7 50.6 29.2 43.7 44.9 26.7 66.6 79.4 28.9 37.8 37.0 36.6 29.6 40.5 54.4 37.6 19.8 24.8 24.7 23.5 9.8 16.7 16.8 88.7 10.0 34.0 58.4 32.& 53.9 61.8 44.8 76.5 101.1 40.8 66.4 43.9 49.8 40.7 52.3 70.8 62.6 36.6 40.6 38.8 47.0 26.0 28.1 36.9 TUBERCULOSIS (ALL FORMS) NUMBER RATE Total White Col. Total White Col. 2362 2531 2683 2642 2620 2448 2278 2307 2375 2190 2176 2165 1933 1777 1772 1731 1713 1649 1612 1533 1533 1385 1265 1304 1107 882 1480 81.6 52.0 123.8 892 1639 87.4 52.1 138.1 991 1692 92.6 67.4 144.2 965 1677 91.1 55.5 144.5 917 1703 90.3 52.3 148.4 872 1676 84.4 49.8 139.0 807 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 57.1 33.6 98.2 648 1065 56.1 33.3 96.2 559 990 50.3 28.5 89.0 602 1010 52.0 30.4 90.3 543 990 49.1 27.2 88.1 644 989 49.1 26.7 91.2 501 884 44.0 24.3 81.3 466 800 40.6 22.8 73.7 499 805 41.7 24.5 74.2 418 689 35.4 20.5 63.5 Information and Statistic$ 31 DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY CoLoR, IN GEORGIA: 1920-1944 Year 1920 i921 1922 1928 1924 1926 1926 1927 1il28 1929 1930 1931 1932 1933 1934 1936 1936 1937 1938 1939 1940 1941 1942 1943 1944 SYPHILIS NUMBER RATE Total White Col. Total White Col. 204 34 170 7.0 2.0 14.2 296 56 240 10.2 8.8 20.2 421 70 351 14.5 4.1 29.9 371 73 298 12.8 4.2 25.7 425 81 344 14.7 4.7 80.0 454 72 382 16.6 4.1 83.7 409 59 350 14.1 3.3 81.2 457 65 392 16.7 3.6 36.4 494 100 394 17.0 6.6 36.0 461 82 379 16.9 4.5 85.0 429 77 852 14.7 4.2 82.8 413 54 859 14.1 2.9 33.2 425 73 352 14.4 8.9 32.5 391 57 334 13.1 3.0 30.6 444 87 357 14.8 4.6 82.6 403 85 318 13.3 4.4 28.9 444 77 367 14.5 4.0 83.2 496 96 400 16.1 4.9 36.9 478 77 401 16.4 3.9 35.9 473 61 412 15.1 3.1 36.7 587 127 460 18.8 6.2 42.4 503 110 393 16.0 6.3 36.2 462 97 365 14.8 4.8 33.6 435 102 333 13.9 6.0 so.7 372 78 274 11.9 4.8 25.2 CANCER NUMBER RATE Total White Col. Total White Col. 1124 1210 1212 1263 1893 1311 1257 1470 1510 1466 1652 15SO 1631 1647 1762 1715 1751 1797 1929 2003 1959 2139 766 803 782 S70 913 S91 S60 995 1013 9SS 1106 1106 1052 1213 1272 1239 1239 1320 1843 1426 13SO 1473 358 38.8 46.2 29.8 407 41.8 46.9 u.s 430 41.8 45.3 36.6 398 43.6 50.0 33.11 4SO 48.0 52.1 41.8 420 45.2 50.4 37.0 397 43.3 48.2 35.4 475 50.6 66.4 42.9 497 52.0 56.9 45.4 46S 60.1 64.1 43.8 447 53.3 60.0 41.7 474 53.8 69.5 43.9 479 61.7 56.1 44.2 434 55.2 64.0 39.S 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 5S6 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 2120 2097 2256 1509 1547 1616 611 67.9 74.0 56.8 550 67.1 75.9 50.7 640 72.2 79.3 69.0 Year 1920 192! 1922 1928 1924 1925 1926 1927 19211 1929 1930 1931 1932 1933 1934 1936 1936 t','l7 i~s 19~ 1940 1941 1942 1943 1944 DIABETES MELLITUS NUMBER RATE Total White Col. Total White Col. 182 139 48 6.3 S.2 3.6 202 144 58 7.0 S.4 4.9 255 182 73 8.8 10.6 6.2 249 18.2 67 S.6 10.5 5.8 247 161 S6 S.5 9.2 7.5 234 174 223 138 60 S.1 9.S 5.3 85 7.,. 7.7 7.6 259 177 S2 S.9 9.9 7.4 329 227 102 11.8 12.5 9.3 802 201 101 10.4 11.0 9.3 352 240 112 12.1 13.0 '10.4 822 224 98 11.0 12.1 9.1 843 260 S3 11.6 13.9 7.7 349 241 10S 11.7 12.7 9.9 8S9 275 114 12.9 14.4 10.4 ass 297 91 12.8 15.4 S.3 891 299 92 12.8 15.4 8.3 392 2S1 111 12.7 14.3 10.0 420 811 109 13.5 15.7 9.7 868 247 121 11.S 12.4 10.S 849 25S 91 11.2 12.7 8.4 876 27S 9S 12.0 13.6 9.0 870 275 95 11.S 13.5 S.8 430 325 106 13.8 15.9 9.7 875 249 126 12.0 12.2 11.6 PELLAGRA NUMBER RATE Total White Col. Total White Col. 432 210 222 14.9 12.4 18.G 512 234 278 17.7 13.7 23.4 527 249 278 1S.2 14.4 23.7 444 227 217 16.3 13.1 18.7 337 1S1 156 u.s 10.8 13.6 366 181 185 12.6 10.2 16.3 425 225 200 14.6 12.6 17.S 617 292 325 21.2 16.3 29.3 S46 35S 48S 29.1 19.8 44.6 S71 334 537 30.0 18.3 49.7 713 255 45S 24.5 18.8 42.7 668 102 371 19.2 10.8 34.4 492 205 287 16.6 10.9 28.5 421 179 242 14.1 9.6 22.2 851 163 188 11.7 S.5 17.2 365 190 175 12.0 9.9 15.9 391 1S4 207 12.S 9.6 1S.7 870 176 195 12.0 8.9 17.5 365 170 195 u.s S.6 17.4 271 134 137 S.7 6.7 12.2 236 us 117 7.6 5.S 10.S 204 106 9S 6.6 6.1 9.0 1S1 104 77 5.8 6.1 7.1 175 S9 86 5.6 4.4 7.9 131 74 57 4.2 3.6 5.8 L6 Georgia Department of Public Health DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAusEs, BY CoLOR, IN GEORGIA: 1920-1944 Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1930 1931 1932 1933 l934 1936 1936 1937 1938 1939 1940 1941 1942 1943 1944 CEREBRAL HEMORRHAGE NUMBER RATE Total White Col. Total White Col. 1336 807 529 46.1 47.6 44.1 1449 839 610 50.0 49.0 51.4 1563 887 676 53.9 51.4 57.6 1724 1002 722 59.5 57.6 62.2 1766 963 803 60.9 64.9 70.0 1995 1044 951 68.7 69.0 83.9 2006 1078 928 69.1 60.6 82.8 2171 1195 976 74.7 66.6 88.1 2394 1297 1097 82.4 71.6 100.2 2299 1257 1042 79.1 68.8 96.3 2523 1317 1206 86.6 71.6 112.4 2340 1256 1084 79.7 67.6 100.6 2382 1269 1113 80.6 67.6 102.6 2159 1196 964 72.4 63.1 88.4 2310 1222 1088 76.8 63.9 99.3 2410 1337 1073 79.6 69.3 97.4 2638 1425 1213 86.4 73.2 109.6 2636 1444 1192 85.7 73.6 107.1 2727 1466 1262 88.0 73.9 112.8 3048 1598 1450 97.6 79.9 129.0 3036 1674 1461 97.2 77.2 134.6 3033 1613 1620 96.4 73.6 139.9 2873 1538 1335 92.0 76.6 123.0 2945 1469 1476 94.3 72.1 136.0 2974 1523 1451 95.2 74.7 133.7 HEART DISEASE NUMBER RATE Total White Col. Total White C..L 1892 1768 1996 2388 2424 2297 2429 2929 3307 3691 4099 3948 4102 3993 6019 5071 6606 6284 6246 6417 6176 6780 5251 5775 5678 1053 923 1963 1186 1165 1077 1198 1497 1717 1923 2109 2101 2308 2360 2901 2961 3270 3132 3059 3240 3662 3316 3165 3662 3620 839 845 943 1202 1259 1220 1231 1432 1590 1768 1990 1847 1794 1633 2118 2110 2336 2162 2187 2177 2614 2464 2086 2113 2058 66.3 61.0 68.9 82.3 83.5 79.1 83.7 100.9 113.8 126.9 140.6 134.4 138.6 133.8 166.9 167.3 183.6 171.7 169.2 173.6 197.7 183.8 168.1 184.9 181.8 62.1 64.0 61.0 68.2 66.4 60.9 67.2 83.3 94.8 105.3 114.6 113.0 123.0 124.6 161.8 163.6 168.0 169.6 164.4 162.1 179.6 161.1 156.3 179.7 177.6 69.9 71.2 80.8 108.6 109.'1 107.6 109.8 129.3 145.3 163.6 185.4 171.2 166.6 149.8 193.3 19i.6 211.0 193.4 196.6 193.'1 231.'1 226.7 192.2 194.7 189.6 Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1930 1931 1932 1933 1934 1936 1936 1937 1938 1939 1940 1941 1942 1943 1944 PNEUMONIA NUMBER RATE Total White Col. Total White Col. 2766 1926 2664 3199 2922 2335 2442 2132 2776 2316 2680 2466 2444 2314 3030 3036 3803 8077 2731 2299 2055 1714 1612 1734 1681 1470 1060 1447 1696 1382 1136 1180 1015 1441 1165 1240 1266 1204 1172 1580 1572 2012 1490 1321 1209 1019 800 737 796 747 1296 875 1217 1603 1540 1200 1262 1117 1335 1151 1340 1210 1240 1142 1460 1463 1791 1587 1410 1090 1036 914 875 938 834 95.6 66.4 91.9 110.3 100.7 80.5 84.1 73.4 95.5 79.6 88.5 83.9 82.6 77.6 100.8 100.2 124.6 100.0 88.1 73.6 65.8 54.6 61.6 56.6 60.6 86.7 61.4 83.9 91.8 78.8 64.2 66.2 66.5 79.5 63.8 67.4 67.6 64.1 61.9 82.7 81.6 103.4 75.9 66.7 60.6 50.0 38.9 36.2 39.1 86.6 108.0 73.7 103.7 138.1 134.2 105.8 112.6 100.8 122.0 106.4 124.9 112.2 114.3 104.8 132.3 132.9 161.8 142.6 126.1 97.0 96.5 84.1 80.6 86.4 76.8 DIARRHEA AND ENTERITIS (UNDER 2 YEARS) NUMBER RATE Total White Col. Total White CoL 1252 759 493 43.2 44.7 41.1 1230 722 608 42.5 42.2 42.8 1175 686 489 40.6 39.8 41.7 1183 698 486 40.8 40.1 41.8 1322 736 686 45.6 42.0 61.1 949 510 439 32.7 28.8 38.7 873 462 411 80.1 26.9 36.7 810 440 370 27.9 24.6 38.4 730 434 296 26.1 24.0 27.0 626 292 234 18.1 16.0 21.6 721 453 268 24.7 24.6 26.0 646 291 264 18.6 15.7 23.6 390 264 136 13.2 13.5 12.6 493 324 169 16.5 17.1 15.6 661 378 278 21.7 19.8 24.9 607 808 199 16.7 16.0 18.1 549 303 246 18.0 16.6 22.2 480 247 233 15.6 12.6 20.t 691 386 306 22.3 19.4 27.4 416 217 199 13.3 10.9 17.7 395 215 180 12.6 10.6 16.6 485 218 217 13.8 10.& 20.0 284 138 146 9.1 6.8 18.6 292 132 160 9.3 6.6 14.7 340 172 168 10.9 8.4 115.6 Cl' Information and Statistics 317 ..J.t:ATHs AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEoRGIA: 1920-1944 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 1944 APPENDICITIS NUMBER RATE Total White Col. Total White Col. 236 162 84 8.2 9.0 7.0 276 190 86 9.5 11.1 7.3 300 208 92 10.4. 12.1 7.8 281 183 98 9.7 10.5 8.4 318 210 108 11.0 12.0 9.4 357 212 145 12.3 12.0 12.8 289 178 111 10.0 10.0 9.9 330 211 119 11.4 11.7 10.7 364 236 128 12.5 13.0 11.7 330 228 102 u.s 12.5 9.4 333 211 122 11.4 11.6 11.4 347 234. 113 11.8 12.6 10.5 858 255 103 12.1 13.6 9.5 323 218 105 10.8 11.5 9.6 339 226 113 11.3 11.8 10.3 300 202 98 9.9 10.5 8.9 312 201 111 10.2 10.3 10.0 319 230 89 10.4 11.7 8.0 287 194. 93 9.3 9.8 8.3 280 186 94. 9.0 9.3 8.4 276 159 117 8.8 - 7.8 10.8 230 185 95 7.3 6.6 8.7 174. 102 72 5.6 5.0 6.6 188 118 70 6.0 5.8 6.4 176 105 70 5.6 5.2 6.4 CIRRHOSIS OF LIVER NUMBER RATE Total White Col. Total White Col. 93 61 83 52 78 43 90 64 98 69 117 77 99 62 125 76 102 61 128 74 134 80 124 87 91 61 116 73 110 73 142 97 139 87 151 95 141 100 152 111 145 102 154 110 167 123 162 104 159 108 32 3.2 3.6 2.7 31 2.9 3.0 2.6 36 2.7 2.6 3.0 36 3.1 3.1 3.1 29 3.4 3.9 2.6 40 4.0 4.4 3.5 37 3.4 8.5 8.8 60 4.3 4.2 4.6 41 3.6 3.4 8.8 64 4.4 4.1 6.0 64 4.6 4.3 6.0 37 4.2 4.7 8.4 30 3.1 3.3 2.8 43 3.9 3.9 3.9 37 3.7 8.8 8.4 46 4.7 6.0 4.1 52 4.6 4.5 4.7 66 4.9 4.8 6.0 41 4.5 5.0 8.7 41 4.9 6.6 8.6 43 4.6 6.0 4.0 44 4.9 5.3 4.0 34 6.0 6.0 8.1 48 4.9 6.1 4.4 51 6.1 6.3 4.7 NEPHRITIS (ACUTE AND CHRONIC) Year NUMBER RATE Total White Col. Total White Col. 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1930 1931 1932 1933 1934 1936 1936 1937 1938 1939 1940 1941 1942 1943 1944 2200 2446 2903 3139 3449 8228 3386 3620 4106 4003 3787 3226 8216 8118 3301 3166 3446 3468 8531 8041 3348 3381 3187 3139 2901 1258 1347 1592 1684 1787 1716 1721 1970 2162 2187 2060 1794 1753 1769 19;03. 