- Collection:
- Georgia Government Publications
- Title:
- Annual report for the year 1946
- Creator:
- Georgia. Department of Public Health
- Contributor to Resource:
- Georgia. Department of Public Health
- Publisher:
- Atlanta, Ga. : Georgia. Department of Public Health
- Date of Original:
- 1946
- Subject:
- Georgia
- Location:
- United States, Georgia, 32.75042, -83.50018
- Medium:
- publications (documents)
- Type:
- Text
- Format:
- application/pdf
- External Identifiers:
- Call Number GA H700 .A1 1946
- Metadata URL:
- https://dlg.galileo.usg.edu/id:dlg_ggpd_y-ga-bh700-b-pa1-b1946
- Digital Object URL:
- https://dlg.galileo.usg.edu/do:dlg_ggpd_y-ga-bh700-b-pa1-b1946
- Language:
- eng
- Holding Institution:
- University of Georgia. Map and Government Information Library
- Rights:
-
STATE OF GEORGIA
EPARTMEN
DD
ANNUAL REPORT
1946
STA1.,E OF GEORGIA
DEPARTMENT OF
PUBLIC HEALTH
T. F. ABERCROMBIE, M.D., Director
ANNUAL REPORT FOR THE YEAR 1946
State Office Building Atlanta, Georgia
STATE OF GEORGIA
DEPARTMENT OF PUBLIC HEALTB
T.F.ABERCROMBIE,M. D., DIRECTOR AT~ANTA
To His Excellency Hon. Ellis Arnall Governor of Georgia
Dear Sir:
I have the honor to present to you the annual report of the work of the Department of Public Health for the year 1946.
Fewer Georgians died in 1946 than in any other year in the history of State health records, There were 27,405 deaths and 85,699 births recorded. The births occurred at the ratio of 313 for each 100 deaths, The death rate from all causes declined to 877.3 per 100,000 population, a decrease of 3.7 per cent over 1945,
Tabulation of deaths from 31 leading causes shows only eight with an increase last year - measles, diabetes, .heart disease and cirrhosis of liver, malformation and early infancy diseases, suicide, homicide and accidents. The other 23 diseases show reductions from 0.9 to 100 per cent.
All communicable diseases, except measles, show appreciable declines. Cancer, nephritis, cerebral hemorrhage, embolism-and thrombosis- causes of'death in the older-age group, all show declines, Typhus fever which has been increasing steadily since 1933, shows an encouraging reduction of 44.1 per cent - the first decided improvement in the rate in the past 13 years,
The ten leading causes of death were, in the order named: heart disease; cerebral hemorrhage; embolism and thromposis; nephritis; cancer; accidents; malformation and early infancy diseases; pneumonia; tuberculosis; homicide and influenza.
Since 1920, births in Georgia have increased from 20;7 per 1,000 population to 27.4. Births per 100 deaths in 1920 were 186 anr. in 1946 were 313.
The infant mortality has declined from 88.3 per 1,000 live births in 1920 to 35.8 last year. Maternal mortality improved from 9,3 deaths per 1,000 live births in 1920 to 2,7 in 1946.
Table of Contents
Page Division of local Health Organizations____________________________________________________ 13 Division of Public Heahh Nursing____________________________________________________________ 55 Division of Public Heahh Engineering______________________________________________________ 65 Division of Dental Health Education________________________________________________________ 91 Division of Maternal and Child Health______________________________________________________ 103 Division of Public Health Education________________________________________________________ 125 Division of Preventable Diseases________________________________________________________________ 133
Cancer Control Service________________________________________________________________________ 13 5 Epidemiologic Service__________________________________________________________________________ 140 Industrial Hygiene Service__________________________________________________________________ 186 Social Hygiene________________________________________ -------------------------------------------- 192 Typhus Control Service______________________________________________________________________ 196 Venereal Disease Control Service________________________________________________________ 21 0 Division of Tuberculosis ComroL______________________________________________________________ 221 Battey State HospitaL_______________________________________________________________________________ 231 Division of laboratories______________________________________________________________________________ 249 Division of Information and Statiscics________________________________________________________ 297
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MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH
C. L. RIDLEY, M. D., Chrtirman______________________________________________________________Macon .R. L. ROGERS, M. D., Vice-Chrtirman______________________________________________Gainesville ROBERT F. MADDOX--------------------------------------------------------------------------------Atlanta B. H. MINCHEW, M. D.______________________________________________________________________Waycross C. K. SHARP, M. D.____________________________________________________________________________Arlingmn
J. A. CORRY, M. D.----------------------------------------------------------------------------Barnesville
\Y/. P. HARBIN, JR., M. D.---------------------------~--------------------------------------------Rome
J. M. BYNE, JR., M. D.____________________________________________________________________Waynesboro
D. N. THOMPSON, M. D.______________________________________________________________________Elbenon GEORGE WRIGHT, PH. G----------------------------~------------------------------------------Tifton J. W. WHITE, PH. G--------------------------------------------------------------------Thomasville
J. G. WILLIAMS, D. D. s_______________________________________________________________________Atlama w. K. WHITE, D. D. s_____________________________________________________________________Savannah
J. C. PATTERSON---------------------------------------------------.-------------------------------Cuthbert
Brief History of Public I-lealth in Georgia
England set a fine example of early public health effort by appropriating, .in 1732, 13 guineas ( $62.40) for the relief of sick mothers during passage to the province.
Colonial records for 1739 reveal that 40 pounds, 17 shillings, and 6 pence were paid for "physicks" to be given soldiers in General Oglethorpe's Regiment in Savannah.
As early as 1760, there was an act to oblige ships and other vessels coming from places infected with the plague, smallpox, or other contagious diseases to be quarantined. Later, in 1817, a Georgia law was passed prohibiting the sale of unwholesome meat, bread, and liquors. Offenders could be .fined for the first offense and imprisoned for the second.
In 1823, a law was passed establishing an office in each county for the purpose of recording births. In fact, Georgia was the second of the Stares to require registracion 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 an epidemic of yellow fever.
Doctor Taliaferro made a complete investigation of the origin of the yellow fever epidemic and reported that sailors on the "Maria Carlina", who had moved their bedding to a boarding house, brought the fever to Savannah. At that time, sanitary conditions in Savannah, as well as in other parts of the State, were very poor and played an important part in the spread of the disease. Cases occurred in Augusta, Brunswick, and Macon.
10
Georgia Depa1tment of Pttblic Health
On Ocwber 30, 1876, the S<tvannah Moming News stared thac 8,000 refugees had lefc 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 charicy during the epidemic. Thac year, only $1,000 was spenc for public health in the entire State!
The next outlook for public health work in Georgia was even darker, as no appropriation was made for che concinuation of the work in 1877. Records for chat period, furnished every ten years by che Census Bureau, show a constant increase in deaths from the more serious public health problems. Typhoid fever, malaria ( then called bilious fever), and smallpox raged. Pellagra and hookworm disease were making cheir appearance.
Georgia was without a public health program twenty-six years. The second Scare Board of Health was organized September 10, 1903, under an act of Legislacure. An appropriation of $3,000 was made and Dr. H. F. Harris was elected Secretary ac a salary of $2,000 yearly. The remainder of the appropriation was used in the general work of the Board.
Doccor Harris, using a microscope and other apparatus of his own, began operation in one small room in the basement of che Capicol in 1904. His first work was devoted to bacteriology and the control of smallpox and yellow fever. He also did a vase amount of research in an efforc to determine rhe cause of pellagra.
A laboracory was opened in 1905. With assistance, Doccor Harris expanded his activities to include the manufacture of Pasteur treatment in 1908; diphtheria anticoxin in 1909; and typhoid vaccine in 1912.
The first full-time county health project was established in Glynn County in 1914. Later in che year, the Ellis Health Law was passed, thereby creating a board of health in every county in the State. This law further provides for the employment of a full-time councy health officer upon two successive recommendations of the grand jury. Following the passage of chis law, Glynn Hnd Floyd Counties adopted its provisions.
At a meeting of the Smte Board of Helllth, in January of 1914, Doctor Harris expressed a desire to retire from public health work as soon as he could be relieved of his duties without prejudice to the work, in order that he might devore 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 elecced Secretary.
Following is a list of the services of the State Department of Public Health, with the date of their establishment:
Laboratory --------------------------------------------------------------------------1905
Field Sanitation (now Local Health Organizations) ________ 1910
Venereal Disease ControL__________________________________________________ 1918
~-l
A Brief History
11
Vital Statistics ---------------------------------------------------------------------1919 Maternal and Child Healrh ------------------------------- _______________ 1920 Sanitary Engineering----------------------- ---------------------------------1920 Dental Health Education ____________________________________________________1928 Tuberculosis Control ___________________________________________________________ 1930 Preventable Disease______________________________ ------------------------------19 31 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
---_-l
Division of Local Health Organizations
GuY G. LUNSFORD, M. D., Di1ector H. M. GRANING, M. D., Assist?tnt Director W. D. CAGLE, M. D., Medicctl Director________________________ Nonhwestern Region. W. B. HARRISON, M. D., Medica! Di-recto1____________________ Northeastern Region __________________________________________________________________________________________West Central Region R. B. GRIFFIN, M. D., Medicct! Director_______________________ East Central Region 0. F. WHITMAN, M. D., Medical Director____________________Southwestern Region JOHN D. STILLWELL, M. D., Medical Director______:________ Southeastern Region
LOCAL HEALTH SERVICE STATE OF GEORGIA
:: :: county health units county health districts
nursing counties / health regions
Division of Local Health Organizations
Following is the annual narrative reporc of the Division of Local Healrh Organizations and the statistical report covering the activities of the 6
regional offices, 66 counties with full time health departments, 36 counties
having nursing service and the City Health Department of Atlanta. The counties of Barrow, Polk, Douglas and Long are also included in
tl1is reporc. They have had nursing service during the year and have recently joined various multiple county units.
Personnel Regional:
The Medical Director of the East Central Region resigned in August
1946, leaving thac position vacant. Doctor W. D. Cagle, Medical Director of the West Central Region resigned February 28, 1946, ctnd accepted a
position as Health Commissioner of Whitfield County. On June 1 he accepted the position as Medical Director of the Northwestern Health Region.
There is still a shortage of engineers and consultant nurses in regional positions. The Ease Central Region and the Southwestern Region have only one consultant nurse each. The Southwestern Region is the only region that has had its full quota of cwo engineers during the year. The remaining five regions have had only one engineer in each region.
County Personnel:
There continues w be a marked shortage of qualified personnel for county positions, no doubt due to the face that the salaries paid by the State Department of Health are nor sufficient to compete with those offered elsewhere. At the end of 1946 there were only 39 counties having a health commissioner, whereas 75 counties were budgeted for full time health units. (The City of Atlanta is not included in chese figures).
Om of 66 counties budgeced for nursing service only 36 actually had nursing service at the end of the year. Three of these 36 coumies employed a nurse for che first time during 1946. (Early, Hart and Talbot).
Most County Health Deparcments .throughout the State are functioning with only a skeleton personnel and much credit is due to all the personnel who have served so faithfully during these abnormal times.
P1tblic Hectlth Interest
There has been a very decided upswing in the demand for county public health workers and this demand is far in excess of the supply. The public in general has shown more interest in public health work than in previous years.
Multiple County Units:
In view of the face that Georgia has 159 counties and that 132 of these
have a population of 25,000 people, any efforts made in furthering public
16
Georgi?t Department of Pttblic Health
health activities were directed toward the formation of multiple county units, each having a population as near 50,000 as possible.
During the year the following districts were created and have been functioning under the direction of a health commissioner since the time of formation:
Thomas-Grady Spalding-lamar-Pike Coffee-Atkinson-Berrien Richmond-Columbia Colquitt-Brooks
The following districts have been approved and accepted by the various County Boards of Health but are not yet functioning because of the Jack of qualified persqnnel:
Bartow-Gordon Polk-Paulding Carroll-Douglas-Haralson Brantley-liberty-long-Wayne
The statistical summary following g1ves a detailed report of activities during the year.
It is interesting to note that almost twice as many venereal disease cases were treated at rapid treatment centers as during the previous year. This has been responsible for a marked decline in the number of syphilis cases being rreated in the various county clinics. At the close of the year many of rhese former treatment clinics were operating as diagnostic clinics, and were refering all suitable cases of venereal disease to the rapid treatment centers. Because of this treatment program it was possible to close many rural venereal disease clinics, thereby releasing the nurse for other important duties.
About one third as many patients were admitted to hospitals with diphtheria as in 1945. There was an increase in the activities of the Crippled Children's Service, more patients being reported and examined at diagnostic clinics than during 1945.
There was a rather marked increase in all activities related to general sanitation. All activities related to insect and rodent control showed a decided increase over 1945.
On December 31, 1946, only 39 of the organized counties and the City of. Atlanta actually had a health commissioner, this represented 50.75% of the total population; however, with the exception of two, the remaining organized counties, 13.63% of the population of Georgia, had nursing
Local Hectlth Orgctnizcttions
17
service. Of the remaining counties 36 nurses served 16.88% of the entire population of the State, a total of 81.26%, leaving 18.75% of the entire population without public health service provided locally. As has been brought out in previous paragraphs, although money is budgeted, vacancies exist in many 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 w the time that the nurse could take training in public health.
The counties having no public health service provided locally were rendered occasional service by the staff of the regional office.
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946
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COMMUNICABLE DISEASE CONTROL
Admission to medical service .
101
155
201
54
2
G
....
2
Consultations with physicians... .
Field visits. . . . . . . . . . . . . . . . . . . .......
....
2~5
1
135
654
I !GO
riss
7 6.1
I
1
29
Smallpox immunizations..... . . . . . . . . . . . . .
284
315
4461
735
ti3
4G4
. ...
214
.139
Diphtheria immunizations....
218
386
4758
144
299
277
100
G3
Typhoid immunizations. . . . . . . . . . . ....
3513
1952
6794
3119
1827
3489
1560
3590
Whooping cough. . . . . . . . . . . . . . . ...........
124
145
1440
109
32
170
70
16
....
VENERAL DISEASE CONTROL
Admission to medical service .................
70
99
10245
93
28
84
....
38
Clinic visits.... . . . . . . . . . . . . ...............
502
517
88428
424
629
359
....
90
51G
Field visits .................
..............
23
54
14598
85
22
82
30
55
Number of clinic treatments ..
304
345
52604
3G5
220
280
....
504
TUBERCULOSIS CONTROL
Admission to meiical service
44
50
1067
47
Admission to nursing service
......
G4
G2
2328
148
Clinic visits.... . . . . . . . . . . . . . Field and office visits . . . . . . . .
. .......... .
44 144
50
4638
221
14103
47 185
26
55
....
64
55
....
33
8G
87
147
20
17G
GG
55
!JO
149
187
202
MATERNITY SERVICE
Admission to medical service .....
85
82
91
47
96
112
Admission to nursing service ......... .: . : .......
88
82
720
50
162
225
Visits by ante-partum cases to medical conferences.
2G5
238
390
105
402
237
Field and office visits .....
...... 283
271
2885
158
744
483
31
Gil
20
98
182
41
INFANT HYGIENE Admission to medical service ... Admission to nursing service .... Visits to medical conferences.. Field and office visits . . . . . .
24
G9
910
23
91
25
G9
7982
50
82
3~2
38
94
2233
56
4
255
48
212
11455
121
420
807
20
105
20
49
255
47
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289 ~ !58
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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PRESCHOOL HYGIENE
Admission to medical service ......
5
58
2623
7
34
. ...
17
....
Admission to nursing service. . .... : : : .
5
Visits to medical conferences .............
7
Field and office visits ..... Dental inspections........... ::::::::::::::::: ..
....8
58 80
...83.
5239 4510
9.6.2..0
16
9
.
16 ...
.... . ... . ...
101
....
85
. ...
.3.0..5
. ...
142 66 262
15
2o
. ...
........
..
... ...
SCHOOL HYGIENE Inspections by physicians or nurses ........ ...... 200
138
113875
306
....
Examinations by physicians. . . . . . . . . . . . . ....
16
Admission to nursing service....... . ...........
16
198
23472
45
4152
5
........
Field and Office visits.. . . . . . . . . . . ............. Dental inspections.. ............................
...2.0
.6..5.8
9282 30249
..1.3.
. ...
405 80 14 2
....................
67 5 2 4
502 21
....2
................
ADULT HYGIENE Medical examinations...... . . . . . ............
70
....
43214
. ...
....
368
3
1 . ...
MORBIDITY SERVICE
Medical visits.............. Nursing visits . .............
......................
....
Admissions to hospitals ..... ...............
1
19
238
627 3
694 2406
1 ....
.4.5..8
12
. ...
52 8
. ...
. ...
29 2
2 . ...
........
SANITATION
Water supplies approved. . . . . . ...
Privies and septic tanks instalied. . . . . . . . ...
8
Food-haudlh1g establishments registered ...........
Dairy farms registered. . . .......
Milk plants registered ... Field visits .. .. .. .. . .. .. ..
. ....
. i4
..4.2.
19 3191
682
33
99
61216
1
....
39
....
.... '":i
1
13
5
9
54
9
31
22
73
15
LABORATORY SPECIMENS Specimens examined . ..... .................... 1293
1145
52848
997
978
1862
21
893
314 ....
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CONDENSED REPORT OP AcTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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COMMUNICABLE DISEASE CONTROL
Admission to medical service.... . . ..... .......
159
22
30
197
30
300
47
2
5
254
Consultations with physicians... Field visits ....................
3 499
Smallpox immunizations ............. : : : : : : : : 1421
44 242
...44
1G 170 374
13
1
127
87
363
81
36
18
7
309
1534
823
588
516
16
Diphtheria immunizations........
. ....
779
Typhoid immunizations. . . . . . . . . . ........... 1585
Whooping cough ..........
............ . ...
267
1070 140
........ . ...
377 2755 228
170 2786 148
550
512
354
170
6
4565 354
4357 129
2.7.5..4.
1949 147
..9.4.7
VENERAL DISEASE CONTROL Admission to medical service .... Clinic visits ...............
Field visits ................. Number of clinic treatments .........
..... .....
.... ......
2708 26077
2061 18862
82
. ...
664
. ...
107
. ...
333
62
136
1G2
188
87
158
203
688
1588
1554
2972
789
2270
314
146
2
75
136
37
76
30
540
1588
856
2885
403
2270
181
TUBERCULOSIS CONTROL
Admission to medical service ..
............ 208
43
Admission to nursing service.
..........
205
70
Clinic visits .............
796
43
Field and office visits ............ :. :::::::::.
1452
181
13
1
59
GO
47
60
53
29
21
97
72
137
56
128
61
1
11
190
59
GO
25
59
52
19
43
339
125
208
291
190
197
30
MATERNITY SERVICE
Admission to medical service. . .................. 1345 Admission to nursing service..................... 1529 Visits by ante-partum cases to medical conferences .. 4274 Field and office visits ...... ....... . ....... 2190
140
224
150
l
324
424
... i
55{
434
1000
80
80 265 268
304
573
340
435
693
1646
723
1141
109 143 231 428
193 193 417
486
........ . ...
INFANT HYGIENE
Admission to medical service ... .............. 668
37
. ...
7
46
287
253
51
151
Admission to nursing service ...
........
1044
47
221
70
478
182
138
171
. ...
Visits to medical conferences.. Field and office visits ........
1458
......
1758
107
....
133
. ...
10 826
292 76
463 757
483 346
73 234
151
250 . ...
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97 151
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 ( Conrinued)
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!>RESCHOOL HYGIENE
Admission to medical service.
315
Admission to nursing service ...
645
Visits to medical conferences ..
820
Field and office visits .... Ill! Dental inspections ......
I
136
51
RO
2:J
:n
141
261
4
256
60
31
I
226
57
JOJ
25
31
415
480
2
414
69
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SCHOOL HYGIENE
Inspections by physicians or nurses. Examinations by physicians ......
......
Admission to nursing service.
Field and office visits.
......
Dental inspections.........
13244 3721
808 1709
413
5
28
1157
1715
87
1767
1006
246
406
28
351
9
29
2
51
9
lO
11
17
277
31
17
29
16
11
519
....
ADULT HYGIENE Mcdioal examinations.
............ 2362
179
88
29
232
441
302
12
MORBIDITY SERVICE
Medi.r.al vi.s!t .... Nursmg; VIsits............... Admissions to ho;;pitals .....
(j
3
47
8
J:l2
OS
G
3
14
SANITATION
Wat.er supplies approved. . . . . . . . . . .........
33
5
16
Privies and septic tanks installed. . . . ..
368
2
2
Food~handling establishments registered ..........
381
Dair.v farms registered. . . . . . . . . . . . . . . . ....
135
....
....
11 8
1
74
58
27
41
I
G
53 1
Milk plants registered........ . . . . . ...
11
1
3
Field visits .................................... 28150
17
40
18
751
958
122
24
LABORATORY SPECIMENS
Specimens examined ..
- 20593
961
GO
2978
761
3893
2264
2630
1115
313
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0
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"' 96 ~"a-'
133 ti
~ "'
.:.;.:..
202 "~-
--26
49
."",''.
a
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54 4
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~ "'
:":"s-
6Q.l
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
COMMUNICABLE DISEASE CONTROL
Admission to medical service ..........
Consultations with physicians.....
Field visits. . . .
. ...
Rmallpox immunizations ....
Diphtheria immunizations.
Typhoid immunizations .
Whooping cough ....
VENERAL DISEASE CONTROL Admission to medical service......
Clinic visits ........ Field visits .................
Number of clinic treatments.
............ ....... .....
TUBERCULOSIS CONTROL
Admission to medical servire ..
.......
Admission to nursing service. ............
Clinic visits............... .............
Field and office visits .....
MATERNITY SERVICE
Admission to medical service ...
Admission to nursing service.....................
Visits by ante-partum cases to medical conferences.
Field :ind office visits. . . . . . . . .
. .......
INFANT HYGIENE Admission. to medical service ..................... Admission to nursing service ................ Visits to medical conferences ..................... li'ield and office visits ...........................
0::
<'."l
5 3 g 304 83 3007 191
46 364 16 281
30
iii
i
3
~ ~
<.l
11 778 574 GG18 258
7
....5
. "3:i
82 299
i7
48
3 130 14 275
E"
~
g
~
~""''
":"g'
"<.'l
<".'l
"<.'l
115
305
181
140
138G
123
3358
25
233
1818
13
873
7479
293
SG
783
4
59
7138
279
GG127
24
1014
200
8182
4GG
G
437
1777
15
6775
81
12>5
95
1338
195
31!3
317
10026
iii
25
178
86
2836
15
42
631
164
1491!
30
g.
.8 ";<
~""'
~"'
,.,
>"0 .
<".'l
.c <.l
0'"
0'"
0"'
118 ....
2
259 591
995 3212
...........
10 399 159 21(12
42
40
240
. ...
56
689
....
523
347 691
. ...
17 382
28
....
53
173 336 1170
........ . ...
90 59 146
216
....
84
248
95
512
180
761
188
345 . ...
17
""":i
271 1124 1464
........
23 23
38
;".":!:0';
32
t-<
C)
" 203 ~
::c 163
70
"' 999
20 ~
":::";...
GG
a 549 "' 83 O"q
"' 343 "" N
""ii '""C""')'
"' ..78 <-,
43 73 113 176
13 41 20 80
h.l \JO
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
-
Q)
Q)
~ <".>'
tl
.0s <".>'
.cs:
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"'.::;
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>,
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.::;
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.::;
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1"3'
1"3'
PRESCHOOL HYGIENE Admission to medical service .... Admission to nursing service ...
Visits to medical conferences ..
Field and o!fice visits ........ Dental inspections... .......
19
1
254
31
I
410
. ...
SCHOOL HYGIENE
Inspections by physicians or nurses .. Examination by physicians ....
Admission to nursing service ........ Field and o!fice visits ............... Dental inspections....................
31 9
.4..1.6
6
6
8
....
ADULT HYGIENE
Medical examinations ...................
49
MORBIDITY SERVICE
Medical visits..... . . . ........
Nursing visits.. . . . . . . . . .... Admissions to hospitals .....
....... ....
.
64 ...
SANITATION Water supplies approved ........
Privies and septic tanks installed ..........
....
........
Foodhandliug establishments registered ...
....
Dairy farms registered .......................... ....
Milk plants registered .......................
Field visits ................
86
............
LABORATORY SPECIMENS Specimens examined ..........
........
140
329
10
!50
132
989
18
331
1G6
5789
417
27
144
....
. ...
45
. ...
.2.2.1.
!0
42569
5
2128
4
........
........
1265 644
55 70 684
5706 8558 2166
3
. ..1.7
....
. ...
140
44
. ...
. ...
. ...
1766
.... .... 1277 ....
620
66
5440
2610
....
.... ....
10
. ...
. ...
.... 23
6 27
192
292
950 30
....
.36 ........
................
i4i
. ...
115
36
42
7 59900
....
78
"i:i
6 13137
10
863
73127
....
. ...
. ...
6638
....
c:
~
13
3 3 3 7
235 . ...
83
. 492 . ...
4 70
164 603
N
""
-E
c:
13
c;)
"'<::l
~
7 ~-
12
8 tJ
. ..1.5
~
~
1217
30 5 !10
"~'"
";;;',
""
<::l
620
-"\:!
~
35
-.. 48
":"":"'c'"
"' I !< ~ ;:,...
60 676
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
""c0""
=c"0"''
~
ccC"
:C"
E
- c
g
c
~ c~
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3:
c~
c.
c":;'
c'C""'
15
~
c
COMMUNICABLE DISEASE CONTROL
Admission to medical service... . . . . ............. 309
201
66
1
Consultations witl1 physicians ....................
24
11
1
Field visits .................................... 780
373
230
3
Smallpox immunizations. . . . . . . . . . . . . . .......... 906
901
573
403
Diphtheria immunizations ...........
552
974
541
160
Typlwid immunizations ......................... 7629 Whooping cough ........................ ..... 119
2.7.4.5.
3516 139
3259 19
3
1 ....
13
....
2
3
2
7 282 114 966
35
7 422 204 1333
105
5
56
77
641
85
288
974
2409
24
66
12 27 113 50 1
....2
............
VENERAL DISEASE CONTROL
Admission to medical service..................... 230
382
238
51
Clinic visits ............... ............... 1191
2121
774
434
Field visits. . .. .. .. .. . . .. . .. ...
447
260
370
120
Number of clinic treatments ......... : : : : : : ...
1053
1295
724
274
23 36 9 27
313
3510 202
1833
25 174
. ii:i
342 2923
99 1101
.... ...1.1
.... ........
. ...
TUBERCULOSIS CONTROL
Admission to medical service..................... 194
136
77
~ft~~s~~it!~. ~~-r~~~~ ~~~~i.e~."."."::: ..'..'.".' .. .....
279 182
136 120
143 167
Field and office visits ......................
1029
796
407
14
7
26
14
58
"74
42
10
173
66
32
169
48
40
10
206
175
52
595
75
....
MATERNITY SERVICE
Admission to medical service ....................
7
263
210
Admission to nursing service.....................
43
289
295
Visits by ante-partum cases to medical conferences.
3
611
342
Field and office visits . . . . .. . ..........
110
858
634
4 13
4 53
3 12
4 22
. i84
399
50 109
284 257 794 798
":io
57
.... ............
INFANT HYGIENE
Admission to medical service.....................
4
307
106
Admission to nursing service...............
49
333
189
Visits to medical conferences.. . ................ Field and office visits .......................
li7
530 707
173 385
13 21
1
"'i
................
.. ii "iii
106 104 158 170
":i2 io2
................
c~
.... t-<
":ii
<::>
<')
254 ~
::c 213
1703
181 ~
~
;:s...
a 1594
4568
"" 137
3372
O'Q
~
88 79 170
~~
"<::">
"' 252 ""
304 304
884 945
276 276 507 631
l'-'
VI
j
1'0 0\
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
PRESCHOOL HYGIENE Admission to medical service. Admission to nursing service .. Visits to medical conferences .. Field and office visits. Denial inspections..
SCHOOL HYGIENE Inspections by physicians or nurses. Examinations by physicians ... Admission to nursing service. Field and office visits .... Dental inspections..
:"E'
."g'
'E""''
'5
E
C"
:>
0
0
g
'-'
'-'
'-'
'-'
'-'
375
158
20
336
187
46
40
373
323
44
429
459
115
122
168
318
3054
1354
556
207
624
301
33
351
2
59
....
91
4G5
I
1
I
1Gi
1
so
1:
~
~
0
'-'
~
~
'-'
e.
0
Q""""'
12
41
14
16
41
33
i4
8 17
47 52
G8
175
12
247
4R
1
23
8
1
133
10
<=
..0
3'
Q
c~ c;)
...(1)
<::>
107 107
O;"':Q:,..
114 114
t:J
(1)
~ ;::,.
~ S34
3049 (1)
;;:l
-..."" 192
3049 <::>
ADULT HYGIENE Medical examination...
679
240
539
9
357
1G4 :'";1::::1
<:::;--
MORBIDITY SERVICE
~
Medical visits ........
81
10
1
Nursing visits...........
83
24
95
13
1
Admissions to hospitals .. ...............
3
62
7
".~ ....
(1)
!>.
SANITATION
i:;:"
\~rater supplies approved. . . . . . .
2
IS
3
<:J..
Privies and septic tanks installed .........
!53
18
25
2
I
55
6
85
!55
Food-handling establishments registered ..
30
50
70
Dairy farms registered ......................
18
3
Milk plall(S registered ......
2
2
Field visits ...............
1133
46
1653
52
39
111
3S
2968
14
1
2356
l'
LABORATORY SPECIMENS
Specimens examined.
.....
4260
1739
4224
342
lui
999
250
2920
90
4140
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
1
COUNTIEs-1946 (Continued)
~""'
0
C..),
-g
0
>.
c0
.~.c.,
i5
0
00
g" .
c
00
>. 0:::
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;c;::
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U1
iii
-.,
"c:' "E
U1
COMMUNICABLE DISEASE CONTROL
Admission to med.ical service ............
97
Consultations with physicians..... . . . . . . . ...
58
Field visits. . . . . . . . . . . . . . . . . . . . . . . . .........
317
Smallpox immunizations .....................
1294
Diphtheria immunizations ...... .............
582
Typhoid immunizations ...
8400
Whooping cough .......
87
265
10 144 2255 796 39115 382
1
98
1
37
1
274
786
....
187 3536
....
204
"578
207
2 3
8 964 337 3554 70
............ ........ ........
8
12 269 127 2185 44
1 1 1
........ ....
23
8 50 166 335 3029 54
VENERAL DISEASE CONTROL
Admission to medical service ....
405
81
699
1
52
81
Clinic visits ................. ............... 2582
253
7803
3
669
425
Field visits ... Number of clinic
treait~l(mts ......
:
460 2528
257
....
530
213
....
6882
11
3G
40 522
133 304
TUBERCULOSIS CONTROL
Admission to medical service.
Admission to nursing service.
Clinic visits ....
.........
Field and office visits." ." : ... ......
344
128
345
154
344
125
445
364
181
54
456
14
120
....
75
40
293
91
54
1252
35
153
197
93
MATERNITY SERVICE
Admission to medical service..... . . . ........... 288
125
348
2
....
84
Admission to nursing service...................
461
128
375
18
6G
31
108
Visits by ante-partum cases to medical conferences.
R35
Field and office visits .......................... 1050
324
1502
445
....
1766
4:i
144
.. 78
166 256
INFANT HYGIENE
Admission to medical sen~ice.
108
88
81
Admission to nursing service. . . ::::::
411
176
397
Visiis to medical conferences .....
292
258
224
Fiold and office visits ....................
671
362
1145
21
. 28
11 31
....
. ...
19
28
....
72
60
c00
">
U1
101 t-<
" 126 <::>
276 .~.......
197 2445
~
"' 152 ~ ~
71 <:5--
a 269
273
..,_
156
O"Q
~
"~'-
~
47 1
""<:':'>"
"' 130 <.-,
65 73 138 230
43 1QO
38 203
l'-.l --.J
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
"..".
~
~
'""C'"
(5
,..
0
(5
~
"cQ""""
."~ .'.
"Q
CJ
.1..i
0"'
."::"!
E
~""""'"
i":""i'i
05
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PRESCHOOL HYGIENE
Admission to medical service.. . . . . . . . ......
411
Admission to nursing service ..................... 450
Visits to medical conferences. . . ................. 403
Field and office visits ........................... 156
Dental inspections...............................
....
264
56
1157
....
618
63
....
3828
. ...
. ...
. ...
13
....
9
15
........
........
19
........
. ...
. ...
SCHOOL HYGIENE lnspect.ions by physicians or nurses.
..... 4077
668
5684
121
. ...
301
508
Examinations by physicians. . . . . . .....
860
372
....
38
36
40
Admission to nursing service. Field and office visits ......
Dental inspections...........
...... 306
.....
345
....... ....
60
92
. ...
118
129
....
..3..8
24 26
2 3
ADULT HYGIENE Medical examinations........
1443
....
68
. ...
.... .... .... . ... . ...
MORBIDITY SERVICE
Medical visil s . . . . . . . . . . . . . . . . . . . .
5
....
Nursing visits ..............
256
126
. ...
Admissions to hospitals ....... : : : : ...... : : : : : ...
81
....
5
6 . ...
....2 ....
221 ....
. ...
21 . ...
SANITATION
Water supplies approved ..............
Privies and septic tanks installed .......... Food-handling establishments registered...
Dairy farms registered. Milk plants registered ...... :
8 705
....5
....
. ...
2
. ...
23 163 16
2
Field visits .................... :::: ... :::::: ... 1999
24
143
.7
23
38
6 ....
25
18
LABORATORY SPECIMENS Specimens examined ....................
3561
2556
5159
44'
371
2
1021
13
1025
h.l 00
..~""..' (')
"'Cl
4 13
~ :";,'
22 tJ
~
.149
1 30 37
.~..... ~
"':..;.s...
.... -.C..l...
. ...
'i:l
~
.<.:.:.!.-
. ii3i
7
:"":"r:: ~"'
~
13 607
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
COUNTIES-1946 (Continued)
";:'
~"'
!!l "$
~"'
.,
c>. ii:
.=c~..
.:;;:;
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:;; .
0
g a~
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1:
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COMMUNICABLE DISEASE CONTROL
Admission to medical service.........
1
Consultations with physicians........... : : : : .
1
....
Field visits. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...
9
....
Smallpox immunizations................
123
Diphtheria immunizations. . . . . . . . . . . . . . . ....
246
....
Typhoid immunizations .................
1343
Whooping cough ...........................
40
19 4 46 1384 373 8679 205
1 1
... 1
........
3 3 4 18 97 1028 72
65
436 2391 1566 15217 934
............ . ... ........
. ... ........ .. ...... . ...
2856 174 509 923 907 5171 244
. ... . ...
. ...
2 4
VENERAL DISEASE CONTROL Admission to medical service ....... ...........
....
....
398
....
Clinic visits................................. Field visits. . . . . . . . . . . . . . . . . . . . . . . ......... Number of clinic treatments. . . . . . . . ... .....
21 2
....
........
1551 369 1929
............
32 198
6062 15024
........
.. ......
2671 24708
10 115
2450 6939
........
........
821 7420
2 2 3 2
TUBERCULOSIS CONTROL Admission to medical service........
...........
66
Admission to nursing service........
224
Clinic visits ....................................
66
Field and office visits ....................
762
7 7 7 7
646 914 598 2908
................
1920
1
1230
3868
6
3000
5 5
........ ........
507 507 510 688
2 3
MATERNITY SERVICE
Admission to medical service .....................
82
....
Admission to nursing service..................... 136
....
Visits by ante-partum cases to medical conferences.
187
Field and office visits. . . . . . . . . . . . . ............
292
1 32
............
85
....
ioi
518 1017
........
. ... . ...
217 239
........
154
1404 3420
........
. ...
544 427
....
INFANT HYGIENE
Admission to medical service . . . . . . . . . . . . . . .....
61
Admission to nursing service .....................
222
Visits to medical conferences . . . . . . . . . . . . . . . .... 135
Field and office visits . . . . . . . . . . . . . . . . . . . . . . . . . . .
247
... ........
1 66
.... . ...
238
. ...
80
756 1568
........
.... ....
60 500
1500
....
156
134
5569
. ...
1780
1 2
.>, .
::'!
(!)
710 1
t--<
<::>
"' 76S
836 ~
::c 560
5332
"' 161 :::, ~ <::;-
145
1021 C)
192 762
~
:::,
81 88
"~'
~
"<::'>-
206 ~
125
151 379 440
103 211 156 622
~~
\D
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
PRESCHOOL HYGIENE Admission to medical service.. Admission to nursing senrice .. Visits to medical conferences .. Field and office visits .... Dental inspections......
SCHOOL HYGIENE
Inspections by physir.ians or nurses.
]!;xaminations by physicians.
Admission to nursing service.
Field and office visits. Dental inspections..
.
.... .
.
.
.
.
.
.
.
ADULT HYGIENE Medical examinations...
MORBIDITY SERVICE
Medical visits ....
Nursing visits.........
.............
Admissions io 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 ......
c
'
""-
~
'">.
~
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0
ii:
.<::
~
&
.::
:.:=<t
.c s
~
li; .
a
1
a"
a>c=.
c
0
1:
c3
81
342
150
367
150
333
275
753
954
6774
3
132
5
27
5
180
1328
100
11
3
1
2
5
1
14
17
100
76
6
41
47
6053
318
15
2901
1967
2
3969
2942
2
9.5.3..6
247
6301
4266
1481
2956
11052
2692
34
313
256
99
14
1023
456
38
4
11
8141
13
307
12130
354 528 364 825
4734
15J
120
15(i5
7125
1
2619
142 298 22
20
135
10
l
15783
2.1
38818
8
IJO 0
>.
e"C
Cl <:;)
"a " "" 27 0'<:>
52 "~"
48 88 \:)
1521 .157
"""."~~,""."..'
34 ;.",;.;".;.
a
'--1-.
500 'l:i
"" 5 "."<,".'")."..
57 1
J::
"~ ~"
<::l-o
25Q 4047
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
E
""c ~ ' '
<!l
-:;;; .[cc< <!l
"~"""'"'''
J:
"J:
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J":'
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0
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:a
J:
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COMMUNICABLE DISEASE CONTROL Admission to medical service...............
35
1
~ ....
. ...
Consultations with physicians....
1
Field visits ...................................
?
12
15
100
13
2
G
Smallpox immunizations...................
342
784
445
1130
190
G22
GJ
Diphtheria immunizations.
11
248
175
670
109
....
241
32
. ...
Typhoid immunizations. . . . . : :
2714
4841
1890
7148
2564
....
181l
4SG
Whooping cough. . . . . . . . . . . . . . ....
11
G4
148
553
31
....
13
VENEREAL DISEASE CONTROL
Admissiou to medical service....
134
51
96
551
52
102
1
Clinic visits. . . . . ........ Field visits ................ :
1701 19
517
353
2651
4
55
2G8
535
1260
58
50
....
21
54
No. of clinic treatments ...........
1698
419
269
1492
535
871
TUBERCULOSIS CONTROL Admission to medical service ... ....... Admission to nursing service.. Clinic Yisits ................ Field and office visits ..............
333
5G
100
153
22
364
69
78
241
44
1G7
lOG
120
801
251
~
. 49
15
iio
.... ....
MATERNITY SERVICE
Admission to medical service .........
191
20
Admission Lo nursing service .....................
134
47
Visits by ante-partum cases La medical conferences.
325
124
Field and office visits ...............
225
140
6
82
323
20
114
33G
11
149
G78
60
271
857
205
21G
17
800
OG2
37
INFANT HYGIENE
Admission to medical servire ......
36
51
3
73
150
Admission to nursing service.. . . .............
179
75
32
18G
283
Visits to medical conferences ................
47
116
3
12G
218
Firld and office vir::its . . . . . . . . . . .
301
152
165
567
484
so
2
147
141
2
413
!G ....
32
c
ic:'
J":'
:~=I:
. ...
i2
14 483
. ... at-<
::c ....
........
!<:'>> "-
13
"" . ... !:> ;~ :s..
G3 1095
a
5 833
"' ....
~
;!;:s>
4 6 G 29
.... ....
. ...
~-
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";a;s'
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37
20 95
---
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
COUNTIES-1946 (Continued)
E
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PRESCHOOL HYGIENE
AAddmmiissssiioonn ttoo mnuerdsiicnagl sseerrvviiccee... . . ....... ....
5 280
57 63
Visits to medical conferences......... .......
6
116
Field and office visits .... Dental inspections ...........
.....
..4.0.0
..1.5.1
39
!01
....
25
76 92
91 206
........
2
116
276 . ...
191 . ...
....
....1
.... ... ii
2
. ...
5
. ...
....
59 . ...
SCHOOL HYGIENE
Inspections by physicians or nurses. Examinations by physicians....... Admission to nursing service ...... ........ Field and office visits Dental inspections...... : : : : : : : : : .
132
141
135
....
!0
....
58
10
69
!0
....
. ...
748
708
665
120
....
660
....
2
. ...
59
!04
4
. ...
8
64 12
.1.8.5.
. ...
. .2.8.
4
. ...
12
ADULT HYGIENE Medical examinations... .......
48
....
43
. ...
....
. ...
. ...
MORBIDITY SERVICE Medical visits...................
Nursing visits............. Admissions to hospitals ...........
....
83 9
24
95 ....
2 195 . ...
....
19
16
. ...
. j;jg
SANITATION Water supplies approved ............. Privies and septic tanks installed ........ Food-handling establishments registered. Dairy farms registered ........ Milk plants registered .............. Field visits . . . . . . . . . . . . . . . . .
....
3 21
1 7
. ...
6
....
1
1
....
267
749
.... 1
2
7
17
26
....
20
12
86
LABORATORY SPECIMENS Specimens examined.
615
488
742
3087
299
....
615
222
18
698
'JO
N
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53 39
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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~
COMMUNICABLE DISEASE CONTROL
Admissimdo m~dical service.....................
1
1
1
27
175
5
6
3
37
Consultatwns w1th physiCians. . . . . . . . . . . . . . . . . . . .
1
1
1
....
5
4
1
2
Field visits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
13
1
45
26
67
48
G
58
Smallpox immunizations........ . . . . . . . . . . . . . .
....
166
894
575
932
3
1!6
562
502
Diphtheria immunizations.....................
134
270
294
315
89
157
87
236
Typhoid immunizations .............. ,_......
3085
2225
....
2791
2074
39<1
2055
2086
1581
Whooping cough...........................
186
379
....
....
121
57
75
17
<10
VENEREAL DISEASE CONTROL Adm1sswn to medwal serywe.... . . . . . . . . . . . . . . . . . Clinic visits..................... . . . . . . . . . . . . Field visits.. . . . . . . . . . . . . . . . . . . . . . . . . . . Number of clinic treatments..... . . . . . . . . . . . . . . .
16
139
....
149.
81
16
31
90
.9 8
332
1335
....
1020
1265
<17
296
1072
88
18
180
....
1!0
104
3<1
26
127
11
l!G
1288
....
85<1
857
47
269
700
75
TUBERCULOSIS CONTRO.L
Admlsswn to medwal servwc...... . . . . . . . . . . .
Admission to nursing service.
........
....
Clinic Yisits....... . . . .. . . . . . . . . .. .
Field and office visits.........
.............
.
69
54
....
63
138
....
.9 1
75
37
71
69
....
63
118
13
50
108
38
69
54
. . ..
26
177
.. . .
8
61
38
38
168
169
25<1
130
!29
205
49
MATERNITY SERVICE
Admission to medical service............ ...... . . .
Admission to nursing service........... . . . .. . . . . . . . . . Visits by ante-partum cases to medical conferences.. Field and office visits...........................
22
34
....
446
237
39
125
75
32
25
105
....
HG
237
80
125
89
36
35
114
....
1569
859
59
4<17
221
50
39
256
.. . .
1580
890
144
479
279
91
INFANT HYGIENE
Admission to medical service.............. . . . . .
14
33
....
211
107
6
M
10
17
Admissio' to nursing service...
......
....
14
128
....
211
126
53
161
79
20
Visits medical conferences........... . . . . . .. .
55
102
.. . .
584
241
6
115
10
17
Field and office visits.. .. .. .. .. . . . . . .. .
108
207
637
267
106
280
99
34
!
g
~
106 t-<
26 0 111 <""> 301 ~ 771 ~ 4211 ...._ 284 ~
:::
187 3818 C) 109 ..,. 3818 ~
~-
187 :;:,
187 it.
453 o 5<17 ~
199 199
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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-
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.......
'-\
...,
-
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....I
PRESCHOOL HYGIENE
Admission to medical service...... . . . . . . .
....
4
3
....
33
20
40
19
Admission to nursing service..........
..... ....
4
18
....
33
6
13
1!2
11
19
Visits to medical conferences.........