1803 1910 1919 1996 1771 1848 1816 1766 1749 1689 942 1099 1311 1455 1662 1513 1664 1660 1943 1816 1727 1432 1463 1349 1398 1362 1536 1539 1536 1270 1500 1665 1421 1390 1312 76.0 84.4 100.1 108.2 118.9 111.2 116.6 124.6 141.3 137.7 129.9 109.8 108.6 104.6 109.8 104.1 112.9 112.4 113.9 97.4 107.2 107.6 102.0 100.6 92.9 74.2 78.7 92.3 96.8 101.9 97.0 96.6 109.6 119.3 119.8 111.9 96.6 93.4 93.4 99.6 93.5 98.1 97.7 100.7 88.6 90.7 88.2 86.6 86.8 78.0 78.6 92.6 111.7 125.4 144.9 133.4 148.4 148.9 177.5 167.9 160.9 132.8 134.9 123.8 127.6 122.8 138.8 138.3 137.3 113.0 138.2 144.0 130.9 128.1 120.9 MALFORMATION, EARLY INFANCY NUMBER RATE Total White Col. Total White Col. 1878 2480 2842 2878 2995 2526 2239 2192 1869 1742 1890 1827 1662 1639 1904 1736 1797 1663 2431 2155 2034 2163 2020 2048 1855 1245 1446 1506 1636 1674 1434 1261 1244 1132 1060 1185 1111 1024 994 1126 1076 1064 1028 1289 1199 1098 1206 1137 1234 1102 633 1034 1337 1242 1321 1092 988 948 727 692 705 716 638 645 778 660 733 635 1142 956 936 957 883 814 763 64.8 85.6 98.4 99.2 103.2 87.0 77.1 76.6 64.0 59.9 64.8 62.2 56.1 54.9 63.3 57.3 58.8 54.1 78.4 69.0 66.1 68.8 64.7 66.6 59.4 73.4 52.7 84.5 87.1 87.2 113.9 94.0 107.0 95.4 115.1 81.1 96.3 70.2 88.1 69.5 86.6 62.5 66.4 67.6 64.0 64.3 65.7 59.7 66.4 54.6 58.8 62.5 59.2 68.9 71.0 55.8 59.9 54.7 66.2 62.8 67.1 65.1 102.1 60.0 85.1 63.9 86.3 58.6 88.1 66.8 81.3 60.5 76.0 64.1 69.4 318 Georgia Department of Public Health DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAusEs, BY CoLOR, IN GEORGIA: 1920-1944 Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 1929 1980 1981 1982 1983 1984 1936 1936 1937 1938 1989 1940 1941 1942 1943 1944 Year 1920 1921 1922 1923 1924 1926 1926 1927 1928 19211 1930 1981 1932 1983 1934 1986 1986 1937 1938 1939 1940 1941 1942 1943 1944 SUICIDE NUMBER RATE Total White CoL Total White Col. 128 110 167 142 181 152 166 160 196 173 189 169 164 134 198 179 243 210 287 268 296 273 313 282 304 279 312 276 297 266 800 270 311 284 316 288 296 266 816 290 282 246 236 212 219 203 165 162 185 167 18 4.4 6.6 1.6 26 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 7.6 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 16.2 2.9 26 10.3 14.9 2.3 36 10.6 14.6 3.8 82 9.9 13.9 2.9 so 9.9 14.0 2.7 27 10.2 14.6 2.4 27 10.2 14.7 2.4 29 9.6 18.4 2.6 26 10.1 14.6 2.3 36 9.0 12.1 3.3 24 7.5 10.3 2.2 16 7.0 10.0 1.6 13 5.3 7.5 1.2 18 5.9 8.2 1.7 MOTOR VEHICI,E ACCIDENTS NUMBER RATE Total White CoL Total White Col. 140 100 40 4.8 5.9 3.3 182 108 24 4.6 6.3 2.0 203 142 61 7.0 8.2 5.2 267 189 78 9.2 10.9 6.7 313 239 74 10.8 13.6 6.5 348 238 110 12.0 13.5 9.7 870 266 104 12.7 14.9 9.3 433 288 145 14.9 16.0 13.1 473 319 154 16.3 17.6 14.1 531 835 196 18.3 18.3 18.1 612 426 187 21.0 23.1 17.4 665 428 227 22.3 23.0 21.0 585 426 159 19.7 22.7 14.7 675 473 202 22.6 25.0 18.5 809 574 236 26.9 30.0 21.4 942 646 296 81.1 33.5 26.9 991 692 299 32.4 36.5 27.0 964 680 284 31.3 34.6 26.6 789 646 244 26.4 27.6 21.8 669 483 186 21.4 24.2 16.6 802 656 246 26.7 27.3 22.7 946 667 289 30.1 31.9 26.6 673 474 199 21.5 23.3 18.8 606 421 185 19.4 20.7 17.0 644 454 190 20.6 22.3 17.6 HOMICIDE NUMBER RATE Total White Col. Total White CoL 479 100 379 16.6 6.9 31.6 649 143 406 19.0 8.4 34.2 564 146 418 19.6 8.6 36.6 606 125 880 17.4 7.2 32.7 662 156 407 19.4 8.8 86.6 464 141 823 16.0 8.0 28.6 896 97 298 13.6 5.4 26.6 610 141 369 17.6 7.9 38.3 512 159 363 17.6 8.8 82.3 623 149 374 18.0 8.2 34.6 569 168 41i 19.6 8.6 38.3 597 179 418 20.3 9.6 88.8 654 175 379 18.7 9.3 35.0 670 208 462 22.6 11.0 42.4 720 206 616 23.9 10.7 47.0 661 156 604 21.8 8.1 46.8 589 155 434 19.3 8.0 89.2 641 136 506 20.8 6.9 46.4 582 131 461 18.8 6.6 40.3 660 109 461 17.9 5.6 40.1 616 111 606 19.7 6.4 46.6 649 120 629 20.6 6.8 48.7 519 102 417 16.6 6.0 88.4 438 102 336 14.0 5.0 81.0 454 107 347 14.5 5.2 82.0 ACCIDENTS AND OTHER VIOLENCE NUMBER RATE Total White Col. Total White Col. 1603 1456 1608 1676 1772 1682 1685 1831 1901 1978 1992 2010 1914 1992 2251 2428 2776 2413 2125 1860 2057 2208 2056 1926 2011 853 788 846 850 1146 947 928 1035 1090 1113 1164 1243 1182 1213 1389 1453 1682 1495 1309 1186 1217 1412 1328 1192 1249 750 668 662 725 827 735 657 796 811 865 828 767 732 779 862 976 1093 918 816 664 840 796 728 733 762 65.3 50.3 62.0 64.3 61.1 68.0 64.6 63.0 66.4 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 66.8 61.6 64.6 50.3 46.1 49.0 48.9 63.9 53.6 62.1 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 69.7 118.6 65.2 68.5 61.3 62.6 66.3 66.4 62.~ '7~.1 64.8 68.6 71.11 74.1 80.0 ?7.2 '71.1 67.5 71.6 '78.7 88.6 98.7 82.6 73.0 59.0 '77 .4 78.2 67.1 67.5 ?0.2 ln,formation and Statistics 319 TABLE 5 DEATHS AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAQSES, LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS, INFANT AND MATERNAL MoRTALITY WITH RATES PER 1,000 LIVE BIRTHs, BY CoLoR, IN GEORGIA: 1944 Cause of Death NUMBER RATE Total White Colored Total White Colored ALL CAUSES 28,803 ~---------------------------- Typhoid fever ------------------------------------------ 24 Typhus fever ------------------------------------------- 63 ,Malaria ---------------------------------------------------- 34 Smallpox ----------------------------------------------- Measles ---------------------------------------------------- 68 Scarlet fever --------------------------------------------- 2 Whooping cough ------------------------------------- 66 Diphtheria ------------------------------------------------ 40 Influenza ------------------------------------------ 742 Dysentery --------------------------------------------- 63 Poliomyelitis ---------------------------------------- 9 Lethargic ~ncephalitis ---------------------------- 4 Meningocoeeus meningitis ----------------- 66 Tuberculosis ---------------------------------------- 1,107 Syphilis ----------------------------------------------------- 372 Gonorrhea --------------------------------------------- 8 Cancer --------------------------------------------------- 2,266 Diabetes mellitus ----------------------------------- 375 Pellagra ----------------------------------- --- 131 Cerebral hemorrhage, embolism and thrombosis --------------------------------------- 2,974 Heart diseaaes ------------------------------------------- 5,678 Pneumonia ------------------------------------------------- 1,681 Diarrhea and enteritis (-2 Yrs.) .......... 340 Appendicitis ---------------------------------------------- 175 Cirrhosis of liver -------------------------------- 159 Nephritis ------------------------ 2,901 Malformation and early infancy diseases -----------------------------Suicide -------------------------------------------Homicide -------------------------------Motor-vehicle accidents -----------------All other accidents ---------------------- Unkno~ and ill-defined causes____________ All other causes____________________________ 1,866 186 464 644 1,367 1,106 3,965 LIVE BIRTHS -------------------- STILLBIRTHS -------------~----------- lli.'FANT MORTALITY ----------MATERNAL MORTALITY ------- 77,018 2,623 3,398 276 16,118 9 46 12 49 26 34 342 24 9 3 39 418 98 2 1,616 249 74 1,523 3,620 747 172 106 108 1,689 1,102 167 107 464 796 412 2,168 49,464 1,137 1,761 122 12,686 16 18 22 19 1 40 6 400 39 17 689 274 6 640 126 67 1,461 2,068 834 168 70 61 1,312 763 18 347 190 672 694 1,797 27,664 1,386 1,637 164 922.1 0.8 2.0 1.1 2.2 0.1 2.1 1.3 23.8 2.0 0.3 0.1 1.8 36.4 11.9 0.3 72.2 12.0 4.2 96.2 181.8 60.6 10.9 6.6 6.1 92.9 69.4 6.9 14.6 20.6 43.8 36.4 126.9 24.7 32.8 44.1 3.6 790.8 0.4 2.2 0.6 1168.6 1.4 1.7 2.0 2.4 1.8 0.04 0.1 1.2 8.7 1.7 0.6 16.8 86.t 1.2 3.6 0.4 0.1 0.1 1.9 1.6 20.6 63.6 4.8 25.2 0.1 G.6 79.3 69.0 12.2 11.6 3.6 6.3 74.7 177.6 36.6 8.4 6.2 6.3 78.0 133.7 189.6 76.8 16.6 6.4 4.7 120.9 54.1 8.2 5.2 22.3 39.0 20.2 106.4 24.3 23.() 36.6 2.5 69.4 1.7 32.0 17.6 52.7 63.9 166.6 25.4 60.3 69.4 5.6 NOTE: These figures exclude nonresidents of Geora-ia and include births and deaths of Georgia residents occurring in other states. Rates baaed on the 1940 Census Enumerated Population. 320 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 NUMBER Total White Colored ALL CAUSES Typhoid fever ----- -- 29,488 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 --------------- 6 Meningococcus meningitis ---------- 31 Tuberculosis 1,304 Syphilis 436 Gonorrhea 12 Cancer 2,097 Diabetes mellitus --------------- 430 Pellagra 175 Cerebral hemorrhage, embolism and and thrombosis ------------- Heart diseases --------------Pneumonia ----------------- Diarrhea and enteritis (-2 Yrs.) _____ 2,946 6,775 1,734 292 Appendicitis ---------- Cirrhosis of liver____________ 188 152 Nephritis ------------------ 3,139 Malformation and early infancy diseases ---------------- 2,048 Suicide ------Homicide -----------------Motor-vehicle accidents ---------------- All other accidents ------------------------Unknown and ill-defined causes_______ All other causes__________________ 166 438 606 1,319 1,066 4,060 LIVE BIRTHS ------------------- 78,327 STILLBIRTHS -------------------- 2,664 INFANT MORTALITY ----------------- 3,661 MATERNAL MORTALITY --------------- 303 16,414 8 44 16 20 6 76 32 319 42 2 3 27 499 102 2 1,647 326 89 1,469 3,662 796 132 118 104 1,749 1,234 162 102 421 771 887 2,160 60,149 1,238 1,911 160 18,074 15 13 22 7 1 94 16 305 37 1 2 4 806 333 10 660 106 86 1,476 2,113 938 160 70 48 1,390 814 13 336 186 548 678 1,900 28,178 1,426 1,760 153 BATE Total White Colored 94U 0.7 1.8 1.2 806.8 0.4 2.2 0.7 1204.5 1.4 1.2 2.0 0.9 1.0 0.6 0.2 0.2 0.1 6.4 8.7 8.7 1.6 1.6 1.4 20.0 16.7 28.1 2.5 2.1 8.4 0.1 0.1 0.1 0.2 8.1 0.2 1.0 1.8 0.4 41.7 24.5 74.2 13.9 5.0 80.7 0.4 0.1 0.9 67.1 76.9 &o:r 13.8 16.9 9.7 6.6 4.4 7.9 94.8 184.9 66.6 9.8 6.0 4.9 100.5 72.1 179.7 39.1 6.5 5.8 6.1 86.8 136.0 194.7 86.4 14.7 6.4 4.4 128.1 65.6 5.3 14.0 19.4 42.2 84.1 130.0 26.1 34.0 46.7 3.9 60.6 7.6 6.0 20.7 87.8 19.0 106.0 24.6 24.7 38.1 3.0 76.0 1.2 31.0 17.0 110.6 62.6 176.0 26.0 50.6 62.1 6.4 NOTE: These figures exclude nonresidents of Georgia and inelude births and deaths of Georgia residents occurring in other states. Rates based on the 1940 Census Enumerated Population. lnformatwn and Statistics 321 TABLE 7 CENSUS ENUMERATED PoPULATION AS OF APRIL l, 1940, BY coLoR, IN EAcH CouNTY IN GEORGIA Census Enumerated Popula tion as of April 1, 19.U County Total White Colored TOTAL ___3,123,723 2,038,278 1,086,446 Appling ---------- 14,497 Atkinson --------- 