..... ....
4
6
....
98
24
....
76
....
19
Field and office visits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
27
....
135
6
37
183
12
21
Dental inspections............. . . . . . . . . . . . . . . . . . . . . .
....
....
....
....
....
....
16
....
....
SCHOOL HYGIENE
lnspegtio~s by physici~~s or nurses . . . . . . . . . .
....
!38
!054
....
1184
560
....
1066
785
281
Exa"?-u~atwns by J?hystma!'s . .
.....
....
....
....
....
....
....
.. .
489
785
8
Admtsston to nursmg service............ . . . . . . . . . . . . .
....
....
!6
0
46
....
39
Field and office visits . . . . . . . . . . . . . . . . . . . . . . . . . .
....
....
....
35
25
2
303
....
54
Dental inspections... . . . . . . . . . . . . . . . . . . .
....
....
....
....
....
....
....
523
....
300
ADULT HYGIE:NE. MediCal exammatwns.... . . . . . . . . . . . .
9
3
23
....
99
40
....
198
16
53
MORB.IDITY. SERVICE
MediCal VlSlts.... . . . . . . . . . . . . . . . . . . . . . . . . .
....
....
Nursing visits...............................
....
21
55
Admissions to hospitals...
...........
....
....
....
10
6
1
54
....
2
78
18
126
1
....
....
31
4
4
~~~
IVatersupplies approved. . . . . . . .
....
....
1
....
....
Privies and septic tanks installed........ . . . . . . . . .
13
3
25
....
40
. .. .
....
19
5
Food-handling establishments registered. . . . . . . . . . .
....
....
....
....
....
....
....
....
Dairy farmsregistered. . . . . . . . . . . . . . . . . . . . . . . . . .
....
....
....
....
....
....
Milk plantsregistered. . . . . . . . . . . . . . . . . . . .
....
....
Field visits........ . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
53
8
30
....
1098
1
....
186
26
LABORATORY SPECIMENS
Rpecimens examined. . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
243
691
....
1870
3370
398
861
2234
783
IJJ ~
~
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114 IJI:,
114 ~
1 239
tJ
.... ~
~ 965 ~ 302 ~ 30 ,. 262 ~
. . . . ..c......
'i:i 1754 <:::
~
. ... . ....
"::C' :
.... ~
~
20 ;:s... 92 4 3 2 528
2066
CONDENSED REPORT OF ACTIVI'I"lES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
..""..'.'
COMMUNICABLE DISEASE CONTROL
Admission to medical service ............ ... Consultations witlt physicians ..............
........
Field visits ................................. Smallpox immunizations . .....................
.. 83
Diphtheria immunizations. . ................ 130
Typhoid immunizations . . . ......... Whooping cough ..................
..
....................
874. 18
VENEREAL DISEASE CONTROL
Admission to medical service.............
129
Clinic visits............................ ...... 618
Field visits ...................
98
Number of clinic treatments ...... :: ::: ... :::: ... 527
TUBERCULOSIS CONTROL
Admission to medical service. . . . . . ..............
Admission to nursing service.. . .......
6
Clinic visits.... . . . . . . . . . . . . . ...
.....
Field and office visits ............
.....
53
MATERNITY SERVICE
Admission to medical service . ..
238
Admission to nursing service..
.
241
Visits by antepartum cases to medical conferences.
647
Field and office visits ........
749
INFANT HYGIENE
Aamission Admission
to to
medical nursing
service service .
... ..
.. .
.
.
.
.
.
.
.
.
.....
149 163
Visits to medical conferences ...
279
Field and office visits .......
401
.i.,
c 0
8
::i
::i
42
5
1
1
139 237 142 1605 88
....5 ............
247 1230 451 605
................
77 109 92 34.2
................
147 168 382 468
............ ....
128
174 281
........ ....
395
.""s''
",:".''
..0...
46
220
4{
147
313
77
2544
24
479
891
3967
2
184
35
845
476
1288
110
70
374
1215
4.4
260
66
298
43
7
164
728
2
471
56
511
2
1440
309
592
231
52
251
364
64
398
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1 310 . ... . ...
15 161 50 1303 11
1
........4
........
126 38 215 153 1059
75
1 199 93 1181
6
....................
. ... .. i9 . ...
................
325 505 108 262
62 975 122
768
................
.. :ii
1 56
. . . .
............
56 74 50 115
34 55 35 230
................
.. 45
91
........ .. ......
46
..59
162 164
255 271
79 170
............
52
..66
7
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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PRESCHOOL HYGIENE
Admission to medical service.. . . . . . . . ..........
75
Admission to nursing service....... .......
79
Visits to medical conferences ......
104
Field and office visits ...........
.........
233
Dental Inspections ..................
SCHOOL HYGIENE
Inspections by physicians or nurses. . .......
61
Examinations by physicians..
45
Admission to nursing service. . ......... ....
Field and office visits . . . . . . . . . . . . . . . . . . . . .
51
Dental inspections.......... ....
ADULT HYGIENE Medical examinations.
....
MORBIDITY SERVICE
Medical visits...................
....
Nursing visit.s ............... Admissions to hospitals ......
..... .....
..... .....
397
SANITATION
\Vater supplies approved. .
. .........
Privies and septic tanks installed ..........
Food-handling establislunents registered ...
Dairy farms registered . . . . . . . . . . . . . . . . . : :
Milk plants registered........ . . . . . . .........
Field visits. . . . . . . . . . . . . . . . .....
LABORATORY SPECIMENS Specimens examined .............
.... ....
4 1131
108 123 259 337
1
592 66 70 188 757
163
4 69 5
1
34
2151
....
67
82
....
81
150
517 177 403 686
....
1126
145 4523
1
4
1
i5
10
22
675
568S
. ...
80
5
136
. .
......
8
....
417
594
i
69
2
348
3
. ...
1
. ...
17
3 30
6
59
268
9
80
. ...
51
416 . ...
1
13
9
34
5
27
59
25
701
328
3
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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COMMUNICABLE DISEASE CONTROL
Admission to medical service..................
1
....
11
Consultations with physicians... . . . . . . . . . . . . . ...
8
Field visits. . . . . . . . . . . . . . . . . . . . . . . . . . . .....
49
........
. i7i
Smallpox immunizations ....................
675
....
1592
Diphtheria immunizations. . . . . ...
245
....
530
Typhoid immunizations. . . . . . . . . . . . . . . .
. ... 2108
Whooping cough .............................
18
....
3670 287
47
4
io
245
. ... . 736
........ .... . ...
4
120 1194
. ...
.. "4
248
61
62
182
892
283
775 16
2433 29
1999 76
. ..
2549
1164
396
161
VENEREAL DISEASE CONTROL
Admission to medical service..........
214
Clinic visits ........... ; ....... Ji'ield visits ...................... .' ." ."
.
.........
2523 138
Number of clinic treatments ......
1850
............ ....
129 1916 583 1355
62 759 48 398
38 532 95 540
81 902
........
2180 26153
146 1734
. ...
30 784
. .
......
1185 19910
101 1573
TUBERCULOSIS CONTROL
Admission to medical service ..... Admission to nursing service ...
......
35
... i
17
28
27
108
Clinic visits..................
2
... i
33
28
Field and office visits ............ :::::::::
83
251
172
10
..25
. ... ....
256 996
81 78
13
37
43
....
1329
71
....
1323
127 23G
. i4
MATERNITY SERVICE
Admission to medical service. . . . . . .......
202
Admission to nursing service..................... 250
Visits by ante-partum cases to medical confer-ences.
431
Field and office visits ........................... 701
.... ............
295 228 415 70<[
1
40
132 . ...
SSG
55
48
78
158
. ...
1019
144
1
58
289
. ...
1931
131
91
113
345
. ...
3685
319
INFANT HYGIENE
Admission to medical service....
125
Admission to nursing service.. . . . . .. :::. :::::: 191
Visits to medical conferences..............
202
Field and office visits ........................
280
........ ........
173 158
is
89
406
29
12 80 14
97 145 150
............
705 1722 2151
47
127
400
. ...
<[869
52
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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PRESCHOOL HYGIENE
Admission to medical service.
Admission to nursing service. Visits to medical conferences ..
Field and office visits . . . . . .
Dental inspections.........
110 209
10 13
....
4
136
10
.2.6.9.
....
....3
....
....
6 . ...
SCHOOL HYGIENE
Inspection by physicians or nurses. .. .......... 484
Examinations by physicians . .......
. .,.
Admission to nursing service ........
.....
28
Field and office visits . . . . . . . . . . . .
43
Dental inspections....
...........
............ ........
1695 194
........
1
77 ....
........
144
17 20
23
514
48
. ...
3019
23
....
2152
95
.. ......
6. 8.9..1
138
. ...
5482
3
.... ....
1 595
3
. ...
1128
1265
25
....
30
....
327
....
2
3
....
ADULT HYGIENE Medical examinations ..
....
53
....
....
. ...
MORBIDITY SERVICE
Medical visits.........
1
Nursing visits . ..............
224
Admissions to hospitals . . . . . . . . . : : : : : .....
1
.... ....
5 . ...
1 1
83 ....
...7.4
713
1
427
21
SANITATION Water supplie' approved. . . . . . . . . . ..... Privies and septic tanks installed ......... Food-handling establishments registered ... Dairy farms registered ..... Milk plants registered .... Field visits ............
....
4
.2.9.0.
....
....
14
1292
2 11
........
....
63
2
9
........ ....
287 427
2 19
8 16
65
2
25
15 31602
23
28
LABORATORY SPECIMENS Specimens examined . ..................
761
....
1347
317
410
298
.... 30014
442
11
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
::"";:;;' ""-'
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COMMUNICABLE DISEASE CONTROL
Admission to medical service..................... ....
Consultations with physicians.................
....
Field visits .................................... ....
Smallpox immunizations. . . . . . . . . . . . ........... ....
Diphtheria immunizations. . . . . . . . . . . ........... ....
Typhoid immunizations ....................... Whooping Cough ...... .........................
....
....
6
46
. .. 8
152 21 1190
5
....6 ........ . ...
184 1170 950 4972
371
4 1 13 419 117 1455 44
1
5 . ...
1
6
4 718
66 781
....4
115
353
. ...
.3.8..5
1605 100
. ...
........ ................ . ...
i
''':i
205 46 1569 32
VENEREAL DISEASE CONTROL Admission to medical service. . . . . . . . . . . ......... Clinic visits..........................
........
Field visits .................................
NUli!ber of clinic treatments .......... ....
169 728 149 540
................
18 260 178 226
64 280 60 143
. ...
..3..1
114 163 150 123
................
.... ............
5 8
...1.1
TUBERCULOSIS CONTROL
...9 Admission to medic.al service.....................
Admission to nursing service.....................
Clinic visits........................ . g
Field and office visits ...........................
24
....
51 20 94
....
.... ....
35 60 36 161
33 58 69 147
84 67 84 164
57 63 56 215
................
7
..
.
7 .
8 lO
MATERNITY SERVICE Admission to medical service....................
....
Admission to nursing service....................
Visits by ante-partum cases to medical conferences. ....
Field and office visits ...........................
103 117 291
. ... ........
305
....
36 43 90 221
111 134 262
320
.... ....
2
"'2
235 1016
.... ........
. ...
. ...
19 289 88 124
INFANT HYGIENE
Admission to medical service .................... ....
22
Admission to nursing service.... Visits to medical conferences.....
......
....
40 30
Field and office visits ........................... ....
60
13
2
1
29
79
1
14
3
1
129
158
1
241
........
.. ......
16 197
1
609
.. ......
23 1287
...."l.
0
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163
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306
"";~ :s...
189
4057 127
.a...
3535
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91 69 232
.~... ";c;;":
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267 269 425 731
193 204 342 409
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PRESCHOOL HYGIENE
Admission to medical service ...
Admission to nmsing service.. .
Visits i.o medical conferences ... Field and office visits ..........
....
Dental inspections............
17
....
51
21
....
3
G
14G
5
33
....
50
47
....
17
G
50G
5
....
. ...
SCHOOL HYGIENE Inspections by physicians or nurses. Examinations by physicians . . .
Admission to nursing service.
Field and office visits ... Dental inspections ...... .....
....
380
223
. ...
49G
. ...
241
.... ........
231
1
G
1
12
218
1
29
1
374
.... . ...
. ...
ADULT HYGIENE Medical examinations.... .....
. ...
. ...
47
57
....
MORBIDITY SERVICE Medical visits ............
Nursing visits............. Admissions to hospitals ...
...
2
78
G
4
105
....
5
SANITATION
Water supplies approved ........
....
1
Privies and septic tanks installed ......... Food.handling establishments registered ..
Dairy farms registered ............
.....
1G ....
........
1
....
22
Milk plants registered ..................... Fit>ld visits ...................
. i7
55
18
55
227
2 ....
10
3
34
. .
......
38
........
5
G 1G
9 3
3
3G3
LABORATORY SPECIMENS
Specimens examined ..
.......... . ...
G55
11G7
1429
227
242G
. ...
485
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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COMMUNICABLE DISEASE CONTROL Admission to medical service.....................
...
Consultations with physiciaus.................... Field visits ....................................
47a
Smallpox imwunizations ........................
883
Diphtheria immunizations ....................... 874
Typhoid immunizations. . . . . . . . . . . ............. 9477
Whooping cough. . . . . . . . . . .
. . . . . . . . . . . . . 330
....
....
........ ............ ........
48 5
11 1174 522 3828 166
........ .... ........ ........
11
s
.... . ...
21 7
........
153
29
. ...
20
1185
833
218
134G
970
349
. ...
342
154
4542 331
3949 1G2
........
2208 334
1471 23
VENEREAL DISEASE CONTROL Admission to medical service ..................... Clinic visits................................... Field visits .................................... Number of clinic treatmeuts ....................
6263 17316
246 8538
................
.... ....
.... ....
219 2204 132 1702
............ . ...
108 12M
15 594
.. ......
2G6 983
39 132
159 202
196 60
.. ......
44 740
1 78
TUBERCULOSIS CONTROL
Admission to medical service ..................... 1774 Admission to nursing service ..................... 1412
........
.... ....
Clinic visits ................................... 4538 Field and office visits ........................... 3105
....
.... ....
9 153 154
504
. ... ....
208 307 833 1409
113 139 181
272
............ . ...
159 189 141 319
2 13 2 33
MATERNITY SERVICE
Admission to medical service..................... 1014 Admission to nursing service ..................... 1047 Visits by ante-partum cases to medical conferences .. 5803 !field and office visits ........................... 2315
............ ....
........
.... . ...
181
267 444
.. ...... . ...
649
. ...
217
245 768
4
54 4
. ...
.
.
......
613 638 1819
1 18 2
877
175
. ...
1930
30
INFANT HYGIENE
Admission to medical service ..................
711
Admission to nursing service ...................
1427
Visits to medical conferences..................... 1800
Field and office visits ........................... 5075
.... ........ ....
.... ....
........
103 154 245 271
............ . ...
124
. ...
320
312 202 1248
31 142
... .........
395 1029 1010
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PRESCHOOL HYGIENE
Admission to medical service.......... .. . .. .. .. 418
.. . .
.. ..
17
.. ..
127
10
.. ..
231
.. ..
Admission to nursing service...... . . . . . . . . . . . .
730
. .. .
37
....
265
72
....
122
. .. .
Visits to medical conferences.. . . . . . . . . . . . . . . . . . 824
....
18
....
260
10
....
397
....
Field and office visits.. . .. .. . .. .. .. .. .. .. .. . .. . 1866
37
.
2329
53
.. ..
346
.. ..
Dental inspections..... . . . . . . . . . . . . . . . . . .
....
....
....
....
....
....
....
....
....
SCHOOL HYGIENE
Inspections by physicians or nurses.. .. .. .. .. ..
7945
.. ..
44
.. ..
6066
3965
.. ..
42
12
Examinations by physicians.. .. .. .. .. . .. .. .. .. .. 712
.. ..
2
.. ..
655
3
.. ..
ll28
.. ..
Admission to nursing service.................
317
....
. .. .
3
.. ..
10
129
. .. .
. .. .
Field and office visits.. .. .. .. . .. .. . .. .. .. ..
406
.. ..
.. ..
12
.. ..
106
90
.. ..
11
.. ..
Dental inspections............ . . . . . .. .. . . .. .
. .. .
....
.. ..
....
. .. .
. .. .
64
.. ..
....
. .. .
ADULT HYGI~NE_
MediCal exammatwns. .. .. .. .. .. .. .. .. .. .. .. .. .. 12979
. 1..
. .. .
.
MORBIDITY SERVICE
Medical visits........................... .. .. . .. ..
.. ..
.. ..
Nursing visits.......... . .. .. .. . .. .. .. .. 255
.. ..
.. ..
80
.. ..
2
.. ..
2
.. ..
551
.. ..
.. ..
19
.. ..
48
341
.. ..
577
.. ..
2
11
1
Admissions to hospitals.. . .. .. ... .. . .. .. .. .. .. .. . .. ..
.. ..
.. ..
3
.. ..
3
6
.. ..
.. ..
..
~~~
Water supplies approved................. . .. .. ..
99
6
.. ..
6
1
. .. .
.. ..
Privies and septictanks installed. . . . . . . . . . . . . .. .. 235
3
20
15
.. . .
57
88
.. ..
85
28
Food-handling establishments registered........... 758
....
....
35
....
43
21
....
25
Dairy farms registered. . . . . . . . . . . . . . . . . . . . . .
99
. .. .
. .. .
. .. .
.. . .
18
1
. . ..
5
Milk plants registered.......... . . . . . . . . . . . . . . . . .
1
. .. .
. .. .
4
.. . .
5
Field visits................... .. .. .. . .. .. .. . 19950
1
53
1022
37
1151
810
6
1977
68
LABORATORY SPECIMENS
Specimens examined.................... . .. .. . 103119
.. ..
21
2371
.. ..
7105
1055
.. ..
3622
232
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTlES-1946 (Continued)
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COMMUNICABLE DISEASE CONTROL
Admission to medical service...............
....
6
....
9
7
3
56
22
Consultations with. physicians...........
....
Field visits ............................ Smallpox immunizations ...... ..................
........
Diphtheria immunizations . ................... Typhoid immunizations ......................... Whooping cough ...............................
........ ....
11
. 229 2.4.1..2
. . 28
140 112 1047 16
10
198
981
823
273
552
2359
5777
37
165
...8
32
....
65
. ...
8 195
762
565
883
68
76
796
3715 51
2193 47
. ...
9007 230
VENEREAL DISEASE CONTROL
Admission to medical service... .. Clinic visits ..................
Field visits .................. , .. ::::::::
............
No. of clinic treatments ...................
....
48 1913
26 1772
15
206
324
273
2890
2140
40
47
178
168
2769
1573
189
135 . ...
583
542 72 542
320 2
117
........
4747
. ...
787 3510
TUBERCULOS.IS CONTROL
Admission to medical service .................... Admission to nursing service. . . . . . . . . . . . . . . . . . . . Clinic visits ....................................
....
........
Field and office visits ........................... ....
19 25 20
56 64
1 18
4 93 101
4 66 177
71 87 69
. ...
. ...
48 152. 507
62
135
101
191
295
228
....
822
MATERNITY SERVICE
Admission to medical service..................... Admission to nursing service . ....................
.... ....
12
Visits by ante-partum cases to medical conferences .. Field and office visits ...........................
....
....
. . 39
321
431
40
386
435
62
1!82
1331
230
1449
1367
231 231
63 73
. ... . ...
. ...
. ...
279 326
807
172
....
895
848
192
1225
INFANT HYGIENE Admission to medical service .... ................. Admission to nursing service .. ................... Visits to medical conferences.. . . . ............... Field and office visits ...........................
.... ............
...8 . .28
35 101 81
134
274
134
383
534
991
600
!397
96 113 103 187
41 41 83
98
. ... . ...
........ ........
167 333 262 761
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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PRESCHOOL HYGIENE
Admission to medical service... . ..........
Admission to nursing service...... .....
Visits to medical conferences...... .....
Field and office visits ....... Dental inspections..........
....
SCHOOL HYGIENE Inspections by physicians or nurses. Examinations by physicians ...... Admission to nursing service ......... Field and office visits ....... Dental inspections................
.............. .......
....
ADULT HYGIENE 1v1edical examinations..... ........
MORBIDITY SERVICE Medical visits.......... Nursing visits......... Admissions to hospitals.
. .
. .
.
. .
. . .
. . .
. . .
.
..
. . .
. .
. .
. .
. .
. .
..
. .
.
.
.
SANITATION
v-.rater supplies approved ........
Privies and septic tanks installed .......
Food-handling establishments regiRtered ......
Dairy farms registered .............
Milk plants registered ........
....
Field visits ............
LABORATORY SPECIMENS Specimens examined .........
~
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35
34
....
12
.
3 ...
....6
657
....
. ...
2
. ...
21
3
7 2
1
....
....
27
....
. ...
87
....
....
147
439
1464
~
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g 121
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314 4453
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12 22
75 119
........
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91 69
33
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. .
......
.1.6.1.
387
19 16
36 36 36 36
....
........
............
6600
692 91 399
48
. ...
....
. ... ....
447
9
7
33
. ... ....
2 214
....
5
....
53
g
3
270
11
123
8 994
5
44
........
45 2 14G9
2283
1085
6
3543
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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COMMUNICABLE DISEASE CONTROL Admission to medical service... . Consultations with physicians .. . Field visits ............ . Smallpox immunizations .. . Diphtheria immunizations. Typhoid immunizations ........... . Whooping cough ........... .
VENEREAL DISEASE CONTROL Admission to medical service ..... . Clinic visits ................ . Fielrl visits .................. . Number of clinic treatments .. .
TUBERCULOSIS CONTROL Admission to medical service.. Admission to nursing service .. . Clinic visits................. . Field and office visits ........ .
MATERNITY SERVICE Admission to medical service ............ . Admission to nursing service ................... . Visits by antepartum cases to medical conferences. Field and office visits . . . . . . . . . . .
INFANT HYGIENE Admission to medical service .. . Admission to nursing service.. . Visits to medical conferences .. . Field and office visits .......... .
37
8
70 ....
5
97
89 97
1
5 32
29 46 395
160
12 .... 595 ....
5 12
. 22i
330
292
11 2791
16
24 199
1
589 4455 243
506 37G1 306
............
252 3763 214
337 3092
90
126
159
342
....
151
88 ....
2007
402
4275
....
99.5
753
52 1086
2
68 334
:i755
.... ....
339 263
154 260
....
62 232
73
107
22
190
114
92 92 75
............
103 106 93
109 37
2 2
381
27
547
375
....
481
514
33 39
210 278
191 ....
365
191 ....
469
43 53
52 62
434 600
389 430
....
1024 1481
77 153
7 7 7
4
117 289 255
163 163
........
315 453
402
....
1168
17 23 27
14
705
479
1833
70
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
PRESCHOOL HYGIENE Admission to medical service. Admission to nursing service . .. Visits to medical conferences ... .... Field and office visits .... Dental iiL'ipections.. ..............
SCHOOL HYGIENE Inspections by physicians or nurses. Examinations by physicians . .... Admission to nursing service. ... Field and office visits .. ....... Dental inspections. ...
ADULT HYGIENE Medical examinations.
MORBIDITY SERVICE Medical visits ... Nursing visitf! . .............. Admissions tO: hospitals .....
SANITATION Water supplies approved Privies and septic tanks installed........ Food-handling establishments registered. Dairy farms registered ... Milk plants registered ... Field \~sits .. : . .......
LABORATORY SPECIMENS Specimens ex~mined ..
c
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6
122
243 ...
264
12
6
179
243
135
21
7
142
368
109
34
....
9
. 2..1.4
416
.1.1..0
63
567
3S8
1344
3042
50
320
22
54
68
82
4
97
128
39
343
194 2399
181
4
30
12
20
1373
829
85
5
43
3
58
1
2
2
4845
....
...2.4
. . ili
38
2 6 . ...
67 280
35
6
2
18
118
616
12o
16454
7
26
1529
83
1690
11937
3
2773
898
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47
CONDENSED REPORT OF ACTIVITIES OF lOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
:~c
~
COMMUNICABLE DISEASE CONTROL Admissions to medical service.................... Consultations with physicians....................
Field visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Smallpox Immunizations ........................ Diphtheria Immunizations....................... Typhoid Immunizations.........................
Whooping cough; ..............................
VENEREAL DISEASE CONTROL
Admissions to medical service...................
Clinic visits...................................
Field visits Number of
...................... c!inic treatments .......
..............
,......' ......
TUBERCULOSIS CONTROL Admissions to medical service.................... Admission to nursing service..................... Clinic visits...................................
Field and office visits ... , . . . . . . . . . . . . . . . . . .
MATERNITY SERVICE Admission to medical service..................... Admission to nursing service..................... Visits by ante-partum cases to medical conferences ..
Field and office visits . . . . . . . . . . . . . . . . . . . . . . . . . . .
INFANT HYGIENE Adm:ssion to medical service~ .......... Admission to nursing service.... . . . . ..
Visits to medical conferences............ Field and dfice visits .....
...
;;
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~
~
:""i!''i 3:
c g
.. ;cg '
3: ~
7
6
16
6
1
12
16
1
22
20
340
280
772
20
60
192
545
50
1930
1772
3149
16
101
124
279
89
79
181
262
161
834
1866
1488
9
!50
92
73
93
1426
618
187
59
53
188
87
59
210
1348
63
51
183
122
185
399
41
97
206
60
104
294
115
225
497
176
358
880
32
48
188
69
81
316
49
113
426
145
161
730
48
Georgia Depctrtment of Pttblic Health
CONDENSED REPORT OF ACTIVITIES OF lOCAL HEALTH DEPARTMENTS BY COUNTIES-1946 (Continued)
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PRESCHOOL HYGIENE
Admission to medical service.... .
9
22
77
Admissions to nursing service ................. .
10
26
103
Visits to medical conferences.................... .
2
17
54
115
Field and office visits. . . . . ........... .
21
47
224
Dental Inspections .....
SCHOOL HYGIENE
Inspections by physicians or nurses ............. .
255
76
41
342
Examinations by physicians ....
3
15
1
Admissions to nursing service.
53
10
Field and office visits . . . . . . . . . . . . . . . . . . . . . . .
61
38
Dental Inspections.....
. .......... .
2
ADULT HYGIENE Medical examinations..
75
70
MORBIDITY SERVICE Ivledical visits..... . ........... . Nursing visits........ .
Admissions to hospitals.
I
379
2,1
4
1
SANITATION Water supplies approved ....... . Privies and septic tanks installed ........ . Food-hand1ing establishments registered .. Dairy farms registered ............ . Milk plants registered .... . Field visits ....... .
20
21
2
23
53
29
LABORATORY SPECIMENS Specimens examined .....
14
720
546
785
2183
Local Health Orgcmizations
49
COMPARATIVE STATISTICAL SUMMARY OF TOTAL loCAL PUBLIC HEALTH
WORK IN GEORGIA, 1945-1946
COMMUNICABLE DISEASE CONTROL Admissions fo medical service.... Admissions to nursing service ............... Admissions to medical and/or nursing service. Consultations with physicians ..
Field visits: Diphtheria............................ Typhoid fever and paratyphoid fever. Scarlet fever. Smallpox .. Measles ......... Whooping cough. Malaria ..... Hookworm .. Typhus .................... Other communicahle diseases.
Total field visits for communicable disease con trol. ...
Persons treated for hookworms ...
Admissions to hospitals: Diphtheria........................ Typhoid fever and paratyphoid fever. Scarlet fever. Smallpox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other communicable disease patients admitted to hospitals.... ............
Total admissions to hospitals for communicable disease control. ..
Immunizations (persons immunized): Smallpox ................... Diphtheria-under 1 year ...... Diphtheria-l through 4 years. Diphtheria-5 years and over.
Total diphtheria immunizations .. Rchick tests given .... Typhoid fever .................... Whooping cougb-under 1 year ... " 7hooping cough-over 1 year.
Total whooping cough immunizations.
Public lectures and talks ..
Attendance . . . Persons tested
.. in
.s.u.r.veY~::
.
VENEREAL DISEASE CONTROL
Admission to medical service.... . . . . . . . . . . . .
Admissions to nursing service. . . . . . . .. . . . . . .
Tota] admissions to medical and/or nursinA: serv-
ice............................. .
Cases transferred to private physieians.
Clinir visits Iby patients).
Field visits (to patients) ...
Number of clinir treatments:
.' .. DOfifsimceisvseisditfsro-Rmaspeirdvitcree.a. t~~~t ~~~t~;
Public lectures Attendance.
and
talks. ......
.
.
.
.
.
.
Organized Counties
1945
1946
6,154 R,411 9,526 1,227
2,219 509
3,175 25
287 1,035
74 1,827
600 3.283
13,034
2,117
156 5
36
144
341
54,571 13,300 16,574 11,831
41,705 12,790 222,701 8,112 4,918
13,060 115
2.745 10,974
41,194 30,737
43,476 1,679 411,986 42,096 320,284 16,487 2,798
59 4,755
7,863 8,413 9,698 1,119
1,015 285
1,464 32
1,355 602 86
2,692 200
2,345
10,074
3,389
53 27 16
304
400
53,150 11,274 6,566 9, 709
27' 549 8,362 238,047 8, 790 4,418
13,208 216
3,252 63,517
40,728 31,359
51,950 3,374 327,592 32,411 185,355 15,996 5,657
119 6,245
All Counties
1945
1946
7,318 10,050 11 '227
l ,313
2,477 720
3,460 33
311 1,048
74 3,695
636 3,441
18,57a
3,478
8,621 9,693 11,018 1,196
1,144 352
1,542 35
1,401 617
1,105 3,982
207 2,660
12,945
4,393
158
57
6
28
38
16
2
1
152
412
356
514
70,826 17,307 21,902 13,800
53,009 14,558 311,669 11,067
5,909
16,976 143
4,108 13,809
68,133 13,554
1u5,,5m54
40,579 9,247
322,273 10,743 5,220
15,963 372
5.123 65,154
47,447 37,414
50,174 1,899 494,856 49,400 391,282 18,917 3,q52
66 7,347
52,573 34,601
55,194 3,563 358,581 35,143 208,109 16,639 6,759
121 6,274
50
Georgia Dep(trtment of Pttblic Hectlth
COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC HEALTH
WORK IN GEORGIA, 1945-1946-Continued
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/or
nursing service . ........................... . Positive cases ............................... .
Suspicious cases ............................. . Contacts .................................. .. Physical examinations in clinics . .............. . X-ray examinations......................... . . Clinic visits (by patients) ................... .. Visits to Etate clinics (by patients) ............ Visits to private physicians (by patients) ....... . Visits to private physicians (health officer or
nurse) ................................... . Visits to others (health officer or nurse) ........ . Field visits . ................................ . Visits to cases of tuberculosis ................. . Visits to tuberculosis suspects.. ............... .
Visits to contacts........................... .. Office visits................................. . Office visits of eases of tuberculosis . . . . . . . . . . . . . Office visits of tuberculosis suspects ........... . Office visits of contacts ........... ....... . Admissions to sanatoria ....... ......... . Number tuberculin tests completed ..... . Number positive . ................ . Number negative (completed tests) ............ . Contacts broken . ........................... . Contacts partly broken ................ . Relief secured for tuberculosis cases...... ...... . Cottages, sleeping porches, ete. (Number built)
Public lectures and talks .................... .. Attendance ................................. .
MATERNITY SERVICE Cases admitted to prenatal medical service ..... Cases admitted to prenatal nursing service ...... . Cases admitted to medical and/or nursing service. Vis its by prenatal cases to medical conferences . . . Visits by prenatal cases to private physicians .... .
Field visits to prenatal eases .................. . Office nursing visits by prenatal cases . ......... . Cases attended by nurses for delivery service .... . Cases given postpartum medical examination . .. . Cases given postpartum examination by private
physicians . ............................... . Cases admitted to postpartum nursing service . . Visits to postpartum cases .......... . Permanent Health Centers ......... . Number of sessions . ................. . Itinerant health centers .............. . Sessions held ..... ........................... . Midwives registered for formal instruction ...... .
Midwife meetings ........................... . Attendance at meetings......... . . Visits for midwife supervision. . . . . ... Public lectures and talks. . . . . . . .. Attendance................... . Enro11ment in maternity classes .. Attendance................ . ............ .
Organized Countios
1945
1946
12,267 2,419 3,229 6,619 17,861 3,312 4,216 10,R06
19,557 3,510 4,944
11,103 5,450
27,624 27,161
4,557 560
689 802 39,072 10,870 7,234 20,968 20,584 6,472 5,629 8,483 498 14,242 !,370 9,872 1,051 177 228
5 279 23,423
14,459 17,811 18,298 45,121
467 19,3!9 39,827
26 2,885
161 16,118 35.922
157 !,978
5 15 1,121 582 5,513 2,758 192 2,412 74! 2,100
11,269 2,201 3,175 5,890 14,368 2,892 3,406 8,070
16,993 3,570 4,286 9,137 3,745 25,352 25,572 2,575 627
1,197 1,035 34,25>1 9,919 6,274 18,061 19,523 7,0!>1 5,035 7,444
603 17,481 4,547 12,934 1,165
99 316
17 45 3,652
15,486 19,015 19,920 48,148
828 17,898 40,125
9 2,748
136 16 '787 32,8!5
132 3,358
1 4 973 608 4,994 2,266 122 1,313 525 1,230
All Countios
1945
1946
1>!,383 2,675 3,516 8,162 21,884 3,921 5,176 12,787
2!,241 4,186 5,978 14,077 5,450 30,611 30,071 7,427
677
837 1,015 44,896 12,526 8,229 24,1>!1 23,612 7.045 6,528 10,039
580 17,220
5,18! 12,036
1,151 191 251 6 286
24,148
17,130 21,753 22,325 52,133
611 21.,!10 !8, 783
39 3,272
180 17, 74! 38,532
20,! 6,06!
5 15 1,617 1,031 7,549 3, 789 203 2, 700 744 2,100
12,718 2,409 3,,!66 6,843 17,452 3,459 4,122 9,871
20,158 4,160 5.007 10,991 3,7>18
27,176 27,274 4,181
735
1,361 1,212 38,290 11,147 6,997 20,1>!6 21,775 7,515 5,703 8,557
707 19,741 4,972 1>!,769 1,324
105 335
22 50 4,381
17,687 22,627 23,546 53,324
925 20,060 48,292
,!9 3,115
166 18,138 35,147
154 5,056
1 4 1,312 900 6,572 2,976 138 1,444 525 1,230
Local Health Organizations
51
COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC HEALTH WORK IN GEORGIA, 1945-1946-Continued
INFANT AND PRESCHOOL HYGIENE
Infants:
Individuals admitted to medical service .........
Individuals admitted to nursing service ......... Individuals admit.ted to medical and/or nursing
service .... ................................ Permanent health centers..... .................
INt iunmebr aenr tohf esaelstshiocnesn.t.e.rs. ................ .................... .. .. .. .. ..
Sessions held .................................
Visits to medical conferences (by patients) .......
Visits to private phys,icions (by patients) ........
Field visits .......................... Office nursing visits. ................
Consultations with parents ..........
Preschool: Individuals admitted to medico! service ......... Individuals admitted to nursing service ......... Individuals admitted to medical and/or nursing
service .... ................................
IPNteiunrmmebraaennratonhfteshaeelstashlitohcnescn.et.en.rtse.r..s.................................................................
Sessions held . ................................ Visits to medical conferences (by patients) ....... Visits to private physicians (by patioots) ........ Field visits .................................. Office nursing visits (by patients). ............ Inspections by dentists or dental hygienists...... Prophylaxis by dentists or dental hygienists ..... Consultations with parents . ...................
Public lectures and talks ............. Attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enrollment in infant and preschool classes. Attendance . . . . . . . . . . . . . . . . . . . . . . . . .
SCHOOL HYGIENE InspPctions by physicians or nurses . ...... Examinations by physicians ........ ............ Examinations by physicians with parents present. Tndivicluals admitted to nursing service . ........ Field visits . ............................. Office visits.................................. Inspections by dentists or dental hygienists...... Prophylaxis by dentists or dental hygienists .....
Public lectures and talks .......... : ....... Attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . . Classroom health talks ......... Attendance .................
ADULT HYGIENE Medical Examinations:
Milk-handlers............. 0 ther food-handlers ....... Midwives ..... Teachers . . . . . . . . . . . . . . . . . . . . . . . . . . . Other adult medica! examinations . ...
Total adult medical examinations.
MORBIDITY SERVICE
Admissions to medical service ....... .........
Admissions to nursing service . ..
Admissions to medical and/or nursing service ..
Clinic visits (by patients) ...................
Field medical visits ...
............
Field nursing visits . ..
..............
Office Total
nursing visits admissions to
.h..os.p.i.t.a.ls... ...................
Total patient-days of hospital service ...........
Organited Counties
1945
1946
10,081 26,971
27,315 201
6,327 51 113
25,341 241
49,800 31,955 37,859
10,920 23,,133
24,301 179
5,364 150 219
21,2,15 260
34,537 2'1,539
810 47
27.087 406
5, 760
261,H7 43,263
3,540 17,839 24,002 19,315 30,217 3,947
'13,1 13,759
2,191 77,361
860 ,16,205
387 7,17 21.190
69,389
13,,170 '1,704 16,989 14,,148
930 9,188 4, 769 9,,189 59,H4,J
9,944 27,248
27,793 258
5,663 37 98
23,313 262
44,396 27,525 33,582
10,490 21,882
23,082 216
'1,593 124 214
17.641 10<1
29,237 21,543
602 588 26,100 ,125 4,542 ,12 42
255,183 50,1,16
3,227 15,871 21,659 16,296 50,322
2,570 512
2'1.478 2,692
101,276
1,0,17 5<1,823
331 1,879 20,986
79,066
15,883 6,372 20,497 26,266 1,354 9,178 5,370 10,425 65,056
All Counties
,945
1946
11,044 29,896
30,271 2,!1
7,259 51 113
27,443 284
53,848 34,605 40,733
11,528 25,063
25,940 214
6,099 152 221
22,350 287
36,015 26,355
810 56
28,729 ,109
5,850
275,285 43,941
3,593 18,390 2'1, 719 20,525 32,297
4,250 466
15,098 2,786
84,377
10,914 29,748
30,341 268
6,307 37 98
25,234 298
47,388 29,846 35,590
10,963 23,223
24,426 220
5,068 125 221
18,352 138
30,595 22,688
602 588 26,959 426 4,573
60 125
268,611 50,815 3,358 17,276 22,023 16,841 52,107 2, 747 575 28,123 2,856 109,197
860 46,284
396 747 21,213
69,500
13,572 5,771 18,056 14,596
957 11,261 8,252 9,528 59,890
1,093 55,15,1
351 1,879 21,124
79,601
15,971 7,3,15 21,573 26,415 1,367 11,196 8,808 10,474 65,,198
52
Georgict Department of Pttblic Health
COMPARATIVE STATISTICAL SUMMARY OF ToTAL LOCAL PUBLIC HEALTH WORK IN GEORGIA, 1945-1946-Cominued
MORBIDITY SERVICE-Continued Individuals admitted to dental service ...... . Refractions................ . Tonsil and adenoid operations. Other defects corrected.....
CANCER CONTROL
Admissions to medical service..... .
Admissions to nursing service ................. .
Admissions to medical and/or nursing service ... .
Office visits................................. .
Field visits ................... .
ACapsp~lsi.carteicoenivshf1ogr
State aid ..... . diagnostic service
at
S"t.;t~~id
Ca~1~~1crse.c~i~il;g. t~~at~~~-t. s~~~i~e at .st;t~-~id
clinics......... .
CRIPPLE CHILDREN SERVICE
Individuals reported ......................... .
Individuals examined at diagnostic clinics ...... .
Individuals treated .................. .
Individuals admit-ted to nursing service.
Visits to diagnostic clinics (by patients) .
Nursing visits..........
. ......... .
Public lectures and talks.
Attendance ...
OTHER ACTIVITIES Conferences with physicians or dentists ..... .
Personal conferences with others. Newspaper articles ......... . Bulletins distributed....... . Circular letters........ . Miles traveled on duty .. Days off duty................ . Conferences with official groups ........... . Attendance... . . . . . . . . . . . ........... .
Public lectures and talks. Attendance................................. . Home Hygiene and Red Cross Classes (Sessions).
Attendance ...... .
GENERAL SANITATION
Water: Approved individual water supplies installed..
Individual water supplies improved... . Public water supplies improved ...... . Conuect.ion to p!tblic water :mpplies .. Sewage: New privies installed ............. . Wood privies installed at homes... . Concrete pdvies installed at homes ............ . Wood privies installer! at schools .............. . Concrete privies installed at schools ........... . Wood privies installed at other public places .... . Concrete privies installed at other public places ..
Privies repaired (or improved) ... . New septic tanks installed.................... . Septic tanks installed at homes............. . Septic tanks installed at schools ............... . Septic tanks installed at other public places..... . Septic tanks improved ......... . Connections to public sewer ................ . Sewerage systems or plants improved ..... .
Field visits: Private premises .... .
Camp sites ......... . Swimming pools. . . . . . . . . . . . . . . . . . ......... . Barber shops and beauty parlors. Schools..................................... . Public water supplies (plants and systems) ..... . Sewerage plants ............................. . Other field visits for general sanitation ......... .
Total field visits for general sanitation ......... .
Organized Counties
1945
1946
2,325 715 537
1,494
4,780
633 764 3,456
421
430
239
234
539
508
986
928
820
509
329
275
740
725
602
571
598
598
555
(2.8m32 4 112
767 931 675 981 1,019 2,284
14,080 126,110
1,803 140,209 82,312 2,211,799
2,804)1! 1,315 14,812
395 15,546
193 3,425
14,972 147,865
5,995 111,208
67,107
1'987' 666 3,514 1, 754 19,472
776 32,486
1, 734 5,613
704 895 87 4,473
1,055 391 524 26 41 16 57
1,891 1,605 1,500
14 91 597 1,838 745
125,513 493 390 272
1,681 353
1,613 87' 902
218,217
644 1,179
160 7,484
1,475 760 472 29 54 15 145
2,068 3,605 3,442
12 151 619 3,691 220
146,493 713 471 174
2,191 489 986
52,741
204,258
All Counties
1945
1946
2,599 717
566 1,501
4,901
662 773 3,475
435 311 612 1,070 914 386
750
615
449 321 595 1,043 656 343
735
578
702 676 604 l,OfJO
1,027 2,949
5 122
865 961 685 1,186 1,055 2,651
18,830
18,820
146,445 158,526
1,951
6,223
153,033 125,192
94,297
73,601
2,861,797 2,545,291
3,624H 4,203H
1,677
2,090
16,313
22,074
644
1,072
23,826
42,710
230
1,736
3,877
6,453
722 1,192
120 4,756
1,281 449 656 30 52 34 60
2,038 1,849 1, 713
18 118 629 2,048 745
126,460 510 403 272
1,873 674
1,685 87,957
220,014
697 1,489
236 7,729
1,721 872 575 35 56 38 145
2,206 4,114 3,861
20 233 642 3,794 221
148,092 947 485 175
2,527 839
1,072 52,848
206,985
Local Health Org<tnizrttions
53
COMPARATIVE STATISTICAL SUMMARY OF ToTAL loCAL PUBLIC HEALTH
WORK IN GEORGIA, 1945-1946-Continued
GENERAL SANITATION-Continued Insect controll: Buildings mosquito-proofed ............ Minor drainagelinear feet completed ... Linear feet ditch cleared................ Anopheles breeding places eliminated .... Acres drained ..................... Anopheles breeding places controlled.
Miscellaneous:
Public lectures Attendance ...
and ....
talks .... .........
.
.
.
. . . ......
Posters, charts. exhibit models completed..
Sanitation or malaria ma~s completed ....
Rodent control: Premises surveyed for rodent control. .... Buildings rat-proofed ......... Buildings improved ...... Premises improved .............
Pounds of poison bait distributed.
PROTECTION OF FOOD AND MILK
Foodhandling establishments registered for super-
vision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Field visits to food-handling establishments .....
Dairy farms registered for supervision.
Field visits to dairy farms ..............
Milk plants registered for supervision ...
Field visits to milk plants ............
Cows tuberculin tested..............
Animals slaughtered under inspection .....
Carcasses condemned in whole or in part.
Public lectures and talks.
Attendance ..
Organized Counties
1945
1946
All Counties
1945
1946
418 260,325 592,384
569 89972 4,599
56 2,810
83 3
16,180 624
1,147 8,156 26,879
8,673 265,941 971,037
245 79,234)-i
716
418
8,673
260,325 270,942
658,469 1,071,238
569
215
89972 79,234)-i
4,632
720
44 2,893
52 5
67 1,095
96
76 4,551
63 7
27,400 5,235
995 27,145 36,88172
16,290 624
1,147 8,314 26,99872
28,115 5,235 1,325
27,342
39.38672
7,883 79,560 1,207 11 ,131
103 3,503 ll,004 198,483 18,440
204 7,423
7,427
70,613 1,361
13,486 95
3,919 1,556 239,890 21,384
407 9,018
7,883 79,563
1,207 11,150
103 3,511 Jl ,004
198,483 18,440 204 7,423
7,427 70,688 1,361 13,591
95 3,932
4,556 239,890
21,384
407 9,018
Organized Counties
All Counties
1945
1946
1945
1946
Pos. Neg. Pos. Neg. Pos. Neg. Pos. Neg.
LABORATORY
Specimens examined:
Water-bacteriological.
787
water-chemical ......
Milk or milk products.
856
Other foods ............
12
Typhoid: blood cultures.
33
Typhoid: Widal ........
19
Typhoid: stool cultures....
118
Typhoid: urine cultures ...
32
Diphtheria cultures...
614
Syphilis-serological. .
57,394
Sypbilis-darkiield . . . . . . .
17~
Undulent fever (human).
84
Bangs disease (animal)
5
);yphus !ever ......
435
Iularemm........ ............
21
Malaria ......... ...........
63
Gonorrhea . . . . . . .
12,458
Tuberculosis . . . . . . .
1, 759
Feces for parasites Urinalysis . . . . . . .
.....
3,069 3,206
Rabies .........
292
Pneumococcus typing ...
2
Dysentery.........
38
Other laboratory specimens ex-
examined ...
936
4,592 371
10.678 36 424
1,901
7 '765 2,130 7,889 182,882
586 1, 775
65 1,535
149 4,428 71,330 11,652 8,066 39,679
252 17
636
10,915
986 31 917 10
j.j
25
87 34 2J1 54,024
278 84 157 246 19 liS 10,387 1, 723 4,790 3,677
272
3 37
4, 732 376
15.918 122 270
1,819 7,525 2,685 4,585 207,145
599 1,608
778 1.496
113 2,831 55,733
11 '783 11,228 37,265
599 92 644
I, 738 19,969
960
856 12 37 23 142 34 646
62,404 255 91 7 47<1 23 63
12,738 1,921 4,850 3,932 294 2 38
5,801 371
10,678 38 471
1,912
8,217 2,200 8,148 198,437
880 1,810
67 1,599
183 7,094 72,562
13,581 10,305 44,138
255 19
667
1.002 11,433
1,171 33 917 10 19 25 98 34 272
56,800 294 96 158 259 19 126
10,593 1,857 7,601
'1,031 273 3 38
5,674 376
15,918 122 305
1,826 8,109 2,808
4,787 219,061
673 1,641
783 2,067
139 3,455 56,646 13,423 13,122
41,889 612 92 735
2,019 20,144
Total laboratory specimens ex-
amined .......
.. 82,403 369,756 79,898 389,915 90,804 400,929 86,746 414,407
Division of Public Health Nursing
MRS. ABBIE R. WEAVER, R.N.; B. A.; M. A. ____________________________________ Director MISS THEODORA A. FLOYD, R.N.; B. A.; M. A. ___________________ Acting Director MISS ELSIE CROSBY, R. N.; B. A._______________________________________ /lswciate Ditector MRs. BESSIE F. SWAN, R.N.; B. S. ED.; M. S. P. H. ___________jlssocirtte Director
Division of Public Health Nursing
Censtts of Nttrses
There have been many changes in nursing personnel throughout the State in 1946. The annual census of public health nurses mken on January 1, 1946 shows a total of 329 public health and industrial nurses. The motility of public health nurses in Georgia is shown by the results of a study of personnel action records for the first six months of 1946, in the appointment of seventy-six nurses to a11 types of public health nursing positions, and the resignation of seventy nurses during this same period of time. It is regretted that, because of lack of secretarial assistance, the study is not complete for the entire year.
Vctcancies
At the end of the year there were approximately 125 vacancies in public health nursing positions in Georgia. These included a11 types of positions as Associate Director, Regional Consultant, Supervising, Scaff and Clinic Nurses.
Mrs. Abbie R. Weaver, Director of the Public Health Nursing Division, has been on sick leave and leave of absence due to iUness throughout the entire year. Miss Elsie Crosby, former Associate Director of the Public Health Nursing Division, transferred to the Division of Local Health Organizations August 1, 1946.
I. TRAINING OF PERSONNEL
The number of nurses entering Peabody Co11ege for theoretical training in public health nursing was as foHows:
Spring quarter, 3; Summer quarter, 2; Fa11 quarter, 11 (4 on G.L Scholarships). University of North Carolina, Fa11 quarter, 2 ( 1 on G.L Scholarships). Medical CoHege of Virginia, FaH quarter, 9 (a11 Negro nurses already employed).
A total of five nurses received nursing training in premature care. One of the Supervisory Nurses at Piedmont Hospital received a four and onehalf months' course in obstetrics at Margaret Hague Maternity Hospital. Eight senior cadet nurses were accepted for supervised practice in Public Health Nursing. Eight were assigned to FultOn County.
Conferences with Regional Consultant Nurses were held twice in the year with a special conference on orthopedic nursing substituted for one of the regular nursing conferences. One of the regional nursing consultant meetings was held at Battey State Hospital. Doctor Payne outlined che new admission poliCies of the Hospital and arranged for a tour of the Hospital where the modern facilities for the care of 3,000 tuberculosis cases is possible when adequate personnel is available.
58
Georgia Department of Pttblic Health
II. EDUCATIONAL AND FIELD ACTIVITIES; MEETINGS
Eclttcrttionrtl rtncl Field Activities
The major emphasis during 1946 has. been the recruitment of smdents of public health nursing as well as nurses already prepared to enter the public health nursing field. Personal letters were written to nurses who had made inquiries in regard to details of our training program as a result of the announcements made in Public Health Nursing Magazine, American Journal of Nursing, American Journal of Public Health and other professional periodicals. The two associate directors of Public Health Nursing Division made six trips for the purpose of recruitment. These were to hospimls in Macon, Augusta and Savannah; Army Post Hospital, Fort Bragg, Nonh Carolina and Lawson General Hospital, Atlanta; and to public he:tlth nursing departments of Peabody College, Vanderbilt and University of North Carolina.
The 130 nurses who took State Board Examinations in Georgia in the spring were interviewed and given material regarding opportunities for training in public health nursing, as well as available positions in public health nursing in Georgia. Articles were published in the Fifth District Nurses' Bulletin, which has a circulation of about 800 and in the Georgia Srate Nurses' Bulletin, which has a circulation of 5,000. These articles showed the need for public health nurses in Georgia. Pamphlets, "A Career in Public Health Nursing in Georgia", were sent to 1,297 schools of nursing in the United States.
The latest effort on recruitment of nurses for training was to publicize in a simple but pictorial.manner the opportunities for scholarships to prepare nurses for the public health field or for responsible places on hospital staffs as head nurses, supervisors or instructors in special clinical fields as maternicy, pediatrics and tuberculosis. This bulletin was sent to 6,000 nurses registered in Georgia; to approximately 1,000 non-resident nurses registered in Georgia; to the thirty-one approved courses in public healch nursing in the United States; and to all accredited schools of nursing in Georgia. Since this accivity was staned the last few days of the year it is not possible to know the results.
The Acting Direcwr has spent a considerable amount of time in working with the Maternal and Child Health Division on a proposed plan for supervised experience in premature care at Crawford Long Hospital. Since 1942, when we started a program of education in premature care for public health nurses, there has been a definite need for a hospital in Georgia in which nurses, both institutional and public health, could secure this training. The only places where such training could be secured were in Boston, New York City and Chicago. With the high birth rate and the high infant death rate, pirtly due to prematurity, there should be such a place for training in the South. Superintendem of Nurses at the Crawford Long Hospital has been interested for sometime in such a program as a part of their newly created pediatric division. Crawford Long has the largest obstetrical case load of any hospital in the City of Atlanta, and usually has a total of from thineen to
Pre-s chool Child Greets Public H e"ltb Nurse
60
Geurgict Department of Pttblic Her:tlth
nineteen prematmes. There is a whole floor of the new maternity wing of Crawford Long Hospital which has not been opened yet because of the lack of nurses; it could be made into a modern premamre sration with a minimum of architectural changes. If this program can be developed it will be in demand for training of nurses in other Southern States also.
The Acring Director has also worked with the Richmond and Muscogee County Health Departments in an effort to help them become qualified to be field training centers where public health nmsing students might secure the supervised practice following their theoretical study of public health nursing.
The Division has worked closely with the consultant nurses in the Maternal and Child Health Division in the assembling of lists of teaching materials, which should be allocated to the four or five health departments in which we hope to develop field training centers. These materials include teaching aids in relation to obstetrics and pediatrics and child development.
Considerable thought and time has been given the integration of the social and health aspects of nursing in the basic nurse's course. Toward this end, work has been done with Emory University School of Nursing. Firstyear student nurses met at the State Health Department with the nursing personnel and there were also meetings with senior nurses at Emory Hospital for discussing opportunities, functions and organization in public health nursing.
The Associate Director conferred with the Educational Supervisor of the State Board of Nurses Examiners for two purposes:
1. To clarify the policy of giving guidance to schools of nursing.
2. To get the Board's philosophy and ideas with reference to working
with schools of nursing.
The Board believes it necessary for each school of nursing to employ ar ]east one public health nurse for. the purpose of devoting full time to the integration of the social and health aspects of nursing in the basic course. .Also pointed om was the necessity for a revision of the "Curriculum Guide for Schools of Nursing", which places major emphasis upon the social rather than the biological sciences.
The Associate Director served as State Chairman of Public Health Nurse
Week which was observed throughout the United States from April 7 to 13.
Local chairmen were appointed in the large City-County Services in each .region. Practically all counties having a p-L1blic health nursing service, ob.served Public Health Nmse Week. Open house was held in a number of Public Health Centers. Publicity channels and tools widely used included the radio, press, exhibits and posters. An article on Public Health Nurse ""~.'Veek was written and published in the March issue of the Journal of the J\Iedical Association of Georgia and reprinted in Georgia's Health.
The Associate Director's contribution, as a member of the Georgia State Nurses' Association, to the Legislative Committee will probably have far-
Pttblic Health Nttrsing
61
reaching effects, parcicularly if the bill in relation to the education and practice of practical nurses is passed during the current legislative session.
Meetings
The following meetings were attended by members of the Public Healrh Nursing Division:
1. Meetings of the Legislative Committee of rhe Georgia State Nurses' .Association.
2. The Health Education Work Shop at the .Atlanta University.
3. The Biennial Convention of the three Narional Nurses' .Associations in .Atlantic Ciry.
4. The Annual Meeting of the American Public Healrh Association.
5. Annual Meeting of the Georgia State Nurses' Association.
6. Meeting of the Collegiate Council on Public Health Nursing, which is composed of directors of public health nursing courses in rhirty-one universities in the United Stares.
7. Field Meeting of the Collegiate Council on Public Health Nursing and the Council of the State Directors of Public Health Nursing.
8. Meeting of rhe Council of the State Directors of Public Health Nursing.
9. Meeting of the Board of Directors of the National Organization of Public Health Nurses.
10. Field Meeting of the Board of Directors of the American Nurses' Association.
11. The National League of Nursing Education and the National Organization of Public Health Nursing.
III. COMMITTEE PARTICIPATION
The members of the Nursing Division worked wirh the following Nanonal and State Committees or Boards of Directors:
1. Member of the Legislative Committee of the Georgia State Nurses' Association.
2. Chairman of the State Committee for Public Health Nursing Week.
3. Member of the Atlanta Registry Committee.
4. Member of the Program Committee of the Georgia League of Nursing Education.
5. Member of the Narional Committee on Community Nursing Services-A joint committee of the National League of Nursing Education and National Organization of Public Health Nursing.
6. Member of the Education Committee of the National Organization of Public Health Nursing.
62
Georgia Depctrtment of Pttbtic Health
7. Member of the Board of Directors of the Georgia League of Nursing Education.
8. Member of the Regional Study Group appointed by the National Organization of Public Health Nursing to help set up standards for qualifications of public health nurses for 1945-1950.
9. Member of the Board of Directors of the National Organization of Public Health Nursing.
IV. SUMMARY OF FIELD VISITS Regional offices ________________________________ 12 Health departments________________________ ) 7
Hospitals ----------------------------------------14 Miscellaneous meetings __________________ 15 Committee meetings ________________________ 16
Talks ----------------------------------------------2 0
V. PLANS FOR DEVELOPMENTS IN 1947
1. Give systematic planned assistance to local supervising nurses and regional consultant nurses. This includes the preparation of a manual for use of supervisors.
2. Help set up additional field training centers for public health nursing students. It is hoped that fields can be set up for this purpose in Richmond, :Muscogee, Brooks-Colquitt and Whitfield Counties. Fulton County has for entirely too long a time carried the entire burden of the training program in the State. There is need for the services of an additional nurse in Public Health Nursing Division to devote full time to this development.
3. Sponsor as board member of State League of Nursing Education two workshops for institutional and public he~lth nurses on the following topics:
a. Implementation course on methods of integration of social and health aspects of nursing in Basic Nursing Course.
b. Advanced course on maternity and infant care in hospital and public health.
4. Through careful selection of potentially capable nurses and providing the best possible training and graduated experience, attempt to build soundly for the future leadership in public health nursing in Georgia.
5. Help develop teaching programs in Battey Tuberculosis Hospital and Alto Medical Center so that these facilities may be used to provide an affiliation in these respective clinical fields for student nurses.
6. Provide nursing leadership in relation to the Hospital Licensure Law so that safe and acceptable standards of nursing care will be set up and suggested guides and techniques be supplied hospitals whose nursing techniques are questionable. A hospital consultant nurse is essential to the achievement of this objective.
Pttblic Health Nttrsing
63
7. Investigate possibilities of establishing a premamre trammg center at Grady Hospital for colored nurses. At present there is no place to send our colored nurses for this special training.
8. Continue consultation to Emory University School of Nursing and Macon Hospital School of Nursing particularly in relation to the integration of the social and health aspects of nursing in nursing course.
9. Develop closer working relationships with the different divisions of the State Department of Public Health.
10. Improved consultative service to the specialized consultant nurses in the various divisions of the State Health Department.
11. Continue vigorous recruitment for qualified public health nurses as well as trainees who are eligible for becoming public health nurses.
Division of Public Health Engineering
L. M. CLARKSON ____________________________________________________________________________________ Director
Division of Public Health Engineering
WATER SUPPLY AND SEWERAGE
Safe and adequate water and sewerage services are vital and fundamental local governmental undertakings by means of which modern communities exist. In matters of water supply and sewerage no community exists within itself but is related closely through natural flow of streams with other areas. The streams of the state are at the same time sources of water and drainage v:ays carrying the final waste products of human and industrial life. The boundary lines of the state do not limit geogmphkally the collective relationships since the effects of one town upon another cross smte lines through interstate streams. The local mayor and council, through operating department heads, manage the publicly owned services within each community. Smte public health control of water supply and sewerage deals with the local communities both as individual units and as parts of larger areas from which they receive and contribute environmental effects. The public health supervision of community water supply and sewerage facilities by the Georgia Deparrmem of Public Health is effectuated through a coordinated control system of engineering and laboratory servkes within the state and cooperative procedures with adjacent states.
OBJECTIVE OF PUBLIC HEALTH CONTROL PROGRAM
The complex situation necessitates a state wide program of public health engineering which has for its objective the protection of all components of the population and commerce within the state while maintaining mmually satisfactory conditions in sections contiguous with other states. The program operates on a plan of providing to each community every possible technical and advisory servke in assisting it to carry out its own specific governmental responsibilities and to the state as a whole the administrative funcrions inherent in maintaining an area-wide environment of satisfactory sanitation in these essential matters. The procedures involved in the multiphased program are founded on scientific principles and practices of public health engineering interpreted and adapted to the humanistic situations and relations of population and industrial groupings operating and growing within a democracy. The entire plan in almost every part recognizes the forces and coumerforces affecting a desirable condition for the present and future. The forces of greatest beneficial effect are obvious in the results attained in technkally informed and vigilant communities. The adverse operative counterforces are too frequently rooted and obscured in collective apathy and reluctancy to physical change and adjustment to indkated measures for adequate protection to human life. The beneficial forces are given every pract~~~t, support that a central public health engineering agency
can provide while die' adverse ones are attacked continually by every known
method of effective democratk governmental suasion.
The sanitary control of water supply and sewerage services in Georgia from an administrative standpoint functions within the framework of the
68
Georgie& Department of Pttblic Health
public health agencies as presently organized in this state. The control is centralized to the extem necessary to provide continuity and cohesion. It is decentralized in its application to the non-urbanized areas of the state so that it reaches the premises of the individual citizen through the various public health agencies in Georgia.
KNOWLEDGE OF LOCAL PROBLEMS NECESSARY
The program as it applies to providing advisory and technical service to local governmental units throughour the state operates on composite knowledge of current conditions gained primarily from field engineering investigations and laboratory analyses. The physical and operational features of communal warer and sewage facilities are kept under scrutiny. The <:ngineering investigations and laboratory results are evaluated and correlated in reaching decisions for making specific recommendations to rhe responsible officials of cities and industrial communities. Local officials are not relieved of their responsibility by the services from the central public health agency. The service supplements their efforts by providing practical technical assistance in helping them accomplish the objectives sought in undertaking to provide public water and sewage facilities. The problem of supplying safe water and adequate se.wage disposal for a city or industrial installation is not a simple one. On the contrary, it is a highly involved problem in many respects and its solution requires managerial and technical ability of the highest order. The necessity for a higher degree of ability to carry local governmental responsibility is increasing as Georgia's organized communities expand and grow in concentration of dwellings and commercial establishments.
MANY COMMUNITIES HAVE GOOD PROTECTION
Many communities have attained security through proper physical facilities and organization to manage and maintain water and sewage services. The cities and industrial communities in this group recognize their problems. They have well developed plans of operation and are able to function as would any well administered business. There is managerial and technical ability commensurate with the problem. The citizens within such groupings live under a high public health factor of safety. Mutual benefits between such communities and the central public health engineering agency flow ?.utomatically. There are few, if any, barriers of apathy and reluctancy to change as safety indicates.
SOME COMMUNITIES ARE APATHETIC
Other communities do not accept and apply the procedures developed for their protection. They have chosen the way of isolation from the tested means of security and walk alone in disregard of local responsibility or their relation to the sanitary common weal of the region. To this group the central public health engineering agency devotes its major energies to overcome resulting deficiencies that characterize their water and sewage facilities. The
Pttblic He<tlth Engineering
69
annual increment of progress in the group is relatively small but nevertheless substantial. The lagging group will continue to receive intensive and repeated attention in the attempt to effectuate a condition of uniform safety and wrality of service through energizing local officials to appreciation of potential dangers and initiation of accion to accomplish necessary changes. It is a strange yet factual condition of the collective mind of too many municipal and induscrial officials to be lulled into complacency and reliance on good fortune in failing to follow the practical recommendations which are made repeatedly for applying even the simplest safeguards to their public water supplies. It seems to be a 1ixed quality of certain types of minds to react only to stimuli of a spectacular nature and because no outbreak of water borne disease has occurred, to defer actions umil cragedy overcakes them. The hope for better protection in this class of communities lies in the in1iltration of some spark of interest and an awakening by the citizens which will bring response to the constant flow of documentary evidence of danger 1iled in their cicy halls or spare coats hung in the bedroom closet.
EVIDENCES OF CURRENT PROGRESS
Turning to the larger and brighter picture, there is voluminous evidence of progress for the future in the great number of communities that are making plans (accual construction blue prints and specifications, not mere vague or wishful "planning"), and 1inancial arrangements for accomplishing desires and needs of long standing. Because of the shortage of material and labor for present construction projects it is necessarily an era of blue print makings and 1inancial arranging. This report lists the future projects for which such fi<~al plans and specifications have been reviewed and approved by the Georgia Department of Public Health during 1946. The reservoir of such plans for future construction will continue to be enlarged until there is a favorable change in the general consuuction situation.
The reservoir of' future projects includes new or improved facilities for many cypes of water supply and sewerage installations adequate to meet the peculiar needs of each community. Water purification and sewage treatment of the most efficient nature with laboratories for control of processes will be provided. Extension of water and sewerage services to presently entirely unserved or inadequately served areas is receiving maximum emphasis in the program.
SPECIAL FIELD ENGINEERING AND LABORATORY STUDIES
Concurrent with the specific planning of municipal projects and closely related to it are the special technical field and laboratory studies which are being conducted to secure basic data on qualicy of drinking water in certain communities and pollution in several of the major streams of the state. The studies are of varied nature in the bio-chemical and biological field adjusted to meet che present requirements and those anticipated by the accelerated industrialization of Georgia. The water available from the major streams frequently is the determining factor in selection of industrial plant sites. Pre-
70
Georgia Department of Pttblic Health
industrialization smdies of stream conditions have been pushed ahead of normal schedule during 1946 to establish base lines for future use in preserving sections of streams for multipurpose usage and especially public water supply utilization. Investigatory smdies on sections of the Chattahoochee River of most likely new utilization for public water purposes and the entire Ocmulgee-Oconee-Altamaha system of streams have been made during 1946. The studies are not complete nor final but nevertheless provide a working pattern for stream usage and quality conservation.
CONSULTATION SERVICE IS PROVIDED
An extensive service of professional consultation to municipal and industrial officials in approaching and solving local water and sewage problems is provided. The consultations are preceded frequently by appropriate field and laboratory studies to develop feasible solutions within local ability tO finance the indicated process or system. Reports are furnished and interpretative conferences held with local governing bodies during which definite courses of action can be adopted and decisions reached involving the expenditure of large amounts of public funds. Engineering and laboratory farilities are employed in a large variety of ways in meeting the simplest or most complex technical water or sewage problem of immediate interest to limited localities or extensive areas of the state. Increasing complexities of situations have necessitated the expansion of the engineering laboratory both in nature and volume of work performed. The engineering laboratory equipment has been supplemented by some of the most modern apparams available to facilitate these expanded services.
PERSONNEL TRAINING
A system of training local personnel charged with the responsibility of operating water purification and sewage treatment processes long has been a part of the general program of the Georgia Department of Public Health. This consists of on-the-job instruction throughout the year within the local installations by engineers from the central public health engineering agency. This on-the-spot training is augmented by an annual intensive course of instruction in Atlanta at the Georgia Water and Sewage School. The fifteenth annual Water and Sewage School conducted jointly by the Georgia School of Technology, the Georgia Water and Sewage Association and the Georgia Department of Public Health in September 1946 was attended by two hundred eighty municipal, industrial and institutional supervising and operating representatives engaged in water and sewage service.
COOPERATION WITH FEDERAL AND OTHER AGENCIES
Cooperation and assistance have been given to various federal agencies whenever appropriate requests were made or federally controlled projects required public health engineering attention to protect civilian personnel or rhe public interests. These agencies include the War Assets Administrarion, Federal Works Agency, Civilian Production Administration, United States
Pttblic Health Engineering
71
Army Engineers, Department of the Interior, Department of Justice, Federal Security Agency and the Reconstruction Finance Corporation. Dara in considerable amounts are compiled annually for federal and other national statistical agencies for publication and distribution. The frequency of requests from individuals and commercial concerns for special assembling and tabulation of data is increasing as the basic importance of public water supply and sewerage grows in recognition in the economy and welfare of the state and nation.
RESEARCH INVESTIGATION OF DENTAL EFFECT OF
FLUORINE IN WATER
Research investigations of the imporrant public health dental effects of fluorine naturally occurring in drinking water have been conducted in other parts of the United States over a period of years by the Dental Research Division of the National Institute of Health. In cooperation with the Division of Dental Health, preliminary investigation in establishing this fluorinedental relationship in Georgia was under.taken in 1946. The initial work of an engineering nature consisted of analytical determinations in the engineering laboratory on a large number of samples of water from public systems in Georgia to locate the areas of significant fluorine concentration. The effect of this somewhat rarely occurring chemical element on the teeth of persons of long residence in selected Georgia areas was observed by dental representatives of the United States Public Health Service. Fluorine determinations will be continued to eventually include all public water supplies in Georgia. Fluorine analyses of specific supplies of water where multiple sources are involved will be made as rapidly as the correlation of fluorine content of drinking water with dental observations on an epidemiological basis permits.
PRESENT CONDITION OF SAFETY DOES NOT PERMIT
RELAXATION OF EFFORT
Another year, in a long unbroken succession, has elapsed without any water borne disease attributable to public water supplies in Georgia. While this fact is compensation for all efforts expended, it must not encourage anyone connected with local public water supply and sewerage systems to relax vigilance or disregard dangers still lurking in some installations. The public water and sewage services, so frequently taken for granted by most persons, deserve and should receive popular attention and support by citizens 1'hrough constructive inquiry into the condition, management, operarion and results of the systems upon which public reliance is placed with scarcely a thought as to the why, where and how of their existence. It is no overstatement of fact to conclude with the assertion that the truly superly commonplace reality of public water supply and sewerage is foremost among the foundation stones upon which rest human welfare and material progress in Georgia.
72
Georgia Department of Pttblic Health
ENGINEERING LABORATORY
The engineering laboratory has performed all teS(S required in administering the public and private water supply protection program of the Department. In addition it has made routine and special examinations of stream pollution, shellfish and swimming pool samples. Special chemical tests of both qualitative and quamitative nature supplement the primary bacteriological determinations. Studies are conducted to improve methods and techniques to yield the most effective procedures in this 1ield of public health.
The numbers of the several classifications of examinations made during 1946 are shown in the following table:
Bacterialagical Public and semi-public water______________________________________12,877
Private water---------------------------------------------------------------- 819 Swimming Pools---------------------------------------------------------- 240 Shellfish ------------------------------------------------------------------------ 146 Comparative Media______________________________________________________ 98 Chemical -------------------------------------------------------------------------- 426 Se1/Jctge ctncl Strectm Polltttion__________________________________________ 370 Miscellctneotts ------------------------------------------------------------------ 10
Total ------------------------------------------------- _______________________________14,986
The increase for 1946 over 1945 is 1,208 samples.
WATER SUPPLY PROJECTS UNDER CONSTRUCTION OR COMPLETED IN 1946
Adrian-New deep well drilled. Alma-Hypochlorinator installed on deep well supply. Atagon-New chlorinator installed replacing old equipment. Barnesville-New chlorinator to improve purification process. Camak-New deep well drilled. Carrollton-New chlorination equipment to supplement purification. Cave Sptings-Chlorination equipment installed on previously untreated spring
source. Chickamauga-Plant to reduce mineral constituents in water (soften), distribution
system and elevated storage tan!< under construction. Clarkdale-New chlorinator installed to improve purification. Cleveland-Deep wells drilled as source of water for contemplated new municipal
system. Columbus-Construction project to double capacity of filtration units started. River
water intake and distribution system extensions completed. College Park-New chlorinator installed and distribution system extensions com-
pleted. Commerce-Reservoir for storage of creek water completed. Conyers-Hypochlorinators placed on previously untreated deep well system.
Pttblic Health Engineering
73
Danielsville-New deep well completed as source for contemplated new municipal system.
Darien-New deep well drilled.
DeKalb County-Extensive progress has continued on the long-term program to extend water service to industries and homes on a county-wide basis.
Duluth-New deep well supply for contemplated new municipal system.
Elberton-New chlorination equipment secured for filtration plant.
Gracewood-Three hypochlorinators pla.ced in service on previously untreated deep well supplies.
Hogansville-Capacity of purification plant doubled by completion of creel< water pump, iloculation and settling basin, filter, finished water storage and new chlorination facilities.
Locust Grove-Privately owned system acquired by municipality and completely rebuilt. Construction included spring improvements with hypochlorinator for purification and lime feed to reduce corrosion, new reservoir, distribution system and elevated tank.
Manchester-Construction started on additional filtration capacity and finished \Vater reservoir.
Milstead-New ammoniator to supplement sterilization process.
Monroe-Additional chlorination equipment to improve treatment.
Monticello-Filtration plant project to replace obsolete plant placed under construction.
Ochlocknee-New hypochlorinator placed on previously untreated deep well supply.
Patte1son-New hypochlorinator installed on previously untreated deep well supply.
Peppeton-New deep well drilled.
Perry-New chlorinator installed to improve treatment by 1eplacing old equipment.
State Park-New hypochlorinator.
Rockmart-New chlorinator and coagulant feeders placed in service to replace obsolete equipment.
Savannah-Construction begun on new water supply of 35 million gallons per day for process and drinking water for industrial area. Bource will be Savannah River; treatment will include coagulation, sedimentation, filtration and chlorination wilh completely equipped chemical and bacteriological control laboratory.
Soperton-Distribution system extensions.
Thomson-New elevated tank and distribution extensions completed.
Tate-Two hypochlorinators placed on previously untreated system.
"Wadley-Chlorinator installed on previously untreated deep well supply.
Whigham-Hypochlorinator placed on previously untreated deep well system.
MAJOR SEWER EXTENSION PROJECTS UNDER CONSTRUCTION IN 1946
Albany Cairo Decatur Griffin Moultrie
Barnesville College Park DeKalb County Louisville
Baxley Cornelia Dublin Montezuma
74
Georgia Department of Pttblic Health
SEWERAGE
Aldora Mills-Barnesville-New sewer system for industrial village and sewage treatment plant consisting of Imhoff tank, trickling filter, secondary clarifier and sludge drying beds under construction.
Pacolet Mills-Gainesville-Pumping Station and force main completed.
Pacolet Mills-New Holland-Sewage treatment plant consisting of primary sedimentation separate sludge digestion and sludge drying beds completed.
PLANS AND SPECIFICATIONS APPROVED 1946-WATER
Adel-Distribution System Extensions. Augusta-Floculation and Settling Basin Extensions. Bogart-Water vVori<S System. Butler-Distribution System Extensions. Camilla-Distribution System Extensions. Catoosa County-Distribution System. Cartersville-Filtration Plant Additions. Chickamauga-Softening Plant and Distribution System Extensions. Clayton-Filtration Plant and Distribution System Extensions. Clarkesville-Distribution System Extensions. Cleveland-Deep vVells and Distribution System. Columbus-Filtration Plant Additions. Cobb County Water
District No. 2-Distribution System. College Park-Distribution System Extensions. Commerce-Raw vVater Storage Reservoir. Dade County-Distribution System. Danielsville-Deep 'Nell and Distribution System. Donalsonville-Distribution System Extensions. Duluth-Deep vVeiis and Distribution System. Ellijay-Spring Development and Distribution System Extensions. Gray-Distribution System Extensions and Filtration Plant. Griffin-Finished vVater Reservoir. Hampton-Reservoir, Pump Station and Distribution System Extensions. Hogansville-Finished Water Reservoir. La Fayette-Spring Improvements and Reservoir. La Grange-Filtrfttion Plant. Locust Grove-Spring Improvements and Distribution System. Madison-Filtration Plant and Distribution System Extensions. Manchester-Distribution System Extensions. Meansville-Deep vVeii and Distribution System. Milner-Deep Weii and Distribution.
Pttblic Health Engineering
75
Montezuma-Distribution System Extensions. Monticello-Filtration Plant. Powder Springs-Distribution System Extensions. Perry-Treatment Plant (Iron Removal). Royston-Distribution System Extensions. Savannah-Filtration Plant. Smyrna-Distribution System Extensions. St. Marys-Softening; Plant and Distribution System. Thomson-Filtration Plant and Distribution System Extensions. Valdosta-Deep Well and Water Plant Improvements. Vienna-Deep Well, Reservoir and Pump Station Warm Springs-Distribution System Extensions. Warrenton-Filtration Plant.
PLANS AND SPECIFICATIONS APPROVED 1946-SEWERAGE
Albany-Collection System Extensions. Alpharetta-Collection System and Sewage Treatment. Bowman-Collection System and Sewage 'l'reatment. Brunswick
Tidewater Corp.-Sewers and Sewage Treatment. Butler-Collection System, Lift Station and Sewage Treatment. Cairo-Collection System Extensions. Clayton-Collection System Extensions and Sewage Treatment. Cobb County Sewer
Distict No. 1-Collection System and Pump Station. Decatur-Collection System Extensions. Donalsonville-Collection System Extension and Sewage Treatment. Douglas-Collection System Extensions. Gray-Collection System and Sewage Treatment. Hampton-Collection System and Sewage 'l'reatment. Homerville-Collection System Extensions and Lift Station. Lakeland-Collection System. Lyons-Collection System Extensions. Madison-Collection System Extensions, Lift Station and Sewage Treatment. Montezuma-Collection System Extensions. North Georgia
Vocational School-Collection System and Sewage Treatment. Royston-Collection System Extension, Lift Station and Sewage Treatment. St. Marys-Collection System. Tifton-Collection System Extensions. Warm Spl'ings-Collection System and Sewage Treatment. Warrenton-Collection System Extensions and Sewage Treatment.
---.! 0\.
CONDENSED 1946 SUMMARY OF BACTERIOLOGICAL RESULTS OF PUBLIC WATER SUPPLIES BY SOURCE AND
TYPES OF TREATMENT
-----
----------
Number Supplies
No. SUilplies with Percentage of
Number
Source and Type of Treatment
Submitting Sam1lies Number ef Months
Number Supplies Submitting
No Samples
- 1-0--12-
-
6-9 --
-
1-5
--
Ground \Vaters-No treatment. .... .........
92 - -35 - 59
16
Ground Waters-Carbon Dioxide Removal ........
3 - -2 - 0
0
Ground Waters-Iron Removal .................. 1
2
0
0
------
Ground Waters-8oftening ..... _..
1
0
0
0
------
Ground Waters-Chlorination. . . . . . . .........
83 - -16 - 3
2
Total Number Supillies
202 5 3 1
104
10 mi. portions positive fer Coliform Bacteria
0.1
5.1 above
Number Supplies Submitting Samples
I
Sup1liies
Meeting
4l
Bacteriological
"' Standards
C>
~. - -
0
to
to
10.0
5.0 10.0
No.
Per-
- - - - - - - - - - - - - - - - - -c-enta-ge
-
H -
-
-
-45
-
-
-31
-
-
64 -
-
-
-
186 --
-
-
-
-
-120-
-
65.9 ---
0
-
4 -
-
-
-0
-
1
5
4
80.0
----
"t' i
~
~
- -
-1
-
-
-1
-
-
0 -
-
-
-1 -
-
-
-
-3
-
-
-
-2-
-
-6-6.7-
~
-
-0
-
-
-
0-
-
-
I -
-
-
-0
-
-
-
-
I -
-
-
-
-1-
-
-1-00-.0
-
C>
15
-
39
-
-
-
16 --
-
31
--
-
102
70
69.3
----
~
Ground Waters-Chlorination and Carbon
Dioxide RemoYal. ....
.....
7
---
'l ---
- -1 -
0
11
1
7
1
2
--- ---
11
Ground Waters-Chlorination and
I ron Removal. ..........
1 - -0 - - -0 -
0
1
-
0
--
0 --
-
-
1 --
0
1
Ground \Vaters-Chlorination and Roftening......
3
- -0 - - -0 -
0 ------
- -3- -
0 ---
- -1 -
1 ---
1
3
~
9
81.8 ~
- - - - "'
I 100.0 :J::
"~' - - - -
2
66.7
Surface Waters-Filtration and Chlorination.......
79
-
2
--
-
-2
-
1
84
27
39
10
7
--- --- -----
83
- -7-6 - - -91-.5-
Surfaoe Waters-Filtration, Chlorination and Soft-
euing .......................
-
1
-
-
-
-0
-
0
0
1
-
0-
-
1 -
-
-
-
0-
-
-
0
1
1
100.0
--- -----
TOTAL . . . . . . .
..................
271
60
65
19
415
88
137
61
107
396
286
73.3
Pttblic Hectlth Engineeting
77
MILK SANITATION
Service on milk sanitation is designed to assist all local health departments, cities, counties, and the milk industry. Service is rendered those who have established or plan to establish facilities for public milk supplies. Consultation and advice is furnished relative w dairy barns, milk houses, and pasteurization plants. Promotion of adoption of the standard milk ordinance by cities and counties comprises a considerable portion of the service.
After adoption of the ordinance, assistance is rendered in technical and legal interpretation. Commissioners of health, engineers, and sanitarians seek advice from the division in all matters pertaining to sanitary and safe milk supplies. School lunch rooms, of which there are over 1,500 providing school lunches for over 300,000, are also furnished this service. Milk supplies are f.lso certified for the U S. Public Health Service on interstate carriers.
Of particular value in this service is a mobile milk laboratory which has now been in service nearly two years. The objective of this laboratory service is to carry into the field all phases of bacteriological and sanitary production of milk and simultaneously to render service of dairy and milk plant inspection and grading of all milk supplies.
Correlated with this laboratory service is an educational program for the dairy farmers and milk producers. It is so planned that it is itinerant and moved to the various milksheds. The purpose is to completely sanitate and grade each individual milkshed before moving to another. The maxim"Lun l"ime spent on one milkshed has been approximately four and one-half months.
The following milksheds have been serviced to date: Dalton, Eatonton, Griffin, LaGrange, Marietta, Moultrie, Rome, Thomasville. The demand has become so great for this mobile service that it has been necessary to purchase and begin equipping the second mobile laboratory.
In addition to the normal program of milk sanitation, the following was accomplished by the mobile milk laboratory:
Health departments rendered assisrance____________________________ 10
Raw dairies inspected ________________________________________________________ 311
Pasteurization plants inspected____________________________________________ 26
Bacteriological examinations._____________________________________________ 483
Phosphatase tests.----------------------------------------------------------------- 48
Sediment tests--------------------------------------------------------------------- 176
Temperature tests--------------------------------------------------------------- 325
FOOD SANITATION
The service of food sanitation comprises mainly an educational program, inspections and grading of restaurants, cafes, school lunchrooms and other eating and drinking places. Food handling schools for duration of practically one week each have been held in most of the larger cities throughout
78
Ge01gict Depctrtme-nt of Pttblic Health
the srate and at some of the state educational institutions and industrial esrablishmems.
The general routine of these schools comprises initial meetings with organized local restaurant associations, chambers of commerce, civic clubs nnd other imerested groups to discuss the purposes and objectives of the school, followed by three or more days of classes for food handlers. The course of instruction comprises lectures and demonstrations in sanitation, hygiene, elementary bacteriology, types and uses of mechanical equipment and chemical sterilization. It is coordinated with activities of the local health departments and, in general, initiated and sponsored by such departmem.
The same service is rendered for school lunchrooms and in cooperation v:;ith the school lunchroom program of the State Department of Education.
In addition to the food handlers schools, normal service comprises chiefly consultative and advisory service to local health departments and assistance to such local health deparrment personnel for inspections and grading of restaurants and other eating and drinking places. The demand for this service by local health departments, county and municipal officials is far greater than this Division can meet with very limited personnel. A standard ordinance is promoted and adopted by counties and municipalities accepting this service.
In addition to the normal routine of assistance to local health departmems artd others, food handlers schools held to date were in the following places.
Albany Atlanta Augusta Brunswick Columbus
Hinesville
Jesup LaGrange Macon Milledgeville
Savannah St. Simons Thomasville University of Georgia
MALARIA CONTROL
Malaria has continued to follow its trend downward although the 1945 mortality record of 28 deaths from this disease, giving a rate of .8 per 100,000, was an all-time low. Reponed deaths from malaria in 1946 were 12, striking an almost unbelievable new minimum of approximately .34 per 100,000, which lends hope to the Utopian goal of ultimate extinction.
j\tfct!arict Co-nt1ol i-n War Areas
With the cessation of acmal warfare and the rapid demobilization of the armed services, all of the major military and naval establishments in the endemic malaria zone of the state have been closed, making unnecessary further malaria control activities in the extra-cantonment zones surrounding such areas. Exceptions to this were the army's Oliver General Hospital at Augusta, the naval hospital at Dublin, and the former naval fuse loading plant at Macon.
The control operations at Augusta were reduced over previous war years, the Augusra-Richmond County Health Department furnishing two laborers to do minor ditching and larviciding as needed under supervision of this
Public Health Engineering
79
-c....
80
Georgi?t Department of Pttblic Health
Division. Bulldozer .filling operadons were carried out in eliminating some of the continuously watered breeding areas for malaria mosquitoes.
At the Dublin Naval Hospital minor drainage and larviciding was carried on through the entire season. At all times full entomological inspections were maintained in order to detect any unusual mosquito breeding in the area.
No comrol operations were indicated m Macon beyond the regular entomological surveillance which was effective throughout the season.
All of the above were operated in cooperation with the U. S. Public Health Service, Malaria Control in War Areas activity.
M?tlctrict Control in lmpottnded Waters
During 1946, 71 impounded water permits were issued, covering a watered surface of 437.85 acres. This activity is founded on the impounded water regulations of the State Board of Health, promulgated in 1925 with subsequent revisions.
The several agencies and corporations continue cooperation with the Department on malaria mosquito control on hydroelectric development lakes in the state. Regular reports of malaria control operations including clearing, cleaning, and larviciding are received from the hydroelectric companies.
Bartlett's Ferry (Georgia Power Co.) in Muscogee and Harris Coumies. Seasonal larvicidal operations are conducted by the power company under the joint surveillance and approval of this Department and the Alabama State Health Department. Regular larvicicling is accomplished by applying fuel oil, using the oil-water method, to the edges of the pond where mosquiw breeding occurs. Good control is obtained.
Lloyd Shoals (Georgia Power Co.) in Newton, Jasper, Butts, and Henry Counties. Larvicide, consisting of 10% Paris green in 90% hydrated lime, is applied weekly to breeding areas through a power cluster mounted in a boat, the latter propelled by an outboard motor. Fair control is obtained.
Flint River (Georgia Power Co.) in Lee and Dougherty Counties. Larviciding with Paris green is practiced on this reservoir also. The continued encroachment of surface vegetat~on on this pond indicates that additional measures will need to be taken soon w obtain effective control.
Spring Creek (Georgia Light & Power Co.) in Seminole and Decatur Counties. Larvicicling with Paris green is practiced on this reservoir with fair results. The proposed Flint-Chattahoochee Development now in the planning stage, which will back water as far as Bainbridge on the Flint River, will inundate the clamsite of the subject reservoir.
Blue Ridge (Tennessee Valley Authority) in Fannin County, Notley (TVA) in Union County, and Chatuge in Towns County. The .first named has required no control measures, but the TVA exercises vigilant patrol and such control as is indicated on the latter two reservoirs.
Lake Blackshear (Crisp County Power Commission) in Worth, Lee, Crisp, Sumter, and Dooly Counties. Mosquito control on this reservoir has
Pttblic Health Engineering
81
been very difficult since its impoundment without primary conditioning of the basin to be flooded, and subsequent raising of the water level w flood new uncleared areas. Some measure of control has been accomplished with Paris green larviciding from boats but the inaccessibility of the breeding areas has prevented effective results. Contracts were made in 1946 with two differem airplane operators for Paris green applications but the results were disappointing. Adulticides were resorted w for the latter part of the season. All adult mosquiw resting places within one and one-fourth miles of the pond's edge were sprayed with a DDT emulsion. This was very effective in reducing the adult mosquito population for the remainder of the season. To accomplish adequate control on this reservoir it is essential that the inaccessible breeding areas be cleared and made accessible.
Allatoona (U. S. Army Engineers) and Clark's Hill (USED) . The former, which will impound waters of the Allatoona River for a considerable distance above Carrollton, has been started and is well under way. The latter, which calls for a dam across the Savannah River a short distance above Augusta, will soon be under construction. Assurance of the engineer corps has been obtained for safeguarding health on both of these projeCts.
The Production and Marketing Administration Agency (formerly AAA) of the U. S. Department of Agriculture has incorporated in the remainder of the calendar year 1946 (starting October 1) a conservation practice which provides up to $300 payments on construction of dams and spillways for farm stock water and irrigation ponds. The practice will also be continued through 1947. This has stimulated the construction of small impoundments, taxing the facilities of field personnel in furnishing advisory assistance and inspection for compliance with regulations of the Board. Letters of authorization for beginning construction have been issued for several hundreds of new ponds, many of which will not be ready for maintenance permits until 1947. The excellent cooperation of the Federal Soil Conservation Service in rendering advisory assistance to farm owners has been of inestimable aid to public health authorities in obtaining proper pond conditioning prior to impoundment.
''Extended iHalaria Control"
Extended malaria control is the name given to a program stemming from the cooperative Malaria Control in War Areas program in which the U. S. Public Health Service furnished personnel, equipment and materials for comrol of malaria mosquito breeding in the vicinity of military camps and war industrial areas. In an extension of this program an entirely new concept of malaria control was evolved. The new insecticide DDT ( dichlorodiphenyl-trichloroethane) was applied in an emulsion to the walls and ceilings of homes and privies in certain of the counties having the highest !ldemic malaria rates in recent years, the object being to destroy the insect carrier of malaria either before biting a malaria carrier and becoming infected or before it had an opportunity to transmit the infection to a well person.