7,093 Bacon ------------- 8,096 Baker -------------- 7,344 Baldwin ------- 16,411 Banks ----------- 8,733 Barrow --------- 13,064 Bartow ----------- 26,283 Ben Hill -------- 14,623 Berrien -------- 16,370 Bibb ----------- 83,783 Bleckley ------- 9,666 Brantley ----- 6,871 Brooks ------- 20,497 Bryan ----------- 6,288 Bulloch ---------- 26,010 Burke --------- 26,620 Butta ------------- 9,182 Calhoun ~-~---4 10,438 Camden ----------- 6,910 Candler --------- 9,103 Carroll ------------- 34,166 Catoosa ------- 10,899 Charlton -------- 6,266 Chatham ------ 117,970 Chattahoochee 6,138 Chattooga ------- 18,582 Cherokee ------ 20,126 Clarke ------------- 28,898 Clay ---------------- 7,064 Clayton --------- 11,655 Clinch ---------- 6,437 Cobb ------------ 38,272 Coffee ------------ 21,541 Colquitt ------ 33,012 Columbia ----- 9,433 Cook -------------- 11,919 Coweta ----- 26,972 Crawford ----- 7,128 Crisp --------------- 17,540 Dade ------------- 6,894 Dawson 4,479 Decatur ---------- 22,234 DeKalb --------- 86,942 Dodge ---------------- 21,022 Dooly -------- 16,886 --- Dougherty 28,666 - - - Douglas 10,063 Early ------------ 18,679 11,866 6,422 7,042 3,049 7,713 8,072 10,606 21,073 9,674 13,033 48,239 6,331 6,727 9,990 3,735 16,168 6,664 4,891 3,309 2,486 5,996 26,903 10,676 3,760 66,027 3,110 16,720 19,229 18,336 2,077 8,671 8,938 31,990 16,166 24,966 3,769 8,728 16,149 3,106 9,426 6,697 4,415 11,473 72,973 14,046 7,566 13,028 7,880 9,065 2,641 1,671 1,064 4,296 8,698 661 2,469 4,210 4,849 2,337 36,644 8,324 1,144 10,607 2,663 9,842 19,866 4,291 7,129 3,424 3,107 7,263 323 1,496 52,943 2,028 1,812 897 10,063 4,987 2,984 2,499 6,282 6,376 8,067 6,664 3,191 10,823 4,023 8,114 297 64 10,761 18,969 6,977 9,381 15,587 2,178 9,614 County Census Enumerated Popula tlon as of April 1, 1940 Total White Colored Echols ------------ 2,964 Effingham ----- 9,646 Elbert ------------- 19,618 Emanuel --------- 23,617 Evans ------------- 7,401 Fannin ------------ 14,762 Fayette ------------ 8,170 Floyd ------------- 66,141 Forsyth ----------- 11,322 Franklin ---------- 16,612 Fulton ------------- 392,886 Gilmer ----------- 9,001 Glascock ---------- 4,647 Glynn -------------- 21,920 Gordon ---------- 18,446 Grady -------------- 19,654 Greene ---------- 18,709 Gwinnett -------- 29,087 Habersham ---- 14,771 Hall ------------------ 34,822 Hancock ---------- 12,764 Haralson ---------- 14,377 Harris -------------- 11,428 Hart ----------------- 16,612 Heard --------------- 8,610 Henry ------------- 16,119 Houston ----------- 11,303 Irwin -------------- 12,986 Jackson ----------- 20,089 Jasper ----------- 8,772 Jeff Davis -------- 8,841 Jefferson -------- 20,040 Jenkins --------- 11,843 Johnson ------------ 12,9113 Jones ---------------- 8,331 Lamar ----------- 10,091 Lanier ---------- 6,632 Laurens ---------- 83,606 Lee ------------- 7,837 Liberty ------------ 8,695 Lincoln ----------- 7,042 Long -.------------- 4,086 Lowndes ---------- 31,860 Lumpkin --------- 6,228 McDuffie -------- 10,878 Mcintosh -------- 6,292 Macon ----------- 15,947 Madison ------ 13,431 Marion --------- 6,964 1,899 6,644 11,887 15,206 4,908 14,676 6,603 47,600 11.281 13,342 2611,743 8,962 3,326 18,366 17,242 12,930 6,664 26,761 14.104 31,483 3,681 12,863 4,626 11,561 6,023 7,966 3,984 8,178 16,648 3,777 7,231 8,683 6,806 8,029 3,260 5,668 4,017 19,861 1,895 3,077 8,423 2,625 17,186 6,003 5,665 2,136 6,053 10,826 3,129 1,066 4,002 7,731 8,311 2,493 77 2,667 8,641 41 2,270 123,148 49 1,221 8,664 1,208 6,726 7,1611 3,888 681 3,389 9.183 1.624 6,802 3,961 2,687 7,164 7,319 4,768 3,541 4.995 1,610 11,467 6.687 4,924 6,081 4,428 1,611 13,7411 6,942 5,618 3,619 1,461 14,67'4 220 6,318 3,167 10,894 2,606 3,826 322 Georgia Department of Public Health TABLE 7-Continued CENSUS ENUMERATED POPULATION AS OF APRIL 1, 1940, BY coLoR, IN EAcH CouNTY IN GEORGIA Census Enumerated Population as of April 1, 1940 Census Enumerated Population as of April I, 1940 County Total White Colored County Total White Colored Meriwether 22,055 Miller --------- 9,998 Mitchell ------- 23,261 Monroe ---------- 10,749 Montgomery __ 9,668 Morgan ----- 12,713 Murray ------ 11,137 Muscogee ------ 75,494 Newton ------------ 18,576 Oconee ------- 7,576 Oglethorpe ----- 12,430 Paulding ------- 12,832 Peach ------------- 10,378 Pickens ----------- 9,136 Pierce ------------ 11,800 Pike ----------- 10,375 Polk ---------- 28,467 Pulaski ----------Putnam ---------Quitman -----Rabun -------- 9,829 8,514 3,435 7,821 Randolph ------- 16,609 Richmond ---- 81,863 Rockdale ------ 7,724 Schley ----- 6,033 Screven ------- 20,353 Seminole 8,492 Spalding ------ 28,427 Stephens --------- 12,972 Stewart --------- 10,603 Sumter ---- 24,502 10,334 6,763 10,996 4,596 5,788 5,9~6 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 9,604 11,721 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 1,866 7,721 14,998 Talbot ----------- 8,141 Taliaferro ----- 6,278 Tattnall - - - 16,243 Taylor ------------- 10,768 Telfair ------------ 15,145 Terrell ------------- 16,675 Thomas ---------- 31,289 Tift ----------------- 18,599 Toombs ------------ 16,952 Towns ---------- 4,925 Treutlen ---------- 7,632 Troup ---------------- 43,879 Turner ------------ 10,846 Twiggs ----------- 9,117 Union ----------- 7,680 Upson ------------ 25,064 Walker ------------- 31,024 Walton ---------- 20,777 Ware -------------- 27,929 Warren --------- 10,236 Washington ---- 24,230 Wayne ----------- 13,122 Webster ------ 4,726 Wheeler --- 8,635 White ------------- 6,417 Whitfield ----- 26,105 Wilcox ---------- 12,755 Wilkes ----- 15,084 Wilkinson ------- 11,025 Worth ---------- 21,374 2,460 1,997 12,076 5,686 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 3,671 10,367 10,328 1,834 6,855 6,050 24,640 7,879 6,041 6,618 11,397 6,681 4,281 4,167 5,182 4,787 11,961 13,980 5,493 4,518 2,299 16,352 3,810 6,864 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 6,407 9,977 *Baldwin County population excludes the State Milledgeville Hospital. Information and Statistics 323 TABLE 8 LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHs IN EAcH CouNTY IN GEORGIA: 1943 AND 1944..___ County LIVE BIRTHS Rate Per 100,000 STILLBIRTHS Rate Per 100,000 Number Population Number Population 1944 1943 1944 1943 1944 1943 1944 19(3 TOTAL Appling ----------------------Atkinson ------------------Bacon -----------------------Baker --------------------------------Baldwin -----------------------------Banks -----------------------------------Barrow ---------------------------------------Bartow ------------------------Ben Hill -----------------------Berrien -----------------------------Bibb ------------------------Bleckley -------------------Brantley ---------------------Brooks ----------------------Bryan --------------------Bulloch -------------------------Burke -------------------------Butta --------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 ---------DDooodlgye _-_-_ - - - - - - - - - - - Dougherty Douglas -------- 77018 334 191 283 168 361 142 239 659 368 364 2554 229 213 507 156 596 642 185 262 169 162 680 265 110 3737 48 444 446 664 209 267 128 1087 668 1024 246 256 540 171 485 152 74 708 2023 466 369 871 197 78327 403 196 228 159 397 196 289 587 321 340 2728 258 188 529 141 582 638 226 253 177 190 722 307 112 3625 45 480 453 615 176 268 184 952 700 996 226 283 571 182 483 173 93 697 2074 450 364 859 202 24.7 23.0 26.9 35.0 22.9 22.0 16.3 18.3 26.1 25.3 23.7 30.5 23.7 81.0 24.7 24.8 22.9 24.2 20.1 25.1 28.6 17.8 19.9 24.3 20.9 31.7 9.3 24.0 22.2 23.4 29.6 22.9 19.9 28.4 31.0 31.0 26.1 21.5 20.0 24.0 24.8 25.8 16.5 31.8 23.3 22.2 21.9 30.5 19.6 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 20.1 2523 13 4 5 3 8 5 6 26 7 8 99 6 7 23 4 21 35 8 12 9 1 31 4 3 147 4 8 8 28 11 8 1 29 25 25 8 12 12 10 21 4 1 34 63 11 21 24 6 2664 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 36 7 32.8 38.9 20.9 17.7 17.9 22.2 35.2' 25.1 39.5 19.0 22.0 38.8 26.2 32.9 45.4 25.6 35.2 54.5 43.2 45.8 53.3 6.2 45.6 15.1 27.3 39.3 83.3 18.0 17.9 42.2 52.6 30.0 7.8 26.7 37.4 24.4 32.5 46.9 22.2 58.5 48.3 26.3 13.5 48.0 31.1 23.6 56.9 27.6 25.4 34.0 44.7 30.6 36.7 44.0 25.2 30.6 27.7 32.4 49.8 32.4 87.8 46.5 21.8 43.5 63.8 44.7 40.8 35.4 59.8 67.8 21.1 88.0 19.6 1'f.9 43.8 66.'1' 8.8 26.6 4o.'l' 84.1 26.1 29.9 28.4 34.8 34.1 22.1 86.11 21.0 54.9 39.8 5.8 32.8 50.2 2U 48.9 24.7 40.7 84.7 324 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: 1943 AND 1944____ LIVE BIRTHS STILLBIRTHS Rate Per 100,000 Rate Per 100,000 Number Population Number Population County 1944 1943 1944 1943 1944 1943 1944 1943 Early ~--------------- 610 483 27.3 25.9 11 17 !&.5 86.1 Echola ------------------------------- 61 42 20.6 14.2 1 16.4 Effingham ---------------------------- 261 252 26.0 26.1 13 9 61.8 36.7 Elbert --------------------------- 438 450 22.3 22.9 8 10 18.8 22.1 Emanuel --------------------------------- 482 482 20.5 20.5 16 16 31.1 31.1 Evana ------------------------------ 201 166 27.2 22.3 6 8 29.9 48.6 Fannin --------------------------- 364 442 24.7 80.0 7 9 19.2 20.4 Fayette ----------------------------------- 144 190 17.6 23.3 6 1 41.7 11.8 Floyd ---------------------------------------- 1268 1268 22.6 22.6 32 29 26.2 22.8 Forsyth ----------------------------- 241 266 21.3 23.5 4 6 16.6 18.8 FFuraltnoknlin___..-._-_-_-_-__-_-_-_-_-_-__-_-_-_-_-_-__-_-_-_-_-_-__-_-_-_-_-_ 346 8639 360 8716 22.2 22.0 23.1 22.2 6 261 16 294 17.3 30.2 44.4 83.7 Gilmer --------------------- 266 270 29.4 80.0 6 7 22.6 25.9 Glascock ----------------------- 99 102 21.8 22.4 1 4 10.1 39.2 Glynn ---t---------------------------- 1154 919 52.6 41.9 39 44 83.8 47.9 Gordon ------------------------------- 404 458 21.9 24.8 7 10 17.3 21.8 Grady ------------------------- 486 488 24.7 24.6 20 16 41.2 31.1 Greene ------------------------- 292 336 21.3 24.6 6 15 17.1 44.6 GwinneU --------------------------- 578 541 19.9 18.6 10 11 17.8 20.8 Habersham ------------------------ 366 355 u.o 24.0 12 10 33.8 28.2 Hall ------------------------------- 745 821 21.4 28.6 26 14 34.9 17.1 Hancock ---------------------------------- 303 316 23.7 24.8 17 18 56.1 41.1 Haralaon ---------------------------------------- 275 325 19.1 22.6 4 9 14.6 27.7 Harria ------------------------------------ 229 275 20.0 24.1 7 7 30.6 26.6 Hart -------------------------------- 215 276 13.9 17.8 9 6 41.9 18.1 Heard ---------------------------- 117 122 13.6 14.2 7 6 69.8 49.2 Henry -------------------------------------- 364 868 24.1 24.3 8 12 22.0 82.6 Houston ------------------------------ 647 418 48.4 37.0 11 18 20.1 81.1 Irwin ---------------------------------- 824 856 26.0 27.4 8 10 24.7 28.2 Jackson --------------------------------- 468 493 22.8 2U 11 10 24.0 20.3 Jasper ----------------------------------- 171 198 19.6 22.6 6 10 29.2 50.6 Jeff Davia ----------------------------- 238 286 26.9 26.7 16 6 67.2 21.2 Jefferson --------------------------------- 610 1>14 26.4 25.6 17 17 33.3 311.1 Jenklna ---------------------------------- 272 302 23.0 25.6 7 6 26.7 16.6 Johnson ----------------------- 279 263 21.6 19.6 7 7 25.1 27.'1 Jonea ---------------------------------- 174 197 20.9 23.6 7 9 40.2 46.7 Lamar --------------------------------- 230 242 22.8 24.0 12 7 52.2 28.9 Lanier ----------------------------- 86 86 16.1 16.1 2 8 23.& 36.8 Laurena ------------------------ 807 762 24.0 22.7 24 31 29.7 40.7 Lee -------------------------- 216 ll22 27.6 28.3 9 12 41.7 64.1 Liberty ----------------------------------- 263 244 80.6 28.4 6 8 22.8 82.8 Lincoln ---------------------------- 148 187 21.0 26.6 2 3 13.6 16.0 Long -------------------------------------------- 79 83 19.8 20.3 4 2 60.6 24.1 Lowndes ---------------------------------- 962 906 80.2 28.4 22 29 22.9 32.0 Lumpkin ----------------------------- 161 162 26.9 26.0 2 6 12.4 30.9 McDuffie --------------------- 269 266 23.8 24.4 12 20 46.3 76.6 Mcintosh ------------------------------ 161 164 30.4 81.0 11 6 68.3 80.6 Macon ----------------------------------------- 411 469 25.8 28.8 12 15 29.2 32.6 Information and Statistics 325 TABLE 8-Continued LIVE BIRTHS AND RATES PER 1,000 PoPULATION, STILLBIRTHs AND RATES PER 1,000 LIVE BIRTHs IN EACH CouNTY IN GEoRGIA: 1943 AND 1944..___ LIVE BIRTHS STILLBIRTHS Rate Per 100,000 Rate Per 100,000 Number Population Number Population County 1944 i943 1944 1943 1944 1943 1944 1943 Madison 275 291 20.5 21.7 5 3 18.2 27.5 Marion --------------------- 205 199 29.5 28.6 11 12 58.7 60.8 Meriwether ---------------- 538 532 24.4 24.1 27 19 50.2 35.7 Miller --------------------- 219 219 21.9 21.9 7 6 32.0 27.4 Mitchell -------------------- 606 605 26.1 26.0 17 21 28.1 au Monroe --------------------- 238 271 22.1 25.2 6 11 25.2 40.6 Montgomery ---------------- 177 166 18.3 17.2 3 4 16.9 24.1 Morgan 277 308 21.8 24.2 13 u 46.9 46.5 Murray - - - - - - 235 296 21.1 26.6 6 2 25.5 6.8 Muscogee 2762 3043 36.6 40.3 94 80 34.0 26.8 Newton 503 496 27.1 26.7 19 25 87.8 50.4 Oconee 138 130 18.2 17.2 3 2 21.7 16.4 Oglethorpe 313 266 25.2 21.4 8 16 25.6 60.2 Paulding 240 287 18.7 22.4 11 8 45.8 27.9 Peach 293 280 28.2 27.0 9 10 30.7 86.7 Pickens Pierce - - - - - Pike------ 182 208 19.9 22.8 2 6 11.0 28.8 333 310 28.2 26.3 u. 15 42.0 48.4 241 244 23.2 23.5 4 10 16.6 41.0 Polk ----------------------- 620 705 21.8 24.8 18 25 29.0 36.5 Pulaski 233 236 23.7 24.0 15 14 64.4 59.3 Putnam ------- 160 212 18.8 24.9 7 9 43.8 42.5 Quitman Rabun _ 80 71 23.3 20.7 5 4 62.5 66.3 203 180 26.0 23.0 4 2 19.7 11.1 Randolph ------ 427 380 25.7 22.9 18 18 42.2 47.4 Richmond 2276 2250 27.8 27.5 62 68 27.2 30.2 Rockdale 195 153 25.2 19.8 8 7 41.0 46.8 Schley 113 128 22.5 25.4 6 4 53.1 81.8 Screven ---- 485 420 23.8 20.6 22 17 45.4 40.6 Seminole 115 177 13.5 20.8 3 6 26.1 88.9 Spalding 666 712 23.4 25.0 29 23 43.5 82.8 Stephens - - - - - - - - - - 422 457 32.5 35.2 10 7 28.7 16.3 Stewart -------------- 250 284 23.6 26.8 7 7 28.0 24.6 Sumter ----Talbot _ 607 579 24.8 23.6 23 32 37.9 56.8 191 213 23.5 26.2 8 5 41.9 28.5 Taliaferro 97 129 15.5 20.5 4 8 41.2 152.0 Tattnall 309 347 19.0 21.4 10 12 32.4 84.6 Taylor 257 265 23.9 24.6 11 9 42.8 84.0 Telfair 294 295 19.4 19.5 8 12 27.2 40.7 Terrell 419 495 25.1 29.7 13 23 31.0 46.5 Thomas 855 738 27.3 23.6 83 82 88.6 48.4 Tift --------Toombs - - - - - - - 500 517 26.9 27.8 18 23 36.0 44.5 416 367 24.5 21.6 11 9 26.4 24.5 Towns 87 131 17.7 26.6 8 4 34.5 80.6 Treutlen 139 128 18.2 16.8 4 8 28.8 23.4 Troup - - - - - - - - - 1051 1133 24.0 25.8 45 41 42.8 86.2 Turner 190 206 17.5 19.0 7 17 36.8 82.5 Twiggs 203 255 22.3 28.0 11 9 54.2 36.3 Union ------------ 176 211 22.9 27.5 4 10 22.7 47.4 326 Georgia Department of Public Health TABLE &-Continued LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1943 AND 19~- LIVE BIRTHS STILLBIRTHS Rate Per 100,000 Rate Per 100,000 Number Population Number Population Count)' 19U 1943 19U 1943 19U 1943 19U 1943 Upson - - - - - - - - - - - - - - 606 609 24.2 24.3 11 13 18.2 21.3 Walker ---- 762 877 24.6 28.3 9 9 11.8 10.3 Walton 604 466 24.3 21.9 13 14 26.8 30.'1 Ware -- 804 776 28.8 27.8 32 36 39.8 46.4 Warren -------------- 229 240 22.4 23.4 11 8 48.0 29.2 - - - - - - - - Washington 696 629 24.6 26.0 33 27 66.6 42.9 Wayne - - - - - - - - - - - 429 399 32.7 80.4 17 11 39.6 27.6 Webster - - - - - - - - - - - 118 133 26.0 28.1 2 2 16.9 16.0 Wheeler 158 176 18.5 20.6 7 6 44.3 34.1 White 137 172 21.3 26.8 4 6 29.2 29.1 Whitfield 677 747 25.9 28.6 17 19 26.1 26.4 Wilcox - - - - - - - - - - - 268 261 21.0 19.7 8 6 29.9 23.9 Wilkes 346 357 22.9 23.7 12 14 84.7 39.2 Wilkinson 243 256 22.0 23.2 11 11 45.3 43.0 Worth 600 677 28.1 27.0 24 27 40.0 46.8 Militar:v Reservations 81 98 1 2 !."'OTE: These figures are alloeated to county of residence, exclude nonresidents of Georgia and include residents of Georgia with birth ocdllrring in other states. Live birth rates based on the 1940 Census Enumerated Population. Information and Statistics 327 TABLE I INFANT AND MATERNAL MoRTALITY WITH RATEs PER 1,000 LivE BIRTHs IN EAcH COUNTY IN GEORGIA: 1943 AND 1944 County TOTAL ---------- Appling ---------------------- Atkinson ----------------- Bacon ------- Baker ----------------------- Baldwin ------------ Banks ------------------ Barrow ------------------------- Bartow ------------------------- Ben Hill ------------------------ Berrien --------------------- Bibb ------------------------ Bleckley ------------------------- Brantley ------------ Brooks -----------Bryan ----------------- Bulloch Burke Butta Calhoun Camden Candler Carroll Catoosa Charlton Chatham Chattahoochee - - - - - - Chattoop Cherokee - - - Clarke Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur DeKalb Dodee Dooly INFANT MORTALITY MATERNAL MORTALITY Rat Per 1,000 Rate Per 1,000 Number LiYe Births Number Lin Births 1944 1943 1944 1943 1944 1943 1944 1943 3398 3661 44.1 46.7 276 803 8.6 8.9 9 11 26.9 27.3 2 3 6.0 '1.4 2 6 10.6 26.6 1 6.1 10 13 35.3 67.0 2 1 7.1 4.4 8 4 47.6 25.2 1 6.8 11 14 30.5 35.3 1 4 2.8 10.1 6 9 42.3 45.9 15 23 62.8 79.6 2 6.9 32 37 48.6 63.0 2 3 3.0 5.1 17 23 46.2 71.7 2 2 6.4 6.2 10 8 27.5 23.5 6 2 16.6 6.9 122 148 47.8 54.3 8 6 3.1 2.2 12 10 52.4 38.8 2 7.8 8 15 37.6 79.8 1 2 4.7 10.6 17 20 33.5 37.8 2 2 3.9 3.8 11 6 70.5 42.6 30 25 50 43.0 6 2 10.1 3.4 28 30 43.6 47.0 2 5 3.1 7.8 7 9 37.8 39.8 12 19 45.8 75.1 7 141 41.4 79.1 1 6.6 6 6 80.9 31.6 37 25 54.4 34.6 2 6 2.11 8.3 12 16 45.3 52.1 7 12 63.6 107.1 1 9.1 176 242 47.1 66.8 18 13 4.8 8.6 2 6 41.7 111.1 10 12 22.5 26.0 2 8 41.6 6.8 26 14 56.1 30.9 4 9.0 83 42 49,7 68.3 2 6 3.0 9.8 15 10 71.8 56.8 9 9 33.7 33.6 1 3.'1 1 6 7.8 44.8 39 87 86.9 38.9 8 4 2.8 4.2 341 41 40 50.9 57.1 53 40.0 53.2 '11 6.0 7 10.7 7.0 9 12 36.6 53.1 3 2 12.2 8.8 11 6 43.0 21.2 II 19 9.8 33.8 '2 14.1 8.5 7 9 40.9 49.6 2 1 11.7 5.5 28 21 119.8 418.6 2 a 4.6 6.9 8 5 19.7 28~9 1 13.5 80 28 42.4 40.2 8 7 4.2 10.0 88 68 411.0 82.8 1 4 0.6 1.9 11 18 23.6 40.0 3 1 6.4 2.a 14 11 87.9 80.2 ' 5 10.8 18.7 328 Georgia Department of Public Health TABLE 9.-<:ontinued INFANT AND MATERNAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS IN EAcH CouNTY IN GEORGIA: 1943 AND 1944 INFANT MORTALITY MATERNAL MORTALITY County Number Rate Per 1,000 Live Births Rate Per 1,000 Number Live Births 1944 1943 1944 1943 1944 1943 19U 1941 Dougherty - - - - - - - - - 29 29 88.3 38.8 4 2 4.6 2.8 Douglas ----------------- 15 15 25.4 24.8 1 11.1 Early -------------------- 111 27 29.4 65.9 2 8.9 Echols ------------------------ 4 95.2 Effingham ---------------------- 18 12 61.8 47.6 1 4.0 Elbert ----------------------------- 20 14 45.7 31.1 2 1 4.8 2.2 Emanuel ---------------------- 25 25 51.9 51.9 1 5 2.1 10.4 Evans --------------------- 6 16 24.9 90.9 1 5.0 Fannin ------------- 21 17 57.7 38.5 1 2.7 Fayette --------------------- 4 11 27.8 67.9 1 2 6.9 10.11 Floyd ---------------------- 74 40 58.4 31.6 5 8 8.9 2.4 Forsyth ----------------------- 7 2 29.0 7.5 Franklin ------------- 7 21 20.2 58.4 2 1 5.8 2.8 Fulton ----------------------------- 430 420 49.8 48.2 22 22 2.5 2.6 Gilmer ------------------ 9 18 34.0 66.7 8 1 11.8 3.7 Glascock ------------------ 2 2 20.2 19.6 Glynn --------------- 77 86 66.7 93.6 4 4 3.11 4.4 Gordon ------------ 16 20 39.6 43.7 1 1 2.6 3.2 Grady ------------------------- 22 22 45.3 45.6 1 4 2.1 8.a Greene ------------------------ 11 26 37.7 74.4 2 Gwlnnett ------------------- 18 25 31.1 46.2 2 3.5 Habersham ------------------ 12 10 33.8 28.2 8 8.6 Hall ------------------ 41 82 55.0 39.0 4 8 5.4 3.7 Hancock ------------- 9 9 29.7 28.5 2 8.6 Haralson ------------------- 7 20 25.6 61.6 Harris ------------------ 6 13 26.2 47.3 2 z 8.7 7.8 Hart ---------------------- 16 16 69.8 54.3 1 2 4.7 7.2 Heard --------------- 10 6 86.6 49.2 Henry ---------------- 10 18 27.5 48.9 1 8.2 2 2.7 u Houston 18 18 32.9 43.1 1 1.4 Irwin ------------- 10 9 80.9 26.4 1 8.1 Jackson ----------- 21 20 45.9 40.6 Jasper ------ 16 13 87.7 66.7 1 1 6.8 5.1 Jeff Davis------------------- 9 6 37.8 26.4 1 4.2 Jefferson ----------------- 21 16 41.2 31.1 2 8.9 Jenkins ---------------- 22 16 80.9 63.0 8 2 