In 1945 the cost of this new program in all or parts of fourteen
82
Georgict Department of Pttblic He,tlth
counties was defrayed largely by Federal funds, through the U. S. Public Health Service, and 25,000 units were treated once, twice, or three times during the season.
The popularity of the program for general household insect control and the limitation of Federal funds required the adoption of a new policy in order to meet expanded needs. A new proposal was submitted to the fifty-four counties having the highest malaria mortality rate for the five-year period .!938-42. In this proposal the counties were offered the program if they would furnish office and warehouse space and the necessary labor (with transportation) for applying the spray; the state and USPHS to furnish supervision, chemicals, equipment for spraying, contact personnel, mapping and record form requirements and such incidentals as were required.
The response was very gratifying and thirty-seven counties participated during the season. Cities under 4,000 population were included, but for larger cities to join the program it was necessary to ask them to furnish the extra chemicals required.
The operating procedure was very similar to the pattern developed for the 1945 season and reported on in the annual report. It was necessary to decentralize supervision to some extent and use was made of three district supervisors to direct operations in the eleven areas comprising the thirtyseven counties. For the first three months DDT was applied at the rate of 200 milligrams per square foot of surface sprayed. The unprecedented demand for the insecticide made deliveries from the manufacturer uncertain and it became necessary to reduce applications to the 1945 rate of 100 mg. per square fom. The latter dosage apparently had sufficient residual potency over the three month planned control period, and resulted in a very material saving in total costs of the program. The sharp reduction in Federal allocations to the states made it necessary to continue this saving during the remainder of the season, though DDT deliveries were sharply increased during August and September.
A total of 158,369 units (houses) was sprayed during the season, involving a gross man-hour expenditure of 133,853. Emulsion totaling 411,200.6 gallons was used in spraying the 717,557 rooms, 221,427 porches, 117,877 privies, and thousands of mattresses comprising the units mentioned above.
The following table shows the location, number and local costs borne by counties and cities.
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83
1946 EXTENDED MALARIA CONTROL PROGRAM
LOCAL PARTICIPATION CosTs
County
Local
Costs
Lora!
Local
Units (wjo DDT) Cost/Unit DDT Cost
Bacon ..... .. . . . . .... .. ...... .. .
s 3,047 1,913
. 63
Baker...........................
2,519 1,916
. 75
*Ben Hill..... Brantley ....
... ..
. .
. .
.. .'
.. . .
.
..
. . .
. .
. .
.
1,238
667
.5o!
2,331 1,652
. 71
***MCFBBBCCCCtrauuaaloo.aynlmlrlulhyGqakdoldo.nuelctaeeu.ri.hi.nitr.nn.et.....e.........s...............................................................
2,319 7,707 10,131 3, 736 2,180 1,055 2, 794
93 6,816 I ,571
2,019 7,285 7,373 2,342 1,629 1,057 1,758
46 6,033
060
.87 .95 .73 .63 . 75
1.00 .63
.49 .89 .61
s 765
5H 40 1,218
Crisp ..........
4,564 3,758
.82
1,073
Decatur ........
6,310 4,008
.61
*Bainbridge ......
3<14
238
.69
311
Dooly..........
5,831 1,800
.82
Dougherty .....
3,030 1,801
.60
Early .........
7,264 4,H3
.57
Echols ...... ............
1,234
827
.67
Jefferson . .........
6,662 I, 700
. 71
Jenkins ...........
4,135 3,809
.86
Johnson .........
3,528 3,598 1.02
Lee............
LSSMMMceibiromalecenliveortnregtnoy.nol..e.m........e.....r....y............................................
2,996 3,600 5,937 3,850 2,853 7,130 2,965
2,199
1,883 5,052 2,MO 2,175 6,137 1,671
.73 .52
.85 . 66 . 76 .86 .56
Sumter........ 6,476 '1,284
.66
1,292
Terrell ........
Toombs . . . . . . . *Treutlen ......
..
.. .
5,979 4,153
. 74
4, 798 3,644
. 76
1,032
716
.69
Turner . . . . . . . . . .
3,378 1,980
.59
Wayne ...........
4,330 3,202
.74
Webster ........
1,691 I ,150
.68
Wilcox .......
...........
3,915 2,608
.66
Worth .......
6,904 1,449
.65
Totals ...
Maxima . . Minima ....
..
..............
Average ...... ...............
158,369 S116,531
S5,2J3
10,131 7,373 1.02
1,032
667
.52
1,280 3,150
. 73
*Received less than two applications.
Total
Total
Cost Cost; Unit
1,913
.63
1,916
.75
667
.54
1,652
. 71
2,619
.87
8,050
1.01
7,373
.73
2,312
.63
1,629
.75
1,571
1.'19
1,758
.63
86
.92
6,033
.89
2,208
1.41
1,831
1.06
4,008
.61
5<19
1.60
4,800
.82
1,804
.60
1,143
.57
827
. 67
I, 700
. 71
3,809
.86
3,598
1.02
2,199
.73
1,883
.52
5,052
.85
2,540
.66
2,175
.76
6,137
.86
1,674
.56
5,576
.86
1,153
.74
3,644
.76
716
.69
1,980
.59
3,202
. 74
1,150
.68
2,608
.66
4,499
.65
$121,774
In a program of this nature where malaria has diminished w an unmeasurable minimum, and its technical justification beyond an absence of household insects is difficult w establish, it was deemed desirable to obtain a public opinion poll in the form of a written statement containing the writer's opinion and any specific constructive criticism of the program. A frank statement was requested of health commissioners, physicians, county commissioners, county agents, rural mail carriers, and other leading citizens who are in frequent contact with the public and whose integrity is unquestionable. Statements were received from 5 health commissioners (all but <)oe); 38 members of local boards of health, 3 members of the State Board cf Health; 9 local health department employees; 33 private physicians; 3 elected state officials; 25 county commissioners; 31 other county officials; and 8 city officials. In no case has the success of the program in homes been questioned, the principal criticism being directed at its limitation to houses
84
Georgict Depctrtment of Pttblic Health
of human occupancy. In the public's opinion the benefits of general household insect control overshadow the primary object of malaria comrol. Several physicians credited the program with rhe reduction of enteric diseases in children as high as 90%.
The extended program operations have in no insmnce curtailed any current health activity, but have awakened the public w the benefits of intelligently and economically conducted public health operations. Local funds used in this program sometimes far exceeded any other annual appropriations made for public health purposes and the phenomenal success of rhis program .,..,-ill no doubt facilitare the secural of local financial participation in fmure public health programs.
Other residual benefits received from the extended program operations are discussed further under mapping and housing sanitarian secrions of rhis report.
Mapping is very closely coordinated with extended malaria program acrivities as personnel on the latter activity use and check rhe maps, and all necessary changes required are promptly furnished the mapping section for (ntering on the original maps.
As each habitable hose is given a number on the county and communiry maps this number is stenciled on a painted board which is nailed to the house or other conveniem location in the immediate vicinity. In this manner every house in the county has a number posred which corresponds to the number shown on the map.
For each house in the coumy the contact individual obtains information on the name of the householder, number of occupants, whether owner or tenant, and whether house is screened, furnished with elecrriciry, type and condition of water supply and sewage disposal. Thus the data on fundamentals of housing sanitation are tabulated for use on future public health activities.
SCHOOL SANITATION
The return of sanitation personnel from the armed services and the augmentarion of county services with new men have accelerared the program of school sanitation. The objective is to see that all schools are provided wirh (a) safe drinking water, (b) approved plumbing, (c) satisfactory sewage disposal, (d) safe milk supply, and (e) sanitary serving of school lunches.
Many schools, having deferred consrruction during the war years, are making plans for new buildings and additions to existing structures. Though the shortage of building materials and excessive uncertain labor costs are a deterrent it is still necessary to review and approve plans and specifications covering sanitation features of construction. The Division cooperates very closely in this work with the Department of Education and with private architects.
Improved excreta disposal facilities have been provided by rhe consrruction of 110 approved privies and 31 septic ranks with auxiliary absorption
Pttblic Hectlth Engineering
85
1ields. Many samples of water from school supplies have been collected and sent to the Division laboratory for bacteriological examination, principally for confirmation of findings of physical inspections of the supplies.
HOUSING SANITATION
During the war the housing sanitation program was directed principally to war housing projects constructed by governmental agencies and those without available public water and sewerage. There has been an increasing activity in private home building since the end of hostilities, limited only by the shortage of certain building materials and uncertainty of labor costs.
This activity has renewed the custom of this Division reviewing plans for subdivisions, where approved public water supplies and sewerage are not available, to determine whether they would be suitable for development 'With individual private water supplies and/or sewerage disposal systems.
All homes built under loans insured by the Federal Housing Administration, for which private water and/or sewerage systems are required, receive inspection and approval by local or regional sanitation personnel and are reviewed and approved in the Division office before approval of the F.H.A. can be secured.
Other Federal agencies operating in the housing programs with which the Division is cooperating are the National Housing Agency and the Veterans Administration.
The following tabular summary shows the distribution by counties of the 1,678 privies and 4,033 septic ranks built, and 2,183 privies repaired, under supervision of sanitation personnel.
PRIVIES AND SEPTIC TANKS CONSTRUCTED BY COUNTIES
County
Home
Appling .... Atkinson.
. . . . . . . . ..............
17
Bacon ........ ...................
1
Banks .....
1
Barrow ..
2
Bartow .....
"Berrien . ....
Bibb .........
39
Brantley ....
Brooks......
Bryan .....
Bulloch ...
3
Burke ....
36
Butts .......
2
Candler ....
Charlton ..
22
Chatham ..
98
Chattooga ..
Clarke ....
54
Clayton ..
9
Clinch ....
1
Cobb .....
19
Coffee . . . .
Colquitt ..
5
Columbia.
2
Cook ...
Coweta ....
38
Crawford ..
PRIVIES
Public Places
Total
8
8
9
26
4
5
1
2
93
132
5
8
7
43
2
22 98
54
9
1
19
16
16
5
2
,!3
Repair
126
5 39
5 169 740
9
2 15
SEPTIC TANKS
Homo
Public Total Places
ll
4
15
10
2,!
34
2
2
3
3
8
9
3
'l
219
226
2
2
1
1
1
65
1
66
17
17
19
25
2
2
5
5
180
14
19,!
36
36
86
1
87
'H
17
61
2
2
127
134
2 14
5
2 19
1
i
10
2
12
3
3
86
Georgir;t Department of Pttblic Health
PRIVIES AND SEPTIC TANKS CONSTRUCTED BY COUNTIES (Continued)
County
Home
Crisp ..................... .
21
Decatur .. .
103
DeKalb.
9
Dooly ....
Dougherty
12
Douglas ..
Earl.v ... .
Elbert .... .
Emanuel .. .
Fannin .... .
Fayette ... .
Floyd ....... .
Franklin ............. .
14
Fulton ............... .
15
Glynn ....... .
Greene. . ........... .
Habersham..
. ......... .
Hall ........................... .
Haralson ................. .......... .
Heard ................. .
Henry ................. .
Houston ..... .
Jackson . ......... .
Jasper . ......... .
Jeff Davis .. .
6
Jenkins . ... .
31
Lamar.
6
Lanier ... .
2
Laurens ........ .......... .
30
Liberty ....... .
Lincoln ....... .
Long ........ .
Macon ............ .
Madison ........ .
4
Marion ........... .
6
McDuffie............ .
10
Mitchell. ............................ . 266
Monroe .................. .
Morgan .................. .
4
Muscogee ......................... .
57
Newton ....................... .
2
Oconee .. ............ .
3
Peach .......... .
3
Pierce . ......... .
Pike ............... .
Polk .................. . Putnam .......... .
. 34
Rabun .......... .
8
Randolph .......................... .
Richmond............ . ......... .
65
Rockdale...................... .
3
Schley ........................ .
2
Screven. . . . . . ............. .
20
Spalding...
. ......... .
18
Stephens .................. .
62
Sumter............ .
18
Talhot. .......... .
Taliaferro . ..................... .
3
Taylor..
. ........ , ......... .
5
Thomas............
. .......... .
4
Tift.................... .
I
Towns ..
2
Troup ........ .
149
Upson ... .
4
Walker...................... .
18
Walton ....... . Ware ....... .
'i4
Warren . ..... .
Washington ... .
Wayne........
. ............ .
White.................. .
2
Wilcox ............................... .
1,411
PRIVIES
Public Places
Total
5
26
22
125
2
11
14
26
14 19
7
2
6
33
6
2
12
42
4
2
8
5
15
4
270
4 61 4
3 3
12
34
8
. 65
3 2 27 18 63 18
5
7
1
2
18
167
4
18
2
14
2 267 1,678
Repair 8 43 10 35
10 14 2
.. 4.5
10 22
2
5 1 197 14 2 28
29 64 160 59 45 6
34 23
1 1 180
2,183
SEPTIC TANKS
Home
Public To tat Places
57
59
3
4
636 1
636z
115
123
7
I
2
2
1
I
1
12
12
1i
17
087
35 1:o:i:i
20
20
I
1i
19
5
7
1
1
5
7
10
10
10
2
12
5
5
1
1
10
19
7
7
13
13
2
1
3
22
10
32
1
I
3
3
i3
13
3
5
4
4
17
17
17
20
9
9
5
5
226
226
13
15
13
13
13
13
I
I
8
8
3
3
3
8
I
I
166
170
17
18
16
16
36
39
25
25
66
1
67
18
10
28
2
2
17
5
22
23
8
31
5
3
8
'64
I
I
18
82
20
20
47
16
63
4
4
53
53
3
3
3
3
4
4
1
I
1
1
3, 781
252 4,033
Pttblic Health Engineering
87
SHELLFISH SANITATION
legislation by the General Assembly of Georgia placed shellfish sanitation under two state departments, namely, the Department of Health and Department of Game and Fish.
legislation concerning the Health Departmem provides for inspection of oyster beds, prohibits taking oysters from contaminated waters and places management and control of sanitation of oysters exclusively under the Health Departmem.
legislation concerning the Game and Fish Department provides for planting and replanting, growing, and gathering, leasing of oyster beds, taxation of the industry and responsibility of recognizing sanitary standards.
Authority given the Health Depanment provides for rules and regulations to be adopted by the Swte Board of Health for the purpose of shellfish sanitation.
Pursuant w these Acts of the General Assembly, the State Board of Health has adopted rules and regulations regarding shellfish sanitation and has placed authority for enforcemem under this Division.
The sanimry conditions of oyster growing areas, shucking houses, and marketing conditions of oysters have improved w the extent that oysters marketed from the various sources meet the requirements under the rules and regulations.
During the past year it was necessary to collect samples only on the boundaries of formerly condemned areas in order w again define these areas. There were numbers of shucking houses improved and issued permits for state and interstate shipment and sale. Approximately 200 acres of previously condemned oyster growing areas were released for production and sale because of a new sewage treatment plant in the Brunswick area.
Following are some of the accomplishments in shellfish sanitation during the year.
Shucking house inspections____________________________________________ 485
Samples of water bacteriologically examined__________________ 146
Acres of waters investigated, approximate______________________ 1,500
Shucking houses certified to USPHS________________________________ 10
Shucking houses improved______________________________________________ 20
Additional acres condemned, approximate____________________ 250
CAMP SANITATION
Cooperation with camp owners has been continued on inspection and recommendations for sanitary improvements at recreation:;t! camps. The arrangements for similar service at all state prison camps, effected at rhe request of the State Department of Corrections, has also been continued.
On April 18, 1946 the State Board of Health adopted regulations concerning sanitary requirements for operation of tourist camps with the stipula-
88
Georgia Depctrtment of Pttblic Hectlth
tion that all shall comply with the regulations and have a permit from the Department by April 1, 1947.
An inventory was begun immediately, but it was found that more personnel would be required to make appreciable progress in a venture of this magnitude.
Upon completion of the spraying season on the extended malaria comrol program certain key personnel being retained for the 1947 season were assigned ro regional offices to assist in making a facrual survey of sanitary conditions at all tourist camps. This survey, which will be the basis for further improvements and final permits from the local and regional health authorities, was completed in December. More than 488 tourist camps, trailer camps, and courts, were inspected. Many excellent camps were found, but many will probably not be able to comply with sanitary requirements and should be closed when the time limit expires on April 1.
MATTRESS SANITATION
The mattress sanitation program conforms to an Act of the General Assembly No. 472, Georgia Laws 1937. This is an act to improve the sanitary condition in the manufacture, remaking or renovation of mattresses, to provide for fees from persons applying to the Board of Health for license, to provide for placing of tags showing date of receipt of the mattress and for a stamp to be attached to the mattress, made, renovated or sold, etc.
To a considerable extent those engaged in the industry have conformed to the laws and regulations. It is now necessary to inform those newly established in the industry of the laws and regulations. Seven new firms began business during 1946.
During the year, 103 complaints were investigated and approximately 85 inspections were made. Shortage of personnel to some extent limited operations. However, it will be continued with all possible attention in order to effect the full purpose of the law.
MAPPING
The Division has continued to make surveys and maps for sanitation services for state, coumy, and municipal public health uses.
Whenever available, aerial photographs are used in the preparation of complete planimetric maps suitable for use in public health activities.
The demand for municipal and county-wide maps for use on the extended malaria control program has taxed all available facilities to the utmost. Complete county maps have been prepared for the following counties:
Bacon Baker Ben Hill Bramley Bulloch
Candler Colquitt Decatur Echols Johnson
Macon Montgomery Pulaski Toombs Treutlen
Turner Wayne Webster
Pttblic Health Engimering
89
Original city and community maps were prepared for the following:
Adrian Ailey Alexis Alma Alston Amboy Amsterdam Ashburn Attapulgus Avera Baconton Bartow Bellville Benevolence Berlin Blitch Camilla Canoochee Carnegie Clarkesville Claxton Climax Coffee Coleman Cotton
Covena Coverdale Crossland Cuthbert Daisy Dakota Doerun Doles Donovan Ellenton Faceville Finleyson FunstOn Garfield Hagan Hartford Hawkinsville Higgs ton Hoboken Hortense Ideal Kite Louisville Marshallville Matthews
Meeks Meigs Metter Modoc Montezuma Needmore Newton Norman Park Normamon Nunez Oakfield Oak Park Odum Oglethorpe Oxford Pelham Pineville Poulan Preston Pulaski Queensland Rebecca Register Richland Riverside
Rockingham Sale City Scott Screven Shellman Shingler Sibley Soperton Sou. Sylvania Springvale Stapleton Stellaville Stillmore Summertown Sycamore Tarrytown Tarver Uvalda Wadley Wesley W. Bainbridge Weston Worth Wrens Wrightsville
RECRUITING PERSONNEL
The Engineering Division is a source from which regions, districts, and counties secure engineers and sanitarians for organized health service. It seems logical that this Division should have a dearer perspective of the engineering and sanitation needs of the state and serve conjunctively with the Division of Local Health Organizations in securing training and assigning engineers and sanitarians.
During the year, the U. S. Public Health Service established two schools in Georgia for training engineers and sanitarians, namely, at Columbus and Savannah. These were established and recognized in addition to University of North Carolina and Vanderbilt University. Previous to acceptance of an applicant for training, his education, experience and general adaptability is .firsr analyzed and second he is evaluated by the Merit System and rated according to classification. During the year a total of 18 engineers and sanitarians wNe recruited for such training.
Division of Dental Health Education
J. G. WILLIAMS, D. D. s.____________________________________________________Part-time Director
ANNIE TAYLOR________________________________________________________________ Edttcrttionctl Director VIRGINIA LI'TTLE________________________________________________Associate Edttctttionctl Director
Division of Dental Health Education
The following narrative and statistical repons summanze the activities
of the Division of Dental Heahh for the year 1946.
Personnel and Policy Chctnges
The appointment of Miss Virginia little as Associa[e Educational Director is the only change in the staff of the Division of Dental Heahh.
A change in the Plctn for Finctncictl Assistctnce to Locctl Hectlth Depctrtments affects the dental program in that dentists are included as basic personnel and grants-in-aid are made w heahh departments for their salaries, which now gives three plans for financial participation to local health departments for dental service programs:
( 1) Employment of a full-time dentis[,
(2) Employment of a part-time dentist,
( 3) Honoraria paid to dentists for service in clinics.
Job classifications for Denktl Clinicictn II, Denktl Health Officer III, and Dented Hectlth Director IV-A have been adopted by the Depanment with Merit System approval. As dentists become available, the larger heahh departments in the State have indicated that they will employ dentists on fulltime and part-time basis.
To promote better dental health for the people of Georgia, the Division of Dental Health has continued w emphasize Plctnning, Edttcation and Sr7rvice at Sta[e and local levels with and through all agencies that are interested in and working for health and welfare. Stttdies to determine needs of children and adults and Resectrch to investigate the epidemiology of demal caries have been the new phases of the dental program during the past year. Both have proved interesting and profitable.
Plcmning at State, county and community levels is encouraged as a means whereby the dental health problem can be studied and programs devised to meet the needs and available facilities. Experience has taught thac when groups or individuals can be brought together for study and cooperative planning and action, [he results are better and more lasting. The staff has taken advantage of every oppormni[y to assis[ local heahh departments in bringing together for study and planning the dentists, school administrators and teachers, county and home demonstration agents, representatives from Parent-Teacher Associations, civic clubs and all agencies capable of assisting in the solution of the dental problem. A permanent committee or council 1n every county is an objective of the Division of Dental Health and one
94
Georgia Department of Pttblic Health
Dental Health Education
95
which is fundamental if successful programs of dental health education and dental service are to be realized.
Education of all the people as to the need for and the ways by which dental health can be attained and maintained is the first objective of the dental health program since every study indicates lack of understanding and knowledge to be the greatest handicapping factor. Listed below are some of the groups toward which our activities have been directed:
Teachers- (both in-service and pre-service) School Administrators Supervisors of Education Visiting Teachers Parents Community Leaders Dentists College Students School Children Parent-Teacher and other Civic Clubs County and Home Demonstration Agents 4-H Club Members
During the year, members of the staff have visited and worked in fortyeight counties. With our limited staff, activities have been directed chiefly toward those who can influence other groups. For example, supervisors of education, in turn, can interpret the dental health program to county teachers, parents and children.
The Pttblic Health course for senior dental students initiated in 1945 proved successful and has been conducted again in 1946 by Dr. Williams with the assistance of the Department of Health staff members.
Georgia Department of Public Health
Educational Aids The Division has used and distributed widely, free of cost, the following
aids: Bulletins Facts About Teeth and Their Care Your Child's Teeth About Faces The Truth About Teeth Hold On To Your Teeth Dental Care for the School Child How to Save Teeth and Money
Films The Student Flyer About Faces Our Teeth Told By A Tooth Winky the Watchman
Dental Service The reports of dentists, local public health personnel and school ad-
ministratOrs indicate that an increasing number of children and adults are going tO dental offices for needed corrections. Every dentist in Georgia is working from early morning until late at night.
Dental Clinics Activities in dental clinics operating during 1946 according tO Regula-
tions for Paying Honoraria to Clinicians Conducting Dental Clinics may be summarized as follows:
There were twenty-one clinics in twenty counties with thirty-seven white dentists and four Negro dentists, working 2,606 hours, admitting 2,123 white children and 421 Negro children. There were 10,500 operations or approximately four operations per child, including fillings, extractions and
Dental Health Edttcation
';)7
Young Cbildreu Are Enconraged to Visit tbe Dmtist
prophylaxis. Local dentists were paid $6,5 15.00 in honoraria for these services.
The clinics have been visited and supervised by the Dental Director.
Counries operating clinics during the year 1946 are as follows:
Cou1zty
Months Operating
in 1946
Type of Clinic
1. Bibb 2. Chadron
3. Chatham.
8
Negro Children
8
White Children
5
Negro Children
98
Georgitt Depttrtment of Pttblic Health
Comzty
1\!Ionths Operttting in 1946
Type of Clinic
4. Clarke
8
5. Clinch
3
6. Decatur
6
7. DeKalb
12
8. Fulton-Adanta City
7
Bass
2
9. Jenkins
9
10. Jones
4
11. Liberty
11
12. Morgan
2
13. Muscogee
5
14. Rabun
11
15. Spalding
12
16. Screven
9
17. Stephens
5
18. Toombs
4
19. Upson
10
20. Ware
6
White Children
White Children Negro Children White Children
White Children White Prenatal Cases White Children White Children Negro Children White Children
Stttdies
With the assistance of Dr. Thomas L. Hagan, Senior Dental Surgeon of the U. S. Public Health Service, a study of 24,092 Georgia children in twelve communities was made to determine demal caries prevalence and rooth mortality. Places included were:
Cities 1. Atlanta 2. Albany 3. Columbus
4. Griffin 5.. Savannah Coumies 6. Camden
7. Glynn 8. Fulton 9. Floyd 10. Muscogee 11. North Georgia Group 12. Spalding
Dental Health Edttcation
99
Appreciation is expressed to Dr. Hagan and to local health departments, school administrators and dentists for their valuable assistance. Dr. Hagan has submitted the full report for publication. A few pertinem findings are listed below:
1. The prevalence of dental caries 1n permanent teeth vanes in the differem places studied.
2. The annual increment of dental caries in permanent reeth also varies from place to place.
3. Evidence has been presented which indicates chat no significant variation in caries experience can be attributed to economic status.
4. There is some evidence that the prevalence of dental canes in permanem reerh may be increasing.
5. The tomb mortality rate of a community adheres quite closely to the relative pattern established by the caries anack rate, except in those places where dental healch promotion is carried out extensively.
6. Individuals in the high economic strata experience significantly lower rooth mortality rates than those persons in the lower economic levels, except where concerted efforts are made to save teeth by dental care.
Also with the assistance of Dr. Hagan, studies of the dental health and dental needs of adulcs were conducced in connection with the TB-VD Surveys in Columbus, Macon and Augusta. When this report is tabulated, ir will represent the largest and most complete cross-section study of the dental needs of adults that has been recorded.
Epidemiological studies of dental caries have been begun in various secdons of Georgia through the cooperation of the Dental Section of the National Institute of Healrh and the Division of Public Health Engineering of the Stare Health Department.
Dr. F. A. Arnold, Dental Surgeon, National Institute of Health, has made examinations of childrens' teeth in McDuffie Coumy and in Richmond County.
Dr. H. T. Dean, also of the National Institute of Health, examined a sampling of childrens' teeth in Colquitt, Pierce, Wayne, Glynn, Camden and Mcintosh Coumies. With the assistance of Mr. Weir, Public Health Engineer, Georgia Department of Public Health, investigations of fluorine coment of water supplies are being studied with relation to dental caries prevalence.
Appreciation is expressed to the Georgia Dental Association, its Public Health Committee and individual members for their cooperating and active support in making possible the dental program described in this report. Appreciation is also expressed to the Department of Education and to its allied agencies, rhe Agricultural Extension Service, the Georgia Congress of Parents and Teachers, and all ocher groups with whom and through whom progress has been made.
100
Georgia Department of Public Health
STATE, LOCAL AND FEDERAL AGENCIES COOPERATE IN THE THOMAS COUNTY SURVEY TO DETERMINE DENTAL NEEDS
CONFERENCES, MEETINGS, AND ASSOCIATIONS ATTENDED
Meetings
Attended By:
Instructional Supervisors' Conference, Atlanta _____________________ ___________Taylor
Little
Seventh District Parent-Teacher Association, Rome
____ ______ ____ ____ Little
American Public Health Association, Cleveland _____ _____________ _________Taylor
Superintendents' Conference, Atlanta __________ ___
_________________Taylor
Fifth District Parent-Teacher Association, Ellenwood ________________________Taylor
Little
Instructional Supervisors' Conference, Atlanta
__ ____ Taylor
Little
Board of Managers, Georgia Congress of Parents & Teachers, Atlanta __ _Taylor
Northeastern Regional Nurses' Conference, Athens ________________________ _______Little
Parent-Teacher Institute, Athens __________________ _________ ______________ _______ Taylor
Georgia Dental Association, Atlanta ---------- ----------------- -- ------------ --- _Williams
Taylor
American Association of Public Health Dentists, Chicago _____________ Williams
American Dental Association, Chicago ___
______ ___Williams
_Georgia Public Health Association, Atlanta
__ _Taylor
Dentrtl Hertlth Edttccttio1~
101
Conference on Rural Life and Education of the South Atlantic Scates, Atlanta__________________________________________________________________________________ Taylor
Parent-Teacher Association Convention, Savannah___________________________ Williams Taylor
Home Economics Council Meeting, Athens____________________________________________Taylor District Parent-Teacher Association, Carrollton______________________________________Taylor District Dental Society (Northwestern), Rome ____________________________________Taylor Hinman Midwinter Dental Clinic, Atlanta ___________________________________________Taylor
Williams Georgia Supervisors' Conference, Atlanta ________________________________________________Taylor Atlanta Social Hygiene Council, Atlanta ________________________________________________Taylor District Dental Society, Columbus _________________________________________________________Taylor
Instructional Supervisors' Conferences in Carrollton, Milledgeville_______ Little
T e?tchers' W arkshops Attended
Troup County-LaGrange Cherokee County-Camon Gwinnett County-Lawrenceville _Health Education Workshop, Athens Visiting Teachers, Athens Instructional Supervisors, Athens Mercer University, Macon G.S.C.W., Milledgeville Thomas County
102
Georgia Department of Pttblic He(tlth
DENTAL CLINIC STATISTICS-JANUARY THROUGH DECEMBER, 1946
NUMBER COUNTIES OPERATING CLINICS ... . NUMBER CLINICS ........................... . NUMBER CLINIC SESSIONS............. . NUMBER CLINIC HOURS (TOTAL) . NUMBER DENTISTS WORKING
HONORARIA PAID DENTISTS .................. .
TOTAJ, ADMISSIONS .......... ..
TOTAL ADMISSIONS BY AGES
6-8 Yrs.............
. ........................ .
9-11 Yrs........
. ...................................... .
12-14 Yrs.......
. ................................... .
% 6-8 Yrs................
. . . . . . . . . . . . . . . . . . . . . . . . . ........... .
%9-11 Yrs........................................... .. .......... .
%12-14 Yrs..............
.. ............................... ..
TOTAL VISITS............
. ...................................... .
TOTAL PATIENTS DISMISSED ....................................... .
Completed .............. . Others. % Completed...
PROPHYLAXIS........ .
% of Admissions . ...... .
NUMBER TEETH EXTRACTED ....
Decid.................... .. 1st. Perm. Molars .......... . Other Perm. Teeth ....... .
NUMBER TEETH FILLED..
Decid................... . 1st Perm. Molars....... . Other Perm. Teeth ...... .
NUMBER FILLINGS ...
Cement... . ....... . Alloy ........................................................... .. Silicate .................... .
Two Clinics in Fulton County.*
White
18 19* 1,158Yz 2,317 37
$5,792.50
2,123
948 754 421 45%
36% 19% 1,928
1,995
1, 759 236 83%
822 39%
2,052
1, 770 247 35
5,150
1,521 2,665
964
6,423
429 5,660
334
Negro
4 4 144Yz 289 4
$722.50
421
178 161 82 42% 38% 20% 669
253
244 9 58%
122 29%
722
565 147 10
359
185 !58 16
359
103 242 14
Division of Maternal and Child Health
GuY V. RICE, M. D.__________________________________________________________________________ Director MYRA REAGAN_ _________ ---------------------- ---------------------- _____ Nttfrition Consttltant
Division of Maternal and Child Health
The maternal and child health program has made definite gains during the latter half of 1946. In the organized counties, maternal and child health conferences reporting to the Division (this includes centers in which the Georgia Department of Public Health participates financially) have increased from 147 in the first half of the year to 164 at the end of the year. However, there was not the same proportionate increase in the nursing counties, there being one less conference at the end of the year than at the beginning.
Although some effort has been made to carry on the type of educational and in-service training program that would increase the enthusiasm of local personnel in maternal and child health work, it has not been possible to produce the desired effect because of limited personnel. Relief of this :ituation next year is anticipated. At least one maternal and child health consultant will be assigned to work in two of the regions, and four prospective nutritionists have been definitely engaged to supplement the regional staff. It is hoped that additional medical personnel may be obtained making possible one maternal and child health consultant for each two regions as a
ll11illmUm.
Personnel
The organization of the Division has remained the same. There has been little change in personnel. Three nutritionists have been granted scholarships in nutrition education and will return to work in Georgia afi:er their training is completed. Miss Hannah Mitchell has joined the Division as nursing consultant.
Plan for lvlCH Di,vision
The annual description of the State Plan for maternal and child health services was submitted the latter part of June in accordance with instructions set forth in MCH Information Circular 18, issued March 1946, by the Children's Bureau of the U. S. Department of Labor. This plan was developed following recommendations of the State and Territorial Health Officers, and consists of the following four parts:
Part I includes an outline of material which will constitute a permctnent MCH State Plan file.
Part II includes an outline of basic plan material for the development of a program for a 5-year MCH State Plan.
Part III
includes material needed annually as a basis for determining that conditions are met for allotment of funds under the provision of Title V, Part 1 of the Social Security Act, as amended. (The annual material requested for subsequent years, when a complete plan is not submitted, will be somewhat modified.)
Part IV includes instructions for preparation of MCH budgets and apportionments of funds for fiscal year 1947.
~06
Georgict Depctrtme-nt of Pttblic Health
lHeclical Activities
lectures:
1. Universiry of Georgia Medical School 2. Health Education Work Shop, University of Georgia 3. Regional nurses conferences 4. Public Health Service internship training program 5. State Nutrition Committee 6. Georgia Dietetic Commictee 7. Science Club, University of Georgia 8. Missionary Group, Presbyterian Church (Negro)
Conferences:
1. Children's Bureau 2. U. S. Public Health Service 3. University o Georgia Medical School 4. Maternal Morbidity and Mortality Committee 5. Pediatric Committee 6. Medical Association o Georgia 7. Pediatric Society 8. Crippled Children's Service 9. Vocation Rehabilitation Service 10. Grady Contraceptive Clinic
11. Dr. W. w. Daniel, re: standing orders for nurse-midwives
12. Nutrition Committee 13. Veterans Administracion 14. Red Cross 15. Superintendent and Medical Administrators, Crawford long Hospital
Membership in Committees:
1. Scientific Advisors Committee, State Nutrition Commitree 2. Policy and Record Committee, State Health Depanmem 3. Joint Health-Education Committee 4. Advisory Committee, Crawford long Premature Training Program
Meetings Arrended:
1. Georgia Pediatric Sociery 2. Medical Associacion of Georgia 3. Georgia Public Health Association 4. American Public Heahh Association 5. Saluda Pediatric Seminar 6. Maternal and Child Health Directors Association 7. Meeting of State and Territorial Heahh Officers
Report of Consttltant Nmse
Emphasis continues w be focused on the care of rhe premature infant. Demonstrations on care and early reporting of infants have been srressed in tonferences and calks w nurses. In every instance, where possible, the use of rhe incubator has been demonstrated to hospital nurses. Programs of coordination of hospital and Health Depanmem have been emphasized. Re-
Mctternal and Child Health
107
ferrals of infants to Health Departments have increased as a result of the emphasis being pm on this program.
Maternal and child health conferences have been visited throughom the year. Conferences with regional personnel have been held. Contans with hospitals under the Emergency Maternity and Infant Care program were made to interpret the program and give assistance where needed.
Plans have been started in connection with the esrablishment of a premature nursery here in Atlanta. Plans are being made for an in-service educational program to be worked out with the regional personnel. Plans for a nurse-midwife service were started late in the year. The nurses will render a direct service ro the patients delivered by midwives.
NUTRITION
The Nutrition Consultant's position was filled by Miss Myra Reagan October 15, 1945, after a lapse of >\pproximarely a year and a half. This lapse necessitated developing an almosr entirely new nutrition program, and the early months of 1946 were devoted to planning and reorganizing the program. The long period without staff education, the employment of many new nurses, and the newer findings in nutrition made this necessary.
Stctff Edttccttion
One region, the Southwestern, planned for the nurses to meer in two groups, each group meeting every other month and devoting half of their meeting-time to nutrition education. This program continued during the entire year.
The East Cenrral Region planned quarterly all-clay conferences for the nurses. The January and April conferences were planned emirely around nurrition.
The Northeastem Region has a plan similar to that of the East Cenrral Region. Their March and September conferences were on nurrition.
The Northwestern Regional conference, held in February, gave about half the day to nutrition.
The nutrition consultant has met with the nurses in twelve regional meetings to help with the nutrition work. In Fulton County the nutritionist mer with the nurses at their regular Monday staff conference for a series of lectures and discussions. A week was spent working with the nurses in Richmond and in Muscogee Counties. An hour each morning was given to lectures and discussions and the rest of the day was spent in clinic, school and home visits helping the nurses with nutrition problems. It is hoped that similar work may be developed in other counties where the staff is large enough to justify such a program.
During the year the nutritionist visited in forty-two counties and worked with the nurses in all but two of these. These two counties did not have nursing service; however, rhere was special nutrition work ro be done in these counties. Work wirh the nurses varied, but consisted chiefly of clinic work, school work and home visits. The object was ro help the nurses underst:md the nutrition problems and the ways whereby they could be met.
108
Georgict Depctrtrnent of Pttb!ic Hectlth
U. S. Pttblic Health Service Ntttrition Stwvey
In 1945 Albany, Georgia was selected as a national training center fat nutrition survey teams with the U. S. Public Health Service. This work was planned so that more accurate information on the nutritive conditions of population groups might be available. It was also hoped that simple methods of evaluating the nutritive status of individuals might be developed. These ~imple methods are needed for general public health work. The findings in particular areas can be used as the basis for a nutrition education program in that area.
Schools in Dougherty, Mitchell and Baker Counties were surveyed. These surveys included hemoglobin readings and nutritional inspections. A survey was also made at the Clarke O.N.T. Mills in Pelham and the Flint River Cotton Mill and village in Albany. These surveys included hemoglobin and hematocrit studie~, dietary analyses and suggestions and nutritional inspections. The survey in Pelham resulted in an immediate introduction and quire generous sales of milk in the mill.
The nutrition survey team spent a few days at the Health EducationNutrition Workshop at the University of Georgia. All workshop participants and demonstration school students were given physical inspection and hemoglobin readings were made on them. Illustrated lectures were given the group, explaining th.i.s work and the signs of malnutrition. The teachers considered this one of the most valuable features of the workshop program and many asked for similar work in their own schools.
The nutrition con~ultant spent a week during September working with the survey team in Albany at the Flint River Cotton Mill and village. Help was given in taking dietary surveys and in consultations on diets. One school child gave such unsatisfactory answers to questions it was believed she was mentally deficient. When the nutritionist checked at the clinic she found this child had a hemoglobin reading of 4.5 grams. It was concluded the deficiency was not mental but physical.
Further studies are planned in the State and the nutritionist hopes to be able to follow these with an educational program and assistance in the mills and schools in their nutrition problems.
Georgict State Callege fM Women
The institutional management director at Georgia State College for Women suggested the possibility of her senior girls giving food demonstrations at the Baldwin County clinics, as a benefit to the clinics, and future help in other sections of the State as these girls graduate and take jobs over the State.
Two trips to Milledgeville were made to work on this. Conferences to plan the work were held with the teachers involved, the county nurses and the Regional Nurse. The nutritionist also met and talked with the two classes concerned. Similar demonstrations were planned, procedures outlined, and inexpensive menus and buying guides were furnished the classes. Con-
iVIatemal and Child Health
109
Proper Prrpara l iou Aids iu Prescrl'iug N ul rilirr Valu e of Foods
rinuarion of this work is planned and it is hoped that similar programs may be developed in other schools.
During the summer session, talks on nutrition in public health were made ro classes in Health Education and in Child Guidance.
Sttrvey on Food Conmmption, Prodttction and Bttying
Quire a large number of questionnaires on the above subject were distributed ro nurses in the Stare bur, except for Richmond County, few have been returned. Forty-nine completed records were made in this county in May, 1946.
Following are a few high-lights from these records :
Amount Spent for Food per Adult Unit per Week White urban families ._____ ------------------------ $5.68 Colored urban families .......----------------------- 4.38 White rural families ........------------------------------- 2.60 Colored rural families ._______________________________________ 1.27
All families spent roo much for protein foods-most of them approximately 30 per cent of rhe food money. None spent enough for milk and cheese. The colored families spent about 7 per cent and the white rural families 9.5 per cent and rhe white urban families 15 per cent.
llO
Georgia Department of Pttblic Hetttth
Crippled Children's Clinic
Representatives of the Crippled Children's Division of the Department of Welfare asked for assistance with their nutrition problems for clinic patients. In June a conference was arranged, in the nutrition consultam's office, with these representatives and the Extension Nutritionist. It was realized that more help was needed than could be given by the Health Department Nutrition Consultant and rhe Extension Nutritionist. Ir was dedeled to call on the Red Cross nutrition workers for help. The nutrition consultant has taken the lead in securing help for these clinics and planning the type work to be done. The nurrition consultant works in rwo clinics a month. The State Red Cross Nutririonist takes two clinics a month and the Atlanta Red Cross Nutritionist usually works in four a momh. The pediarridan refers patients who need special advice on diet to the nutririonist serving the clinic.
The nutririon consultant has prepared for distribution at these clinics materials on reducing diets for children of different ages, good normal diets, and rraining in food habits. A supply of feeding cards and meal planning guides is also kept for distribution. Similar clinics are held in Augusta, Columbus and Savannah but lack of personnel has made it impossible to give any assistance in these ciries.
Tttberctt!osis Association
The nutritionist has worked with the Atlanta Tuberculosis Association on diets for the tuberculous patient and the convalescent. Recognizing that many of the "returnees" to the institutions could be prevented by proper diet, tentative plans have been made for a nutrition education program with these p.tients while they are in institutions and after their return home. Marerial on diet in tuberculosis has been prepared for distribution to the medical officers and nurses. This has been discussed in rhe staff education meetings.
School Lttnch Program
It is difficult to enumerate the different ways the nutrition consultant has worked on this phase of child health. She has had numerous consultarions with rhe supervisors of the program in the Deparrment of Education.
At some of the regional conferences the nurririonisr suggested having talks from a representative of the School Lunch Division. These ralks explained the program and the ways public health workers could help.
The nurritionist visited lunch rooms in Augusta in May and wrote a report on conditions. This report resulted in a meering of school people to consider the school lunch situation. Only two schools in the city were serving lunches. The other schools had counters where soft drinks, candy, cakes, potato chips and similar products were sold. In the fall of 1946 twelve more schools in the city started serving a complete lunch.
The nurrition consultant met with lunch room managers in a summer workshop and ralked on the imporrance for good health of nutrition and the school lunch.
lHaternctl ctnd Child Health
111
In a school in Thomas County, there was much concern over the unavailability of milk for the school lunch. The nutritionist was asked to prerare dry skim milk and observe the reaction of the children to it. Eight gallons of this milk were prepared for 130 children. No sugar or flavoring was used. Two high school girls and two elementary children who did nor c.lrink milk anyway left full glasses. Most of the children lined up with their glasses for a second serving. Many wanted a third glass but the quantity prepared was not sufficient. All concerned were convinced this could be a practical way of getting milk in school lunches where fresh milk is not available.
All schools in this county not serving milk have requested dry milk for their lunch rooms and are to receive it starting in January 1947.
Hectlth Edttccttion-Ntttrition Workshop
The nutrition consultant worked with representatives of the University of Georgia, Department of Education and Health Department in planning for the workshop held at the University of Georgia the summer of 1946 and acted as a staff member during the time of the workshop. Two features of the workshop which seemed of particular interest to the participants were results of efforts of the nutrition consultant. The other special feature in nutrition was work conducted by one of the U. S. Public Health Service Nutrition Survey Teams, which has been explained under a previous headi!1g.
In July, the nutritionist spent two days at Atlanta University working with a group of Negro teachers in a Health Education-Nutrition workshop. Unfortunately this group had little staff help on nutrition in their course. The nutritionist discussed with the entire class nutrition problems and teaching methods, then worked with small groups on particular problems. It is hoped that more time may be given to this class another year.
Other Agencies ctnd Organizations
Congress of Parents and Teachers: Talks have been given to these groups on child health and nutrition. The nutritionist has worked with the State chairman and the local group on the training of volunteers to give food demonstrations in the health clinics.
Red Cross Nutrition Program: Vocational Home Economics Education, Extension Service. There are many ways in which these programs coincide with that of the Health Department nutrition work. Close working relations and cooperation with these groups have been maintained.
Georgia Nutrition Committee: The nutrition consultant is an active member of the State Nutrition Committee. She has served on the sub-committee, on Diet Planning and Food Habits, the Scientific Advisors Committee and on a Program Planning Committee.
The nutrition consultant is a member of the Georgia Dietetic Association, the Georgia Home Economics Association, Georgia Home Economics Council, Arlanta Home Economics Club and Atlanta Dietetic Association.
112
Georgia Department of Public H ealth
i\tlaternctl ctnd Child Hectlth
113
Through these organizations she is able to help promote better nutrmon in the State and to help coordinate the entire nutrition program in the State.
Work with Student Nurses: Work has been done with only one group, Negro girls at Grady Hospital. This, however, is a definite part of the nutrition program and will be continued.
lndttstrial W ark
The nutritionist has visited three industrial establishments to encourage 8ncl assist in the development of better feeding facilities for the employees. Plans are to continue and expand this type work.
lnstittttional W ark
Help was requested by the minister in charge of a church orphanage. The nutritionist spent a clay there evaluating the situation. She watched the preparation of the food, ate dinner with the group, inspected the storage and food supplies, observed clishwashing and other sanitary facilities. No menus ~were made bur she secured from the housekeeping-cook the foods served for two clays before.
During the stay at the orphanage, written suggestions on food production, food preparation, menu planning and sanitation were given. This was followed up by writing them more detailed suggestions .on menus, recipes and cooking. The nutritionist also requested the help of the sanitary engineer from the Regional Office for this institution. The nutritionist does not consic!er the work done a finished job, but rather a beginning, and expects ta follow up with all possible help.
It is hoped that this type work can be extended into all private and public institutions in the State.
Thomas Cotmty Ntttrition Edttcation Program
In the early summer, the Commissioner of Health of Thomas Coumy 1equested the nutrition consultant's help in the schools in the county, in the
fall after schools opened. In September, the nutritionist visited the county 2.nd made work-plans with the health officer and the instructional supervisor
of the County Department of Education.
In early October a nutrition education program was launched in all white schools in the county. The ins.tructlonal supervisor had been doing preliminary work with the teachers, so they were willing and anxious to carry on the work. The first step was to secure dietary records on the school children.
These records were on a three-day period, Si.mclay, Monday and Tuesday. Such records were secured from over 2,000 school children. The information obtained was used as the basis of the nutrition teaching.
The health officer devised a growth record which was given to the teachers for each child. All children were weighed and measured and those found more than 12 per cent below the expected weight have been given special examinations, including hookworm tests and hemoglobin readings.
114
Georgia Department of Pttblic Health
Of the seven white schools in the coumy, only two were serving milk in the school lunch, because an approved supply of fresh milk was not available. All schools have become so interested in nutrition that they have requested dry skim milk and are to receive it. The present plan is to start rhe use of Wetzel Grids with the first, second and third grades in two schools. The nmrition consultant plans to spend one week out of each two months in the county working with the County Health Department and the County Department of Education in carrying out the nutrition program with community groups, teachers and pupils. The result of the work is already nmiceable in improved condition of the children and the interest of parents, teachers and children.
Food Demonstrations
Simple demonstrations on food preparation are one of the most effective ways to teach nutrition. This is particularly true for individuals who have little education. It is well known also that the poor preparation of food is one of the biggest factors in malnutrition. For these reasons plans were made to have food demonstrations given at clinics in as many counties as possible.
A questionnaire revealed that six counties already had food demonstrations and that twenty-five others wanted to start them. Arrangements were made to supply simple cooking equipment to these counties and, where necessary, to employ a trained home economist, part-time worker, to give the demonstration. When the counties learned this help could be obtained, more .ielt it would be possible to have the demonstration.
Demonstrations have been planned on dry skim milk, potatoes, leafy vegetables, other vegetables, fruits and fruit juices, cereals, eggs, lean meat (pork liver) and fish.
It has not been possible to visit all coumies wanting to start these demonstrations but it is the plan to do so in the near future.
Work With lHidwi,ves
Unfortunately, it was not possible for the nutrition consultant to do much work with midwives during the past year and she met with only one group c.omposed entirely of midwives.
The nurse in Randolph County requested the help of the nutritionist at one monthly meeting with midwives. The nutritionist talked about the food the mother should have before delivery as well as after. The midwives appeared interested and receptive to the talk. In other meetings with mothers, some midwives were present and received the instruction on diets. Midwives are influential with the women they serve. They reach many women with the least education, and they could be an important factor in improving the diets of these women.
Materials Prepared
One new leaflet for children, called "My House of Health", was prepared
Matern(tl (tnd Child 1-le(tlth
115
for publication. The leaflet "What to Eat Before the Baby Comes" and the nutrition part of the bulletin, "Maternal Care", were completely rewritten.
A series of lessons for use in staff education were prepared. They are:
A General Introduction to Nutrition The Normal Diet Diet in Pregnancy and Lactation Diet in Tuberculosis Proteins
Questions and Answers on Nutrition (This was prepared from questions submirted by the nurses and covered many of the problems most frequendy encountered)
A series of six food demonstrations with recipes has been wrirten. There are robe three more in the series. The six which were completed in 1946 are:
Cereals Eggs Lean Meat (demonstrating pork liver) Fish Dry skim milk Potatoes
Mimeographed material was prepared for distribution at the Crippled Children's Clinic. This is:
Suggestions for Good Food for Children Training in Food Habits Reducing Diets for Children of Different Ages
A questionnaire was prepared on food consumption and food buying. The nutrition consultam hoped that each nurse would use these questionnaires to give her more accurate information on actual eating habits.
Each month the nutrition consultant prepared a shaH nurrition article for Georgia's Health. One on "Mineral Oil" was copied in Consumer's Guide and an excerpt from it was used in at least one other state health department publication. The last few mond1S me series has been on vitamins from Georgia foods. These anicles have been on different vitamins and the everyday foods from which they may be obtained.
EDUCATIONAL ACTIVITIES
Literature Distributed:
Mothers and babies___________ -------------------------------------------- 74,457 N u trition publications____________________________________________________ 5,036 N utrition reprints .____________________------------------------------______ _ 14,396
93,889
116
Georgia Dep,vrtment of Pttblic Health
Professional Personnel Trained:
Public Health Administration (physician) ______ _
1
Premature Care-
Public Health Nurses
--------------------- 4
Institutional Nurses_____
1
5
Maternity Nursing Care-
Public Health Nurses ______ ---------------------------- 0
Institutional Nurses ------------------------------------- 1
1
Midwifery (refresher training)------------------------
1
In-trained in Nmrition Education__________
1
In training, Industrial Feeding ___________________________
1
Southern Pediatric Seminar-Physicians (refresher)_ 24
Slossfield Health Center-Negro Physicians (refresher)____ 8
(Training was offered Negro physicians the second time during the year but plans never materialized because of illness of President of Georgia State Medical Association)
The Director of the Division of Maternal and Child Health has had conferences with the Director of Local Health Organizations, the Director of Nursing, and rhe Regional Medical Directors in regard to developing a coordinated in-training service program which would be developed on a regional basis.
MIDWIVES
The number of midwives continues to decline, as it has for the past ten years. Although no special study has been made to determine the reason for the decline, there are several theories in regard to this. Most of our midwives are colored and better opportunities for the colored individual, with increase in educational facilities, have been extended, and for this and other reasons midwifery does not have the appeal to the individual that it formerly had. 1-'atients are becoming more aware of the fact that the services of a physician are desirable. During the past two or three years, the Emergency Maternity and Infant Care program has probably caused more infants to be delivered by physicians than in the past. Another factor in the decrease is the fact that rhe Georgia Department of Public Health has discouraged the appointment of midwives improperly trained with the hope that a program of some kind would be developed to properly train qualified personnel to rake the place of the existing midwife as she drops out of the program. Closer supervision has resulted in the refusal to certify midwives who are non-cooperative and inefficient.
1\!Ictternctl ctnd Child Hectlth
117
MIDWIFE APPLICATIONS, DEATI-IS, AND CERTIFICATIONS BY AGE GROUP
Initial Certifications by Age Group
Year TotalCertifwic.ations c.
Under
Over Age Total Applica- Midwife Midwives
50 50-65 65 Unknown
tions He.. Deaths Retired
fused
1932
3358
2919
1933
3562
3463
1934
3434
3402
99
1935
3510 316 3191
3510
223
1936
3297 326 2971
135
3509
165
1937
3171
1938
3049 298 2751
134
518
134
1939
2951
59
749
85
1940
281H 267 2594
75
653
86
1941
2594 253 2341 37
22
4
5
68
638
71
1942
2412 233 2179 25
13
3
2
43
447
61
37
1943
2203 200 2003 21
16
6
6
52
394
46
45
1944
2074 180 1891 21
10
2
1
31
290
43
38
1945
1944 151 1790 10
7
1
20
235
35
30
1916
1759 146 1613 12
3
1
17
233
38
34
NURSE-MIDWIFE PROGRAM
Preparations were made for a nurse-midwife program to begin in Walton County January 1, 1947. Although this program was tried in Walton Coumy a few years ago, and discominued because it was not working satisfactorily, it is thought that most of the difficulties which were encountered before have been amicipated and their possibility of occurring again has been eliminated.
Standing orders and policies have been approved by the local medical profession, the local board of health, local hospital board and the State Department of Health. The program will be operated under the county health department in cooperation with the local physicians and hospital, with consultation and direction from the Division of Maternal and Child Health, State Department of Public Health.
Nurse-midwife patients are to be delivered in the local hospital with medical consultation from the local clinicians. Patients are to be admitted to the hospital for three days, at a total cost of $15.00, which is equivalent to the fee charged by the local untrained midwife.
The program is set up so that there will be a minimum of two nursemidwives. In addition to the delivery of midwife cases, the nurse-midwives will assist the physicians with their private cases. They also will assist with prenatal conferences, and make a minimum of one prenatal visit and three postpartum visits to patients attending the prenatal conferences.
It is anticipated that this service will be established in two additional centers during 1947. This division expects to develop a service in connection with a maternity shelter, and a service in a county in which home deliveries will be done.
118
Georgi<t Department of Pttblic Health
MATERNAL AND CHILD HEALTH CENTERS
Maternal and child health centers have increased during the year. Prenatal admissions also have increased from 13,931 to 14,776. This is not the case for infam and preschool admissions, which show a decline of approximately 7 per cent.
In a number of our MCH clinics, nurses have been hired on an honorarium basis to free the public health 'nurse from technical details in order to give her more time for personal interviews and educational programs with the patients. Nutrition demonstrations have been arranged in several of the counties as a part of the maternity class program.
The Maternal and Child Health Direcwr collaborated with the Direcwr of the Division of Laboratories in furnishing additional laboratory aid to the maternity patiems by including Rh factor testing. This rest is done from specimens ordinarily sent in for serology.
MATERNAL AND CHILD HEALTH CENTERS REPORTING TO THIS OFFICE, 1946
Nursing Counties Sponsoring MCI-I Centers
27
Maternal Centers
7
Infant Centers
Combined Centers
29
Organized Counties Sponsoring MCH Centers
54
Total
81
50
62
52
57
67
81
MATERNAL HEALTH CENTER ACTIVITIES
Prenatal Admissions
Admissions, total................................................. White .............................................................. Negro ..............................................................
1945
13,931 1,226
12,705
Period gestacion, total..........................................
Under 16 weeks--- 16-27 weeks.................................................. 28-36 weeks--- ....................... Over 36 weeks---
13,931 3,754 7,112 2,703 362
Prmatal Syphilis
Reports, total....................................................... White .............................................................. Negro .............................................................
9,962 879
9,.083
1946
14,776 1,248
13,528
14,776 4,052 7,201 3,052
471
10,744 895
9,849
%plus or minus
++
6 2
I
T
+6 ++ + 13 + 30
+++ 2
iHaternal ?tnd Child Health
Number posicive, total-----------------------------------------White -------------------------------------------------------------Negro ------------------------------------ -------------------------
1945
1,069 51
l,OlS
Preuatal Acti-vities
Visi cs, to tal---------------------------------------------------
46,045
'Whice -------------------------------------------------------------- 4,080
Negro -------------------------------------------------------------- 41,965
Transerred, toea!------------------------------------------------
146
Postnatal Activities
Admissions, total-------------------------------------------------\Vhice -------------------------------------------------------------Negro ------------------------------ -------------------------------
3, 581 447
3,134
Visits, tocal---------------------------------------------------------\Vhi te -------------------------------------------------------------Negro ------------------------------------------------------
4,416 56 6
3,850
1946
1,027 37
990
119
%plus
-or-m-in-us 4 -27 -3
44,711 3,824
40,887
465
3 6
+218
3,225 229
2,896
3,873 426
3,447
- 10 -49
12 -25 - 10
INFANT HEALTH CENTER ACTIVITIES
Admissious-Injmtt am{ Preschool
1945
Admissions, total--------- --------------- 1),917 \Vhite -------------------------------------- 6,103 Negro -------------------------------- 9,814
1946
14,822 5,142 9,680
Age groups, cotal----------------------------- Under 4 monchs--------------------- 4- 12 months..... ---------------------1-5 yearS------- -------------------
15,917 5,642 3,823 6,452
14,822 5,5 66 3,985 5,271
Visits a111l Acti-vities
Visits, total------------------------------- 44,994
Whice ----------------------------------- 16,737
Negro
28,257
38,00 3 13,3 87 24,616
Referred Cases-------------------------------- 2,082
1,286
%plus or fl1lflUS
7 16
7
1
I
I
4
18
- 16 - 20
- 13
- 38
Special Projects
Plans were iniriated with the Dean and rhe Professor of Obstetrics ar rhe Universiry Medical School, Augusta, for a refresher course for privare practmoners, to be held in the fall of 1947. Scholarships will be granted maternal and child health clinicians by rhe Department of Public Health.
All incubators on hand have been distributed, and an additional 100, which will be distributed to local health departments, hospitals and clinics, are being constructed.
120
Georgia Department of Public H ealth
iHaternctl and Chile! Health
121
Plans are under way for the establishment of a premature trammg center at Crawford Long Hospital in order that nurses may be trained in premature c.are without having to be sent out of the State. The Georgia Department of Public Health will grant scholarships and participate in salaries of personnel conducting the training program. An advisory committee, composed of two members of Crawford Long Hospital, two members from the State Health Department and one other member were selected to aid in establishing plans Bnd policies for the training program. The Children's Bureau will make a survey and recommendations before the program is begun.
Personnel and office space were furnished the Georgia Chapter of the American Academy of Pediatrics for the purpose of conducting a State-wide survey of medical and hospital treatment of children.
EMERGENCY MATERNITY AND INFANT CARE ACTIVITIES
The patient load of the Emergency Maternity and Infant Care program has declined considerably during the year. During the month of January 1946 there were 478 maternity and 42 infant cases authorized. This dropped to 134 maternity and 12 infant cases during the month of December.
EMIC ACTIVITIES, 1946 MATERNITY CASES
Number
1. lvlacerni ty cases completed--------------------------------------------- -------------------------------------- 6,463
2. Cases completed after delivery---------------------------------------------------------------------------- 5,333
a. Person in attendance------------ 5,3 33 b. Place of delivery------ 5,3 3 3
(I) Doctors of medicine------ 5,323
(I) In hospitals-------- 4,662
(2) Osteopaths ------------------
0
(2) At home------------ 671
(3) Others ------------------------ 10
3. Cases completed before delivery ------------------------------------------------------------------------- 1,130
Number of cases receiving
cate
Atnount of money approved for payment
4. Total ---------------------------------------------------------------------------
6,3 2 6
5. Both services of attending physicians and hospital care paid for, but paid separately------------------------------------------ 3,98 9 a. Physicians' services-------------------------------------- .... b. Hospital care----------------------------------------------------------(Days of hospital care--------3 0,2 46)
6. Both physicians' services and hospital care paid for in single payment to hospitals-------------------------------------------------------- 182 (Days of hospital care------------9 53)
7. Attending physicians' services paid for but not hospital care 95 5
8. Hospital care paid for but not attending physicians' services 5 5 (Days of hospital care----------5 ,462)
$476,281.72
398,179.66 193,450.28 204,729.3 8
5,498.63
37,037.60 29,413.78
122
GeMgict Department of Pttblic Hectlth
Number of cases receiving
care
9. Consultation serv.ice----------------------------------- 163 I 0. Bedside nursing......................................................................
11. Prenatal and postpartum care provided in clinics buc noc
included in items 5, 6, or 3............................................
0
12. Drugs, ambulance, blood for uansfusions, travel of con-
suloants, and all ocher services noo included above............
0
An1ount of money approved for payment
5,116.30 136.00
349.75
INFANT CASES
Number of cases receiving
care
I 3. Total
595
14. Booh sel'Vices of anending physicians and hospital care for sick infants paid for, buo paid separately.................... 130
a. Physicians' services---------------b. Hospital care..........................................................
(Days of hospital carc--------2,224)
15. Both physicians' services and hospital care for sick infants
paid for in single payment to hospitals............................
23
(Days of hospital care------------471)
16. Attending physicians' services for care of sick infants paid for, but not hospi<al care...................................... .. 271
17. Hospital care for sick infants paid for, but not attending
physicians' services.... --------- ..... ---.---.------- ... ---- ....... -- .. ---------
99
(Days of hospital care----------1,662)
13. Consultation service....................................................
21
19. Bedside nursing for care of sick infants paid for............
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 con-
sultants, and all other services for sick infams not
included above.....................................................................
0
22. Immunizations of well infants............................................
0
An1ount of money approved for paymenc $ 36,254.02
19,491.92 4,241.50 15,250.42
2,3 56.29
4,313.01
9,437.30
645.00
i'v1cttemity Home, Rabttn Com~ty
The Maternity Home in Rabun County, which was begun m 1943, has continued to enjoy its community popularity.
Jvlaternal and Child Health
123
ACTIVITIES OF. RABUN COUNTY MATERNITY HOME
Total
1. Antepartum admissions__________________________________________________________________ f-80
(a) Private physician's cases______________________________________________________ 278
(b) Service Cases________________________________________________________________________
0
(c) Non-registered cases____________________________________________________________
0
2. T oral deliveries______________________ -------------------------------------------------------- 282
(a) Deliveries by physicians____________________________ -------------------------- 282
(b) Deliveries by nurse-midwife______________________________________________
0
(c) Precipitate deliveries -----------------------------------------------------------
0
3. Stillbirths
3
4. Abortions
0
5. labor cases wirh complications---------------------------------------------------
0
6. Operarive obstetric cases______________________________________________________________ 17
Forceps
(a) low ------------------------------------------------------------------------------------
8
(b) Medium ------------------------------------------------------------- _________________
0
(c) High ------------------------------------------------------------------------------------
2
Version ------------------------------------------------------------------------------------------
1
Breech extraction________________________________________________________________________
6
7. Postpartum admissions (delivered in maternity home)_____________ 282
8. Postpartum admissions (delivered elsewhere)----------------------------
0
9. Cases rransferred to hospitaL______________________________________________________
0
(a) Antepartum cases________________________________________________________________
0
(b) Postpartum cases__________________________________________________________________
0
(c) Newborn ----------------------------------------------------------------------------
0
(d) Premature infants__________________________________________ ----------------------
0
10. Public Health nursing visits in maternity home________________________ 3,101
(a) Amepartum ------------------------------------------------------------------------ 105
(b) Intrapartum ------------------------------------------------------------------------ 43
(c) Postpartum ----------------------------------------------------------------- ________ 1,418
(d) Newborn ---------------------------------------------------------------------------- 1,413
(e) Premature infant-----------------------------------------------------------------
0
(f) Infant 4 weeks, over____________________________________________________________ 124
11. Medical service ( H.O.) :--------------------------------------------------------------
0
12. Days of care__________________________________________________________________________________ 3,821
(a) Antepartum ------------------------------------------------------------------------- 149
(b) Postpartum ------------------------------------------------------------------------ 1,832
(c) Newborn ------------------------------------------------------------ ________________ 1,813
(d) Premature -------------------------------------------------------------------------- 27
(e) Infant (readmitted or born elsewhere)----------------------------
0
124
Georgia Department of Public Hectlth
ACTIVITIES OF RABUN COUNTY MATERNITY HOME (Continued)
Total
13. Newborn admissions (born in maternity home) __
280
(a) Infants _ _________________ ------------------ - ___ _________ -------- __
279
(b) Premature infants---------------
_______________ _______ ___
1
14. Newborn admissions (born elsewhere) _________________ _
0
(a) Premature infants _________________________ _
0
(b) Infants __ __ __ _ ______________
0
15. Morbidity cases _______________
______________ ----- - ----------------- ----
0
(a) Antepartum _______________
----------------- ____ _
0
(b) Imrapartum ______________________________________________________________
0
(c) Postpartum ________________
________________________ _
0
(d) Newborn ________ ------------------
------ ----- -------
0
(e) Premature __________ ----------------------------
0
16. Birth and deaths:__________________ ____
-- -------------------
0
(a) Maternal dearhs ________________ ______________
______________ _
0
(b) Infant deaths____________________
__________________ _
0
(c) live births_______________
__ --------- ---------------------
280
(d) Out of Co. births -------------------------------- __________ __ _ _
60
J7. Instruction and demonstrations to practical nurses ___________________ 90
] 8. Instruction and demonstrations to cases __________ _
65
Division of Public llealth Education
c. D. BOWDOIN, M.D..
ActinJ; Director
MAYOLA S. CENTER .......
A.r.riJtant Director
GEORGE M. STENHOUSE ........ .... .. . Pttblic H ectlth Info1nzationctl Exemtite
------- ---------
Division of Public Health Education
The personnel of the Division of Public Health Education included the Acting Director; Assistant Direcwr; Public Health Informarional Execmive; Ediwrial Clerk, and a Stenographer.
The activities of the Division of Public Health Education for the past year fall into two general classifications: ( 1) the distribution of health publications and films authorized by the Department; ( 2) participarion in the planning and direction of the community health project.
PUBLICATIONS AND FILMS
The distribution of healrh publications and films to lay and professional people and groups throughour the state was the main activity of the Division.
Publications are mailed upon request w interested persons for either personal use or as resource use for health education courses by reachers or other workers. These requests are filled daily; if any of the requesrs cannot be mer by the Division, a letter is written suggesting possible sources for the information. The following tables show rhe amount of literature distribmed during the year. Visual aid in the form of 16 mm films is sent upon request to regional, county, disrrict, and ciry public health personnel or to schools and community groups when requested through the above officers. Several new films, the names of which are included later in this report, have been added to the film library of the Departmem. The following table shows by months the number of films which was shown and the estimared attendance.
JANUARY-DECEMBER, 1946
LITERATURE
January _________ ----------------------------------------------------------------- ____________________ _ 26,903 February --------------------------------------------------------------------------------------------- 13,729 1,1arch __________________________________----------------------------------------------__________________ 16,922 April ___------------------------------------------ --------------------------------------- ---------------- 19,601 May ------------------------------------------------------------------------------------------------------ 20,361 June--------------------------------------------------------------------------------------------------- 19,185 July ------------------------------------------------------------------------------------------------------ 21,979 iiugusr -------------------------------------------------------------------------------------------------- 12,669 September -------------------------------------------------------------------------------------------- 24,155 October ------------------------------------------------------------------------------------------------ 18,028 November -------------------------------------------------------------------------------------------- 23,897 l)ecember -------------------------------------------------------------------------------------------- 8,985
TOTAL LITERATURE DISTRIBUTION________________________________ 226,414
128
Georgirt Department of Pttb!ic Health
NEW FILMS
Title
Remarks
Using the Classroom Film ___________________ ]_ reel, 30 minutes, showin,g how to
use film in teaching children The Man Who Missed His Breakfast__]_ reel, 15 ~inutes, Nutrition Infantile Paralysis_________________________________ 1 reel, 30 minutes, Treatment of the
disease Message to Women______________________________ 2 reels, 30 minutes each, Syphilis and
Gonorrhea
Joan Avoids a Cold-------------------------------1 reel, 15 minutes, Immunization Kids Must Eat--------------------------------------1 reel, 30 minutes, Nutrition School Days in the CountrY---------------.1 reel, 30 minutes Care of the Newborn Baby__________________ I reel, 30 minutes
Life Begins____________________________________________r.; reels, 15 minutes each, Child Growth and development from birth w
one year Your Health Department in Action ____ 1 reel, 30 minmes
Lanakila ------------------------------------------------1 reel, 30 minutes, Tuberculosis
JANUARY-DECEMBER, 1946 FILMS
Month
No. Different Films shown
January------------------------------------ 22 February---------------------------------- 32 March-------------------------------------- 36 Apr11---------------------------------------- 47 May------------------------------------------ 35 June------------------------------___________ 34
July------------------------------------------ 34 August------------------------------------- 34 September_______________________________ 20
October------------------------------------ 27 November__________ --------------------- 33 December..______________________________ 46
No. Times Shown
45 83 69 83 60 84 43 275 66 77 122 107
TOTALS 1,114
.!lttendance
3,616 9,110 8,933 11,358 11,646 5,358 1,989 11,224 6,620 4,197 16,524 12,062
102,637
Public Health Education
129
COMMUNITY HEALTH PROJECT
Through a regional planning conference and a state meeting of representatives from the State Departments of Health and Education in 1944, it was decided that some kind of cooperative effort on the part of these agencies was necessary if any significant improvement in the health of the people of Georgia was to rake place. It was also decided that such a cooperative enterprise should be educational in nature.
Since no pattern suitable to the needs of Georgia was available, a joint health-education committee comprised of equal representation from the two Departments was established to study the problems, formulate a plan of z.crion, and direct the project. A project of community health education in tour experimental or spot counties in the State was approved by this committee. It was hoped that some of the techniques and procedures found successful in these spot counties would be used in other communities and counties which might desire to sponsor similar projects.
This project of health education was supported by a grant from the William K. Kellogg Foundation of Battle Creek, Michigan. Each community group in the spot counties felt that the school was the logical agency through which the program of health education could best be realized since the m:1.jor part of the population had an interest in the schools.
Pupils Discowr and List H ealtb Proble111s
130
Georgia Department of Public H ealth
In an effort to help teachers become leaders in health education in their schools and communities and to acquaint them with the personnel and services of the local and State Departments of Education, two summer workshops have been conducted. The first was held in 1945 at GSCW, Milledgeville, and the second was conducted by the College of Education of the University of Georgia, Athens. The participants were selected from teachers of Cobb, Crisp, Spalding, and Walton Counties, the spot counties, and received scholarships amounting to about one-half of their college expenses. A state-level coordinator, Mr. Marvin Shields, did follow-up work after each workshop in the four experimental counties.
Workshops for Negro teachers were held concurrenrly at Arlanta University, Arlanta. State-level coordinator, Miss Dorothy Ury, did follow-up work in the Negro schools.
Pttblic Health Education
131
-c
Division of Preventable Diseases
C. D. BOWDOIN, M.D. ________________________________________.Director otncl Epidemiologist \'{/JLLIAM ]. MURPHY, M.D. ____________________________________________________ C,tncer Control LESTER M. PETRIE, M.D. ______________________________________________________lndttstrial Hygiene MAYOLA S. CENTER, CONSULTANT_______________ __________________________ Social Hygienr: RoY]. BosTON, M.S. Eng'r. ___________________________________________.Typhtts Fe-ver Control C. D. BoWDOIN, M.D. ________________________________________________ Venereal Disease Control
--------------------------------------------------------
Division of Preventable Diseases
CANCER CONTROL SERVICE
The Georgia Cancer Control Program continued to function without interruption throughout the year and it was possible to provide diagnostic and treatment services for all eligible patients who reported to the clinics. Some delay was experienced in obtaining hospitalization for many stace-aid patients but this was not of sufficient degree to detract from the effectiveness of the program. With few exceptions, emergency cases were hospitalized promptly.
The Dalton Clinic reopened in April after having been on an inaccive Stiltus since October, 1943. A new clinic was organized during the year at the Athens General Hospital. For a year or more prior to its opening, members of the hospital staff, in cooperation with the board of directors, had been working with a view to establishing a clinic which would meet the requirements for recognition as a state-aid treatment center. This included remodeling of one floor of the hospital and the installation of new equipment. The services of a radiologist were secured and several of the younger physicians of Athens became associated with the clinic following their discharge from rhe armed services. The clinic was approved as a state-aid treatment center in June. This addition to the program makes a total of thirteen state-aid clinics now in operation.
One of the encouraging feamres noted with respect to the operation of the state-aid clinics during the past year has been the interest shown by many of the younger physicians following their discharge from the armed services. This has been especially true in Athens and Macon.
Due to the sharp increase in hospital costs during the past two years, it was deemed necessary to adjust the rates paid for hospital services. Prior to tile time the adjustment was made, the cooperating hospitals had been receiving $4.00 per day for hospital board plus separate fees for a variety of different services. The cost of these various services amounted w approximately $1.00 per hospital day during 1945 and $1.15 per day during the first 9 months of 1946. In order to provide the hospitals with an increased return and, at the same time, eliminate a large amount of bookkeeping, a flat rate of $6.00 per hospital day was established which includes all of the various hospital services. The new rate went into effect on October 1.
Clinic Acti-vities
The number of applicants for state-aid increased from 1910 during 1945 tO 2290 in 1946, an increase of about 20 per cent. This is the first sizable increase noted since 1941. During the war years the number of applicants gradually declined up to 1945, when the figure approximated that of the year before. During the first six months of 1946 a moderate increase in the number of applicants was noted but during the latter half of the year it became Yery marked. If this trend continues into 1947 it will mean a marked increase in the cost of the program.
136
Georgict Department of Pttblic Health
Acmally, a sharp increase in expenditures has already occurred. During 1946 the cost of the program amounted to approximately $27,500.00 more than in the previous year. This increase is accounted for by three separate factors: (1 ) Increase in the patient load, ( 2) Increase in the rate for hospitalization, and ( 3) Increase in the average cost per case.
During the past year a total of 2360 patients received financial aid, an increase of 350 over the figure for the previous year. This accoumed for an increased expenditure of approximately $17,000.00.
During the last three months of the year a flat rate of $6.00 per day was paid for hospitalization which included all hospital services. This increased the amount paid for hospitalization by approximately 85 cents per hospital day and accounted for an increase of about $3,000.00 in the cost of the program.
As will be noted in table 3, the average cost per case increased by about $6.00 per malignant case and $3.00 per non-malignant case. This may be accounted for in part (about $1.30 per case) by the new hospital rate which became effective on October 1 but the biggest factor involved is the duration of hospitalization. During 1946 the average period of hospitalization was approximately one hospital day per patient greater than in 1945. This may have been due to a relative increase in the number of cases requiring major surgery or, on the other hand, may simply have resulted from failure to get patients om of the hospital as promptly as in the past. Whatever the cause, it accounted for an increase in the cost of the program of approximately $7,500.00. Due to the amount of funds involved, this question is being given further study.
Other Activities
Funds collected by the Field Army are being used in a variety of ways to increase the effectiveness of the state-aid program. In order that better clerical assistance might be available, the sum of $900.00 was allotted for that purpCJse to each of the smaller clinics and $1,800.00 to each of the four largest dinics. Also, at a meeting of the Executive Committee in December the sum of $600.00 was made available to each clinic director for emergency purposes, e.g. special nurses and drugs.
During the coming year increased attention will be given to educational activities, both lay and professional. An illustrated cancer bulletin obtained from the Illinois Cancer Committee will be mailed to all practicing physicians in the state about once a month. It will be sent out as a publication of the Georgia Cancer Commission. It will actually be mailed to the physicians by the Department of Public Health but all incidental expenses will be paid by the Field Army.
The services of a professional public relations organization have been secured to assist in lay education. It will attempt to reach the public through many different channels and its activities will gradually be extended to all pr,rts of the state. This organization operated in Florida last year and was highly recommended.
Preventable Diseases
137
The first Cancer detection clinic in Georgia was opened in Atlama late in December. Space was provided at the Sheffield Clinic and all expenses will be paid by the Field Army. This is purely a diagnostic clinic and patients with pathology will be referred to their private physicians.
Activities carried on during the year by the Cancer Control Service are tabulated below:
Addresses made________________________________________________________________ Estimated number addressed __________________________________________ M~e~ing~ ~ttended other than those addressed ________________ Cl1n1c v1s1 ts __________________________! _____________________________________ ------
Consultations -----------------------------------------------------------------Miscellaneous visits______________________________ ---------------------------Literature dis tributed _________________ ------------------------------------Ar tides written-------------------_______________________----------------------
5 225
10
10
23 6
3723 5
TABLE I.
EXPENDITURES ACCORDING TO TYPE OF SERVICE RENDERED BY CLINICS
1946
Hospital Other Hosp. Board Outside Radium X-ray Diagnostic
Board Expense*
Hospital Therapy Therapy X-rays Biopsies Total
Americus........ 3,628.00 311.50
Athens . . . . . . . . . . 2,010.00 1l<J.40
Augusta..... ... 11,106.00 1,850.50
Canton ...... 2,120.00 55J. 90
Columbus ....... 2,024.00 1-19.50
Dalton ......
5<18.00 28.50
LaGrange .... 2,218.00 302.00
Macon ....... 10,530.00 2,938.87
Savannah ...
2,378.00 707A2
Sheffield ........ 11,924.00 2,141.'17
Thomasville ..... 5,221.00 1,021. 75
waycross........ 752.00 223.00
Winship......... 5,256.00 611. 68
--------
TOTALS ...... $60,018.00 11.288.'19
454.75
785.00
34:5o
79.88 481.47 16.00 807.50
52.50 14.00
2,725.60
489.21 1,855.12 333.30
29.76 365.62 15.50
1,645.43 2,553.68 1,009.50
63.00 2,488. 75 116.50
110.85 1,197.53 121.50
151.25 516.25
4.00
453.12 1,751.00 45.00
2,84J.l2 3, 138.73 755.50
654.78 556.62 80.50
977.25 4,200.22 544.00
568.57 2,738.69 263.50
613.38 2,101.00 72.00
-
-
-**-
2,555.00
---
352.50
8,630.72 26,648.21 3, 743.30
237.00 7,338.88
33.00 2,598.28
774.00 20,024.11
63.00 5,406.15
51.00 3,958.88
15.00 1,293.00
159.00 5,008.00
660.00 21,343.69
285.00 4,678.32
375.00 21,272.-H
264.00 10,080.51
48.00 4,191.88
-3-03-.00-
9,122.18
----
3. 267.00 116' 321. 32
*Other hospital expense includes all cost associated with hospitalization other than hospital hoard; e. g., operating room fees, dressings, anaesthetics, blood transfusions, drugs, etc.
**The Robert Winship Clinic makes no charge for radium therapy.
138
Georgia Department of Pttblic Hectlth
TABLE II.
SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID WI'I'.ff COST FOR
CALENDAR YEAR 1946
Clinics
No. Cases
Americus ....
118
Athens......
20
Augusta.
285
Canton ......... 92
Columbus ..
54
Dalton . . . .
18
LaGrange ....... 103
Macon .......... 362
Savannah ....... 66
Sheffield......... 206
Thomasville ..... 166
Waycross........ 102
Winship ......... 157
TOTAL ..... 1,749
Malignant
Amount Average Cost
6,359.96
2,515.28 14,648.61 3,955.05
3,416.57
1,290.00 4,576.50 18,168.36 3,272.64
17,266.69 7,604.11 3, 799.38 7,230.68
53.90 125.76 51.40 42.99
63.27 71.67 44.43 50.19 49.58 86.08 45.81 37.25 46.06
$91 ,103. 83 $53.80
Non-Malignant
Malignant and Non-Malignant
No. Amount Average No. Amount Average
Cases
Cost Cases
Cost
41
978.92 22.25 162 7,338.88 15.30
16
83.00 5.19
36 2,598.28 72.17
126 5,375.50 42.66 !11 20,024.11 43.72
31 1,151.10 16.80 123 5,406.15 43.95
12
5<12.31 45.19
66 3,958.88 59.98
1
3.00 3.00
19 1,293.00 68.05
13
431.50 33.19 116 5,008.00 43.17
101 3,180.33 31.49 463 21,348.69 46.11
57 1,405.68 24.66 123 4,678.32 38.04
81 4,005. 75 17 .69 290 21,272.44 73.35
59 2,476.40 41.97 225 10,080.51 44.80
17
392.50 23.09 119 4,191.88 35.23
50 1,891.50 37.83 207 9,122.18 44.07
611 $22,217.49 S36. 36 2,360 $116,321.32 M9.29
TABLE III
SUMMARY OF ACTIVITIES
1945-1946
APPLICATIONS
1945
Total received___________ ---------------------------------Number approved________________________________________ Number disapproved__________________________________ Counties representecL________________________________
1910
1904 6
156
PATIENTS REPORTING TO CLINICS Total number reporting______________________________ Classed as malignant__________________________________
Non-malignant and precancerous______________ Deferred diagnosis______________________________________
1676 1044
580 52
CASES GIVEN FINANCIAL AID
Tocal number---------------------------------------------Malignant ------------------------- ------------------ _______ Non-malignant --------------------------------------------
2010 1537 473
AMOUNT OF FINANCIAL AID
Total amount given..__________________________________ $88,845.13
Average amount per malignant case____________
47.46
Average amount per non-malignant case____
33.63
1946 2290 2285
5 154
1860 1083 777
2360 1749 611
$116,321.32 53.80 36.36
Preventable Diseases
139
TABLE IV
SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINICS WITH COST FOR CALENDAR YEAR-1946
Counties
~
~
"""-"'"o""''
::!E
'""'."~ ""gj'
::!E~ 0
g'"o'
z
13
0
1-
Appling ..
Atkinson ... Bacon ...... Baker....... Baldwin . . . . Banks ..... Barrow . . . .
Bartow ..... BenHill..... Berrien .....
Bibb...... Bleckley .... Brantley ... Brooks.... Bryan . . . . . . . . .
Bulloch ...... Burke........ Butts ......... Calhoun ...... Camden ... Candler .. Carroll .... Catoosa ... Charlton .... Chatham . . . . . . . . Chattahoochee .. Chatooga.... Cherokee .. Clarke ...... Clay........ Clayton .....
Clinch ...... Cobb ....... Coffee ...... C:olquitt. ..... Columbia ..... Cook ........... Coweta ......... Crawford ........ Crisp ...... Dade ......... Dawson ..... Decatur .... DeKalb ..... Dodge ...... Dooly ....... Dougherty .. Douglas.........
Early ........... Echols ........ Effingham .... Elbert ....... Emanuel .... Evans . . . . . . . . Fannin . . . . . . . . Fayette ...... Floyd . . . . . . . . . Forsyth .......
Franklin ....... Fulton ....... Gilmer...... Glascock ...
7 4 11
3
3
7
7
14
5
10 4 14
10 4 14
6 4 10
5
5
8 2 10
7 3 10
93 13 106
15
17
7
7
4
5
1
1
33
6
13 8 21
6 9 15
62
8
32
5
8 11 19
32 9 41
2
2
46 17 63
2
2
20 2 22
14 3 17
1 4
"4
1 8
31
4
16 5 21
10 1 11
27 9 36
8 6 14
52
7
18 4 22
51
6
6
8
71
8
10 2 12
22 5 27
26 10 36
14 3 17
19 5 24
17 7 2'1
22 2 24
51
6
l 5
9
5 6 11
39 19 58
io 1
1
2,!
34
7 3 10
42
6
8 7 15
10 4 14
6
6
4
4
~
0
138.35 143.75 119.00 211.51 272.65 218.75 208.00 372.50 417.08 497.91 5842.34 1069.33 256.50 263.57 93.00 144.57 1063.15 1144.71 203.76 204.00 816.32 2683.62
53.00 2879.98
204.75 869.00 1198.45
10.00 482.30 211.00 1687.50 625.50 1425.62 721.55 567.06 879.38 451.40 676.90
. 386:00
874.61 879.95 1322.65 935.75 1R51. 68 1817.73 1206.93 295.00 310.10 915.05 2643.35
6.00 1488.00 246.85 214.25 856.00 337.75
267.00 38.50
Counties
~
~
~"""''"~""'''
."":!''
'""'::!E~"'
~
0
~
::!E
z
1-
Glynn .... Gordon ......
10
13
52
7
Grady ..... Greene ..... Gwinnett . . . .
Habcrshanr.
8
8
8 4 12
19 2 21
63
9
Hall ........ Hancock .... Haralson .... Harris .....
Hart ... Heard ......... Henry .......
13 5 18
6
6
8 2 10
12
3
4
4
2
2
14 2 16
Houston ... . Irwin .......
7 10 17
5
5
.Jackfion .. Jasper . ......
Jeff Davis ...
Jefferson ... Jenkins .... Johnson .... Jones . ..... J.amar ..... Lanier .... Laurens ..
12 4 16
6 5 11
13 3 16
22 11 33
15 7 22
JO 2 12
51
B
10 3 13
51
6
38 7 45
Lee . . . . . . . . . .
Liberty ...... Lincoln ..... J..~ong. .....
I.owndes .... Lumpkin ......
McDuffie......
l\Irlntosh ......
Macon ........ Madison .....
Marion ...... Meriwether . .
10 2 12
3 9 12
11 11 22
1
1
20 7 27
14
5
12 2 1,!
1
1
7 7 14
2J 6 26
23
5
23 2 25
Miller .......... Mitchell .......
72
9
15 6 21
Monroe ...... Montgomery ...
81
9
14 3 17
Morgan ... Murray ...
7 3 10
41
5
Muscogee ..
31 4 35
Newton ..
9 5 14
Oconee . . . . . . . . Oglethorpe ... Paulding ... Peach ..... }lickens . .....
72
9
8 4 12
15 7 22
8
'j
12
12 3 15
Pierce . . . . . . .
10 1 11
Pike ....... Polk ........ Pulaski. ....
Putnam ......
6 5 11
12 11 23
72
9
5
5
Quitman .....
Rabun.
7
7
Randolph ......
71
8
Richmond ....... 78 33 111
Rockdale ........
6
4 10
Schley ..........
1
1
~
0
525.00 271.00 371.22 549.12 972.80 935.97 1141.45 449.95 1090.15" 213.50 121.75 34.75 1173.68 618.73 297.80 1353.35 427.71 167.00 1066.30 959.43 400.35 384.92 264.20 193.60 ]532. 73 24,1.93 593.17 673.85
9.00 975.79 106.10 865.80
3.00 741.66 606.25 166.60 1383.25 231.60 R59.00 503.35 639.53 709.75
86.00 2712.03
643.25 219.75 331.25 671.55 575.60 R54. 50 358.10 639.75 1515.55 369.16 583.55
756.51
558.79
535'1. 50
811.25
42.00
140
Georgict Department of Pttblic Health
TABLE IV
SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINICS WITH COST FOR CALENDAR YEAR-1946
Counties
~creveu . . Seminole. Spalding ..... Stephens . .. Stewart ... Rumter .. Talbot. .... Taliaferro .... Tattnall .. Taylor ... Telfair .. Terrell. Thomas Tift ...... Toombs .. Towns .... Treutlen. Troup... .. Turw~r ...
=o>w
" "Q1W
~8
=."~
*s"" ""ilw
:E~"
"
w
:E
z
0
1-
0
""
27 15 ll 1 32 15 7 32 28 16 3
3 2
13 12
JJ 15 5 23 '1 5 12 2 27 2 51
42
2,118.26
12
659.12
47
3458.'15
7
783,32
. 5
290.50
H
1985.2,1
3
353.50
'j
208.50
5
115.95
16
5M.02
19
7,15.20
17
725.53
21
714.70
11
255.95
2S
820.36
g
710.75
H
474.00
29
1616.37
6
474.70
Counties
=""
= "' "w
cnw
""ilw :E~
"" '" ~~ <0
:E z
2
~
0s
~
~
""
Twiggs ..
7
Union .......
10
Upson .....
23
Walker .....
8
Walton ....
10
Ware ...
15
\Yarren ... ....
6
Washiogton ..
8
Wayne ....
3
Wehster ....
4
Wheeler ..
14
White ......
1
Whitfield ..
11
\Vilcox ..
19
'Yillws ...
j
Vlilkinson.
6
Worth ...
13
Total. ...... .... 1'7'19
11
31R.05
H
353.05
30
799.'13
6
8 16
119.75 1389.05
1 16
1151. 9S
3
9
65R.OO
.j
12
802. RO
3
187.50
.3
'1 17
124.03 .521. 20
l
2
295.50
11
1207.75
22
1056.00
8
487.00
7
161.61
21 - -11-81.-JJ
611 2,31j0 Sll6,32!.32
EPIDENIIOLOGIC SERVICE
Personnel
The personnel of the central office consisted of the State Epidemiologist and one stenographer. The field personnel assigned to the biological section of (he Service was made up of a Senior Biologist, who acts as executive as sistant to the Epidemiologist in supervising biological activities, a permanent field biologist, a field nurse and a secretary. A second permanent field biologist 1esigned during the year. During the summer months, the former Assistant Director of the Malaria and Hookworm Service returned to continue a special research program and two additional temporary biologists were employed on special projects.