11.0 8.6 Johnson ------------- 6 9 21.5 85.6 Jones -------------- 6 8 28.7 40.6 Lamar ------------ 11 9 47.8 37.2 Lanier --- 3 4 35.3 47.1 Laurens ------- 86 36 44.6 47.2 Lee ------------- 14 11 64.8 49.5 Liberty - - - - - - - - - 12 18 46.6 63.3 1 1 8.8 4.0 3 12.4 a 1 '8 8.7 u 4.8 11.6 a 12.8 Lincoln 4 3 27.0 16.0 1 1.1 Long 1 6 12.7 72.3 Lowndes Lumpkin 41 80 42.6 88.1 3 6 12.4 80.9 4 ' 4.1 4.4 McDuffie 6 11 38.2 41.6 1 8.8 Information and Statistics 329 TABLE 9-Contlnued INFANT AND MATERNAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS IN EAcH CouNTY IN GEORGIA: 1943 AND 1944 INFANT MORTALITY MATERNAL MORTALITY Counb' Rate Per 1,000 Rate Per 1,000 Number Live Births Number Live Births 1944 1943 1944 1943 1944 1943 1944 19U Meintoeh 10 7 62.1 42.7 Maeon - - - - - - - - - 18 28 43.8 60.9 Madison ---------------- 16 14 58.2 48.1 2 .., 1 4.9 I.! 1 Marion ------------------ 11 14 63.7 70.4 1 8 4.11 111.1 Meriwether ------------- 26 16 48.3 30.1 8 2 5.6 3.8 Miller -------------- 10 8 45.7 36.5 1 4.11 Mitehell ----------------- 39 22 64.4 36.4 4 8 6.8 6.0 Monroe ---------- 11 9 46.2 33.2 2 1 8.4 3.7 Montgomery --------- 7 7 39.6 42.2 Morgan ------------ 12 14 43.3 45.6 1 8.8 Murray ----------------Museogee --------------- 10 119 3 106 42.6 43.1 10.1 au 6 1 8.4 6 1.8 2.0 Newton ----------------------- 27 15 53.7 30.2 1 2.0 Oeonee ------ 7 12 60.7 92.8 Ogltehorpe ---- 17 11 64.3 41.4 II 18.8 Paulding -------------- 7 16 29.2 65.7 2 8.1 Peaeh - - - - - - - - 14 27 47.8 96.4 2 8.8 Piekena ---------- 13 9 71.4 48.3 2 11.0 Pleree --------- 9 19 27.0 81.3 1 3.2 Pike -------------- 8 10 33.2 41.0 1 3 4.1 12.8 Polk 26 38 41.9 63.9 Pulaski ----------------- 11 10 47.2 42.4 1 1 ' 1.6 4.8 11.7 Putnam 12 10 75.0 47.2 1 2 G.8 9.4 Quitman 6 6 76.0 70.4 1 14.1 Rabun ----------------- 1 6 4.9 27.8 1 4.9 Randolph ----------- 16 23 35.1 60.5 2 2 4.7 11.1 Riehmond --------------- 99 110 43.6 48.9 4 6 1.8 u Roekdale -------------- 6 10 25.6 66.4 1 11.1 Sehle:y - - - - - - - - - - 1 9 8.8 70.8 Screven --------------- 28 29 47.4 69.0 4 8 8.2 '1.1 Seminole --------------- 7 4 60.9 22.6 1 2 8.7 11.8 Spalding ------------ 87 46 66.6 68.2 6 8 7.11 u Stephens 4 6 9.6 13.1 2 4.7 Stewart -------------- 8 10 32.0 85.2 2 1 8.0 Ui Sumter ---------------- 39 86 64.3 62.2 1 8 1.8 11.1 Talbot ---------' -- 10 21 62.4 98.8 1 4.7 Taliaferro ------------------- 7 8 72.2 62.0 Tattnall ----------- 9 14 29.1 40.3 3 2 9.7 6.8 Taylor 7 8 27.2 '11.8 Telfair 10 4 34.0 13.6 1 8.4 Terrell ------------- 26 25 62.1 60.6 1 4 2.4 8.1 Thomas 29 39 83.9 62.8 4 4 4.7 11.4 Tift 28 32 66.0 61.9 1 1 2.0 1.9 Toombs 11 14 26.4 38.1 2 4 4.8 10.8 Towns ---- 1 6 11.5 38.2 Treutlen Troup ------ 4 6 28.8 411.9 1 7.8 62 68 49.6 80.0 II 6 6.7 4.4 330 Georgia Department of Public Health INFANT AND MATERNAL MoRTALITY WITH RATES PER 1,000 LIVE BIRTHS IN EAcH CoUNTY IN GEoRGIA: 1943 AND 1944 County Turuer Twfap Union Upson Walker Walton Ware ----- Warren --Waahington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth ----------Residents of Georgia, death occurring in other atatee- INFANT MORTALITY MATERNAL MORTALITY Rate Per 1,000 Rate Per 1,000 Number Live Births Number Lin Births 1944 1943 19U 1943 1944 1943 1944 1943 12 16 83.2 77.7 1 1 &.3 4.9 12 10 &9.1 39.2 2 '1.8 8 10 4&.6 47.4 27 22 44.6 86.1 4 3 6.6 4.8 26 88 84.1 87.6 1 1 1.3 1.1 27 30 63.6 66.8 1 1 2.0 2.2 26 37 82.3 47.7 1 6 1.2 8.4 14 16 61.1 62.& 1 U 30 26 60.4 41.3 4 6.7 12 16 28.0 37.6 2 1 4.7 2.& 4 4 33.9 30.1 7 4 u.s . 22.7 2 1U 9 10 66.7 68.1 1 '1.3 27 29 89.9 88.8 2 4 3.0 &.4 6 7 18.7 27.9 1 1 8.7 4.0 18 13 62.0 86.4 1 8 2.9 u 17 8 70.0 81.8 2 8 8.2 11.7 34 26 66.7 46.1 1 6 1.7 8.7 7 16 3 2 NOTE: These figures are allocated to county of residence, exclude nonresidents of Georgia and include residents of Georgia with death occurring in other states. Information and Statistics 331 TABLE 10 DEATHS AND DEATH RATEs PER 1,000 PoPULATION IN EAcH CoUNTY IN GEORGIA: 1943 AND 1944 County DEATHS Rate Per 1,000 Number Population 1944 1943 1944 1943 County DEATHS Rate Per 1,00t Number Population 1944 1943 1944 1943 TOTAL _28803 - - Appling 80 - - Atkinson 26 Bacon - - - 74 Baker ---- 46 Baldwin ------ 148 Banks _ _ _ 44 29488 75 40 73 40 147 52 - - Barrow 132 124 Bartow-- 227 201 Ben Hill ___ 146 170 Berrien __ 82 84 Bibb ----1106 1164 Bleckley _ _ 81 85 Brantley _ _ 55 68 - - - Brooks 165 180 Bryan--- 65 69 Bulloch-- 187 187 Burke--- 241 225 - - - Butts 112 100 Calhoun 98 97 - - Camden 69 86 Candler - - - 55 57 - - Carroll 290 266 Catoosa-- 71 76 - - Charlton 34 83 Chatham -1790 1946 Chattahoochee 16 20 Chattooga - 98 96 - - Cherokee 146 133 - - Clarke 301 834 Clay 60 68 Clayton-- 97 96 Clinch 81 - - Cobb - - - 849 Coffee 188 - - - - Colquitt 276 36 884 188 290 Columbia-- '16 82 Cook - - - 91 84 Coweta-- 176 168 Crawford __ 64 70 Crisp _ _ _ 199 191 Dade--- 85 49 Dawson _ _ 12 15 - - Decatur 254 241 DeKalb _ _ 826 765 Dodge 110 180 - - - Doo!y 124 166 9.2 5.5 8.7 9.1 6.8 9.0 6.0 10.1 9.0 10.1 6.3 18.2 8.4 8.0 8.0 10.3 7.2 9.1 12.2 8.9 11.7 6.0 8.5 6.5 6.6 15.2 8.1 5.8 7.8 10.6 7.1 8.8 4.8 9.1 8.7 8.8 8.1 7.6 6.6 9.0 11.8 6.11 2.7 11.4 9.6 6.2 7.8 9.4 Dougherty 844 357 5.2 Douglas _ _ 65 51 - - - 5.6 Early 131 146 9.0 Echols - - 12 12 6.4 Effingham_ 83 89 9.0 Elbert _ _ _ 161 146 - - 6.0 Emanuel 175 9.5 Evans _ _ _ 55 173 65 8.0 Fannin _ _ 119 106 11.7 Fayette _ _ 61 67 - - - 6.5 Floyd 496 406 13.9 Forsyth-- 32 26 8.8 Franklin _ _ 98 124 9.9 Fulton --4266 4550 - - 8.8 Gilmer 63 11.0 Glascock _ _ 25 78 24 - - - 7.2 Glynn 380 355 8.5 Gordon _ _ 101 134 10.9 Grady--- 156 126 - - 9.8 Greene 142 168 14.6 Gwinnett __ 198 227 - 6.3 Habersham 104 101 - - - 7.8 Hall 260 236 7.0 Haneock _ _ 92 95 8.8 16.6 8.9 6.2 Haralson 73 - - Harris 111 - - Hart 99 - - - Heard ___ 60 96 113 87 66 8.6 Henry _ _ _ 161 146 11.8 Houston _ _ 111 109 9.6 8.2 6.6 Irwin - - - 82 Jackson 117 ---- Jasper 121 66 129 102 10.0 Jeff Davis _ 54 66 8.7 Jefferson __ 148 151 8.8 Jenkins _ _ 125 106 - - 8.7 Johnson 70 81 '1.0 Jones '17 ----- 6.2 Lamar 104 78 100 - - 11.8 Lanier - - 74 10.9 Laurens 885 26 309 8.8 Lee 86 78 8.8 Liberty-- '12 112 10.8 Lincoln _ _ 20 24 8.8 Long--- 29 S4 8.2 Lowndes _ _ 822 840 - - 11.2 Lumpkin 26 40 12.0 6.5 7.0 4.0 8.6 8.2 7.4 7.4 8.1 7.6 8.8 2.8 6.3 10.9 7.0 5.5 17.3 6.5 7.9 10.4 6.8 7.0 7.6 7.2 5.1 9.7 6.4 7.0 10.6 9.8 6.3 6.8 18.8 6.1 7.4 10.8 1.4 9.2 10.8 18.1 10.0 11.0 8.4 2.8 7.1 10.1 4.2 12.5 6.1 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 6.3 16.2 7.8 6.4 11.2 7.8 6.8 6.8 7.4 6.7 9.9 6.6 6.4 9.7 9.6 5.1 6.4 11.41 u 7.5 8.9 6.3 8.8 9.11 4.4 9.1 11.1 18.0 u 8.8 10.'1 8.4 332 Georgia Department of Public Health TABLE Ill-Continued DEATHS AND DEATH RATEs PER 1,000 PoPULATION IN EAcH CoUNTY IN GEORGIA: 1943 AND 1944 DEATHS Rate Per 1,000 Number Population County 1944 1943 1944 1943 McDuffie 78 88 7.2 8.1 Mcintosh 82 67 16.6 12.7 Macon ---- 178 166 11.2 10.4 Madison -------- 107 84 8.0 6.3 Marion --------- 76 67 10.9 9.6 - Meriwether 202 199 9.2 9.0 Miller - - - 78 68 7.8 6.8 - - - Mitchell 211 193 9.1 8.8 Monroe ___ 125 107 11.6 10.0 Montgomery .. 61 58 6.3 6.0 - - Morgan 121 186 9.5 10.7 Murray-- 74 59 6.6 &.8 Muscogee --- 804 821 10.6 10.9 Newton--- 186 155 10.0 8.3 - - - Oconee 48 68 6.3 8.8 Oglethorpe __ 106 88 8.4 7.1 - - Paulding 77 sa 6.0 6.11 - - - - Peach 126 133 12.1 12.8 Pickens ----- 76 67 8.2 7.3 Pierce ___ 110 91 9.3 7.7 Pike 86 111 8.8 10.7 - - - - - Polk 200 228 7.0 8.0 Pulaski ___ 79 88 8.0 9.0 Putnam --- 108 Quitman _ _ so 95 12.1 11.2 21 8.7 6.1 - - - - R a b n n 23 26 2.9 3.2 Randolph - 146 179 8.7 10.8 Richmond -1000 1064 12.2 13.0 - - Rockdale 63 72 6.9 9.8 Schley--- 32 44 6.4 8.7 - - Screven 131 149 6.4 7.3 - - Seminole 66 69 7.8 6.9 - - Spalding 292 297 10.3 10.4 Stephens - - - 49 61 3.8 8.9 Stewart 103 88 9.7 8.8 DEATHS Rate Per 1,000 Number Population County 1944 1943 1944 1943 Sumter 291 304 11.9 12.4 Talbot ------ 73 106 9.0 13.0 Taliaferro - 46 42 7.2 6.7 - - - Tattnall 86 93 5.2 5.7 Taylor ------ 66 46 6.0 4.2 - - - Telfair 114 98 7.6 6.5 - - - - T e r r e l l 180 183 10.8 11.0 Thomas ------ 308 836 9.8 10.7 Tift -------- 181 176 '9.7 9.5 Toombs ---------- 102 128 6.0 7.6 Towns-------- 12 26 2.4 5.3 Treutlen ----- 50 49 6.6 6.4 Troup ------ 445 421 10.1 9.6 Turner - - - 74 66 6.8 6.1 Twiggs---- 83 73 9.1 8.0 Union ----- 29 49 3.8 6.4 Upson ------ 192 188 7.7 7.11 Walker ------ 196 218 6.3 7.0 Walton--- 209 207 10.1 10.0 Ware------ 303 305 10.8 10.9 Warren - - - 93 82 9.1 8.0 Washington _ 200 209 8.8 8.6 - - Wayne ------- 123 Webster 26 Wheeler ---- 62 107 39 44 9.4 6.8 6.1 8.2 8.8 6.2 - - - White 56 46 8.6 7.0 Whitfield __ 174 211 6.7 8.1 - - - Wilcox 74 76 6.8 11.9 - - Wilkes 140 160 9.3 9.9 Wilkinson - 99 74 9.0 6.7 Worth--- 180 182 8.4 8.11 Residents of Georgia, death occurring in other states _ 204 287 NOTE: These figures are allocated to county of residence, exclude nonresidents of Georgia and include residents of Georgia with death occurring in other: states. Rates based on the 1940 Census Enumerated Population. Information cuul Statistics 333 TABLE 11 DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM TYPHOID AND TYPHUS IN EACH COUNTY IN GEORGIA: 1943 AND 1944 Counf;J' TOTAL ------------------- Applina- Atkinson ---------Baeon ---------------- Baker --------------- Baldwin -----------------Banks ------------------ Barrow ------------ Bartow --------------------Ben Bill --------------------------- Berrien ------------------- Bibb ----------------------------- Bleckley --------------------- Brantley --------------Brooks ------------- Bryan -------------- Bulloch --------------------- Burke -------------------Butta --------------------Calhoun ------------------- Camden --------Candler ------------------------------ Carroll ------------------------Catoosa ----------------------Charlton ---------------Chatham ---------------------Chattehoochee ----------------------Chattooga ------------------------------ Cherokee ------------------- Clarke --------------- Clay ----------------------- Clayton ------------------------ Clinch ---------------------Cobb -----------------------------Coffee -------------------------Colquitt ------------------------- Columbia ----------------------------- Cook -- Coweta ------------------ Crawford ----------- Crisp -----------------Dade ---------------Dawoon ------------Decatur ------------ DeKalb Dod&'e ------------- Dooly ---------------------------- TYPHOID TYPHUS Rate Per 100,088 Rate Per 100,0H Number Population Number Population 1944 1943 1944 1943 1944 1943 1944 19U 24 23 0.8 0.7 63 67 2.0 1.8 1 14.1 1 1.11 1 18.6 2 21.1 1 6.9 1 4.0 1 6.9 6.9 1 1 1.2 1.1 1 10.4 1 1U 1 1 4.9 4.11 a 11.6 1 9.6 2 6.9 1 9.2 1 11.0 1 9.1 0.8 3 3 2.6 2.1 1 6.4 6.4 1 3.6 1 8.11 "' 1 a 11.1 1 1.1 a.o 10.6 1 6.7 1 a 6.7 17.1 1 22.8 1 4.& 1 1.1 1 1.11 334 Georgia Department of Public Health TABLE U-continued DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM TYPHOID AND TYPHUs IN EAcH CoUNTY IN GEORGIA: 1943 AND 1944 County 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 Henry Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurena Lee Liberty Lincoln Long Lowndes ------ TYPHOID TYPHUS Rate Per 100,000 Rate Per 100,000 Number Population Number Population 1944 1943 1944 1943 1944 1943 1944 1943 1 3.6 1 9.9 1 6.4 1 6.4 10.4 2 10.2 1 18.6 1 6.8 1 1 0.3 0.8 4 li 1.0 1.3 1 22.0 1 4.6 2 10.2 2 10.2 1 6.8 1 8.8 1 8.8 1 7.'1 1 11.8 1 8.4 4 2 11.9 6.0 1 3.1 4 12.6 Information and Statistics 335 TABLE 11-continuecl DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND TYPHUs IN EAcH CoUNTY IN GEoRGIA: 1943 AND 1944 County Lumpkin McDuffie Mcintosh Macon ------ Madison ----------- Marion ~-------------Meriwether ~---- Miller ---------Mitchell --------Monroe --------Montgomery ---------- Morgan Murray ----- Muscogee -- Newton ----------- Oconee Oglethorpe Pauldine 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 ---- TYPHOID TYPHUS Rate Per 100,000 Rate Per 100,800 Number. Population Number Population 1944 1943 1944 1943 1944 1943 1944 1943 1 14.4 1 14.4 1 4.3 1 10.0 2 1 8.6 4.3 1 10.3 1 10.3 1 1 7.9 7.9 1 9.6 1 8.0 1 u 1 3.6 1 10.2 2 12.0 1 6.0 2 3 2.4 8.'1 l! 39.'1 2 1 9.8 4.9 l! 1 23.6 11.8 1 9.4 2 8.2 1 3 4.1 12.2 1 12.3 l! 12.8 1 6.6 1 6.0 2 6.4 2 10.8 l! 10.8 2 11.8 336 Georgia Department of Public Health TABLE 11---Colltlaaed DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM TYPHOID AND TYPHUS IN EAcH CouNTY IN GEORGIA: 1943 AND 1944 Coant,. Troup Turner Twiggs -------------------Union ---------------Upson -------------Walker -----------------Walton -------Ware --------Warren Washington Wayne -----------------Webater Wheeler White Whitfield Wilcox Wilkes Wilkinaon Worth TYPHOID TYPHUS Rate Per 100,000 Rate Per 100,000 Namber Population Namber Popalatloa 1944 1943 1944 1941 1944 1941 1944 1941 1 2.8 1 II 9.2 18.4 1 13.0 1 8.2 1 3.2 1 3.6 1 4.1 1 1 7.6 7.1 1 11.7 1 1 11.7 11.7 1 1 7.8 7.8 1 4.7 1 1 NOTE: These figures are allocated to county of residenee, exelude nonresident. of Georgia and include residents of Georgia with death oeeurrlng in other atates. Rates based on the 1940 Census Enumerated Population. Information and Statistics 337 TABLE 12 DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM MALARIA AND TuBERCULosis IN EAcH CouNTY IN GEORGIA: 1943 AND 1944 County TOTAL Appling Atkinson Baeon - Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb ---- Bleckley Brantley Brooks --- Bryan Bulloeh __ Burke Butta ----- Calhoun Camden Candler Carroll Catoosa Charlton Chatham Chattahoochee Chattooga Cherokee Clarke Clay Clayton Clineh Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawaon Decatur DeKalb Dodae MALARIA TUBERCULOSIS Rate Per 100,000 Rate Per 100,000 Number Population Number Population 19U 1943 19U 1943 1944 1943 1944 1943 34 37 1.1 1.2 1107 1304 35.4 41.7 1 14.1 1 1 6.9 6.9 1 2 14.1 28,2 1 1 12.4 12.4 1 6.1 9 5 64.8 3~5 3 34.4 1 6 7.7 as.a 1 4.0 13 6 61.4 23.7 1 6.11 10 4 68.9 27.6 2 18.0 66 66 66.6 66.8 1 1 10.4 10.4 4 41.4 1 14.8 2 2 11.8 9.8 1 6 4.9 29.8 1 15.9 1 2 16.9 31.8 1 1 8.8 8.8 9 6 34.6 23.1 1 3.8 7 11 26.4 41.6 6 4 66.3 43.6 2 l 19.2 28.7 1 2 16.11 33.8 3 33.0 10 8 29.3 8.8 6 3 46.9 27.6 79 119 67.0 83.11 3 11 118.4 69.4 32.4 2 12 9.11 69.6 II 8 81.7 28.2 1 14.2 2 3 28.8 42.11 6 a 11.1 211.7 2 31.1 10 12 28.1 11.4 z a 11.8 18.11 2 8.1 2 8 8.1 18.2 1 4 10.8 42.4 4 6 83.6 41.11 18 6. 48.2 22.2 1 1 14.0 11.7 1 7 ' 14.0 16.1 6 89.9 28;1 2 1 88.9 17.0 1 4.1 8 8 27.0 27.0 28 u 28.5 89.1 8 2 14.3 9.1 338 Georgia Department of Public Health TABLE 12-<:ontlnued DEATHS AND DEATH RATES PER 100,000 POPULATION FROM MALARIA AND TuBERCULOSIS IN EAcH CouNTY IN GEORGIA: 1943 AND 1944 County Dooly ---------------------------- Dougherty ----------------------- Douglaa ---------------- Early ------------------------------- Echola ----------------------------------- Effingham ------------------------- Elbert ------------------------------- F,manuel ----------------------------- Evans ------------------------------------ Fannin --------------------------------------- Fayette -------------------------------- Floyd ------------------------------ Forsyth ------------------------------- Franklin ----------------------------------- Fulton --------------------------------------- Gllme~: ---------------------------- Glaacock --------------------- Glynn ---------------------------------- Gordon ----------------------------- Grady ------------------------------ Greene -------------------------------- Gwlnneti ------------------------- Habersham ---------------------- Hall ------------------------ :Hancock ---------------------------- Haralson ------------------------------- llarria ------------------- Hart ---------------------------------- :Heard ------------------------------:Henry ------------------------------ :Houston ---------------------------- Irwin ---'"---------------------------------- Jackson ------------------------------------ Jasper -------------------------------- Jeff Davia ------------------------------ Jefferson -------------------------------- Jenkins Johnson -__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-, Jones ---------------------------------------------- Lamar ------------------------------------ Lanier -------------------------------------- Laurena ------------------------------- Lee --------------------------------------- _______ Liberty Lincoln ---------------,_--_-_-_-_-_-_--_-_-_-_-_--_-_-_-_-_- Long ------------------------------ Lowndes ----------------------------------- MALARIA TUBERCULOSIS Rate Per 100,000 Rate Per 100,008 Number Population Number Population 1944 1943 194!& 19!&3 19!&!& 19!&3 194!& 19!&3 7 6 41.5 35.5 1 3.6 u 2!& 49.0 84.0 1 9.9 2 5.4 10.7 4 6 2U 82.1 1 33.7 10.4 10.4 2 8 20.7 31.1 6 7 26.6 36.7 1 4.3 1 4 4.3 17.0 1 13.6 3 8 zo.a 54.2 2 24.5 18 20 23.2 35.6 1 u 238 261 80.6 68.4 2 22.2 1 22.0 6 11 27.4 50.2 3 8 16.a 48.4 6 3 25.4 16.3 1 7.3 6 6 43.8 36.6 7 9 24.1 30.9 2 5 13.5 33.9 4 10 11.6 28.7 1 8 7.8 621.7 6 3 41.7 20.9 a 3 26.8 26.8 2 2 12.9 12.9 2 3 23.2 34.8 4 2 ' 26.11 39.7 1 17.7 8.8 2 2 16.15 16.6 2 1 10.0 G.O 1 2 11.4 22.8 1 11.3 1 6.0 6.0 7 7 34.9 34.9 6 8 42.2 67.6 2 16.4 1 2 7.7 15.4 4 3 48.0 86.0 1 5 9.9 49.5 1 1 17.8 17.8 2 6.0 12 17 36.7 60.6 1 12.8 6 3 63.8 88.8 1 11.6 1 1 11.6 11.6 1 14.2 1 2 24.6 48.t 1 1 3.1 3.1 6 8 18.8 25.1 Information and Statistics 339 TABLE U....Continuecl DEATHS AND DEATH RATES PER 100,000 POPULATION FROM MALARIA AND TUBERCULOSIS IN EAcH CouNTY IN GEORGIA: 1943 AND 1944 County Lumpkin McDuffie --------- Mcintosh Macon Madison Marion -- Meriwether --------------- Miller --------------- Mitchell ---------------- - Monroe _____________ Montgomel"l' ----------- 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 ------------------ rallaferro Tattnall Taylor 'l'elfalr -----'terrell ----------------- Thomas ---- Tift --- Toombs Towna ----------------- MALARIA TUBERCULOSIS Rate Per 100,000 Rate Per 100,000 Number Population Number Population 1944 1943 1944 1943 1944 1943 1944 1943 1 16.1 1 6 9.2 66.2 2 87.8 2 10 12.6 62.7 6 4 37.2 29.8 2 a 28.8 43.1 9 2 40.8 9.1 1 6 10.0 60.0 4 8 17.2 34.4. 9.8 4 6 37.2 46.6 1 1 10.3 10.3 1 3 10.3 31.0 6 6 39.3 89.8 7 4 62.9 36.9 2 2.6 84. 33 46.0 43.7 1 8 6.4. 43.1 2 4 26.4 62.8 1 4 8.0 82.2 1 7.8 9 6 86.7 48.2 1 1 10.9 10.9 2 1 16.9 8.1 2 2 19.8 19.3 111 14 112.7 ~ 49.1 1 2 10.2 20.8 3 8 30.6 30.1 2 2 28.6 23.11 2 118.2 II 11 80.1 641.1 82 60 '16.7 78.3 ' 61.8 1 u 8 8 29.11 81.8 6 1 68.9 11.8 1 11.8 14 8 49.2 28.1 8 3 23.1 28.1 1 9.4 I 4 47.2 37.7 1 4.1 u 8 16 32.7 61.2 2 3 24.6 36.11 2 31.9 1 4 6.2 24.8 1 9.8 1 9.3 9.3 & 4 88.0 26.4 1 6.0 7 7 42.0 42.0 1 1 3.2 8.2 7 4 22.4 12.8 1 11.4 1 9 6.4 48.4 1 6.9 2 8 11.8 17.'f 2 40.6 340 Georgia Department of Public Health TABLE 12-contlnued DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM MALARIA AND TuBERCULOSIS IN EAcH CouNTY IN GEORGIA: 1943 AND 1944 County Treutlen Troup Turner Twigp Union - Upson Walker Walton _ Ware Warren --- Washington Wa:rne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth Residents of Georgia, death occurring in other states_ MALARIA TUBERCULOSIS Rate Per 100,000 Rate Per 100,000 Number Population Number Population 1944 1943 1944 1943 1944 1943 1944 1943 1 2.3 1 1 13.1 18.1 u 22 31.9 50.1 4 3 36.9 27.'7 1 11.0 1 4 11.0 43.8 2 26.0 13 16 51.9 63.8 1 3.2 14 20 45.1 64.