F:tnctiom
The office of the State Epidemiologist is the center of all activities related to reporting and control of preventable diseases. To this end, weekly and monthly morbidity reports, which are compiled from data assembled by the Central Tabulating Unit, are forwarded to all staff personnel and health officers. Regional Medical Directors are notified of all cases of preventable diseases reported to the office and are delegated to make such investigations as seem pertinent. Special assistance in investigating and combatting epidemic conditions is rendered by the Epidemiologist or h'is medical and scientific t.ides whenever such assistance is requested. As an aid to communication
Pre,ventable Disectses
141
with private physicians in the state and for the convenience of public health
workers, a classified medical directory of physicians in the state by county
is mimeographed and circulated to health officials and others interested.
This directory is kept up-to-date by forwarding supplements and cor-
rections as changes occur. The general biological activities carried on by
the Service fall into two groups: helminthological investigations and control
programs, aimed primarily at hookworm control; and entomological studies
which provide data for the insect control activities of other scate and county
:tgencies, or which are designed to work out simpler, more economical meth-
ods of controlling medically important insects. This general plan of activities
envisions the temporary employment of consultant biologists and biological
aides during the summer months when entomological activities are at their
peak, and cooperation with colleges and universities in providing materials
and facilities for parasitological research which bears on the work of the
<;:
~ervKe.
During 1946, several investigations on worm diseases were made as described briefly under the general heading on hookworm control and three major entomological investigations were carried out. These programs are described under appropriate headings.
Field Visits
The total number of field visits made in unorganized counties by regional medical directors and public health nurses amounted to 2,671 in 1946 and 5.617 in 1945. This was a 52.5 per cent reduction in field visits, which was brought about largely by a reduction in field visits in the control of malaria.
The following table shows the summary broken clown by diseases and personnel:
SUMMARY OF ACTIVITIES IN THE CONTROL OF PREVENTABLE DISEASES,
1945 AND 1946
Type of Activity
Regional Medical Directors and Epidemiologist
1945
1946
Consultations Admissions to
wmiethdicpahlysseircviaicnes . .... .... .. .. .. .. .. .. .. ..
101
70
1196
704
Admissions to nursing service . ...............
Admissions to medical and/or nursing service . ...
Field Visits
Diphtheria .....
............
:Malaria ......
Measles ......
Scarlet fever . ..
Smallpox ...............
Typhoid and paratyphoid ....
Typhus....
. ...
Whooping cough ...........
Hookworm ...............
Others ...................
57
1
8
2
'j
1
33
26
21
2
71
35
Total field visits..........
195
75
Public Health Nurses
1945
1946
1636
1179
200 2835
20 278
6 189 14
16 1771
93
5422
119 888 4,1 73
2 38
3 15 1209 205
2596
Total
1945
1946
101
70
1196
704
1636
1179
1726
1217
257
127
2335 21
88,g9
286
75
10
3
222
64
35
5
16
15
1771
1209
164
240
5617
2671
142
Georgia Depctrtment of Pttblic Health
The following tabulations will show the number of field visits made by public health workers in the state by counties:
Diphtherict:
Appling ------------------------------ 7 Baldwin ------------------------------ 28 Barrow -------------------------------- 1 Barrow -------------------------------- 21 Bibb ------------------------------------ 132 Brantley ------------------------------ 1 Brooks -------------------------------- 8 Bulloch -------------------------------- 20 Burke ---------------------------------- 5 Butts ------------------------------ ______ 22
Camden ------------------------------ 2 Carroll -------------------------------- 4
Chacham ------------------------------ 40
Clarke ---------------------------------- 44 Clayton -------------------------------- 2 Cobb ------------------------------------ 179
Coffee ---------------------------------- 26
Colquitt ------------------------------ 70 Cook ------------------------------------ 2 Coweta -------------------------------- 1 Crisp ------------------------------------ 12 Dade ---------------------------------- 2 DeKalb ____________ -------------------- 16
Dodge ---------------------------------- 8 Emanuel ------------------------------ 8 Floyd ---------------------------------- 3 Fulton ---------------------------------- 56 Grady ---------------------------------- 3 Gwinnett ---------------------------- 2 Habersham _______ _____________ _____ 7
Hall ------------------------------------ 46 Hart _----------------------------------- 6 Jeff Davis ---------------------------- 1
]enkins -------------------------------- 1 Johnson ------------------------------ 23
Laurens -------------------------------- 3 Long ------------------------------------ 5 Lowndes ------------------------------ 5
Macon -------------------------------- 1 Meriwether ------------------------ 5 Mitchell ------------------------------ 5 Montgomery ------------------------ 2 Muscogee ---------------------------- 31 Pierce ---------------------------------- 13 Rabun ---------------------------------- 2 Richmond -------------------------- 28 Spalding ------------------------------ 112 Sumter -------------------------------- 1
Telfair -------------------------------- 3 Terrell -------------------------------- 3
Thomas ------------------------------ 39 Tift ------------------------------------ 1
Toombs __________ ______________ ______ 4
Troup ---------------------------------- 14 Upson ---------------------------------- 8 Walker ___ ----------------------------- 2 Walton -------------------------------- 11
Ware ---------------------------------- 4 W ashingwn ------------------------ 3
Wayne -------------------------------- 20
Whitfield ---------------------------- 4 Wilcox -------------------------------- 1 Wilkes -------------------------------- 1 Worth ------------------'------ ______ 4
Total ---------------------------- 1144
l-1 ookworm:
Appling ----------------------------- 198 Atkinson ---------------------------- 122 Bacon ---------------------------------- 139 Baker ---------------------------------- 113 Baldwin ------------------------------ 23 Berrien -------------------------------- 19 Bleckley ------------------------------ 30 Brantley ------------------------------ 41
Brooks __ ----------------------------- 59
Bryan ---------------------------------- 87 Bulloch -------------------------------- 324 Burke _____ ----------------------------- 22
Calhoun ------------------------------ 8 Candler -------------------------------- 32 Charlwn ------------------------------ 133 Chatham ---------------------------- 176
Pre-ventable Diseases
143
Clinch ---------------------------------- 74 Cobb ---------- ------------------- ______ 1 Coffee ---------------------------------- 199
Colquitt ------------------------------ 1 Cook ------------------------------------ 2 Decatur ------------------------------ 30
Dodge -------------------------------- 121 Dougherty ------------------------- 39 Effingham ----------------------_------ 10
Emanuel ------------------------------ 28
Evans ---------------------------------- 105 Fulton -------------------------------- 3
Glynn -------------------------------- 50 Grady ---------------------------------- 75 5 Jasper ---------------------------------- 1
Jefferson -----------"----------- ._____ 6
Jenkins -------------------------------- 20 Johnson ------------------------------ 23
Jones ---------------------------------- 2 Lanier --------------------------------- 46 laurens -------------------------------- 100
libeny -------------------------------- 29
long -------------- ______ ------------- 136
lowndes ------------------------------ 56
Mcintosh ---------------------------- 19
Mitchell ------------------------------ 112
Montgomery ---------------------- 5
Muscogee ---------------------------- 31
Pierce ---------------------------------- 101
Pulaski -------------------------------- 12
Screven -------------------------------- 6 Stephens ------------------- ___________ 3
Sumter -------------------------------- 5
Taylor ______ ___________________________
8
0
Terrell ----------------------- _________ 1
Thomas ------------------------------ 23 Toombs ------------------------------ 58
Upson ---------------------------------- 24
Wayne -------------------------------- 101
Wilcox -------------------------------- 7 Wonh. -------------------------------- 3
Total ---------------------------- 3882
Mala-ria:
Bacon -------- ------------------------- 1 Baker ---------------------------------- 87 5 Bibb ------------------------------------ 3 Calhoun ------------------------------ 1 Charlton ------------------------------ 1 Chatham ------------------------------ 19 Effingham ---------------------------- 2 Evans ---------------------------------- 1 Glynn ---------------------------------- 3 Jenkins -------------------------------- 1 lowndes ------------------------------ 20
Measles:
Bacon ---------------------------------- 2 Baldwin ------------------------------ 1 Bibb ----------------------------------- 47 . Brooks ------------------------------- 2 Bulloch ------------------------------ 7
Burke ----------~----------------------- 9
Butts ------------------------------------ 4 Calhoun ------------------------------ 2 Catoosa -------------------------------- 6 Chatham ------------------------------ 286
Mclmosh ---------------------------- 6
Muscogee ---------------------------- 2 Sumter -------------------------------- 2 Thomas ------------------------------ 1 Tift ------------------------------------ 1 Troup ---------------------------------- 2 Upson -------------------------------- 4 Wilcox --------------------------- ____ 6
Total ---------------------------- 951
Clarke ---------------------------------- 49 Cobb ---------------------------------- 17 Coffee --------------- ___________________ 98 Colquitt ------------------------------ 3 DeKalb ______ ------------------------ 10 Dodge -------------------------------- 3 Dougherty -------------------------- 102 Evans ---------------------------------- 17 Fannin ________ ------------------------ 1 Floyd ---------------------------------- 28
144
Georgia Department of Pttblic Hectlth
Fulton -------------------------------- 186 Glynn --------------------------------- 77 Gwinnett ____________________________ 1 Habersham ____________________ ------ 5 Hall ____________________ _____________ 2 Henry ______________ ___ ______________ 1
Jasper ---------------------------------- 1 Jenkins -------------------------- _____ 1 Johnson ------------------------------ 1 Jones ________________ _ __ _________ 36
Liberty __ --------------------------- 31 Long __ ____________ ___ __ __ ___ _ ___ 5 Lowndes _____ ______________________ _ 100 Lumpkin __ __________________ 5 Meriwether _______________________ 1
Scarlet Fever: Bibb _____ __ _____________________ _____ 101
Bartow -------------------------------- 1 Bleckley _____ ___________________ 4
Brooks -------------------------------- 3 Bulloch _____ ________ _______________ 2 Burke ______________ ___________________ 6
Chatham ------------------------------ 171 Clarke _____________ _________________ 28
Claywn -------------------------------- 7
Cobb ---------- ---------- -------------- 335
Colquitt ___ __________________________ 10
Columbia _______ _____________ ____ 1
Coweta _________________________
1
Crawford ---------------------------- 5 Crisp _____________ ____ _______________ 28
Dade ____________________ __ _ _____ 10
Decatur ____________________
1
DeKalb ____________ _________________ 113
Dodge ________ ____ ____________ 7
Dougherty -------------------------- 3 Emanuel ___________________ _________ 1
Fannin -------------------------------- 3 Floyd _________ ______ ____________ 15 Franklin ______ ___ ___________________ 1
Fulton ---------------------------------- 385 Glynn __________________ ____________ 17
Habersham -------------------------- 3
Small-pox:
Dooly ______________________________ Jasper ___ _____ __________ ______ ____ 2 Meriwether __________________________ 29
Muscogee ________________
11
Peach ------------------- ______________ 1 Pulaski ______________ ___________ ____ 4
Richmond _________________
187
Screven -------------------------------- 1 Stephens ____ _____ ___________________ 17
Sumter ----------------------- _
8
Terrell _______________ _________________ 1
Troup ----------- --------------------- 29
Upson _____ _
10
Walton ------------------------------ _ 5 Ware --------------------------------- 2
Total _______________ 1423
Hall ----------------------------------- 29 Jasper __________ ---------------------- _ 9
Johnson --------------------------- 15 Jones _______________________ __________ 10
Lamar ---------------------------------- 5 Laurens ____________ ___________________ 1
Liberty _____ _ __ ______ _______ 5
Lowndes __________
4
Lumpkin ________ --------------------- 9
Mitchell ___ __ ___________________ 2 Muscogee ___ _______________________ 27 Peach _____________________ ____ _____ 7
Pike ---------------------------- ______ 6
Richmond _ _ ___________ _____ 39
Spalding ________________
22
Stephens ------------------------------ 2 Terrell ------------------------------- 1 Troup _____________ ________________ ___ 60
Upson ---------------------------------- 1 Walker _______ __________________ _____ 1 Walton __________________________ ______ 7 Ware _____ _________________ __________ 2
W ashingcon ------------------------ 2 Wayne ------------------------------ 8 Whitfield _________________ ________ 5
Total __ ____________________ 1541
Terrell -------------------------------- 3 Total _____ ____________________ 35
Preventctble Diseases
145
Typhoid Feve-r:
Atkinson ---------------------------- 4 Bibb ------------------------------------ 6 Bulloch ------------------------------ 4 Burke ---------------------------------- 2 Butts ------------------------------------ 3
Chatham ----------------------------- 64
Clarke ---------------------------------- 2 Clayton -------------------------------- 1 Cobb ------------------------------------ . 7 Colquitt ------------------------------ 8 Coweta -------------------------------- 4 Crisp _____________ -------------------- 10 DeKalb -------------------- __________ . 13
Dougherty -------------------------- 4 Emanuel ------------------------------ 12 Fannin -------------------------------- 1 Forsyth -------------------------------- 1 Franklin ------------------------------ 3 Fulcon ---------------------------------- 50 Glynn ---------------------------------- 2 Greene -------------------------------- 1 Hall ------------------------------------ 11 Hancock ------------------------------ 13 Haralson ------------------------------ 1 Henry ---------------------------------- 6
]ackson -------------------------------- 1 Jefferson ------------------------------ 22 Johnson ______ ________ _________ _______ 1
Laurens ------------------------------ ()
Lincoln -------------------------------- 5 Lowndes ------------------------------ 13 McDuffie ---------------------------- 4
Meriwether -------------------------- 11 Montgomery ---------------------- 3 Muscogee ---------------------------- 6 Newton ------------------------------ 1 ,Oglethorpe -------------------------- 5
Pickens -------------------------------- 6
Pierce ---------------------------------- 4 Pike ------------------------------------ 3 Putnam -------------------------------- 4 Richmond ---------------------------- 8 Spalding -----------------------------. 5 Thomas ------------------------------ 2 Toombs ------------------------------ 3 Troup ---------------------------------- 5 Wayne -------------------------------- 3 Wilcox -------------------------------- 1
Total ---------------------------- 355
Typhtts Fever:
Bulloch -------------------------------- 4
Burke ---------------------------------- 3
Calhoun ------------------------------ 1 Carroll -------------------------------- 1 Chatham ------------------------------ 85 Coffee ---------------------------------- 21 DeKalb ------------------------------ 2 Dodge ________ ------------------------ 1
Dougherty -------------------------- 2 Evans ---------------------------------- 2 Glynn ---------------------------------- 10 Haralson __________ -------------------- 2 Jenkins -------------------------------- 1 Johnson ------------------------------ 1
Liberty ------------------------------- 2 Lowndes ------------------------------ 4 Mcintosh ---------------------------- 2 Meriwether -------------------------- 3 Pulaski _____________ ------------------ 2 Richmond ---------------------------- 8 Screven -------------------------------- 3 Tift ------------------- _____________ ______ 6 Walker -------------------------------- 2 Walton -------------------------------- 2 Washington ------------------------ 1 W orrh ________________ ________________ 4
Tom!--------------------------- 175
Whooping Cottgh:
Bibb ------------------------------------ 102 Catoosa -------------------------------- 1
Charlton ------------------------------ 5 Chatham ------------------------------ 36
146
Georgict Department of Pttb!ic Health
Clarke ---------------------------------- 55 -Cobb ----------------------------------- 3 Coffee ---------------------------------- 14 Colquirr ------------------------------ 1 Columbia ---------------------------- 1
Cook ------------------------------------ 1 Dougherty -------------------------- 51 :Evans ---------------------------------- 1
Fannin -------------------------------- 4 Fulton -------------------------------- 56 Glynn ---------------------------------- 25
Greene -------------------------------- 1 Gwinnett ---------------------------- 9
Liberty -------------------------------- 7 Lowndes ------------------------ _____ 111 Muscogee ---------------------------- 4 Newton ------------------------------ 3 Pierce --------------------------------- 1 Pulaski -------------------------------- 23 Richmond -------------------------- 52 Spalding ------------------------------ 14 Stephens _----------------------------- 1 Troup ---------------------------------- 36 Walton -------------------------------- 1
Total _________ ------------------ 619
Others:
Atkinson ------------------------------ 9 Bacon ---------------------------------- 18 Baldwin ------------------------------ 13 Barrow -------------------------------- 7 Berrien -------------------------------- 2 Bibb ----------------------------------- 108 Bleckley ------------------------------ 10 Brantley ------------------------------ 2 Brooks -------------------------------- 98 Bulloch -------------------------------- 2 Burke --------------------------------- 36 Butrs ------------------------------------ 7 Calhoun ------------------------------ 6 Camden ------------------------------ 5 Carroll -------------------------------- 4 Catoosa ------------------------------- 4 Charlton ------------------------------ 1 Chatham ---------------------------- 509 Clarke ---------------------------------- 81 Clinch ---------------------------------- 129
Cobb ------------------------------------ 238 Coffee ---------------------------------- 15 Columbia ---------------------------- 1 Colquitt ------------------------------ 49 Cook ----------------------------------- 2 Coweta -------------------------------- 1 Crisp ---------------------------------- G Dawson ------------------------------ 2 DeKalb -------------------------------- 154 Dodge -------------------------------- 4 Dougherty -------------------------- 73 Early ------------------------------------ 8 Elbert ---------------------------------- 1
Emanuel ------------------------------ 1 Fulton ---------------------- ___________ 354 Glynn ---------------------------------- 32 5 Grady ---------------------------------- 10 Hall ------------------------------------ 12 Henry ---------------------------------- 5 Jefferson ------------------------------ 17 Jenkins -------------------------------- 3 Johnson ------------------------------ 3 Lamar ---------------------------------- 1 Lanier ---------------------------------- 12 Laurens ------ -------- ... -------------- 1 Libeny -------------------------------- 65 Long ___________..________________________ 1
Lumpkin ---------------------------- 1 Mdmosh ------- -------------------- 11 Mitchell ------------------------------ 4 Muscogee ---------------------------- 7 Pierce -------------- ------------------- 65 Pike ------------------------------------ 4 Polk _________________________..__________ 4
Pulaski -------------------------------- 25 Rabun -------------------------------- 1 Richmond -------------------------- 153 Screven -------------------------------- 1 Stephens _______________ ______________ 6
Sumter -------------------------------- 4 Taylor ---------------------------------- 3 Telfair -------------------------------- 14 Terrell -------------------------------- 1 Thomas ------------------------------ 133 'Troup ---------------------------------- 49 Upson ---------------------------------- 42
Preventable Diseases
147
Walton -------------------------------- 10 Ware ---------------------------------- 4 Washington ------------------------ 6
Whitfield ---------------------------- 3
Wilcox __ ----------------------------- 1 Worth ---------------------------------- 11
Toml -------------------------- 2978
Otttbrectks ln-vestigctted
The staff members of the Epidemiologic Service investigated only three outbreaks of any consequence, which are as follows:
Gastroenteritis- ( 1) An investigation was made by both the Clayton County Nurse and a staff member of the Department of an October outbreak of food poisoning in Jonesboro. Twenty-five persons developed sympwms typical of toxin food poisoning. It was found that all patients had eaten chicken salad at a certain Jonesboro restaurant. Specimens of the salad were examined by the Public Health laboramry, and a hemolytic staphylococcus was recovered in practically a pure culture. Upon investigation, it was obvious that the staphylococcus enterotoxin was present in the salad at the time of preparation. How the chicken had become contaminated originally was not definitely determined.
( 2) In February there was a sudden outbreak of a gastro-intestinal disorder among the students in the Conyers High School. Staff members of the Department investigated and found that approximately 66 per cent of the entire dairy herd which supplied milk for the school cafeteria were found to give positive reactions for mastitis. It was concluded that the most probable cause of the outbreak was the presence in the milk of staphylococcus enterotoxin.
iHeningococctts iHeningitis-A small outbreak of meningococcus meningitis occurred in Hall County from January 2 to February 1, involving five cases. Control measures which were applied were effective and further spread was prevented.
Qttctrctntine R egttlcttion
On June 17 a quarantine regulation was released by the Director calling attention to an epidemic of infantile paralysis in Florida and notifying the public that people coming from Florida into Georgia would be expected m place themselves under voluntary quarantine and report to their health officer at their point of destination. Quarantine for a period of two weeks applied to all people with the exception of the bret'ldwinner in the family who must be isolated and remain away from the person in quarantine in rhe home. A person whose occupation had to do with the handling of food for public consumption was not allowed to return to his job until the period of two weeks was up. No barriers were placed at the smte line nor was there any interference with interstate commerce. People traveling by automobile to other states were permitted m continue on their way without being molested. On July S it was deemed necessary to amend the quarantine regulation to rhe effect that all persons entering Florida and returning to Georgia for other than necessary business would be subject to quarantine for a period of two weeks upon remrn, which included all members of the family.
148
Georgict Department of Pttblic Hectlth
Other Acti-vities
Typhoid Cctrriers-Through the efforts of all public health workers during the year 1946 a total of 6 typhoid carriers was found, which was a considerable reduction from the 21 found in 1945, the largesc number of chronic carriers found in any one year. Since there was a 51.8 per cent reduction in the number of cases of typhoid fever during the year, the demand for investigation of carriers was less.
Edttccttionctl-During the year the Director attended 19 meetings, 11 of which were addressed by him, with a total attendance of approximacely 1015. The number of pieces of literature distributed on the control of communicable diseases totaled 34,077.
Conferences-The Director held a total of 76 field conferences connected with the promotional activities related to the Epidemiologic Service as well as other Services coming under his jurisdiction.
.!lnrtlysis of Stcttisticctl Reports
A table of data on che morbidity and fatality rates of reportable diseases v,rhich follows these comments gives the morbidity rates per 100,000 population and the fatality rates as percentages of cases which were reported as
deaths for the year 1946 and for the preceding 9 years. Since these data are
so readily available, it seemed desirable to avoid repetition and instead to utilize the individual discussion of diseases to point out the degree to which the number of cases and deaths in 1946 varied from the number of cases and deaths in 1945, and, as a broader index of trend of the disease, to indicate the median number of cases and deaths in the five years 1942-1946, inclusive. Accordingly each paragraph of discussion is prefaced by: ( 1) a statement of the median number of cases, the number of cases in 1946 and che percentage increase or decrease of cases in 1946 compared with 1945; and by ( 2) a statement of the median number of deaths, the number of df'aths in 1946, and the percentage increase or decrease in deaths in 1946 compared wich 1945.
Diphtherirt
Crtses Median (1942-1946) __________ 520 Reported in 1946 ____________ __ 371
Percentage decrease since 1945 ---------------------------- 46.6
Dectths Median (1942-1946)_________ 47 Reported in 1946._______________ 45
Percentage decrease since 1945 ---------------------------- 36.G
Diphtheria cases and deaths decreased rather sharply in 1946 from the totals recorded in 1945. Previous to 1945, a tendency toward reduction in incidence of the disease had been apparent, and the increased 1945 rates had therefore been viewed with some concern. It was suggested in the 1945 Annual Report that, "During 1945, it is possible that the introduction of a number of veterans returning from epidemic areas in the European theatre of war might have raised the carrier rate in the general population and thus :;.ccounted for the upswing." The resumption of a downward trend in 1946, when the number of returning European veterans was much less, lends added
Pre,ventable Diseases
149
credibility to this suggestion. The fatality rate, 12.1 %, remained above the general level however. The median fatality rate for 1942-1946 was 9.0% and for the preceding five-year period the rate was 8.6%.
Dysentery
Cases Median ( 1942-1946) __________ 313 Reported in 1946________________ 214
Percentage decrease since
1945 ---------------------------- 31.6
Deaths
Median ( 1942-1946) ______
63
Reported in 1946________________ 36
Percentage decrease since
1945 ---------------------------- 40.0
Cases and deaths from dysentery were the lowest of record in 1946. There had been little change in cases and deaths in 1945 as compared with 1944, Dlthough a steady decrease in cases and deaths had occurred during the period 1937-1944. The resumption of a downward trend is therefore encouraging. lt is considered quite possible that the widespread use of residual insecticides might have been an appreciable factor in producing the marked drop in dysenteric disorders during 1946. Considerable effort has also been expended on improvement in restaurant sanitation by all public health agencies, and major significance should be attributed to this factor. The fatality rate was slightly below the median rate for 1942-1945.
Gonorrhect
Cctses Median (1942-1946) __________12 340 Reported in 1946 _______________ 15282
Percentage increase since 1945 --------------------- ------ 23.8
Dectths Median (1942-1946) __________ 6 Reported in 1946 _______________ 2
Percentage decrease since 1945 ---------------------------- 60.0
The number of reported cases of gonorrhea continued in 1946 co show the effect of an active case-finding program and of public confidence in the rapid treatment methods in use. The number of cases found was only slightly below the all-time high reported in 1942 when the wartime control program was at its peak. The 1946 record, however, reflects only the activities of state and local organizations in control of gonorrhea. Success in case finding and treatment is reflected in a decrease in reported deaths. The fatality rate is the lowest of record.
Hooku;orm
Cctses Median (1942-1946) __________ 3799 Reported in 1946 _______________ 4928
Percentage increase since
1945 ---------------------------- 29.7
Dectths Median ( 1942-1946) __________ 1 Reported in 1946 _______________ 0
Percentage change since
1945 ---------------------------- 0
The apparent increase in number of cases of hookworm shown in 1946 1s attributable partly to a change in reporting methods made in mid year. During the period 1936-1940, the median number of cases reported was 17,307, a figure which derives from the inclusion of all cases positive by salt flotation. The median shown above for 1942-1946 is influenced very largely
150
Georgict Department of Pttblic Health
by che limitation of reporting to infecrions showing an egg count of 2,000 or more eggs per cc as determined by che Stoll dilution method, and also by wartime limitations on case finding and treatmem. In 1946, active hookworm control work was resumed, and late in che year reporting of all positives was again begun. It is cherefore likely chat routine and special sanitation activities will reflect themselves in higher yearly case totals, although it is not expected that the limited survey methods now in use will permit che attainment of totals comparable to the figures based on general surveys.
Infittenza
Cases Median (1942-1946) __________ 3780 Reponed in 1946________________ 2279
Percentage decrease since
1945 ---------------------------- 39.7
Dectths Median (1942-1946) __________ 482 Reported in 1946________________ Li23
Percentage decrease since 1945 ---------------------------- 10.6
Influenza in 1946 fell to a new low in number of cases and deaths. The death rate also fell to a new low, bm, as has been the experience in other years of low endemicity ( 1938, 1942, 1945), the case facality rate ( 18.6%) was high, being exceeded during the period 1937-1946 only by the rate for 1938. Ic has been customary co assume that the high fatality rates of nonepidemic years were conditioned pardy by variations in attention paid to reporting between epidemic and non-epidemic periods, as well as by variations in severity of the disease. Inasmuch as neither 1945 nor 1946 can be considered an epidemic year, and inasmuch as reporting should have varied little between these two years, it is perhaps worthwhile to report that analysis shows a statistically significant difference between deaths and survivals from influenza in these two years. Either the age factor in persons attacked or virulence of the non-epidemic organism would, of course, suffice to explain chis difference.
Malctrict
Cases Median (1942-1946) __________ 460 Reported in 1946________________ 115
Percentage decrease since 1945 ---------------------------- 75.0
Deaths Median (1942-1946) __________ 34 Reported in 1946 _______________ 12
Percentage decrease since
1945 ---------------------------- 53.8
A sharp decrease in malaria cases and deaths from malaria occurred in 1946 in contnist to the increase in number of cases which was reported in 1945. This rise and fall in case totals is apparently a refleccion of the return of veterans with active cases from the Pacific, African, and Caribbean theatres of war in 1945 and che subsequent subsidence of many of these active cases. Failure co report recurrent cases in 1946 is also a probable factor. Continued efforts co find endemic foci in Georgia by thick smear surveys have yielded no positive cases. Investigation of reported malaria cases has as yec revealed no confirmed case of locally transmitted malaria. The total number of deachs from malaria decreased nearly as sharply as the number of cases, but the fatality race, which was strongly affected by the high proportion of chronic infections in the total cases reported, rose to a ten-year peak.
Pre,ventable Diseases
151
i'vlectsles
Cases
Median (1942-1946) __________ 4413 Reported in 1946________________ 4184
Dectths Median (1942-1946) ________ 44
Reported in 1946________________ 44
Percentage increase since 1945 ---------------------------- 540,7
Percentage increase since 1945 ---------------------------- 442.8
Measles increased markedly in cases and deaths over 1945, but the 1946 totals fell short of. the five-year case median and provide the median number of deaths for the same base period. Recem experience with measles can best be summarized by pointing out that the median number of cases for the period 1937-1946 is 5167, and the median number of deaths for the same period is 48. Therefore, the 1946 history is very nearly an average of the record for the past ten years. No significant change in fatality rate has occurred in ten years and no change at all in the past three years.
i\lleningitis (Met~ingococctts)
Cases Median ( 1942-1946) __________ 117
Reported in 1946________________ 70
Deaths Median ( 1942-1946) __________ 31 Reported in 1946________________ 31
Percentage decrease since 1945 ---------------------------- 40.2
Percentage decrease since 1945 ---------------------------- 18.4
A decrease again occurred in Meningococcus Meningitis cases and deaths 1n 1946, cominuing a downward trend which started in 1945. Comparison of the two medians for 1937-1941 (35) with the case median shown above indicates that~the disease tripled in incidence in the 1942-1946 period. The combined ten-year median ( 61) reflects a falling incidence of the disease in the early part of the period, a steadily rising incidence which began in 1941 and culminated in 1944, and the recession reported in the last two years. The present downward swing has, then, not yet reached the level of reasonable expectancy. It will be noted that the number of deaths recorded is
quite large in comparison with the total number of cases and the facality rate is relatively high. The calculated line of trend for the period 1939-1946 indicates a pronounced falling off of the fatality rate first dearly manifested in 1943, continuing downward in 1944, moving upward slightly in 1945, and very markedly swinging upward in 1946. The level reached in 1946 by this smoothed curve is, however, still considerably below the levels calculated for the four-year period 1939-1942. Since the years with lower fatality rates are aiso years of increased incidence, the effect manifested is not entirely at-
tribmable to the use of improved therapy. It also follows that it would be
llilwarranted at this time to attribute rising fatality rates entirely to the developmem of drug-resistant strains of the Meningococcus.
Pellctgrct
Cases Median (1942-1946) __________ 159 Reported in 1946________________ 107 Percentage decrease since
1945 ---------------------------- 2.7
Deaths Median ( 1942-1946) __________ 131 Reported in 1946________________ 93
Percentage decrease since
1945 ---------------------------- 12.3
152
Georgia Depa'!'tment of Pttblic 1-Je,tfth
Pellagra cases and deachs continued the decline first manifested in 1939. There was, however, only a minor reduction in cases from the number recorded in 1945. The number of deaths decreased slightly but not enough tO interrupt the upward trend of the fatality rate which has risen as the number of cases reported has fallen. This would s~Cem to indicate that a t<"ndency exists to report only frank cases of pellagra, a large proportion of which terminate fatally.
Pnettmonia
C?tSes
Median (1942-1946) .......... 2524 Reported in 1946................ 1947 Percentage increase since
1945 - 1.9
De?tths
Median (1942-1946) ....------ 1581 Reported in 1946................ 1341 Percentage decrease since
1945 - 10.6
The number of cases of pneumonia rose slightly in 1946 but not suf!iriently to indicate a change in the general tendency toward reduction in the number of cases. The number of deaths reported continued the downward movement in 1946, and the widened spread between cases and deaths caused a slight and non-significant reduction in fatality rate. Improved therapy is apparently indirectly responsible for the higher fatality rates of the last few years. A great many cases are being averted and pneumonias develop chiefly under circumstances which make for a poor prognosis. A portion of. the cases reported are undoubtedly due to virus pneumonias.
Poliomyelitis
Cases
Median (1942-1946).......... 104 Reported in 1946................ 165 Percentage increase since
1945 ............................ 28.9
De?tths
Median (1942-1946) .......... 9 Reported in 1946................ 8
Percentage decrease since 1945 ........................... 20.0
Poliomyelitis cases in Georgia continued the upswing begun in 1944 and rr::flected in a measure the sharply increased incidence experienced in an adjoining state. Maps of case distribution indicated a tendency for the disease to develop in conjunction with well traveled tourist routes and limitation of non-essential travel to and from the most seriously affected area was resorted to in an effort to block, or at least delay, the northward progression of the disease. Since the season of greatest incidence is usually summer and early fall, it appeared reasonable to believe that a delayed onset would shorten the course of an epidemic and reduce considerably the danger therefrom. Under these circumstances, interdiction of idle and unnecessary travel was considered to be indicated and was accordingly placed in effect. The increase in cases in 1946 was not accompanied by an increase in deaths, and the fatality rate was the lowest recorded since the epidemic year of 1949 (790 cases).
Preventctble Disemes
153
Scarlet Fever
Cctses Median (1942-1946) __________ 997 Reported in 1946________________ 503
Percentage decrease since
1945 ---------------------------- 57.6
Deaths Median (1942-1946) __________ 2 Reported in 1946________________ 1
Percentage decrease since 1945 ---------------------------- 80.0
There were less than half as many cases of scarlet fever in 1946 as in 1945, and the .figure for 1946 is the lowest shown in the period 1937-1946. Deaths were correspondingly reduced and the fatality rate is down again to the low level which has been characteristic of the 1942-1946 period. Improvement in therapy is of course the explanation of the lowered fatality rate. However, no ready explanation of the fall in rotal number of cases after a ten-year period in which scarlet fever has remained virtually static at ap proximately 1,000 cases per year can be offered, unless it be assumed that a larger than usual percentage of streptococci infections were unattended by the characteristic sign of scarlet fever. This rash suggestion should probably be tempered with the notation chat the increased use of penicillin alone and in combination with the sulfonamides might account for a number of aborted cases, and so be responsible for the lowered totals.
,Smallpox
Cctses Median (1942-1946) ---------- 7 Reported in 1946________________ 3
Percentage decrease since 1945 ---------------------------- 70.0
Dectths Median ( 1942-1946) __________ 0 Reported in 1946________________ 0
Percemage decrease since 1945 --------------------- ------ 100.0
Smallpox cases decreased in a new low level in 1946. There were no fatal cases in 1946. Inasmuch as only one fatality occurred in 1945, the reduction in deaths appears as a percentage decrease of 100%. The fatality reported in 1945 is the only one recorded for the 1937-1946 period. Comparison of the case median for 1937-1941 (15) with the .figure for 19421946 shown above is the best indication of the present trend.
Syphilis
Cases Median (1942-1946) ----------13954 Reported in 1946________________11477
Percentage decrease since 1945 ---------------------------- 6.1
Dectths Median (1942-1946) __________ 372 Reported in 1946________________ 309
Percentage decrease since 1945 - -------------------------- 13.7
Comparison of the case median shown above with the case median for 1937-1941 (19,540) gives a true indication of an improving position with regard to syphilis. A rise in total cases accompanied the increased casefinding activities of the late pre-war and war periods, but a steady decline has been noted for the last three years, despite the fact that case finding activities have constantly been augmented. The .figures indicate not a relaxation of effort but a reduction of the disease and the lowered totals are the result of treatment of large numbers of individuals in rapid treatment
154
Georgia Dep(trtment of Pttblic Health
centers. The smaller number of dea(hs reported is likewise the resuh of modern case finding and treatment campaigns. The fatali(y ra(e, however, shows no material change and reflects the residuum of cases which was not reached by early diagnosis and treatmem.
T ttbercttlosis
Cases Median (1942-1946) --------- 2608 Reported in 1946________________ 2534
Percentage increase since
1945 -------------------------- 20.0
Deaths Median (1942-1946) --------- 1108 Reported in 1946________________ 1048 Percemage decrease since
1945 ---------------------------- 5.4
Tuberculosis cases rose slightly in 1946 largely as the result of the x-ray examina(ion of greater numbers of individuals in combined YD.-Tuberculosis surveys which reached thousands of individuals who would not otherwise have been prompted to seek medical attention. The slow recession of tuberculosis is best indicated by comparing the median number of deaths in 1937-1941 (1533) with the median deaths for 1942-1946 shown above.
Typhoid Fe,ver
C(tses Median (1942-1946) __________ 177 Reported in 1946________________ 81
Percentage decrease since
1945 ---------------------------- 51.8
Deaths Median ( 1942-1946)__________ 23 Reported in 1946________________ 11
Percentage decrease since 1945 ---------------------------- 52.2
Typhoid fever, which has declined year by year since 1934 with the exception of 1938, fell to the lowest recorded levels in 1946. The decrease in cases over this period is clearly indicated by the relationship between the .five-year medians; the 1942-1946 median is equal to less than one-third of the 1937-1941 median. Deaths from typhoid fell sharply in 1946 after remaining nearly static for the previous four years. The fatality rate has changed linle in trend since 1938.
Typhtts Fever
Cases Median (1942-1946) __________ 1153 Reported in 1946________________ 606
Percemage decrease since
1945 ---------------------------- 45.5
Deaths Median ( 1942-1946) __________ 57
Reported in 1946________________ 33
Percentage decrease since
1945 ---------------------------- 44.1
The case total for typhus fever fell sharply in 1946. A slight reduction in cases had been noted in the four previous years during which control activities have been carried on, and the present drop in cases is therefore especially encouraging. Before (he control program began operation, typhus was slowly increasing in Georgia. The 1937-1941 median was 1017 cases, 136 cases less than the median shown above. Therefore, the apparent reverse in trend is in itself a hopeful sign. Cases and deaths fell at about the same rate in 1946 and the fatality rate shows litde change.
Preventable Disectses
155
Undttlcmt Fe,ver
Cctses Median (1942-1946)__________ 151 Reported in 1946________________ 169
Percentage increase since
1945 ---------------------------- 1L9
Dectths
Median (1942-1946) ---------- 3 Reported in 1946________________ 3 Percentage change since
1945 --------------------------- 0
Undulant fever reswned its upward course in 1946, Despite minor fluctuations in case totals for the past ten years, it is obvious from the calculated trend line that a steady increase in this disease is transpiring, The death coral has remained abouc the same so that it is possible that greater attention to this disease may be responsible for a part of the apparent increase. Whichever interpretation is correct, there is no justification for confidence with regard to undulant fever.
Tl7 hooping Cottgh
Cases Median (1942-1946)__________ 921 Reported in 1946_______________ 615
Percentage decrease since
1945 ---------------------------- 33.2
Dectths Median (1942-19Li6)__________ 65 Reported in 1946________________ 60
Percentage decrease since
1945 ---------------------------- 7.7
The disappointing rise in whooping cough in 1945 did not repeat itself in 1946 and the case total is well below that of 1944, the previous all-time low. The downward reach of the calculated trend line is interrupted only by the statistical effect of the upsurge in 1943. Deaths remained at about the level reached in 1944 and 1945. The fatality rate continued to be approximately twice that of poliomyelitis and in excess of rhat produced by such frightening entities as typhus and scarlet fever.
Gonorrhea, hookworm, measles, pneumonia, poliomyelitis, tuberculosis and undulant fever increased in number of cases in 1946. Diphtheria, dysentery, influenza, malaria, meningitis, pellagra, scarlet fever, small-pox, syphilis, typhoid fever, typhus fever and whooping cough decreased in number of cases in 1946. The number of deaths from measles, only, increased in 1946, and the deaths from diphtheria, dysenrery, gonorrhea, influenza, malaria, meningitis, pellagra, pneumonia, poliomyelitis, scarlet fever, smallpox, syphilis, tuberculosis, typhoid fever, typhus fever and whooping cough decreased in 1946. Deaths from hookworm and undulant fever remained L111changed.
Other Tctbtt!cttions
Following rhe morbidity, mortality and fatality tables will be found the reported incidence of notifiable diseases by months, the number of known cases by color, sex, and age, and rhe reported number of cases and case rates per 100,000 population of the major notifiable diseases by counties and cities of 5,000 populations and above.
156
Georgict Department of Pttblic Health
TABLE I
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES
REPORTED IN GEORGIA, 1937-1946 WITH RATES PER 100,000
POPULATION AND PER CENT FATALITY
Diseases Diphtheria: Dysentery: Gonorrhea: Hookworm: Influenza:
Case Rate
Death Rate
Per 100,000
Per 100,000 Fatality Rate
Year Cases Population
Deaths
Population
(Per Cent)
1937
917
29.8
108
1938
1232
39.7
106
1939
1112
35.3
95
1940
543
17.4
59
1941
758
24.1
63
1942
660
21.1
55
1943
520
16.6
47
1944
162
14.8
40
1945
695
22.2
71
1946
371
11.9
45
1937
715
23.2
130
1938
679
21.9
192
1939
585
18.6
127
1940
582
18.6
126
1941
516
16.4
109
1942
584
18.7
86
1943
459
14.7
79
194<1
304
9. 7
63
1945
313
10.0
60
1946
214
6. 9
36
1937
5549 180.4
24
1938
4686 151.2
21
1939
4583 145.7
24
1940
5282 169.1
22
19Jl
7229 229.8
21
1912
16786 537.4
6
1943
10028 321.0
12
1944
8557 273.9
8
1945
12340 395.0
5
1946
15282 489.2
2
1937
15891 516.6
2
1938
17711 571.4
2
1939
20384 647.9
1940
17306 554.0
1941
7H3 227.1
1942
4617 147.8
2
1943
3409 109.1
1
1944
3372 107.9
1915
3799 121.6
1946
4928 157.8
1937
14799 481.0
1436
1938
3782 122.0
802
1939
11592 368.5
950
1940
13420 429.6
924
1941
36021 1145.3
994
1942
2900
92.8
182
1943
13238 423.8
624
1944
8118 259.9
742
1945
3780 121.0
473
1946
2279
73.0
123
3.5 3.'! 3.0 1.9 2.0 1.8 1.5 1.3 2.3 1.4
4.2 6.2 !.1 1.0 3.5 2.8 2.5 2.0 2.0 1.2
0.8 0. 7 0.8 0. 7 0.8 0.2 0.4 0.3 0.2 0.1
0.1 0.1
0.3 0.03 0.1 0.03
11.8 8.6 8.5 10.9 8.3 8.3 9.0 8. 7 10.2 12.1
18.2 28.3 21.7 21.6 21.1 H.7 17.2 20.7 19.2 16.8
0.4 0.4 0.5 0.4 0.3 0.03 0.1 0.1 0.04 0.01
0.01 0.01
0.04 0.01 0.01 0.02
46.7
9. 7
25.9
21.2
30.4
8.2
29.6
6.9
31.6
2.8
15.'!
16.6
20.0
!. 7
23.8
9.1
15.1
12.5
13.5
B.6
Pre,ventctble Diseases
157
TABLE !-Continued
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES
REPORTED IN GEORGIA, 1937-1946 WITH RATES PER 100,000
POPULATION AND PER CENT FATALITY
Diseases Malaria: Measles: Meningitis: (Meningococcus) Pellagra: Pnr.:umonia:
Year
1937 1038 1939 1040 19<Jl 1942 1943 19<1<1 1945 1946
1037 1938 1939 1940 1941 1942 1943 19<!4 1945 1946
1937 1038 1939 1040 19<!1 1942 1943 194<! 1945 1946
1937 1938 1939 1940 19!1 1942 1943 10<H 1945 1946
1937 1938 1939 19<!0 19<!1 1042 1943 194-l 1945 19<!6
Case Rate Per 100,000 Cases Population
Deaths
6813 3816 2906 2502 1122
981 525 416 460 115
221.4 123.1 95.2 80.1 35.7 31A 16.8
13.3
H.7 3. 7
926
105H 3423 3282 11009
5921 4413 6230
G53 4184
30.1
339.2 108.8 105.1 250.0 189.5 141.3 199.7
20.9 133.9
9<!
3.1
40
1.3
35
1.1
27
0.9
35
1.1
53
1.7
211
6.8
215
6.9
ll7
3. 7
70
2.2
847
27.5
1209
39.0
715
23.7
429
13.7
33<1
10.6
257
8.2.