& 1 4.8 7 3 33.7 14.4 6 20 21.6 71.8 li 4 48.8 39.1 4 8 16.5 33.0 1 7.6 5 38.1 1 11.'7 6 1 77.9 16.8 10 16 38.8 61.1 2 16.'7 1 '7.8 2 2 18.8 18.1 1 9.1 4 3 36.3 27.2 1 4.7 7 9 32.8 42.1 38 61 NOTE: These figures are allocated to county of residence, exclude nonresidents of Georgia and include residents of Georgia with death occurring in other states. Rates baaed on the 1940 Census Enumerated Population. Information and Statistics 341 TABLE 13 DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM CANCER AND PELLAGRA IN EACH CoUNTY IN GEORGIA: 1943 AND 1944 County TOTAL Appling -~------------------------------------- Atkinson ---------------------------------------- Bacon ----------------------------~---------------- Baker --------------------------------------------- Baldwin ---------------------------------- Banks ----------------------------------------------- Barrow ------------------------------------------- Bartow ------------------------------------------- Ben Hill -------------------------------------- lJerrien -------------------------------------------- Bibb --------------------------------------------- Bleckley ------------------------------------------- Brantley ---------------------------------------- Brooks ------------------------------------------ Bryan ------------------------------------------------ Bulloch -------------------------------------------- Burke ---------------------------------------- Butts ------------------------------------------- Calhoun --------------------------------------- Camden ---------------------- Candler ------------------------------- Carroll ----------------------------------- Catoosa -------------------------------- C h a r l t o n -----------------~--------- Chatham -------------- Chattahoochee ------------------ Chattooga -------------------- Cherokee ---- Clarke ------------------ Clay ------------------------ Clayton --------------------- Clinch ------------------------------- Cobb -----------------Coffee ------Colquitt -----------------rColumbia -----------------Cook ---------------------Coweta ------------------Crawford ------------------ Crisp Dade -------------------------- Dawson ---------------Decatur -----------------DeKalb ------------- Dodge Dooly --------- CANCER PELLAGRA Rate Per 100,000 Rate Per 100,000 Number Population Number Population 1944 1943 1944 1943 1944 1943 1944 1943 2256 2097 72.2 67.1 131 175 4.2 5.6 2 2 13.8 13.8 3 14.1 42.3 1 14.1 3 7 37.1 86.5 1 2 12.4 24.7 4 3 54.5 40.8 1 13.6 9 12 64.8 73.1 3 5 34.4 57.3 1 11.5 12 11 91.9 84.2 4 30.6 17 14 67.2 55.4 2 7.9 10 8 68.9 55.1 3 2 20.7 13.8 6 7 39.0 45.5 1 3 6.5 19.5 83 76 99.1 90.7 3 4 3.6 4.8 4 4 41.4 41.4 3 43.7 14.6 2 8 9.8 39.0 2 9.8 2 2 31.8. 31.8 1 15.9 11 10 42.3 38.4 1 3.8 16 18 60.3 67.9 2 7.5 11 6 119.8 65.3 2 21.8 10.9 9 6 86.2 57.5 1 s 16.9 50.8 2 3 22.0 33.0 20 22 58.6 64.4 3 9.6 11.0 8.8 2.9 11 5 100.9 45.9 1 19.0 19.0 131 114 111.0 96.6 12 28 10.2 19.5 2 38.9 8 9 43.2 48.6 9 13 44.7 64.6 1 5.0 19 25 66.9 88.0 1 3.5 3 3 42.5 42.5 8 6 68.6 51.5 1 4 15.5 62.1 34 34 88.8 88.8 4 3 10.6 '1.8 15 12 69.6 55.7 1 4.6 17 11 51.5 38.3 4 lll.l 7 6 74.2 53.0 1 10.6 6 6 50.3 50.3 1 8.4 22 17 81.6 63.0 1 3.7 5 4 70.1 56.1 1 14.0 8 11 45.6 62.7 3 7 50.9 118.8 2 1 44.7 22.3 13 12 58.5 54.0 1 2 4.5 9.0 88 85 101.2 97.8 2 2.3 '1 8 33.3 38.1 9 8 53.3 47.4 3 17.8 342 Georgia Department of Public Health TABLE U.....Continuecl DEATHS AND DEATH RATES PER 100,000 POPULATION FROM CANCER AND PELLAGRA IN EACH CouNTY IN GEoRGIA: 1943 AND 1944 County 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 McDuffie CANCER PELLAGRA Rate Per 100,000 Rate Per 100,000 NuBlber Population Nuber Population 1944 1943 1944 1943 1944 1943 1944 1943 24 23 84.0 80.5 2 7.0 3 6 29.8 49.7 2 19.9 8 6 42.8 32.1 2 10.7 4 6 41.6 61.8 12 16 61.2 76.6 7 9 29.8 38.3 4 6 64.0 81.1 6 9 33.9 61.0 10 6 122.4 73.4 61 43 108.7 76.6 3 4 26.6 36.3 9 8 67.6 51.2 439 373 111.7 94.9 8 3 88.9 33.8 3 6 66.0 110.0 16 10 68.4 45.6 17 16 92.2 81.3 11 9 66.0 45.8 13 13 94.8 94.8 20 18 68.8 61.9 12 13 81.2 88.0 14 21 40.2 60.8 4 6 31.3 39.2 6 8 41.7 55.6 13 6 113.8 43.8 8 9 61.6 58.0 7 6 81.3 69.7 16 10 106.8 66.1 12 2 106.2 17.7 7 2 64.1 15.5 8 6 39.8 24.9 8 12 91.2 136.8 6 1 66.6 11.3 9 6 44.9 29.9 4 6 33.8 50.7 2 6 16.4 88.6 2 6 24.0 60.0 4 8 39.6 29.7 2 1 36.6 17.8 10 10 29.8 29.8 6 6 63.8 76.6 6 7 58.2 81.4 2 5 28.4 71.0 2 3 48.9 73.4 18 26 66.5 81.6 3 6 48.2 96.4 6 3 65.2 27.6 1 10.4 1 6.1 2 8.6 2 2 27.0 27.0 2 1 13.6 6.8 1 1 12.2 12.2 6 3 8.9 6.8 1 8.8 1 6.4 9 13 2.3 3.8 1 1 5.4 1 1 6.1 6.1 1 1 7.3 7.3 2 6 6.9 20.6 4 1 27.1 6.8 6 17.2 1 1 7.8 7.8 1 7.0 1 1 6.6 1 1 7.7 7.7 1 6.0 1 1 1U 11.4 1 3 6.0 16.0 3 26.3 1 7.7 2 1 19.8 9.9 1 3 8.0 8.9 1 12.8 2 23.8 1 24.1 8 9.4 Information and Statistics 343 TABLE 13--contlnued DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM CANCER AND PELLAGRA IN EACH CouNTY IN GEORGIA: 1943 AND 1944 County Mcintosh ---------- Macon ---------------------- Madison ------------------------- Marion --------------------- Meriwether -------------------------- Miller ----------------------------------- Mitchell ----------------------------------- Monroe -------------------------- Montgomery ---------------------- Morgan ------------------------------ Murray ---------------------------------- Muscogee -------------------------------- Newton --------------------------------------- Oconee ------------------------------------------ Oglethorpe ---------~----~-------------- P a u l d i n g -------------------~------- P e a c h -----~------------------ 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 ------------- Turner --------------- Twiggs ----------------------- CANCER PELLAGRA Rate Per 100,000 Rate Per 100,001 Number Population Number Popnlatlon 1944 1943 1944 1943 19U 1943 1944 1943 5 3 94.5 56.7 2 87.8 6 10 37.6 62.7 3 3 18.8 18.8 7 8 52.1 59.6 2 14.9 4 3 57.5 43.1 17 19 77.1 86.1 1 4.6 6 2 60.0 20.0 10.0 9 8 38.7 34.4 1 2 4.3 8.6 15 12 139.5 111.6 3 27.9 3 4 31.0 41.4 8 7 62.9 55.1 2 3 16.7 23.6 2 10 18.0 89.8 58 48 76.8 63.6 6 6.6 11 12 59.2 64.6 2 2 10.8 10.8 2 7 26.4 92.4 5 6 40.2 48.8 6 4 39.0 31.2 1 7.8 7 7 67.5 67.6 1 9.6 9.6 6 7 65.7 76.6 7 I) 59.8 42.4 1 8.5 10 7 96.4 67.6 2 19.8 17 29 59.7 101.9 1 2 8.6 7.0 6 11 61.0 111.9 1 10.2 10 7 117.6 82.2 2 3 23.6 35.2 1 3 29.1 87.8 4 2 51.1 25.6 12 12 72.2 72.2 92 77 112.4 94.1 4 4.9 3 6 38.8 64.7 3 7 59.6 189.1 6 6 29.5 29.5 1 4.9 2 3 23.6 36.8 2 28.6 23 17 80.9 59.8 3 2 10.6 7.0 4 2 30.8 15.4 7 2 66.0 18.9 1 9.4 16 12 65.3 49.0 3 6 36.9 61.4 7 2 111.5 31.9 9 4 56.4 24.6 6 1 46.4 9.3 10 8 66.0 52.8 1 2 6.6 18.2 9 14 54.0 84.0 1 1 6.0 6.0 24 24 76.7 76.7 4 12.8 22 17 118.3 91.4 1 6.4 3 11 17.7 64.9 2 1 11.8 6.9 1 20.3 1 3 13.1 39.3 31 86 70.6 82.0 2 1 4.6 2.8 6 3 65.3 27.7 1 9.2 2 6 21.9 65.8 1 11.0 344 Georgia Department of Public Health TABLE 13-continuecl DEATHS AND DEATH RATES PER 100,000 POPULATION FROM CANCER AND PELLAGRA IN EAcH CouNTY IN GEoRGIA: 1943 AND 1944 CANCER PELLAGRA County Rate Per 100,000 Rate Per 100,000 Number Populatil81 Number Population 1944 1943 1944 1943 1944 1943 1944 1943 Union ---------------------- 1 2 13.0 26.0 2 26.0 Upson -------------------------- 14 17 66.9 67.8 Walker ------------------------------ 21 16 67.7 61.6 1 3.2 Walton ----------------------- 19 18 91.4 86.6 1 2 4.8 9.6 Ware --------------------------- 9 21 32.2 76.2 2 7.2 Warren ------------------- 7 2 68.4 19.6 1 9.8 Washington ------------------------ 16 10 66.0 41.3 Wayne ------------------ 12 10 91.4 76.2 1 1 7.6 7.6 Webster -------------------- 2 4 42.3 84.6 Wheeler --------------------------- - 10 3 117.2 36.1 1 11.7 White ------------------ 3 6 46.8 77.9 Whitfield -------------------- 19 11 72.8 42.1 WIICOll: ----------------- 7 2 64..9 16.7 2 7.7 1 7.8 Wilkes ------------------- 10 12 66.3 79.6 1 8.6 Wilkinson ------------- 6 2 64.4 18.1 Worth --------------------- 14. 10 66.6 46.8 Residents of Georgia, death occurring in other states__ 25 25 NOTE: These figures are allocated to county of residence, exclude nonresidents, of Georgia and include residents of Georgia with death occurring in other states. Rates baaed on the 1940 Censua Enumerated Population. Information and Statistics 345 TABLEU DEATHS AND DEATH RATES PER 100,000 POPULATION FROM PNEUMONIA ANn MOTOR-VEHICLE ACCIDENTS IN EACH COUNTY IN GEORGIA: 1943 -1944 PNEUMONIA MOTOR-VEHICLE ACCIDENTS Rate Per 100,000 Rate Per 100,000 Number Population Number Population County 1944 1943 1944 1943 1944 1943 1944 1"3 TOTAL ---------------------- 1581 1734 50.6 65.5 644 606 20.6 19.4 Appling ----------------------------------------- 1 4 6.9 27.6 1 6 6.9 4U Atkinson ------------------------------------ 3 42.3 5 70.6 Bacon ---------------------------------------- 8 4 98.8 49.4 a 37.1 Baker ---------------------------------------- 3 40.8 1 13.6 Baldwin --------------------------------- 20 17 121.9 103.6 6 4 36.6 2U Banks ----------------------------------------- 4 45.8 11.5 2 22.9 Barrow ---------------------------------- 7 6 63.6 45.9 3 3 23.0 28.0 Bartow ---------------------------------------- 10 11 39.6 43.6 7 4 27.7 16.8 Ben Hill ----------------------------- 11 20 76.7 137.7 6 41.3 Berrien --------------------------------------- 3 2 19.5 13.0 2 13.0 6.6 Bibb ---------------------------------------- 52 61 62.1 72.8 311 14 41.8 18.7 Bleckley ------------------------------------- 6 4 62.1 41.4 1 10.4 Brantley -------------------------- 3 3 43.7 43.7 3 43.7 Brooks ------------------------ 4 16 19.5 78.1 8 3 14.6 14.11 Bryan ------------------ 7 3 111.3 47.7 3 47.7 Bulloch --------------------- 11 7 42.3 26.9 6 8 23.1 ao.s Burke ------------------------- 11 12 41.5 45.2 6 6 22.8 18.1 Butta -----------------------------Calhoun ---------------------------- 3 1 3 32.7 32.7 9.6 9.6 2 1 ' 21.8 43.6 1 9.6 9.6 Camden ---------------------------- 9 11 152.3 186.1 4 2 67.7 88.8 Candle:r: ------------------------------- 1 11.0 1 2 11.0 22.0 Carroll ---------------------------- 15 18 43.9 52.7 9 6 28.8 17.6 Catooaa --------------------- 6 3 55.1 27.6 2 1 18.4 9.2 Charlton --------------------- 7 2 133.2 88.1 1 1 19.0 19.0 Chatham -------------- 104 119 88.2 100.9 46 33 88.1 28.0 Chattahoochee -------------- 1 2 19.6 38.9 1 2 19.11 88.9 Chattooga ------------Cherokee ---------- 7 8 6 37.8 32.4 4 89.7 19.9 2 1 10.8 II 6.0 24.8 Clarke 17 22 59.9 77.6 6 8 21.1 28.11 Clay -------- 1 7 U.1 99.1 1 14.2 Clayton 7 9 60.1 77.2 6 2 42.9 17.2 Clinch 3 46.6 Cobb - - - - - 21 19 54.9 49.6 Coffee ------------- 10 15 46.4 69.6 4 1 62.1 16.6 8 20 20.9 62.8 7 6 32.6 27.9 Colquitt ----------------- 16 29 48.5 87.8 7 3 21.2 9.1 Columbia ---------- 9 7 95.4 74.2 1 3 10.6 81.8 Cook ------ 4 4 33.6 33.6 1 8.4 Coweta ----------- 11 8 40.8 29.7 6 4 18.6 14.8 Crawford ------- II 4 70.1 56.1 1 8 14.0 4ll.l Crisp 3 6 17.1 84.2 2 8 11.4 17.1 Dade 4 4 67.9 67.9 1 1 17.0 17.0 Dawson 1 2 22.3 44.7 1 22.8 Decatur 16 12 72.0 64.0 6 6 22.5 22.5 DeKalb. 