208
6. 7
159
5.1
110
3.5
107
3.4
5637 5165 4765 4480
3623 4172
3707 2524 1911 1947
183.2
166.6 151.5
1<!3.4 115.2 133.6 121.6
80.8 61.2 62.3
235 146 101 80 75
76 37 3<! 26 12
10 157 51 23 157 60 27 68
7 44
35 20 15 9 17 18 31 56 38 31
370 365 271 235 204 181 175 131 106
93
3077 2731 2299 2055 17H 1612 1734 1581 1500 13<ll
Death Rate Per 100,000 Population
Fatality Rate (Per Cent)
7.6 4. 7 3.2 2.8 2A 2A 1.2 1.1 0.8 0.4
0.3 5.1 1.6 0. 7 5.0 1.9 0.9 2.2 0.2 1.4
1.1 0.6 0.5 0.3 0.5 0.6 1.0 1.8 1.2 1.0
12.0 11.8 3. 7
7.5 6.5 5.8 5.6 4.2 3.4 3.0
100.0 88.1 73.6 65.8 5<!.5 51.6 55.5 50.6 48.0 42.9
3.4 3.8 3.4 3.6 6. 7 7.7 7.0 8.2 6.0 lOA
1.1 1.5 1.5 0. 7 1.4 1.0 0.6 1.1 1.1 1.1
37.2 50.0 !2.9 33.3 48.6 34.0 14.7 26.0 32.5 44.3
43.7 30.2 36.4 54.8 61.1 70.4 8<!.1 32.4 96.4 8G.9
54.6 52.9 48.2 15.9 47.3 33.6 45.7 62.6 78.5 68.9
158
Georgia Department of Pttblic Health
TABLE I-Continuecl
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES
REPORTED IN GEORGIA, 1937-1946 WnH RATES PER 100,000
POPULATION AND PER CENT FATALITY
Diseases Poliomyelitis: Searle~ Fever:
Smallpox: Syphilis: Tuberculosis:
Year
Case Rate Per 100,000 Cases Population
D~aths
Death Rate Per 100,000
Population
Fatalitv Rate I Per Cent)
1937
94
3.1
1938
76
2.5
1939
101
3.2
1910
30
1.0
1941
790
25.1
1942
19
1.6
1913
28
0.9
1944
104
3.3
1945
128
4.1
1946
165
5.3
1937 1938 1939 1940 19!1 1942 1943 1941 1915 1946
1937 1938 1939 1910 1941 1942 1943 1944 1945 1946
1937 1938 1939 1940 1941 1942 1943 1944 1915 1946
935 782 1055 1000 1079 1148 964 997 1187 503
15 33 47 11 11
7 12 7 10
3
15341 18043 20183 21259 19540 21544 215<18 13951 12224 11477
30.4 25.2 33.5 32.0 34.3 36.8 30.9 31.9 38.0 16.1
0.5 1.1 1.5 0.4 0.3 0.2 0.4 0.2 0.3 0.1
498.6 582.1 641.7 680.6 621.3 689.7 689.8 446.7 391.3 367.4
1937 1938 1939 1910 1941
1942 1943 1944 1945
1946
3016
98.0
3011
97.1
2996
%.2
2805
89.8
2635
83.8
3067
98.2
2891
92.5
2608
83.5
2112
67.6
2534
81.1
20 18 12 7 33 10 3 9 10 8
11 13 19 16 9 2 6
2 5 1
496 478 473 587 503 462 435 372 358 309
1549 1612 1533 1533 1385 1265 1304 1107 1108 1048
0.7
21.3
0.6
23.7
0.4
11.9
0.2
23.3
1.1
4.2
0.3
20.4
0.1
10.7
0.3
8. 7
0.3
8.0
0.3
1.8
0.4
1.2
0.4
1.6
0.6
1.8
0.5
1.6
0.3
0.8
0.1
0.2
0.2
0.6
0.1
0.2
0.2
0.4
0.03
0.2
0.03
io:o
16.1
3.2
15.4
2.6
15.1
2.3
18.8
2.8
16.0
2.6
14.8
2.1
13.9
2.0
11.9
2.7
11.5
2.9
9.9
2.7
50.3
51.4
52.0
5:1.5
49.1
51.2
49.1
54.7
44.0
52.6
40.5
41.2
41.7
43.7
35.4
42.4
35.5
52.5
33.5
41.4
Preventable Diseases
159
TABLE !-Continued
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES
REPORTED IN GEORGIA, 1937-1946 WITH RATES PER 100,000
POPULATION AND PER CENT FATALITY
Diseases Typhoid Fever:
Typhus Fever:
Undulant Fever: Whooping Cough;
Case Rate
Death Rate
Per 100,000
Per 100,000 Fatality Rata
Year
Cases Population
Deaths
Population
(Per Cent)
1937
719
23.4
139
1938
829
26.7
121
1939
564
17.9
83
1940
487
15.6
68
1941
397
12.6
55
1942
384
12.3
24
1943
208
6.7
23
1944
177
5. 7
24
1945
168
5.4
23
1946
81
2.6
11
1937
1092
35.5
54
1938
1017
32.8
47
1939
1131
35.9
44
1940
589
18.9
26
1941
941
30.2
36
1942
1153
36.9
52
1943
1256
40.2
57
1944
1182
37.8
63
1945
1111
35.6
59
1946
606
19.4
33
1937
58
1.9
1
1938
83
2. 7
3
1939
121
3.8
2
1940
123
3.9
3
1941
117
3.5
2
1942
129
4.1
1943
98
3.1
1944
159
5.1
1945
151
4.8
1946
169
5.4
1937
1714
55.7
142
1938
2329
75.1
225
1939
1614
51.3
134
1940
1020
32.7
108
1941
1406
44.7
140
1942
1369
43.8
101
1943
1749
56.0
170
1944
792
25.4
65
1945
921
29.5
65
1946
615
19.7
60
4.5 3.9 2.7 2.2 1.7 0.8 0. 7 0.8 0. 7 0.4
1.8 1.5 1.4 0.8 1.1 1.7 1.8 2.0 1.9 1.1
0.03 0.1 0.1 0.1 0.1
0.1 0.1 0.1 0.1
4.6 7.3 4.3 3.5 4.5 3.2 5.4 2.1 2.1 1.9
19.3 14.6 14.7 14.0 13.9
6.3 11.1 13.6 13.7 13.6
4.9 4.6 3.9 4.4 3.8 4.6 4.5 5.3 5.3 5.4
1.7 3.6 1.7 2.4 1.7
3.1 1.9 2.0 1.8
8.3 9. 7 8.3 10.6 10.0 7.4 9. 7 8.2 7.1 9.8
TABLE II NUMBER OF CASES OF NOTIFIABLE DISEASES REPORTED IN GEORGIA BY MONTHS, 1946
Total
Jan.
Feb. March April
May
June
July
Aug.
Sept.
Oct.
Nov.
Actinomycosis. . . . . . . . . . . . . . . . . . . . . . .
Acute Iuf. Conjunctivitis.. . . . . . . .. . . . . . .
Anthrax................... . . . . . . . . . . .
Chickenpox..................... . . . . . .
Cholera................... . . . . . . . . Dengue Fever. . . . . . . . . . . . . . . . . . . . . . .
Di11htheria............. . . . . . . . . . .
Dysentery, Amebic........... . . . . . .
Dyseutery, Bacillary............. . . . . . .
Dysentery, Unspecified........ . . . . . . . .
Glanders. . . . . . . . . . . . . . . . . . . . . . . . . . . . Gonorrhea .............................
Hookworn...............
Iniluenza.............. . . . . . . . . . . .
Leprosy......... .
...........
Lethar~ic Encephalitis. . . . . . . . . . . . . .
Malaria.............................
Measles................... . . . . . . .
Meningococcus Meningitis.... . . . .
Mwnps...............................
Paratyphoid Fever. . . . . . . . . . . . . . . . . . . .
Pellagra. . . . . . . . . . . . . . . . . . . . . . . . . l)la~ue.................. . . . . . . . . . .
Pneumonia..........................
Poliomyelitis........ . . . . . . . . . . . . . . . . .
Puerperal Sepsis. . . . . . . . . . . . . . . . . . . . . .
Rabies (in man)..................
Rheumatic Fever.................. . . . .
Roc~"Y Mountain Spotted Fever. . . . . .
Scarlet Fever. . . . . . . . . . . . . . . . . . . . . . . .
Screw \Vorm Infection (in man). . . . . .
Septic Sore Throat...................
Smallpox....... . . . . . . .
Syphilis.............. . . . . . . . . . . .
Tetanus...... . . . . . . . . . . . . . . . . . . . . . .
Tr~cl~om~ ..... .
TriclnnostS. . . . . . . . . . . . . .
....
Tuberr:ulosis (all forms)............
Tularemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Typhoid Fever......
Typhus Fever....
.. .. .
Undulant Fever...... . . . . . . . . . . . . . .
Vincent's lnfeclion...
........
Whooping Cough................. . . . .
1 33 ... 654
2 371 43 131 -.40 ..... 15,282 4,928 2.279
5 115 4,184 70 413 60 107 ..... 1,947 165
3 65 32 502 .... 274
3 11,477
44
2,534 63 R1 606 169 104 615
TOTAL ........................... 47,402
.. .. .....
62
35 2 3 1 ..... 1,186 283 1,046 . ..... 3 132 8 31 8 11
310 3
....
8
52
17 l 983 3
.... 144
7 6 56 19 4 46
4,470
..... 4
..... 91 .. 1 21 6 3
.... .. 1,157
402 416
l 7 510 10 51 2 13
241 5
1
46
39 1 1,022 2
.... 172
6 7 20 14 10 75
4,356
2
142 .
22 2 14 25
1,570 465 398
.. 9
1,256 16 116 9 10
245 1
.... 3
59
59 ..... 1,378
4
.... 189
14 7 23 15 6 58
6,117
.... 1
75
8 3 3 3 1,315 439 31
8 834
6 80 5 9 .. 123 1
1 1
32 ... 34.
904 4
196 6 6 25
17 2 78
4,250
2
49
13 2 23 5
1,227 508 23
13 657
4 39 11 13 ..... llO 4 ... 1 4 2 29 .. 11 1 864 2
.... 180
4 5 39 15 2 50
3,912
2
35
17 1 22 1 1,402 507 27
23 293
8 26 5 9
81 22
7 13 18
18
1,135 10
.... 250
2 13 57 12 2 77
4,095
1
4
1 13 1 10
1,138 398 12 1 14 72 1 10 6 9 .. 88 34
1 3 10 19 ... 22
752 2
296 4 15 97 10 8 39
3,091
6
4
.... 34 11 12 3
1,599 500 21
l
11 53
2 12 4 8
126 36 ..... ... 11 5 42 ..... 18
1,019 4
257 1
10 93 20 16 34
3,973
3
7
55 7 14 1 1,353 416 29
8 20 2 5 3 12
. 113 25 .....
6 l 35
23 .... 939
2
143 4 6 53 13
11 31
3,341
..... 5
9
GO .. 11 .....
1,108 385 47
9 34 2 12 4 3
118 20
7 1 55
12
862 4
264 2 4 54
10 8 22
3,132
. .... 3
73
. .. 53
4 5 ..... 1,290 472 117 ..... 5 151 7 22 2 5 .... 179 8 .. .. 6
65
9 . .... 1,015
2
249 7 1 49 16 27 55
3,897
0\ 0
Dec.
103
40 c;j
4 "'
11 a
1~
~
937 153
t~J
112 "'
'"1::;2~
5 172
"~ -
4~
9 ""
1 5~
213 '"l:i
6~
o::-... ~
8 ..,...
o.~..;
50 "' ~
12 1:;
604 5
. 194
(i
1 40 8 8 50
2,768
Pre-ventable Dise?tses
161
TABLE III
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1946
1940 Census
Diphtheria
Gonorrhea
Influenza
Malaria
Area
Populationt Cases Rate Cases Rate .cases . Rate Cases Rate
State Total.
Rural. ........ Cities 2500 5000 ..... Cities 5000 & Above., .. Milita.ry Reservations ....
3,123,723 2,062,070
135,683 925,970
Not Available
Appling ......... Atkinson ........ Bacon ........ Baker. Baldwin . . . . Banks. Barrow .. Bartow. Ben Hill Berrien. Bibb.... Bleckley . . . . . . . . . . Brantley .... Brooks....
Bryan ......
Bulloc!J .... Burke .. Butts .... Calhoun ... :
Camden .... Candler .... Carroll ...
Catoosa. Charlton ... Chathan....... Chattahoochee. Chattooga .. Cherokee. Clarke ... Clay ......
Clayton. Clinch .... Cobb., ....
Coffee ..... Colquitt. .... Columbia . . . . Coole ........ Coweta ...... Crawford Crisp ... Dade ..... Dawson ... Deeatur . . DeKalb .. Dodge ... Dooly ......... Dougherty ..... Douglas..... Early., ..... Echols .... :.
Efiingham ... Elbert. .... Effianuel .... Evans . . . . Fannin ... Fayette ... Floyd ...
Forsyth ..... Franklin .... Fulton ....
11,197 7,093 8,096 7,344 16,l11 8, 733 13,061 25,283 14,523 15,370
83,783 9,655 6,871 20,197 6,288
26,010 26,520 9,182 9,382
5,910 9,103 34,156
10,899 5,256 117,970
5,138 18,532 20,126 28,398 7 ,061 J1 ,655 6,137 38,272 21,511 33,012 9,133
11 '919 26,972 7,128 17 ,510 5,894
4,479 22,234 86,912
21,022 16,886 28,565 10,053
'1~:~~~
9,646 19,618 23,517 7 ,101
14,752 8,170 56,141 11 ,322 15,612 392,886
371 11.9 15282 4R9.2 2279 73.0 115
216 11.9 2523 122A Jl80 57.2
84
20 14.7 496 365.6 109 80.3
9
105 11.3 10872 117<1.1 978 105,6
19
1391
12
2 13.8 2 28,2 1 12.4
36.6 68.7
23,7
1 6.5 10 11.9
.. i 14,6
1 19,5 1 15,9 3 11.5 1 3.8 3 32.7 2 21.3 1 16.9
4 11.7
10.0 5.1
19 13Ll
20.7
9 122:5
34 207,2
2 i2:2
1 1L5
12 91.9
19 145:4
11 43.5 110 435,1
3 20.7
1 6,9
3 19.5
4 26.0
142 169.5
2 2A
24 248.6
6 62.1
2 29,1
3L2
1 4,9
21 33LO
29 1ii:5
12 46,1
149 561.8
4 15.1
10 7
1708L.96 ''
6 65.3 3 32.0
1 11.0 29 8L9 3 27.5
439 372-1
3 8,8
12 110.0 7 133.0
108 91.5
10.8
io:s
16,2
2 9.9
39,7
8 28,2
61 2H.8
10.6
1 14,2
42.9
2 i7:2
2 31.1
2 31.1
6 15,7
88 229,9
12 31.4
9 4L8 238 1104.9
8 37.1
14 42A 176 533.1
5 15.1
I 10.6
8 67,1
25:2
2 7A
3 ILJ
14,8
I 14.0
I 5.7 116 66L3
5 28.5
1 17.0
I 17.0
2 33.9
1 22.3
I 89.3
3 13.5
2 9.0 206 926:5
2
6 6. 9
59 67.9 257 295.6
2
1 19.0
20 95.1
5 23.8
2 11.8 430 1505.3
6 22
3n5o.5
5 49.7
1 9. 9
4 20.3
2 10.1
1 10.4
2 io:2
1 5.1
6 25,5
1 4.3
1 51.0
6 40.7
19 128.8
1 12.2
5 6L2
1 7 .I 218 388,3
1 35,3
I 35.3
10 64.1
16 102,5
28 7.1 6891 1753.9
lOA 35.7 1.3
26 176:2 I 12.2 4 7.I 2 17,7 17 108.9 375 95.4
3. 7 4,1 6,6 2.1
i2:4
6.9 1.2 lOA 19.5 3.8 3.8 10.9 10.7 5.9 38.1 0.1
14,2 2.6 4. 6 . 8:4
9.0 2.3
13.5
.2:o
162
Georgia Department of Pttblic Health
TABLE III-Continued
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1946
1940 Census
Diphtheria
Gonorrhea
Influenza
Malaria
Area
Populationt Cases Rate Casss Rate Cases Rate Cases Rate
Gilmer .................. Glascock ................ Glynn ................... Gordon ................. Grady .................. Greene ............. Gwinnett . . . . . . . . . . . . Habersham .......... Hall ................ Hancock ..........
Haralson ....
HHaarrrt i.s............. ......... . . . Heard . . . . . . . . . . . . . . . . . . . Henry .................. Houston ................. Irwin ................... Jackson ................. Jasper .................. Jeff Davis ............. Jefferson ..............
JJoenhknisnosn.......
Jones . ....
La1nar .................. Lanier ........
LLeaeu.re.n..s...............
Liberty ................. Lincoln ............... Long .................... Lowndes ...... Lumpkin ......
Macon ........ Madison ..... :Marion . . . . . . . . McDuffie . . . . . . . . . . . . . . . . Mcintosh ............... Meriwether . . . . . . . . . . . . . . Miller. . . . . . . . . . . Mitchell ................. Monroe ................. Montgomery ............. Morgan ................. Murray ................. Muscogee ...............
Newton .................
Oconee .................. Oglethorpe .............. Paulding ................ Peach ................... Pickens . . . . . . . . . . . . . . . . .
Pierce . . . . . . . . . . . . . . . . . . . Pike .................... Polk ....................
Pulaski.. ................ Putnam ................. Quitman ................ Rabun .................. Randolph ............... Richmond ............... Rockdale ................ Schley .................. Screven . ................ Seminole ................ Spalding ................ Stephens ................
Stewart. ................
9,001 1,547 21,920 18,445 19,654
13' 709 29,087 H,771 34,822 12,764 14.377 11,428 15,512 8,610 15,119 11,303 12,936 20,089 8, 772
8,841 20,040 11,843 12,953 8,331 10,091 5,632 33,606
7,837 8,595 7,042 4,086 31,860 6,223 15,947 13,431 6,954 10,878 5,292 22,055 9,998 23,261 10,719 9,668 12,713 11,137 75,494 18,576 7,576 12,430 12,832
10,378 9,136 11,800 10,375 28,167
9,829 8,5H 3,435 7,821 16,609 81,863 7,724 5,033 20,353
8,492 28,427 12,972
10,603
2 22.2 2 44.0
1 44.4
2 10.8 .. 2i 1i:i:iJ
3 15.3
47 239.1
3 21.9
9 65.7
10 34.4
14 48.1
1 6.8
14 94.8
10 28.7 209 600.2
... i
7.0
1 7.8
1 8.8
10 87:5
1 6.1
"i 6.6
4 16.5 3 19.8
1 8.8
42 371.6
1 7.7
1 7. 7
2 10.0
9 41.8
5 57.0
1 ii:il
1 5.0
22 109.8
1 8.4
46 388.4
1 30.9
1 7.7
2 24.0
26:8 27<1 815.3 25 319.0 3 34.9
2 22.2'
9 41.1
2
6 32.5
5 25.4
39 284.5
6 20.6
14 4o:2
1
3 23.5
1 7.0
1 8.8
9 58.0
2 23.2
2 13.2
2
2 17.7
10 49.8 52 592.8
2 22.6 3 15.0 ... i
27 208.4
2 24.0
1 9.9
1 15
17.8 44.6
"'i;
1 12.8
1 ll.fi
2 6.3 2 32.1 2 12.5
2 14.9
19 59.6 J 64.3 45 282.2 26 193.6
2 6.3 1 16.1 2 12.5 10 74.5
2 18.4 . ii4 10-is:o
1 !.5
1 18.9 44 199.5
.. '2
. iJ:i
I 10.0
1 10.0
2 20.0
7 30.1
17 73.1
3 12.9
1 9.3
1 9.3
'"i
9.0
1 10.3 14 110.1 3 26.9
.. 28 220.2
H 18.5 425 563.0
26 34.4
2
3 16.1
30 161.5
6 32.3
3 39.6
4 52.8
18.3
4 32.2
35 281.6
... i
10.9
"89 857.6 10 109.5
1 5
7.8 48.2
'"i
32 350.3
5 42.4
1 8.5
1 8.5
17 163.9
11 106.0
31.6
36 126.5
93 326.7
18 183.1 8 94.0
'"i
ii:7
... 4
51.1
2 58.2 1 12.8
1 7
. 9:4 8.6
1388 16!i5:5
6 56.6 85 103.8
5 1
3 38.8
6 77.7
1 19.9 209 1026.9
22 108.1 '"i
10.6
4 47.1 61 214.6
'",j
14.1
13
9.4
34 262.1 11 103.7
13 100.2 1 9.4
'"4
9.1 2.9 13.2 5.0 11.4 8.4 14.9
2.6 9.6
47:i
1.2 4.9 506.4 37.7
Pre-ventctble DisectSes
163
TABLE III-Continued
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1946
Area
1940 Census
Diphtheria
POJJulationt Cases Rate
Gonorrhea Cases Rate
Influenza Cases Rate
Malaria Cases Rate
Sumter._ ........ Talbot ............. Taliaferro ............... Tattnall................. Taylor, ................. Telfair ................. Terrell .................. Thomas ................. Tift..................... Toombs . . . . . . . . . . . . . . . . . Towns .................. Treutlen .............
Troup............... Turner . . . . . . . . . . . . . . . . . . Twiggs.................. Union ................... Upson ..................
Walker.................. Walton.................. Ware ................... Warren ................. Washington.............. Wayne.................. Webster................. Wheeler................. White ................... Whitfield................ Wilcox .................. Wilkes .................. Wilkinson ............... Worth .................. Military Reservations ....
24,502 8,141 (),278 1(),243
10,768 15,145 16,675 31,289 18,599 16,952
4,925 7,632 43,879 10,846 9,117 7,680 25,064 31,024 20,777
27.929 10,23()
24,230 13,122
4,72()
8,535 6,417 2(),105
12,755 15,084 1J,025 21,374
Not Available
217 885.()
3 18.5 1 9.3
3 19.8
6 36.0 9 28.8 3 16,1
1 9.3
5 33.0 8 48.0
229 731.9 54 290.3 5 29.5
2 2
26.2 4.6
"24i 549.2
2 18.'1
8 87.7
3 39.1
4 52.1
2 8.0
3 12.0
3 i4:4
3() 116.0 137 659.4
1 3.()
34 121.7
2 19.5
1 4.1
7 28.9
3 22.9
37 282.0
... i ii:7
2 31.2
17 264.9
5 19.2 149 570.8
3 23.5
3 23.5
2 13.3
6 39.8
3 27.2
10 46.8
()1 285.4
1391
tRates are based on enumerated census population of 1940.
48 195.9 3 36.9 1 15.9
2 13.2 5 30.0 10 32.0 1 5.4 1 5.9
1 13.1 28 63.8
1 9.2 i 43.9 15 195.3 8 31.9 2 6.4 7 33.7 9 32.2 5 48.8 35 144.4
12 253.9 2 23.4 1 15.6 4 15.3
2 13.3 2 18.1 7 32.8
12
5.9
.2::i
3. 2 4.1
4
31.4
164
Georgia Department of Pttblic Health
TABLE III-Continued
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1946
Area
Measles Cases Rate
Meningococcus Meningitis
Pneumonia
Cases Rate Cases Rate
Poliomyelitis Cases Rate
Scarlet Fevr
Cases Rate
Rtate Total. ....
Rural. .......... Cities 2500-5000 ......
Cities 5000 and Above .. Military Reservations ..
4181 133.9
1608 78.0 349 257.2 2204 238.0 23
Appling .. Atkinson ...
Bacon ....
Baker.....
Baldwin ..
Banks ..
Barrow
Bartow . .
Ben Hill.
Berrien
Bibb .....
Bleckley.
Brantley.
Brooks ..
Bryan ...
Bulloch.
Burke ..
Butts .....
Calhoun ..
C'amden ....
Candler ...
Carroll ..
Catoosa ..
Charlton ..
Chatham .......
Chattahoochee.
Chattooga.
Cherokee ..
Clarke.
Clay....
Clayton.
Clinch.
Cobb ..
Coffee ....
ColqJitt ....
Columbia ..
Cook ....
Coweta ....
Crawford ..
Crisp.
Dade ...
Dawson .. Decatur .. ............
DeKalb.
Dodge.
Dooly .. Dougherty...
Douglas ..
Early ..
Echols .....
Effingham.
Elbert. ....
Emanuel ..
Evans . .
Fannin ....
Fayette ..
Floyd ...
Forsyth.
FrankJin.
Fulton.
6. 9
80 316.4
75 89.5
2 9.8 5 79.5 63 242.2 186 701.4
32.0
316 925.2 9 82.6 1 19.0
317 268.7 21.6
32 112.7 17.2
73 190.7 38 176.4
1 3.0
42.1
1 22.3 70 314.8 150 172.5 19 90.4
1 5.9 97 33\i. 6
I 41.5 138 703.4
1 4.3 27.1 12.2
42 71.8 21 134.5 536 136.4
70 2.2 1947 62.3
38 1.8 1030 49.9
3 2.2 103 75.9
27 2. 9 723 78.1
2
91
7. 7 11.9
r,.5 1.2
2.5 9.9
5.2
3. 7 l<J.O
1.2 3. 5 10.4
5.3 8.8 tl.4 1.8
6 11.4 4 56.4 9 111.2 3 40.8 18 109.7 1 11.5 4 30.6 21 83.1 5 34.4 4 26.0 16 M.9 17 176.1 1 14.6
7 34.2 9 143.1 14 53.8 17 64.1 I 43.6 4 12.6 3 50.8 2 22.0 15 13. 9 6 55.1 3 57.1 106 89.9 2 38.9 6 32.4 16 79.5 9 31.7
5 70.8 5 12.9 2 31.1 23 60.1 11 51.1 9 27.3 7 74.2 6 50.3 9 33.4 5 70.1 11 62.7 2 3~.9 2 44.7 30 134.9 55 63.3 5 23.8 9 53.3 14 19.0 3 29.8 9 45.6
2 20.7 6 30.6 6 25.5 5 67.6 17 115.2 7 85.7 28 49.9 5 44.2 8 51.2 231 71.5
165 5.3 502
88 4.3 167
16 ll.8
10
60 6.5 318
1
7
42.3
3 11.9
1 6. 9
5 32.5
6 7.2
20
2 20.7
1 14.6
3.8 3.8
10.7 16.9
11.7
1
5.1
27
5.0
7.0
11
i
2.6
41
37.1
8.4
18.0
4. 6
18
7
1
3
9. 9
5.1
12.8
2
3 .1.3
9
2 17.7
1
3
28 7.1 146
16.1 8.0 7.4
34.3
7.9 20.7 23.9
9.8 ?1.8
3.8 7.5
19.0 22.9
38.7 8. 6
107.1 9.1 10.6 33.6
28.5 33.9
55.2 33.3
5. 9 10.5
i5::i
24:5
16.0 8.8 19.2 37.2
Pre,ventable Dise?tses
165
TABLE III-Continued
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1946
Measles
Meningococcus Meningitis
Pneumonia
Poliomyelitis
Scarlet Fever
Area
Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
Gilmer.... ...........
Glascock.
Glynn ............
Gordon ..........
Gtady .. , ..
Greene . . . . .
Gwinnett .. ...........
Habersham.
Hall ...........
Hancock . . . . . . .
Haralson ....
Harris .........
Hart...........
Heard . . . . . .
Henry ...... Houston ......
.
Irwin .........
Jackson .......
Jasper . . . . . . . . .
Jell" Davis ...
Jefferson . ........
Jenkins .....
Johnson ..
Jones .......
Lamar ........
Lanier ..... ............
Laurens .... . . . . . . . . . . .
Lee .........
Liberty .....
Lincoln .... ...........
Long .........
Lowndes .....
Lumpkin .....
Macon ......
Madison .....
Marion ......
McDuffie ......
Mcintosh .....
j\Ieriwether.
Miller . . . . . . . . .
Mitchell ....
Monroe ...
i.VIontgomery ...
Morgan ....
Murray .......
Muscogee ......
Newton ........
Oconee . . . . . . . . . . .
Oglethorpe . . . .
Paulding ....
Peach ......
Pickens .....
Pierce .......
Pike ....... .............
Polk ....... .............
Pulaski ...... . . . . . . . . . . .
Putna.m ........
Quitman ......
Rabun ........
Randolph .....
Richmond. ..............
Rockdale ...
8chley .....
Screven . ...
Seminole .....
Spalding .....
Stephens .....
30 3
... 5
23
136.9 16,3
36,5 79.1
5 14.4
7.0
ii:iJ
18 159.2
12 59.7 46 524.4
90 44id 129 1089.3
31 372.1
. .. ;1 11.9 6 76.6 1 11.6 3 42.6
11 :j,j:5
84 625.'1
152 1397.3
9.1
12.9
io:3
73 96:7
5 26.9
24.1 7.8
7 76.6 1 8.5 3 28.9 116 '107.5 1 10.2
6 :i6j
753 919.8 1 12.9
1 19.9 8 39.3 21 247.3
1 3.5
9 69.4
6 6">, 1
ILl
22,0
2 44.0 ... i
22 100.4
4.6
2 10.8
11 59,6
6 30,5
2 10.2
39 284.5
1 7.3
2 6,9
11 37.8
1 3.4
8 54.2
17.2
13 37.3
2.9
19
3 23.5
4 27.8
3 20.9
8.8
5 43.8
5 32.2
5 58.1
1 11.6
9 59.5
10 88.5
4 30.9
1 7. 7
12 59.7
11.4
2 22.8
11.3
7 79.2
11.3
6 29.9
5.0
20 168.9
3 23.2
3 36.0
8 79.3
2 19.8
.. i9 56.5
3 38.3
11.6
1 11.6
11 156.2
ii
1 24.5 12 37.7 2 32.1
i 16.1
11 69.0
2 12.5
16 119.1
2 28.8
9.2
5 '16.0
4 75.6
1 4.5
7 31.7
2 20.0
10 43.0
12.9
7 65.1
'1 '11.4
7.9
16 125.9
4 5.3
5 <14.9 68 90.1
5 6. 6 .. 28
8 '13.1
1
13.2
4 52.8
1 8.0
8 62.3
16 154.2
5 48.2
8 87.6
5 42.4
8.5
8 77.1
2
3.5
27 94.8
3 10.5
6 61.0
2 23.3
7 82.2
1 29.1
6 36.1
3.7
98 119.7
21
6 77.7
6 29.5
3 35.3
7.0
13 45.7
8 61.7
18.2 27.1 5,1 7.3 54.6
11.6 46.3 23.2
71.0
122.4
4.3 9.3 37.1 5.4
:i2:8 i9:3
25.7
7. 7
166
Geatgia Depctrtment of Pttblic Health
TABLE III-Continued
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1946
Measles
Meningococcus Meningitis
Pneumonia
Poliomyelitis
Scarlet fever
Area
Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
SSutemwtaerrt......... .....
4 37.7 27 110.2
Talbot ..........
Taliaferro .....
Tattnall.........
Taylor ..........
74.3
Telfair ..........
rrerrell .........
rrhomas .......
Tift...........
Toombs ......
5.9
Towns .........
Treutlen .......
Troup.........
55 125.3
Turner . . . . . . . . . . . . . . . . . .
Twiggs . . . . . . . . . . . . . . . . . .
21.9
Union ..........
Upson .......
10 39.9
Walker..................
Walton ..............
6 28.9
Ware ...........
3 10.7
Warren .......
Washington.
Wayne.........
Webster .........
8 169.3
Wheeler . . . . . . . . .
White..............
Whitfield . . . . . . . . . . .
10 38.3
Wilcox .........
Wilkes ............
60 397.8
Wilkinson . . . . . . . . . Worth .................. ...
Military Reservations..... 23
12.3 6.4 'l. 6 21.9
15.6 2
tRates based on enumerated cemus population of 1940.
7 66.0
13 53.1
5 61.4
12.3
3 47.8
5 30.8
2 12.3
5 46.4
1 9.3
4 26.4
1 6. 6
16 96.0
1 6.0
16 51.1
1 3.2
5 26.9
3 16.1
8 47.2
1 5.9
3 60.9
4 52.4
31 70.6
3 6.8
19
4 4:i:9
2 18.4
6 78.1
8 31.9
5 19.9
1
8 25.8
1 3.2
4
13 62.6
1 4.8
1
9 32.2
3 10.7
4 39.1
9 37.1
3
4 30.5
7.6
3
3 63.5
3 35.1 1 15.6
2 23.4 ...i
11 42.1 ... i
4
4 31.4
7.8
3 19.9
1 6.6
5 45.4 18 84.2
... i
'4:7
91
1
7
43.3
4.0 12.9 4.8
12.4 22.9
15.6 15.3
Pre-ventable Diseases
167
TABLE III-Continued
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1946
Area
Syphilis Gases Rate
Tuberculosis Cases Rate
Typhoid Fever
Cases Rate
Typhus Fever
Cases Rate
Whooping Gough
Cases Rate
State TotaL , , , .........
RuraL ................. Cities 2500-5000 ......... Cities 5000 and Above .... Military Reservations
11,477 2,651
580 7,937
309
367.4 128.6 427.5 857,2
2534 81.1 927 45.0
103 75.9
1486 160.5
18
81 2.6 606 19.4 615 19.7
50 2.'1 421 20.4 306 14.8
5 3, 7
33 24.3
22 16.2
26 2.8 152 16.4 287 31.0
Appling .......
Atkinson ...... Bacon .........
Baker........... Baldwin . . . . . . . . . Banks.. "' ..... Barrow ....... Bartow........ Ben Hill ...... Berrien ..... .. Bibb........... Bleckley........ Brantley ......
Brooks........ Bryan .......... Bulloch ........ Burke . . . . . . . . . But.ts ......... Calhoun .........
Camden . . . . . . . . . Candler .......... Carroll........... Catoosa ............. Charlton ........... Chatham . . . . . . . . . . Chattahoochee .... Chattooga . . . . . . . .
Cherokee . . . . . . . . . . rtarke ............ Clay............. Clayton ............ Clinch .. '" ......... Cobb .............. Coffee .............. Colquitt............. Columbia ...........
Cook . . . . . . . . . . . . . . . . Coweta ............. Crawford......... Crisp ............ Dade ............... Dawson .......... Decatur . . . . . . DeKalb ............
Dodge ............. Dooly........... Dougherty ....... Douglas........... Early ............ Echols .......... Effingham ....... Elbert .. , .. , .... Emanuel. ...... Evans ...... Fannin ...... Fayette ..... Floyd........ Forsyth ...... Franklin...... ...........
12 82.8
1 13.6 75 457.0 1 11.5 15 114.8 3 11.9 3 20.7
380 453.6 10 103.6
76 370.g 9 143.1
76 292,2 270 1018.1
1 10,9 47 501.0
3 33,0 16 46.8 1 9.2 1 19.0 2,788 2363.3 7 136.2
4 19.9 218 767.7
1 14.2 3 25,7
130 339.7 101 468,9 77 233.2
1 10.6 6 50.3 3 11.1 1 H.O 160 912,2 1 17.0 2 4!.7 5 22.5 236 271.4 38 180.8 7 Jl.5 129 451.6
15.2
13 134:8 5 25.5 10 42.5 1 13.5 8 M.2
. i84 327.7
3 20,7 1 H.1 ! 49.4 3 40.8 18 109,7 1 11.5 1 7.7 18 71.2 6 41.3 5 32.5 101 120.5 2 20.7 2 29.1 8 39.0 6 95.4 12 !6.1 15 56.6 ! !3.6 6 64.0 4 67.7 5 54.9 16 46,8 8 73.4
i89 160.2
28 1i>i:i 9 44.7 21 73.9
6 5i:5 4 62.1 37 96,7 12 55.7 18 54,5 1 10,6 9 75.5 7 26.0 1 14.0 7 39.9 13 220.6 1 22,3 8 36.0 54 62.1 4 19.0 5 29.6 32 112.0 6 59.7 18 91.2 1 33.7 7 72,6 8 40.8 6 25.5 2 27.0 14 94.9 1 12.2 85 151.4 5 <14.2 6 38.'!
1.2
"""i
3.8
5.9
3.4 5.4 5.0 3.5
2.6 2 6,1
2 7.4 1. 5.7
3.5
7.0
. 5:i 12.8
... i
6.8 1 12.2 2 3.6 2 17.7 1 6.4
12 82.8 4 56.4 5 61.8 1 13.6
1 ii:5
1 7, 7 2 7. 9 7 48.2 8 52,0 9 10.7 6 62.1 2 29.1 5 24.4 2 31.8 10 38.4 4 15.1
3 32.0 1 16.9 3 33.0 7 20.5
21 17-8
! 27.6
2 15,3 H 55.4 41 48.9
.. "8 30,8
32,0 5 14.6 7 64.2 1 19.0 1J 9.3
:ii:i 28.3
3 7.8 2! 111.4 20 60.6 1 10.6 8 67.1 I 3.7
51.3
1 5.0 28 98.6
.i3 34.0
3 13.9
1 10.6 2 16.8 1 3.7
2 ii:4
15 67.5 4 4.6 8 38.1 12 71.1 5 17.5
15.2
2 20.7
H 59.5 11 HS.6
1.8
i3:5 9.2
i 5.9
31 108.5
23 117.2
.. i7 1i5:2
9 16.0 1 8.8
168
Georgict Depctrtment of Pt~blic Hectlth
TABLE III-Continued
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY CoUNTIEs, 1946
Syphilis
Tuberculosis
Typhoid Fever
Typhus Fever
Whooping Cough
Area
Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
Fulton ....... Gilmer .................. Glascock ................ Glynn ........... Gordon .......... :::::::
Grady ..................
Greene . . . . . . . . . . . . . . . . . . Gwinneoo .... : . .......... Habersham .............. Hall .................... Hancock ................
Haralson ................
Harris ............. Haro . . . . . . . . . . . . . . . . Heard .............
Henry ............. Houston ............
Irwin ................... Jackson ................. Jasper .................. Jeff Davis ...............
Jefferson . ........ Jenkins .......... ,Johnson ............. ::. Jones ........ ........... Lamar ..................
Lanier . . . . . . . . . . . . . . . . . . LLeaeu.re.n. s. .. .. . . . ........ . . . . Libert.y . . . . . . . . . . . . . . . . . Lincoln ............ Long . . . . . . . . . . . . . . . . . . . .
Lowndes . . . . . . . . . . . . . . . . Lumpkin ................ Macon .................. Madison ................ Marion ................. McDuffie ................ Mcinoosh ............... Meriwether. ............. Miller . . . . . . . . . . . . . . . . . . . Mitchell .................
Monroe ................
lVIontgomery . . . . . . Morgan ........... Murray ..........
Muscogee ......... Newton . . . . . . . . . . . Oconee . . . . . . . . . . . . . . . . . . Oglethorpe .............. Paulding ................ Peach ................... Pickens ................. Pierce ................... Pike .................... Polk .................... Pulaski. ................ Puonam ................. Quitman . . . . . . . . . . . . . . . . . Rabun .................. Randolph ............... Richmond ............... Rockdale ................ Schley ..................
Screven . ................
Seminole ................
2605 6R5.0 1 11.1 2 44.0 15 68.4
103 524.1 36 262.6 19 65.3 3 20.3 71 203.9 2 15.7
36. 3i5:o 4 25.8 1 11.6
16 t4i:li
29.9
! 45.2 103 514.0 84 709.3
12 144:o 1 9.9 1 17.8 97 288.6 3 38.3 2! 279.2 3 42.6 2 48.9 8 25.1
.. 19 119.1 7 52.1 2 28.8 1 9.2 5 94.5 89 403.5 4 40.0 93 399.8 1 9.3 3 31.0 8 62.9 3 26.9
854 1131.2 3 16.1 8 105.6 10 80.5
66 636.0 2 21.9 3 25.4 1 9.6 25 87.8 26 264.5 1 11.7
24:1 212 259.0
1 12.9 2 39.7 154 756.6 8 94.2
123 107.7 5 55.5 1 22.0 20 91.2 3 16.3 7 35.6 3 21.9 8 27.5 3 20.3 18 51.7 8 62.7 9 62.6 5 43.8
1 11.6 8 52.9 5 <14.2 6 46.4 2 10.0 6 68A 2 22.6 11 54.9 7 59.1 1 7.7 2 24.0 8 79.3 1 17.8 19 56.5 2 25.5 5 58.2
3 73.4 17 53 A 2 32.1 5 31.4 2 H.9 4 57.5 5 46.0 2 37.8 10 45.3 2 20.0 9 38.7 9 83.7 1 10.3 4 31.5 4 35.9 480 635.8 8 43.1 1 13.2 2 16.1 5 39.0 11 106.0 4 43.8 2 16.9 ! 38.6 13 45.7 1 10.2 2 23.5 1 29.1
3 i8:i 115 140.5
3 38.8 1 19.9 8 39.3 3 35.3
1.5
4.6
3A 2 5.7 1 7.8
R.8 11.6
5.0 ... i
11.3 4 20.0
7i:O
9.2 2 9.1
.. 1 5.<1
8.0
.j
9.6
1 10.9
1i:7
11.8
33 SA
41.1 40.7
8.6
i3:9
6.4
3 26:5 8 61.8
1oi :S 5.0 8.!
7.7
3 29:7 5 88.8 9 26.8 3 38.3 2 23.3
2 48:9 13 40.8 3 48.2 3 18.8
57.5
18.9
2 20.0 7 30.1 1 9.3 1 10.3 1 7.9
"""1
1.3
1 5.4
! 38.5 8 87.6 10 84.7
2 7.0 4 40.7
10 60.2 10 12.2 1 12.9 11 218.6 10 49.1
7 82.4
39 9.0
17 77.6
6 43.8 5 17.2 1 6.8 ! 11.5
7.0 8.8 "j ii:il 44.2
26 129:7 2 16.9
11.6
6.3 7.4 9.2
1.3
7.9 .. i3 17:2
1 5.4 8.0 7.8
12 131.3 15 1<14.6 10 35.1 25 25<1.3
69 84.3 6 77.7
35.3
Preventctble Disectses
169
TABLE III-Continued
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1946
Syphilis
Tuberculosis
Typhoid Fever
Typhus Fever
Whooping Cough
Area
Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
Spalding ................
~i:~~~~~::::::::::::: ...
Sumter.......... Talbot .............. Taliaferro ............... Tattnall ................. Taylor .......... Telfair ............. Terrell ............. Thomas . . . . . . . Tift........... Toombs .......
Towns ........ Treutlen ....... Troup................... :ru~ner . . . . . . . . . . . . . . . . . . Tw1ggs . . . . . . . . . . Union ........... Upson .......... Walker . . . . . . . . . . Walton .......... Ware .............. Warren ............ Washington . . . . . . . . . Wayne ......... Webster ....... Wheeler . . . . . . . . . White ........... Whitfield ........ Wilcox .......... Wilkes . . . . . . . . . . . Wilkinson . . . . . . . . . . . . . Worth .................. Military Reservations.....
46 161.8 3 23.1 5 47.2 213 869.3 1 12.3
7 43.1 2 18.6 28 184.9 85 509.7 35 111.9 120 645.2 2 11.8 1 20.3
133 303.1 7 64.5 8 87.7
2 8.0 2 6.4 43 207.0 44 157.5 2 19.5 110 454.0 33 251.5 1 21.2 3 35.1
28 107:3 2 15.7 6 39.8 17 154.2 70 327.5 309
11 33.7
3.5
9 69.4
6 56.6 17 69.4
.. il 44.9
2 24.6
1 12.3
3 !7.8 5 30.8
4:i:i
1 9.3
6 39.6
3 19.8
6 36.0
2 12.0
20 63.9
2 6.4
18 57.5
13 69.9
3 16.1
19 102.2
10 59.0
1 5.9
! 23.6
3 60.9
2 26.2
25 57.0
1 2.3
6 55.3
10 92.2
3 32.9
1 11.0
1 12
13.0 47.9
... i
4:o
4.0
25 80.6
11 52.9
1 1.8
21 75.2
10 35.8
1 9.8
7 28.9 .. '2
.. '4 16.5
8 61.0
15.2
7 53.3
1 21.2
2 42.3
4 46.9
2 23.4
5 58.6
6 93.5 32 122.6
2 7.7 '"i 3.8
3 23.5
1 7.8
6 47.0
4 26.5 ! 36.3
1 .9:1
9 42.1
10 46.8
18
tRates are based on enumerated census population of 1940.
3.5
2 8.2
H 130.0 1 6.6 4 12.8 3 16.1
!8 109.4
io 247.4
6 23.9 1 3.2
7.6
3.8 7.8
ko
170
Georgia Dep?trtment of Pttblic Health
TABLE IV
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN CITIES OF 5,000
1946 POPULATION AND ABOVE IN GEORGIA,
Diphtheria
Gonorrhea
Influenza
Malaria
Area
Population Cases Rate Cases Rate Cases Rate Cases Rate
TOTAL .... Albany . . . . . Americus . . . . . Athens . . . . . . . . . . . . . . Atlanta (DeKalb) ....
Atlanta (Fulton). Augusta . . . . . . . . Bainbridge ..... Brunswick . . . . Carrollton ...... Cartersville .... .
Cedartown ..... College Park.... Columbus ..... Cordele ........ Dalton . . . . . . . . Decatur ......
Douglas . . . . . . . Dublin ........ East Point.... Elberton ..... Fitzgerald ..... Gainesville ...
Griffin . . . . . . . Hapeville . . . . . I~aGrange ...... Macon ........ Marietta .... 'Milledgeville.
Moultrie ....... Newnan ........ Rome ........ Savannah .... Statesboro.... Thomaston ...
Thomasville .... Tifton ..... Toccoa... Valdosta . . . . . Waycross . . . . .