20 46 23.0 52.9 18 8 20.7 9.2 Dodge 4 6 19.0 19.0 2 7 9.5 83.8 346 Georgia Department of Public Health TABLE u-continuetl DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM PNEUMONIA AND MoTOR-VEHICLE AcciDENTs IN EACH CouNTY IN GEORGIA: 1943-1944 County 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 ------------------------------- PNEUMONIA MOTOR-VEHICLE ACCIDENTS Rate Per 100,00t Rate Per 100,0011 Number Population Number Population 1944 1943 1944 1943 1944 1943 19U 1943 6 12 35.5 71.1 1 7 6.9 41.6 22 20 77.0 70.0 5 7 17.5 24.5 5 5 49.7 49.7 2 3 19.9 29.8 3 11 16.1 58.9 1 3 6.4 16.1 2 67.5 1 33.7 6 2 62.2 26.7 3 3 31.1 31.1 11 6 56.1 30.6 1 1 5.1 5.1 7 18 29.8 55.3 5 10 21.3 42.5 1 3 13.5 40.6 1 2 13.5 27.0 11 4 74.6 27.1 2 3 13.6 20.3 2 3 24.6 36.7 1 1 12.2 12.2 38 24 67.7 42.7 6 5 10.7 8.9 1 8.8 2 1 17.7 8.8 4 6 25.6 38.4 2 1 12.8 6.4 198 242 60.4 61.6 77 60 19.6 15.3 1 4 11.1 44.4 1 11.1 4 1 88.0 22.0 1 22.0 45 46 205.8 209.9 10 11 46.6 50.2 8 7 16.8 88.0 4 4 21.7 21.7 5 6 25.4 30.5 4 20.4 6 18 43.8 181.3 1 2 7.3 14.6 9 19 80.9 66.8 9 7 30.9 24.1 8 3 20.8 20.3 1 3 6.8 20.8 18 12 37.3 34.6 6 6 17.2 17.2 8 6 62.7 47.0 1 7.8 4 7 27.8 48.7 2 2 13.9 13.9 6 6 52.5 62.5 3 1 26.3 8.8 11 8 70.9 51.6 7 7 81.3 81.3 2 12.9 z 23.2 9 8 59.5 52.9 6 6 39.7 39.7 8 9 26.5 79.6 2 3 17.7 26.& 5 1 38.7 7.7 7 4 34.8 19.9 1 3 5.0 14.9 7 3 79.8 34.2 7 6 79.8 68.4 10 5 113.1 56.6 1 11.3 2 12 10.0 59.9 3 2 15.0 10.0 14 11 118.2 92.9 4 2 33.8 16.9 6 5 38.6 38.6 1 1 7.7 7.7 5 6 60.0 72.0 1 2 12.0 24.0 12 5 118.9 49.6 1 1 9.9 9.9 1 2 17.8 35.6 1 17.8 18 13 38.7 88.7 7 6 20.8 14.9 8 4 76.6 51.0 1 12.8 1 1 11.6 11.6 18 12 151.3 139.6 1 14.2 1 24.5 1 s 24.6 78.4 Information and Statistics 347 TABLE 1-ContiJlaed DEATHS AND DEATH RATES PER 100,000 POPULATION FROM PNEUMONIA AND MoToR-VEHICLE AcciDENTs IN EAcH CouNTY IN GEORGIA: 1943-1944 County Lowndes ----~------------- Lumpkin -----------------McDuffie ---------------------Mcintosh -------------------Macon ----------------------Madison ------------------------Marion -----------------------Meriwether ---------------------------Miller -----------------------Mitchell ------------------ Monroe -------------- Montgomery ------------------- Morgan ------------------------ Murray ----------------------Muacogee ---------------------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 -------------- PNEUMONIA MOTOR-VEHICLE ACCIDENTS Rate Per 100,000 Rate Per 100,000 Number Population Number Population 1944 1943 1944 1943 1944 1943 1944 1943 18 17 66.6 63.4 6 7 16.7 22.0 1 3 16.1 48.2 6 6 46.0 46.0 6 46.0 6 2 113.4 37.8 3 3 66.7 66.7 9 6 66.4 37.6 4 8 26.1 18.8 6 4 87.2 29.8 3 22.3 6 4 71.9 67.6 2 1 28.8 14.4 17 8 77.1 36.3 8 6 13.6 22.7 4 1 40.0 10.0 1 10.0 10 8 43.0 34.4 3 1 12.9 4.3 7 9 66.1 83.7 6 1 46.6 9.3 4 3 4U 31.0 2 20.7 6 4 39.3 31.6 2 8 16.7 23.6 7 3 62.9 26.9 2 18.0 70 65 92.7 72.9 22 26 29.1 33.1 6 9 32.3 48.4 4 8 21.5 16.1 3 8 39.6 39.6 1 13.2 6 7 48.3 66.3 2 8 16.1 24.1 1 6 7.8 39.0 1 1 7.8 7.8 7 8 67.6 77.1 2 2 19.3 19.3 4 6 43.8 64.7 1 3 10.9 82.8 4 6 33.9 60.8 1 1 8.6 8.5 4 13 38.6 126.8 2 2 19.3 19.8 12 7 42.2 24.6 7 2 24.6 7.0 6 7 60.9 71.2 4 1 40.7 10.2 6 1 70.6 11.7 2 2 23.6 23.5 1 29.1 1 1 29.1 29.1 1 1 12.8 12.8 3 7 18.1 42.1 1 1 6.0 6.0 64 81 78.2 98.9 22 22 26.9 26.9 9 9 116.6 116.6 2 1 26.9 12.9 1 2 19.9 39.7 1 19.9 9 7 44.2 34.4 4 19.7 2 6 28.6 70.7 2 2 23.6 23.6 20 19 70.4 66.8 16 4 66.3 14.1 3 2 28.1 16.4 3 7 28.1 64.0 6 2 47.2 18.9 8 2 75.6 18.9 9 17 36.7 69.4 10 7 40.8 28.6 6 7 73.7 86.0 6 1 73.7 12.8 1 4 16.9 63.7 7 9 43.1 66.4 3 2 18.6 12.8 6 3 46.4 27.9 1 8 9.8 27.9 3 4 19.8 26.4 2 6 13.2 33.0 10 10 I 60.0 60.0 2 4 12.0 24.0 18 22 67.6 70.8 7 7 22.4 22.4 5 6 26.9 82.3 2 3 10.8 16.1 348 Georgia Department of Public Health TABLE 14-Continued DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM PNEUMONIA AND MoToR-VEHICLE AcciDENTs IN EACH CouNTY IN GEoRGIA: 1943- 1944 County Toomba Towns ------------- Treutlen ------------- Troup ------------ Turner Twiggs --Union ---------------Upson -----------Walker------------Walton Ware ----------- Warren ----- Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth Residents of Georgia, death occurring in other atates_ PNEUMONIA MOTOR-VEHICLE ACCIDENTS Rate Per 100,000 Rate Per 100,000 Number Population Number Population 1944 2 3 21 6 4 8 10 10 6 11 3 11 10 2 2 1 7 6 4 8 9 16 1943 1944 6 11.8 2 3 39.3 28 47.9 4 46.1 3 43.9 4 39.1 11 39.9 12 32.2 11 28.9 2& 39.4 8 29.3 8 46.4 2 76.2 2 42.3 2 23.4 1 16.6 9 26.8 6 47.0 6 26.6 7 72.6 7 42.1 1943 29.6 40.6 39.3 63.8 36.9 32.9 62.1 43.9 38.7 62.9 93.1 78.2 33.0 16.2 42.8 23.4 15.6 34.5 39.2 39.8 63.6 32.8 9 -1944 2 2 2 1 4 6 1 3 7 4 2 II 1 2 s 1 2 1 6 1943 2 2 9 1 1 1 z 4 6 8 2 6 ' 1 4 2 2 ' 1944 11.8 26.2 4.6 9.2 43.9 23.9 3.2 14.4 25.1 39.1 8.3 38.1 11.7 81.2 11.5 7.8 13.3 9.1 28.4 1943 11.8 40.6 20.6 9.2 11.0 18.0 8.0 12.9 28.9 28.6 19.6 24.8 au 16.6 15.8 11.7 18.1 18.7 NOTE: These figures are allocated to county of residence, exdlude nonresident. of Georgia and include reaidenta of Georgia with death occurring in other states. Rates baled on the 1940 Enumerated Population. Information and Statistics 349 TABLE 15 NuMBER AND PER CENT oF BIRTHs (ExcLusiVE oF STILLBIRTHs) BY PERSON IN ATTENDANCE AND CoLoR, IN GEORGIA: 1929- 1944 Number Total Physician Midwife Other 1929 1930 68,521 38,448 19,966 117 60,318 89,416 20,728 174 1931 61,774 38,322 23,316 137 1932 63,690 37,981 26,678 181 1933 60,744 36,112 26,396 236 1934 64,616 39,498 26,043 74 1936 63,290 37,312 26,737 241 1936- 61,617 86,669 24,661 297 1937 64,012 39,610 24,262 240 1938 1939 64,307 40,111 23,970 226 64,910 40,866 23,769 286 1940 1941 1942 1948 64,695 41,637 22,807 261 67,786 44,872 22,716 198 72,189 50,099 21,968 122 78,827 67,192 21,018 117 1944 77,018 67,582 19,348 88 White 1929 1980 1981 1982 1938 36,751 32,229 3,429 98 87,064 83,240 3,695 129 87,581 32,663 4,761 107 88,209 32,169 6,944 96 86,692 29,597 6,919 176 1934 88,333 33,062 5,226 55 1935 87,846 81,798 5,878 174 1936 1937 86,320 81,111 4,998 211 88,181 38,412 4,615 154 1988- 88,618 34,014 4,478 126 1939- 88,923 34,448 4,276 200 1940 - - 88,911 84,907 8,830 174 1941 - - 41,277 87,612 8,644 121 1942 --- 45,192 42,077 3,036 80 1948- 60,162 47,798 2,277 77 1944- 49,464 47,666 1,858 55 Colored 1929 22,770 6,219 16,627 24 1930 23,264 6,176 17,088 45 1981 2t,243 6,659 18,654 30 1932 25,481 6,812 19,634 86 1933 - - 26,062 6,616 19,477 60 1934- 26,282 6,446 19,817 19 1986 - - 26,946 6,614 20,364 67 1986- 25,297 6,548 19,668 86 1937 - - 26,831 6,098 19,647 86 1938- 26,694 6,097 19,497 100 1989 26,987 6,408 19,494 85 1940 26,784 6,730 18,977 77 1941 26,608 7,260 19,171 77 1942 26,997 8,022 18,933 42 1943 28,176 9,394 18,741 40 1944- 27,554 10,026 17,495 38 NOTE: Ficarea prior to 1929 not available. Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Pereent Physician lllidwife Other 65.7 84.1 0.2 65.3 34.4 0.3 62.0 37.7 0.3 59.6 40.2 0.2 57.8 41.8 0.4 61.1 38.8 0.1 69.0 40.7 0.3 69.6 40.0 0.6 61.7 87.9 0.4 62.4 37.3 0.8 62.9 36.6 41.6 6U 35.3 0.3 66.2 83.6 0.3 69.4 80.4 0.2 73.0 26.8 0.1 74.8 26.1 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 0.6 100.0 86.2 13.6 0.2 100.0 85.1 14.4 0.5 100.0 85.7 13.8 0.11 100.0 87.5 12.1 0.4 100.0 88.1 11.6 0.8 100.0 88.6 11.0 0.5 100.0 89.7 9.8 0.5 100.0 91.1 8.6 0.11 100.0 93.1 6.7 0.2 100.0 95.8 u 0.! 100.0 96.2 8.7 0.1 100.0 27.3 72.6 0.1 100.0 26.5 78.2 0.3 100.0 23.3 76.5 0.2 100.0 22.8 77.1 0.1 100.0 22.1 77.? 0.2 100.0 24.6 76.4 0.1 100.0 21.3 78.5 0.2 100.0 21.9 77.? 0.4 100.0 23.6 76.1 0.3 100.0 23.7 76.9 0.4 100.0 24.7 76.0 0.8 100.0 26.1 78.6 o.a 100.0 27.4 72.8 0.3 100.0 29.7 ?o.t 0.2 100.0 83.8 66.6 0.1 100.0 311.4 63.5 0.1 350 Georgia Department of Public Health TABLE 18 DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES IN GEORGIA FOR THE YEARS 1850-1940 Caaoe of Death Number of Deatha 1850 1880 1870 1880 1890 1900 19ZO 1930 1940 ALL CAUSES __ 9,925 Tn>hoid fever ------ 557 Malaria ------~ 186 Smallpox ------ Measles ------ 74 Scarlet fever------ 202 Whooping cough - - 385 Diphtheria ------ 344 Dysentery, diarrhea and enteritis --------- 654 Tuberculosis ------ 379 Caneer ----------- 60 Pneumonia - - - - - 651 Heart diseases - - - 603 All other causes_._____ 6,831 12,813 887 568 8 47 217 334 440 1,061 560 81 1,288 723 6,629 13,606 772 705 18 270 12 92 417 1,414 996 131 1,363 274 7,142 21,649 987 1,060 2 496 31 660 1,309 2,011 1,882 240 1,686 1,451 9,746 21,174 1,000 937 440 8 89 663 2,353 2,324 293 1,738 1,405 10,034 26,941 1,766 1,226 46 201 44 222 819 2,285 2,830 382 2,598 2,127 12,4411 32,243 649 669 8 61 82 878 401 1,725 2,862 1,124 2,766 1,892 20,896 85,188 500 442 128 88 257 186 1,347 2,1711 1,662 2,680 4,099 21,986 32,286 68 89 23 16 108 69 693 1,688 1,969 2,066 8,178 19,606 1850 1860 Rates Per 180,000 Popalatioa 1870 1880 1890 1900 19ZO 19U 1940 ALL CAUSES -1096.3 Tn>hoid fever _ _ _ 61.11 Malaria - - - - - - 20.4 Smallpox -----Measles - - - - - - 8.2 Scarlet fever ----- 22.3 Whooping cough ---- 42.6 Diphtheria ---------- 38.0 Dysentery, diarrhea and enteritis __ 72.2 Tubereuloois ----- 41.8 Caneer --------- 6.6 Pneumonia -------- 71.8 Heart diseases --- 66.6 All other causes ___ 643.6 1211.9 83.9 68.7 0.8 4.11 20.6 81.6 41.6 100.4 62.0 7.7 119.9 68.4 627.0 1U9.0 66.2 69.5 1.6 22.8 1.0 7.8 36.2 119.4 84.1 11.1 116.1 23.1 603.2 1397.3 64.0 68.7 0.1 32.2 2.0 42.1 84.9 130.4 122.0 16.6 109.3 94.1 631.9 1162.4 64.4 51.0 24.0 0.4 4.8 30.1 128.1 128.6 16.0 94.6 76.6 U8.1 1219.1 79.9 66.6 2.1 9.1 2.0 10.0 87.1 101.1 128.1 17.3 117.6 96.2 663.1 1113.2 19.0 19.8 0.1 2.1 1.1 12.9 121.8 69.6 81.8 88.8 96.6 66.8 704.2 1207.4 17.2 16.2 u u 8.8 4.8 46.2 74.6 118.8 88.11 140.8 762.7 1088.11 2.2 2.8 o.f 0.1 u 1.1 22.2 49.1 82.'1 1111.8 197.7 1124.4 NOTE: Figures for the year 1910 not available.