925,970 19,055
9,281 20,650 28,994
273,294 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
13,222 5,059 21,983 57,865 8,667 6,778
10,147 7,182 26,282 95,996 5,028 6,396
12,683 5,228 5,494 15,595 16,763
105 11.3 10872 1174.1
375 1968.0
198 2133.4
4 19.4
47 227.6
2 6.9
15 51.7
25 9.1 6477 2370.0
6 9.1 1261 1913.0
1 15.7
1 15.7
11 177.0
16.3
8 130.3
8 88.6 1 12.2 10 18.8
... i
9.6 1 6.0
28 310.2 38 462.7 350 656.9 78 983.7 136 1301.7
-20 120.8
4 77.3 1 12.8
183 3536.2 88 1126.2 48 387.0
5 48.8
2 21.1 118 1152.0
2 15.1
1 4.5 8 13.8 4 !6.2
41 310.1 9 177.9 149 677.8 117 202.2 60 692.3 27 398.3
69.0
"""i 3.8
2 2.1
15.6
115 1133.3 3 41.8
161 612.6 413 430.2
19 377.9 2 31.3
71.0 164 1293.1 40 765.1 24 436.8 12 76.9
34 202.8
978 105.6 17 89.2 44 474.1 3 14.5 2 6.9
363 132.8 81 122.9 5 78.7 8 53.2
76 842.1
25 46:9 5 63.1 4 38.3 160 966.1
2 38.6 5 64.0 2 16.1 1 16.2
29.3
30.3
21 95.5 2 3.5 8 92.3 1 14.8
29.6
2 7.6 105 109.4
4 79.6 1 15.6
39.4
109.2 2 12.8 8 47.7
19
2.1
1.8
2 ii:i
32.2
3.8
i2: 1
19.3 12.8 8.1
9:8
1.7
1.0
Pre-tentable Diseases
171
TABLE IV-Continued
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, 1946
Measles
Meningococcus Meningitis
Pneumonia
Poliomyelitis
Scarlet Fever
Area
Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
TOTAL ......... Albany . . . . . . . . . . Americus . . . . . . . . . . . . . . . . Athens . . . . . . . . . . . . . . . . . . Atlanta (DeKalb) ........
2204
48. 25
32 2
238.0 251.9 269.4 155.0
6.9
Atlanta (Fulton) ...
Augusta............. Bainbridge .......... Brunswick . . . . . . Carrollton ....... Cartersville . . . . . .
474 173.4 717 1087.7
10 157.4 25 166.3
3 48.3 30 488.5
Cedartown ...... College Park ...........
Columbus ............... Cordele .............. Dalton . . . . . . . . . . . . . . . . . . Decatur . . . . . . . . . . . . . . . . .
111 1229.9 53 645.3 65 122.0
.. '3 28:7 72 434.8
Douglas . . . . . . . . . . . . . . . . . Dublin . . . . . . . . . . . . . East Point .......... Elberton ........ Fitzgerald ....
Gainesville ......
29 560.4 2 25.6 2 16.1 96 1551.4
29.3
Griffin . . . . . . . Hapeville . . . . . . . . . . LaGrange ........
Macon .......... Marietta ........ Milledgeville
7.6
9 40.9 57 98.5 68 784.6
Moultrie ..........
9.9
Newnan . . . . . . . . . . . .
Rome ................... 12 45.7
Savannah . .............. 207 215.6
Statesboro . . . Thomaston. .
......
.. ......
.
.
..
.
16 318.2 8 125.1
'"rhomasville . ............ Tifton ..................
Toccoa.................. Valdosta ................ Waycross . . . . . . . . . . . . . . . .
9 163.8
11 70.5 3 17.9
27 2.9 1 5.2
3.4 4 1.5 3 4.6
16.3
1.9
48:8
2 15.1 1 19.8 1 4.5 1 1.7 1 11.5
. i 13.9
1 3.8 2 2.1
7.9
723 78.1 12 63.0 5 53.9
7 33.9 9 31.0
60 6.5 318 1
.4:8 11
10.3
10
207 75.7
19 7.0
98
82 124.4
21
10 157.4
2 31.5
18 119.7
1 6.7
2 32.2
1 16.1
2 32.6
11 121.9 6 73.1 52 97.6 8 100.9 7 67.0 18 108.7
11.1
12.2
5.6
23
1
1
27
7 135.3 7 89.6 12 96.8 2 32.3 1 13.5 1 9.8
58.0 3 11 1 1
8
8 60.5 1 19.8 16 72.8 37 63.9 11 126.9 14 206.6
1 19.8
3
2 9.1
18
6 10.4
18
21
5 49.3 3 41.8 14 53.3 92 95.8 3 59.7 3 46.9
2 7:6
7
6 6.3
26
5 78.2
10 78.8 2 38.3
. "1
19.1
4 72.8
9 57.7
5 29.8
2 11.9
31.3 5.2 53.3 34.5 35.9 31.9 26.6
43.2 12.6 9.6 163.0
38.4 88.7 16.2 13.5 78.1
59.3 81.9 31.1 242.3
19.7 26.6 27.1
i5:6
6.4
172
Georgict Depctrtment of Pttblic Hectlth
TABLE IV-Continued
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, 1946
Syphilis
Tuberculosis
Typhoid Fever
Typhus Fever
Whooping Cough
Area
Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
TOTAL ................. 7937 857.2 1486 160.5
26 2.8 152 16.4 287
31.0
Albany .................. 118 619.3
30 157.<1
2 10.5
4 21.0
11
57.7
Americus. ............... 156 1680.9 Athens.................. 186 900.7
12 129.3 18 87.2
'"i
',1:8
6 64.6 6 29.1
1
10.8
28 135.6
Atlanta (DeKalb) ........
4 13.8
13 44.8
1 3.<!
Atlanta (Fulton) ......... Augusta................. Bainbridge ............. Brunswick . . . . . . . . . . . . . . .
Carrollton .............. Cartersville..............
2683
209 4 11
5 2
981.7 317.1 63.0 73.2
80.5 32.6
330 120.7 107 162.3
6 9<!.5 19 126.4
6 96.6 6 97.7
1.5
26 9.5
36
13.2
9 13.7
69 104.7
11 173.2
7 <!6.6
13
86:5
i6:i
3 48.3
1 16.3
146:6
Cedartown .............. College Park............. Columbus ............... Cordele ................. Dalton..................
Decatur.................
20 221.6 1 12.2 727 1364.5
125 1576.5 26 248.9 119 718.6
6 66.5 6 73.1 405 760.1 6 75.7 26 2<!8.9 15 90.6
2 19.1 1 6.0
22.2
1 .i:9
9 113.5
10 110.8 16.9
18.1
Douglas . . . . . . . . . . . . . . . . . Dublin . . . . . . . . . . . . . . . . . .
East Point .............. Elberton ................ Fitzgerald ............... Gainesville ..............
74 1430.0 25 319.9 2 16.1 3 48.5 1 13.5
56 546.7
6 115.9 9 115.2 10 80.6 4 6<!.6 6 81.2 10 97.6
2 19.5
96.6 38.4
<! 54.1 2 19.5
21 339,<! 29.3
Griffin .................. Hapeville . . . . . . . . . . . . . . . . LaGrange ............... Macon .................. Marietta ................
Milledgeville ..........
30 226.9
86 39L2 334 577.2
95 1096.1 65 959.0
7 52.9 3 59.3 11 50.0 88 152.1 11 126.9 12 177.0
7.6
1 1.7 1 11.5
10.4 2 23.1
7. 6
11
50.0
28
48.<1
12 138.5
Moultrie ................ 66 650.4 Newnan ................. 2 27.8 Rome ................... 141 536.5 Savannah ................ 2390 2189.7 8tatesboro............... 26 517 .l Thomaston .............. l 15.6
5 49.3 2 27.8 51 191.0 164 170.8
5 99.4 10 156.3
2 19.7 2 27.8
3.1
"i 15.6
3 29.6 1 13.9 1 3.8 16 16.7 1 19.9 1 15.6
5 io:o
6
6.3
78.2
Thomasville . ............ Tifton .................. 'foccoa... ...............
Valdosta ................ Waycross ...............
21 165.6 71 1358.1 1 18.2 7 4'!.9 4<1 262.5
H 110.4
7 133.9 7 127A 1<! 89.8 19 113.3
2 15.8
5 39.4 5 95.6
8 51.3 3 17.9
31.5
2
38.3
Pre-vent?tb!e Diseotses
173
TABLE V
NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COLOR, SEX,
AND AGE, 1946
Age Level by Years
Diphtheria
Amebic Dysentery
Bacillary Dysentery**
Malaria
Measles
wc wc wc wc wc
Under 1 Year, ........ M 12
F6
2
10
8
7
2
"i
21 11
5 7
1- 2 years........... M 17
9
9
4
29
8
F 17
5
10
3
33
7
2- 3 ye~rs ....
.M 23
10
7
37
13
F 15
3
3- '!years......... .. M 22
5
F 20
5
1
5 4
3
2 1
i
.i
26 54 35
9 12
12
4- 5 years......... .M 19
1
1
F 16
l
2 1
.i
42
13
29
17
5- 6 years... .... .. M 19
1
2
1
36
8
F9 6- 7 years..... ..... M 11
5 .i
46
10
1
77
7
F 10
7- 8 years .... .... M F
9s
5 3
..
1
2 3
1
70
19
60
6
59
9
8- 9 years..... .. M
5
1
1
1
61
H
F5
7
65
4
9- 10 years....... .M 3
1
24
2
F l 10- 14 years... "' .. .. M 7
2 3
1 .i
2
F 11
2
3
1
23
6
6 2
.i
' 39 68
30 27
15- 19 years....... .. M 2
1
1
10
10
F5
1
2
2l
7
20 - 24 years..... .... M 1 F5
3 2
1 1
8 3
.2
2 4
.7
25 - 29 years...
.... M F
2
1
1
5 2
'j
5 .J
1
8
3
10
2 l
30- 34 years .... .-M
3
6
1
1
1
F
1
3
1
9
35- 39 years
.. M 1 F
2 .i
8 2
'j
3 3
40 - 44 years...
.. M
2
5
F
1
3
45 49 years... ........ M
1
5
2
1
F
4
3
50-54 years......... .-M F
2
1
1
).
2
2 3
.i
55 - 64 years......... .. M
2
2
3
F
1
1
1
1
65- 74 years
... M F
'i
2
2
2 4
1 .i
75 and over .... ...... M F
Unknown Age .... ...... M 1
1
'8
3
2
3
1
1
.i
3
6
81
F1 Total. .... .... M 153
39
27
1
5
63
15
62
26
3
5 586 132
F 134
13
8
2
51
13
32
14 545 158
=1::-J: This includes unspecified dysentery.
174
Georgict Depa-rtment of Pztblic Hectlth
TABLE V-Cominued
NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COLOR, SEX,
AND AGE, 1946
Meningococcus
Age Level by Years
Meningitis
Pneumonia Poliomyelitis
wc wc wc
Scarlet Fever
Septic Sore Throat
wc wc
Under 1 year.
. .. M 3
95 110
2
1- 2 years ..
F3 .. M 4
.2
71 12
97 30
2 10
1 7
F3
10
19
13
3
7
4
2. 3 years
... M 1
13
12
12
2
14
1
F1
4
10
6
3- i years
.... M 3
2
8
6
9
22 31
.i
4- 5 years ..
F2 .M 1
7
9
19
30
2
2
10
6
6
2
21
1
1
F
4
7
22
1
5- 6 years ..
.. lvl 2
5
3
33
1
6- 7 years ..
F .M
F2
4 7 8
.7 2 3
28 28 46
1
5 1
7- 8 years .. ..... M 2
3
5
22
3
F
8- 9 years ..
.. M
5
2
23
1
2
3
1
24
1
F
3
1
3
21
4
9 - 10 years..
.M
8
1
3
6
1
F
1
4
2
17
1
10- 14 years ..
.M 2
15
11
7
13
4
F2
5
5
5
35
15- 19 years ..
.M 5
11
8
2
2
5 6
20 - 24 years ..
F4
.. M
5
11
1
10
8
1
6
8
1
16
1
25- 29 years ..
F
.. M 2
5
13
4
13
16
2
23
2
6
1
30- 34 years ..
F1
.. M
8
12
2
15
13
6 12
'j
35- 39 years 40- 44 years
F
.M
F
..... M
10
23
1
18
19
1
13
10
13
22
8
4 6
'j
1
1
45- 49 years ..
F .. M
.i
13
22
27
36
2 2
F
6
18
1
2
50 - 54 years. .......... lvl 2
18
32
2
1
F
12
29
1
55 - 64 years. .......... lvl 2
61
52
3
F
44
38
1
65- 74 years
.. lvl
F
58
28
73
25
.i
75 years nnd over. .. lvl
103
17
2
F
134
23
Unknown Age ....... ... lvl
67
3
2
2
3
1
F Total. ..... 0 o .M 35
1
8
3
10 593 440
7o
4 ll 210
1 ll
4 75
9
F 20
4 453 380
77
7 267
7
80
9
Pre,ventctble Diseases
175
TABLE V-Continued
NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COLOR, SEX,
AND AGE, 1946
Age level by Years Smallpox Tuberculosis
Typhoid Fever
Typhus Fever
Undulant Fever
Whooping Cough
w c w c w c w c w c wc
Under 1 year ..... M
F
1- 2 years....... M
F
2- 3 years....... M
F
3- 4 years....... M
F
4- 5 years....... M
F
5- 6 years....... M
F
6- 7 years....... M
F
7- 8 years....... M
F
8- 9 years...... .M
F
9- 10 years
M
F
10- 14 years
M
F
15- 19 years
M
F
20- 24 years
M
F
25- 29 years
M
F
30- 34 years
M
F
35- 39 years
M
F
40- 44 years
M
F
45- 49 years
M
F
50 -. 54 years
M
F
55- 64 years
M
F
65- 74 years
M
F
75 -years and over M
F
Unknown
M
F
Total. ........... M F
1
7
1
4
1
3
4
1
3
2
1
2
1
1
.i 4
1
1
2
1
1
2
2
4
.i
6 12 8 23
13 36
46 63
42 74
66 64
47 94
68 65
.i
56 57
87 60
M
67
78 48
51 34
99 57
58 39
1 96 51
59 21
147 47
72 29
85 23
45 12
20 10
17
5
25 14
21
6
811 547
550 527
.~
4
.j
1
1
2
4
2
3
2
2
1
2
2
1
2
1
2
1
3
1
4
3
1
7
1
1
5
1
2
.i
5 31
1
2 13
2 25
13
.i
.i
14 17
3
2 19
3
2 21
3
2 34
1
19
a 2 29 3 21
.i .i
2 24
.i
17 30
16
3
19
2
11
2
1 29
14
24
.i
1 17 6
1
.i
12
1
9
27 16 314
24 13 212
2
.i .i ..
.i
4 .2
.i;
1 5
4
1
4
7
3
7
9
3 10
6 11
.i;
9 16
6
4
4
9
3
3
4 10
1
2
.2
7 4
4
6
3
5
3
7
5
1
1
5
3
53
94
24 50
19 28
19 21
98
13 14
10 18
17 12
11 13
12 15
86
14 6
15 14
10 9
95
13 9
11 6
12 5
63
6
11
.i
12 23
.i
43
3 1 3 1
1 .i .3
1
.i
.2
1 2 1
12
i7
31 102 107
5 125 97
176
Georgia Depctrtment of Pttb!ic Hect!th
Hookworm Cantral
This summary of data on hookworm control actlvmes ~hows a comparison of figures for 1943, 1944 and 1945. Complece 1946 figures are not included, inasmuch as all special hookworm report forms, which include fundamental epidemiological informacion have not been coded and summarized.
It will be noted from the following table that there has been an apparent steady decline in the number of hookworm positives found and in the number of egg counts which exceed 2,000 eggs per cc. This, however, is unfortunately susceptible of another explanation than the sought for recession of the disease. During 1943 and 1944, the activities of the Service were severely hampered by the increasing stringency of tire and gasoline rationing, and the amount of work carried on diminished steadily. Programs were continued and pushed orily in areas in which intensive work had already been done and in which trained personnel was available. As a consequence, the data is very strongly influenced by results obtained in these areas and the apparent decrease is therefore not reflective of a widespread, general reduction in hookworm infestation.
SUMMARY OF HOOKWORM CASES DIAGNOSED BY FLOTATION AND
EGG COUNT, 1945
White
~
."c'
5"'
0
E
i
Brantley ......... 101
Atkinson ........... 466
Appling . . . . . . . . . . . . 321
Clinch ............. 75
Wayne . . .
323
Bacon ..........
382
Candler ............ 162
Grady ............. 177
Lanier . . . . . . . . . . . . . 452
Coiiee ............. 588
Pierce .... .......... 112
Toombs ............ 329
Berrien . .....
168
Bryan ........
94
Long ........
80
Tift .........
191
Telfair ........
97
Liberty ........
108
Crisp ..........
71i
31 Misc. Co's ..
558
..",,.
;;
.~,
;; ~
<> 0..
t<
63 62.4 248 53.2 167 52.0 37 49.3 148 45.8 170 M.5
67 JlA 73 41.2 179 39.6 227 38.6 10 35.7
117 35.6 59 35.1 33 35.1 28 35.0 60 31.4 27 27.8 29 26.9 11 14.7 160 28.7
Totall945 ....... ... 4,859 1,943 10.0
Total1943 .......... 6,155 3, 950 6!.2
Total! 941 ......... 1,195 2,121 50.6
Colored, aU Co's Total1945 ......... 359
304 10.6
Total1943
287
19 17.0
Total1944 .......... 283
48 17.0
Total Submitted Le3s QNS-Percentages
"z '
0'
0
q0
",(;.';
<>
1;;'2.
0
":;!';
:=
0 0
7"'
0
8'l
0 0
.".';
6
q0
"'
0 0
"~ '
0
.0
0 0
,a.
""' <>
~
<>I!
0
0
0
0
0
0
~ gj
49 71.2 5.8 9.6 11.5 19.2 38.5 1.9
87 36.0 10.6 17.0 13.7 9.5 8. 7 5.0
28 28.3 8.5 20.1 10.6 8.2 6.5 3.1
12 31.7 0.5 17.5 7.9 1.8 12.7 6.3
46 31.0 9.0 13.4 14.1 8.3 6.9 1.8
26 20.2 11.5 16.0 12.1 4.8 2.8 0.6 g 15.7 12.4 15.7 9.8 5.2 0.7 0
27 29.3 4.0 15.3 6.0 7.3 9.3 6. 7
64 23.7 7.5 13.4 10.1 5.4 5.4 2.8 68 19.6 8.5 15.6 10.6 1.8 3.1 1.2
10 18.6 9.8 10.8 10.8 2.9 4.9 0
54 18.9 7.3 6.4 8.0 2.9 4. 7 3.3
42 19.0 9.5 18.3 8.7 J.O 5.6 0. 8 10 15.5 7.1 16.7 8.3 2A 3.6 1.2
3 H.3 7.8 19.5 5.2 1.3 6.5 1.3
21 17.1 6.5 11.8 5.3 5.3 4.1 2.4
14 13.3 1 4.7
6.0 13.3 6.5 15. g
1.8 3.7
4.8 0
2.4 0
o1..o2
3 6.9 4.2 4.2 1.4 !A !A 2.8
96 13.2 8.4 12.8 7.1 1.7 2.8 1.5
670 22.2 8.5 15.2 9.5 5.2 5.2 2.2
36.0
26.3
2.5 3.4 1.5 2.0 0.6
0
5.0
3.0
Preventable Diseases
177
In 1945, the hookworm activities of the Service were largely carried on by one .field nurse and even the limited success obtained is rherefore remarkable. Also, a shortage of tetrachlorethylene made ir impossible to treat all positives found, and selective, limited treatment had ro be resorted to.
During 1946, the personnel of the division was augmented and work on a wider scale was again begun. This fact is reflected in the number of specimens examined. However, activity again increased most in areas where previous work had been done and no great percentage increase in positives found is to be noted. More positives were located and many more treared since tetrachlorethylene is now readily available.
The basic plan of hookworm activities underwent some modification in 1946. No great effort to encourage selective school surveys was made except in health officer counties or counties with experienced nurses. In counties with new nurses, ir was found more satisfactory to permit limited general surveys and to encourage the examination of all clinic patients and the for\Varding of specimens on a routine basis by the nurse and by practicing physicians. It was urged that nurses not attempt to .find more cases than they could treat and follow up.
At the year's end, several good community surveys were being organized under the aegis of the local Farm Bureau organizations. These surveys were planned to emphasize the sanitation aspects of the hookworm program and communities accepting such a program, which entails considerable work on the part of biological, engineering, sanitation, nursing and laboratory persunnel involved, were required ro undertake an organized program of privy building and sanitation improvemem. It has been pointed our that these preventive activities are essential if a real reduction in hookworm over a period of time is to be gained.
A new mailing container for hookworm specimens has been developed and is being given a trial. If successful in practice, this new container will further reduce the collection of specimens at schools and will obviate some of the serious defects in the school program.
The emphasis of the present program is therefore being laid not on rhe finding of clinically damaging infestation in the individual, but on reduction of hookworm incidence by intensive sanitation and treatment programs. Provision has been made, however, for easy handling of selective survey in schools where these surveys can be successfully followed through. The .field nurses' activities continue largely unchanged with the exception that a wider l::ase for selection of examinees has been established and egg counting is not used as a basis for the initial decision to treat.
The Stoll count method is no longer routinely applied to all positive specimens but is reserved for special programs in which knowledge of the ltvel of infection is essential, or for cases in which an egg count is of use to the physician in deciding on the treatment, or further treatment, of an individual. This reduces the burden on the laboratories and makes possible the examination and treatment of a greater number of individuals. A new and simpler egg counting method is under study, however, and rhe complete abandonment of quantitative methods is not contemplated.
178
Georgict Depctrtment of Pttblic Hectlth
Further studies are being made on the success of treatment and the effect of low grade infesrations.
Mctlctrict Control
Recem developmems in mosquiro and malaria comrol, including the Malaria Control in War Areas DDT house spraying program, led the biological section of the Epidemiologic Service to consider the possibility that control of anopheline mosquitoes could best be achieved by an inclusive program of DDT spraying of all good rescing places for anophelines in an area either with or without concomitam house spraying. Since the house spraying technique is designed to reduce the possibility that an anopheline mosquito which bites a human malaria carrier will survive through the requisite incubation period and transmit malaria to another person, and the outside resting place spraying plan is designed to reduce the over-all mosquito population, the two methods are not mutually exclusive, but in areas .in which anophelines are abundant and human carriers exist might properly be considered complememary to each other. The outside resting place spraying program is then more nearly a substitute for a general larviciding program. Complete success, i.e., total destruction of the anopheline population, would of course obviate the necessity for ather control devices. Since this is a very remote possibility at the moment, the question at hand can best be stated as follows: Is a program of spraying of natural anopheline resting places, i.e., bridges, culverts, privies, animal shelters, house porches, eaves, doors, windows, the undersides of houses, hollow trees, etc., as effective in reducing adult and larval populations as a fully developed pond larviciding program, and what is the comparative cost of the two programs.
Doztgherty ctnd Worth Cottnties Project
Accordingly, an experimental area was chosen in Dougherty and W orrh Coumies in which the cost in labor and materials of a Paris Green larviciding program was well known. All such larviciding was dispensed with, and entire dependence placed on 5% DDT emulsion spraying of resting places and house exteriors in a sixteen ( 16) square mile area in Worth and Dougherty Counties near Acree, Ga. This area was formerly very malarious ~.nd good data on year-to-year variations in anopheline populations exists.
To the surprise of the cooperating county health departments and the biologist in charge of the experimental work, only two hundred forty-seven ( 247) gallons of DDT concentrate were needed to cover the area. Fifty (50) man hours of labor sufficed for the entire operation despite equipment difficulties which .could easily be avoided in a larger scale program and the total costs of the operation, including labor, materials and operation of equipment, entailed an e:x;penditure of approximately two hundred and four dollars ( $204.00). The cost of larviciding these ponds during an average breeding season would approach one thousand dollars ($1,000.00) if the larvicide were Paris Green, and three hundred and fifty dollars ( $350.00) if the larvicide were DDT. The expenditure required for spraying the occupied dwellings within the community would amount to approximately three hundred and seventy-five dollars ( $375.00). These estimates were supplied
Pre-ventable Diseases
179
by the Sanitary Engineer of Dougheny Coumy who cooperated in the program,
The biological results of the program are shown in the cable which folhws:
Summary of Mosquito Collecrion Dam Dougherty-Worth County Project
Adults Auophelims per Search
Meau No, .Anopheline Larvae per
Sweep
Before Spraying Experimemal Area__________________ 12-89 Check Area______________________________ Areas Combined______________________
0.476 0.721 0.514
After Spraying Experimental Area__________________ *2-37 Check Area______________________________
Areas Combined___ ------------------ ________
0.912 8.343 2.584
Mediau No. A11opheline La>'Vae Per
S11!eep
0.512 0.967 0.513
1.020 6.829 1.254
*Several artificial, unsprayed shelters were purposely added after the area was sprayed. Only one Anopheles adult was found in a sprayed shelter.
From these data, there would appear to have been a considerable reduction in adulr anophelines in the experimental area after spraying. Oi:her areas under study during the period of the experiment did not show any tendency wward a concomitant natural reducdon in population.
Also, it will be noted thar the mean number of larval anophelines found in the sprayed experimental area increased 91.6% after spraying, while the increase in the unsprayed check area was ten times as great.
Further staristical analysis shows that the difference between the mean values obtained from the experimental and check areas before spraying is nor significant, i.e., that the apparent slight difference which existed in the beginning between the two areas is probably due to chance variation in samples. On the mher hand, the difference between the check and experimental means afrer spraying is statisdcally signilicam and the probability that chance alone is responsible for the large difference which developed after the use of DDT is less than one in one hundred.
While this does not emirely exclude the possibility that chance selection . of samples produced the great apparent difference, and while it must be gramed that other unknown factors could have influenced the result, it is certainly permissible to conclude that the most probable cause was the DDT treatment. This interpretation is rendered even more plausible by the fact that the statistical methods used were conservadve and make considerable allowance for the relative smallness of the sample. Catldon in the imerpretarion of the results is considered necessary and proper, and the experiment
180
Georgia Department of Pttblic Health
will be repeated on a larger scale, but publication of the results to date is considered both advisable and justifiable.
Fly and iVlosqttito Control lnvestigcttion
A third entomological project was carried on by the Muscogee County Health Department and biologists of the Epidemiologic Service.
In the city of Columbus, an attempt was made to determine the value of the spraying of houses and outbuildings as a control measure for all domestic mosquitoes and other domestic insects. Particular attention was devoted to anopheline control, control of Aedes egypme, the vector of yellow and dengue fevers, and to house fly control. The city of Phenix City, Alabama, across the river from Columbus was used for check purposes.
Adult collections of house mosquitoes were made routinely, and fly traps, lighting frams, and fly paper strips were used to study the variarions in fly populations between the two cities.
No complete report of the project has been written since the biologist in charge is now teaching at the University of Delaware and the project was Oiganized late in the summer of 1946 and is to be continued during the summer of 1947. However, work reports filed routinely provide an indication of the general results to date.
A material effect on both fly and mosquito populations was noted and incomplete data indicate a possible reduction in dysentery rates, especially among children, in Columbus. Phenix City, on the other hand, experienced no diminution of noxious insect populations and no noticeable change in dysenteric complaints. The project is therefore to be continued until enough data can be assembled to make the results significant.
The Magnolia Springs area of Jenkins County continues to be used as ar- index of Anopheles quaclrimaculatus populations in the southeastern section of the state. For the fifth successive year, the population of A. quadrimaculatus showed an appreciable decrease and is now approximately one tenth of what it was in 1940.
Tick Cantral
The occurrence of seven cases of Rocky Mountain spotted fever during 1945 within one small area in DeKalb County caused considerable interest to develop in the possibility of controlling ticks with DDT dust. The area in question included approximately one hundred seventy acres and was, during 1945 and early 1946, about one-half built up. Interspersed between fully developed streets and additional scattered homes, there were numerous stretches of second-growth woodland, old fields and pastures. These unimproved areas were traversed by numerous paths and unmaintainecl roads 'which were used as short cuts from street to street by the human population in some measure and by the clog population, which was large, as a matter of routine.
Since the clogs provide an excellent host for the so-called wood tick or dog tick, Dermacentor variabilis, conditions were ideal for the development
Pre-ventctble Diseases
181
o a large tick population, and, after the ticks became infected, for the propagation of Rocky Mountain spotted fever,
The DeKalb County Health Department had already carried on a program of immunization against Rocky Mountain spotted fever and the people of the region were well acquainted with the dangers of the disease and its mode of transmission, Therefore, it was relatively easy to secure permission to dust a portion of the area with 10% DDT in Pyrophyllite during the period of nck acrivity and to secure cooperation in searching domestic animals for ticks,
The portion of the area which remained unclustecl was used as a check for comparison with the treated area and the same collection and evaluation techniques were followed carefully in the two sections, These methods consisted principally of dragging paths and roadways wirh a flannel drag which was inspected every 200 ft,, and weekly examination of all clogs and cats resident in the area, The data derived from these investigations are summarized in the table which follows:
Sttmmctry of Tick Collection Dttttt
Before Dusting
Mean No, of Ticks per Infected Dog or Car
Check Area Experimental Area
--------------------~---
Aclulr Ticks by Dragging
Check Area
21
Experimental Area
98
-----------------------~"--
Mean No, of Ticks Tick Numphs and larvae per
Infested Rat
Check Area
0,00
Experimental Area
2DO
.11tter Dusting
L92
L35
5 5
5,35 2-32
Ticks Collected from H1.unans
Check Area
1
7
Experimental Area
1
0
It will be noted from the figures above that the experimental area was considerably more productive of ticks than the check area in the period before dusting, and that after dusting, the situation was apparently reversed, Perhaps the most important and significant effect is indicated by the figures on collections from infested rats, These imply that the trend in numphal and larval activities, i,e., the developing tick population of the next year was materially affected by DDT dusting,
The largest body of data is derived from clog and cat examinations. Since these animals roamed both areas, although they naturally spem more time near home, it is surprising that a marked difference between the areas is
182
Ge01gict Department of Pttblic Health
found before dusting in this caregory of collections. It is equally surprising that after dusting, this marked difference disappeared completely and rhe .check area became slightly more productive of ticks.
It can only be supposed rhar considerable destruction of ticks had occurred in the experimental area. It is also reasonable to assume that all dogs entering the dusted area at any time picked up a small amount of DDT dust and :So in some measure extended the effect of the treatment to the check area. The original difference has statistical significance while the difference after .dusting is not significant, the implication being that some factor, presumably .the DDT dust, intervened to produce a leveling of the rwo populations before .the cessation of seasonal activity would normally have produced such an effect.
However, the sample is coo small to justify the assumption that the apparent statistical significance of the difference is adequate evidence of the value of the program. The most credible indication that some success was :attained lies in rhe fact thar all categories of data point in the same direction, i.e., they indicate an unequal rate of reduction in the two areas as the season _progressed and the tick populations subsided into normal winter inactiviry.
The techniques of collection and evaluation employed were themselves -control methods. All ticks and rats caught were removed from the area instead of being again released as has been the practice in other tick projects. This destruction of ticks and rars was decided upon because rhe area is a focus for Rocky Mountain spotted fever and public health considerations forbade any .experimental procedure, however scientifically sound it might be, which would in any way jeopardize rhe health of the people resident in the area. The results lose in conclusiveness by such a procedure, but it is believed that the data are adequate enough to show thar the method has promise and to justify continued study of the DeKalb area and treatment on an experimental basis of larger, semi-urban areas where Rocky Mc,untain spotted fever 'has become established.
Finally, it is believed from the above evidence and on the basis of results Obtained by Smith, Cole and Gouck in Massachusetts that marerial reduction ln year-co-year popularions of Dermacentor variabilis can be effected in semiurban areas by assiduous collection and destruction of adult ticks engorging on dogs. Dusting dogs with DDT powder and/or dipping twice weekly in :standard derris dip (2 onces of derris and 1 ounce of neutral soap to 1 gallon -of water) as practiced by Smirh and associates in Massachusetts will destroy ticks before the females can engorge and lay eggs. When such a program is combined with DDT dusting or spraying of all vegetation along paths .and roadsides and around residences, there is reason to suppose rhar both rhe current danger from an existing adult population and the area potemial for Rocky Mountain spotted fever can be reduced.
The following table will show a summary of activities by counties in con_necdon with epidemiological and entomological services.
SUMMARY OF ACTIVITIES BY COUNTIES
Educational and Promotional
EPIDEMIOLOGICAL SERVICES
Hookworm Treat.
Containers
COUNTY
Phy.
Mtgs. Addrs. Exhibits Confs' Exams. Hgb.
Home Malaria Spleen
Soil
Altd.
Made
or Ins.
Anthel- Persons Visits Smears
Palp.
Dis!.
Coli.
Samp.
_
_
_
_
_
,_
_
_
,_
_
_
,_
_
_
,_
_
_
,
_
_
_
,_
_
_
_ _ _ mintic
,
_ _ _ Treated
, Iron
,_
_
_,_
_
_,_
_
_,_
_
_
,_
_
_
,_
__
Appling ........ . Atkinson ......... . Bacon ........... . Baker........... . Berrien ........... . Bleckley......... .. Bibb............. . Brantley ........ .. Brooks.......... .. Bryan............ . Bulloch .......... . Burke............ . Candler .......... . Charlton ......... . Chatham...... . Clarke ........... . Coffee . . . . . . . . . . . . 1 Clinch ........... . Cobb ............ . Colquitt.......... . Cook ........... .. Crisp ............ . Dawson .......... . Decatur.......... . DeKalb ........ .. Dougherty ....... . Echoill ........... . Effingham ........ .
22
45
28
1 1
3
3
2
38
2 2 11
8 1
7
21 13
11
6
'3 ..
2 74
1 1 23
93
86
llm1 I ....s.. I ..u.1
u
1
-~
I 15 .J ..... 6 ..
u ..........
u7
1
6
1
3
..... .....
..... .......
........
..... . . .
400
344
61
~
~
~
;;;:-
~
50 50
~
250
~
140
78
"~ '
~
......
00
\,.)J
SUMMARY OF ACTIVITIES BY COUNTIES-Continued
Educational and Promotional
EPIDEMIOLOGICAL SERVICES
COUNTY
Mtgs. Attd.
Addrs. Exhibits Conts. Made
-----1------------
Emanuel ..... .
13
Evans ...... .
2
Floyd...... .
I
Fulton ..... .
148
Grady ...... .
10
Jefferson. . . .
3
Jenkins ..... .
17
Johnson ... .
1
Lanier ... .
5
Laurens.... .
5
Liberty ..... .
11
Long.......... .
7
Lowndes ..... .
6
Mitchell ....... .
1
Montgomery...... .
2
Muscogee ........ .
37
Newton ........ .
1
Pulaski .......... .
1
Phenix City, Ala... .
3
Randolph .. .
4
Richmond.. .
1
Rockdale... .
6
Screven ... .
1
Telfair .. .
6
Terrell ..... .
1
Thomas..... .
13
Toombs .... .
3
\Vare ......... .
90
Washington .... .
2
Wayne... .
17
Wilcox ........ .
6
\Vorth .......... .
5
TOTAL ..
12
810
Hookworm Treat.
Phy.
Exams. Hgb.
Home Malaria Spleen
or Ins.
Anthel- Persons Visits Smears Palp.
mintic Treated
Iron
312 I. . . . . . . I.
.I
I.
I. .. .. .. I. .. .. .
0 I. ~I
u .I.. .. 2 I : :::
11
. ~ . . . . . . . .. . . .
......... . .
21 I.
1
11
~0
........
125
265
36
. 1 .
I ..1..
32
-~i .. :........ : : ... 1 I
14 I.
295
1
359
416
790
282
17
168
1,494
Containers
Dist.
Coli.
~
12 916
~
1~
400
25
2,532
423
,....,
00
""'
Soil Sam11.
c;]
"~"
()<) ~-
tJ
""~"""
~
;";;": -"c ' .
"':
":":''r; ~
~
SUMMARY OF ACTIVITIES BY COUNTIES-Continued
ENTOMOLOGICAL SERVICES
II SANITARIAN SERVICES
SiJeCies Found
Species Found
COUNTY
I Ponds Ponds Anon h.
Adult Anoph.
Sanitary
Light
Map
lnves. Dimwd Neg.
Searches Neg.
AQ.
Ac.
AIJ. Others
Q.
c.
Surveys P. Others Premises
Traps Run
Hours
--- --- --- - - --- --- ---- ---- --- --- --- - - ---
---- ---
Baker ...
2
1
... Ben Hill ... ::::
Brooks .. .... ,.
3
.3.
1
1
3
3
1
1
2
16
10
5
5
5
Bulloch ..
6
4
1
3
3
. ....
69
64
1
5
Burke .... ::::::::.
3
2
1
2
5
3
1
1
Calhoun .. .......
1
1
Crisp
157
115
33
52
1 56
i7
2
2
355
173
138
93
20
DeKalb.:::: ... :: :::
Dooly ......
25
12
3
9
7
3
88
25
69
32
28
Dougherty... .....
490
314
102
110
202
13
503
233
208
1%
36
. . . . . . . . . ...
6
108
1
48
168 4
5
:p
<li
71
'"",""""t."J,"'''-'.'
~-
Emanuel. .. Evans ......
5 3
. . . . .5.
3
1
1
45
22
16
12
7
15
10
1
4
2
"' 58
98 ....... ~
Grady ....... Jenkins . ....
12
12
12
7
4
1
1
79
3
72
g
1
2
88
"'c.,
Lee .............
2
2
2
Muscogee ........ Phenix Ciiy, Ala ..
......
.....
..
88
14
54
85
312
155
Richmond ......
3
2
Sumter ...........
34
11
1
10
11
3
208
59
85
40
11
Thomas ...
14
10
1
1
9
....
7
5
1
\Vayne ...
1
6
6
Wilcox ... Worih ........
40
16
12
2
3
2
107
72
5
58
68
13 ..
23 102
15 45
7 52
I 121
23
TOTAL ..
908
580
161
259
373
57
1,671
693
656
411
108 I 23 II
257 I 867
71
t-'
00 V\
186
Georgia Department of Pttblic Hectlth
Industrial Hygiene Service
lnHodttction
During the year the Industrial Hygiene Service was given full divisional scams and became the Division of Industrial Hygiene. The activities of the division during this period have been to a considerable extent influenced by the general trend of reconversion which currently existed in the industries of Georgia. More freedom has been exercised in the type plants comacted due to the fact that it is now possible w work without restrictions in purely peace time industrial establishments. The programs carried out have become broader and broader, implying the term industrial health rather than purely the hygienic aspects of occupational diseases. This is exemplified by the coverage of the medical program and the great emphasis during this period which has been placed on the mass mberculosis and venereal disease surveys applied to industry.
Personnel
Prior to July l, personnel included one medical director, two consultant nurses, two engineers, one chemist and one secretary. During the second hal of this period an additional secretary and three industrial hygienists were added to the staff. Also during the second hal of this period one engineer resigned.
Existing personnel have been unable to comply with all the requests for services which have come ro the attemion of the Industrial Hygiene Service during this period. This simation has become somewhat more acute clue ro the additional requests for services which have resulted from the passage of the Occupational Disease Law. The need for additional personnel is obvious and critical. An attempt is being made to secure the services of qualified personnel; however, the scarcity of such individuals will undoubtedly delay such proposed employment.
Medical ctnd Nttrsing Programs
Medical and nursing activities are concerned with the investigation of
occupational diseases, or other diseases affecting industrial populations, the
promotion and establishment of nursing services, and the establishment of
proper and accurate record keeping. These services are also concerned with
the promotion of public health measures in industrial establishments and
correlation of industrial health activities with community health services.
Programs dealing with mberculosis, venereal diseases, immunizations, nutri-
tion, sanitation, demal hygiene and health education are especially em-
phasized.
Engineering ctnd Chemical Progrctm
Engineering personnel promote and carry out plant services in order to study processing methods and materials, and their relation ro the working environmem. This is clone by means of an impartial study including accurate chemical determinations where indicated. Observed data are assembled and
Pnwentable Diseases
187
carefully analyzed. Following this, engineering reports are prepared which cover observations and presentation of recommendations for the alleviation of occupational exposures. Professional engineering advice is rendered to the industries in the form of consultations on methods and procedures for the correction of hazards noted in the course of plant studies. In addition, assistance is rendered in the development of proper sanitary facilities in the plams and in training individuals concerned with industrial hygiene and safety programs.
Indttstrial Hygiene Laboratory
Laboratory activities are important factors in the engineering investigation of the industrial environment and evaluation of observed hazards. A laborarory is provided for the quantitation 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 toxic, a certain amount of biochemical work is done on blood, urine, and other biological samples. These data are correlated with the engineering and medical data so that acmal hazards may be properly evaluated and that a more intelligent and comprehensive report may be submitted w the industry concerned.
During the latter half of the year approval was secured for the expansion of the Industrial Hygiene Laborarory. The expansion of these facilities will provide much needed space and equipment to carry out the necessary analytical work of the program. Construction was started and well on the way toward completion at the end of this period.
Pttblic Relations
The work described in this report includes 341 promotional visits, 160 special services and 878 laboratory analyses. 101 meetings were attended, 61 meetings were addressed with an average meeting atendance of 62 and 13,868 pieces of literature were distribmed.
Georgia Section of the American Indttstrial Hygiene Association: The Industrial Hygiene Service continues to cooperate with the Georgia Section of the American Industrial Hygiene Association on matters pertaining to rhe promotion of industrial hygiene in Georgia. This cooperation and the functioning of the Georgia Section of the American Industrial Hygiene Association has done much to promote the program of industrial hygiene which is being carried out by the Georgia Department of Public Health.
In June, representatives of the surrounding states attended a meeting, the purpose of which was to correlate industrial hygiene activities of the se.veral states in the Southeastern area. At this time, a committee was formed to prepare a constitution and by-laws for the activation of a Southeastern Section of the American Industrial Hygiene Association. The chemical engineer of the Industrial Hygiene Service serves as chairman of that committee.
Medicctl Associcttion of Georgia: The Medical Director continues to serve as Secretary of the Committee on Industrial Health for the Medical Association of Georgia.
188
Georgia Depctrtment of Pttblic Hectlth
American Conference of Go-vernmentctl Indttstrial Hygienists.' The Medical Direcwr of the division is curremly serving on a committee for the study and development of industrial hygiene codes, The chemical engineer is curremly serving on a committee for the development of minimum professional standards and requirements for industrial hygiene personneL
Atlantct Hectlth Center, An industrial health center in the Adanta area patterned after the Winder Clinic is being promoted. In addition to rendering more adequate industrial health services to the cooperating small industries, it is hoped that the proposed center may be used for teaching purposes by the medical and engineering colleges. The idea is being promoted actively with the Chamber of Commerce, State and County Medical Societies, Emory Medical School, Georgia Tech, and other interested agencies and individuals too numerous to mention. The Regional Industrial Hygiene Consultant of the Public Health Service has assisted in this promotional and development work.
Engineering and Chemicctl Activities
Grcmite Sheds. The termination of priority restnctwns has permitted allocation of critical material w all types of plants. In this connection, the granite sheds in the area of Elberton are planning the installation of ventilation for the control of dust from plant operations. The Industrial Hygiene Service has cooperated with these sheds in advising as to the type controls i'1dicated and in reviewing plans and specifications covering proposed installations. No individual installations have been completed, therefore no actual plant studies including dust counts have been made in this area.
Carbon 1\llonoxide Exposttres.- Investigations were conducted of acute exposures to carbon monoxide of a non-occupational nature during this period. These investigations involved one private family and one institution. Two fatalities occurred in the institutional exposure.
General 1\llotors Corporcttion. The Industrial Hygiene Service has cooperated with the General Motors Corporation in conducting a study of one of the Company's plants in this area and also in group meetings where personnel of General Motors Corporation served as guest speakers.
Indttstrial Hygiene Trctining ctt the Georgict School of Technology: The Chemical Engineer has assisted through consulta~ions with the Georgia School of. Technology in their establishment of full-time teaching of industrial h) giene, this teaching program being a required term course for industrial management students. It is anticipated that this will be expanded so that the teaching of industrial hygiene will be done in such manner as to be included in the various engineering courses.
Orientcttion Cottrse-U. S. Pttblic 1-lectlth Service.- The Industrial Hygiene Service has cooperated with the U. S. Public Health Service in its orientation course for engineers and sanitarians. In this connection, engineers t;~king this course have spent two weeks with the personnel of the Industrial Hygiene Service, observing techniques as applied to occupational hygiene.
lv'edicctl and Ntirsing Activities
Tttberettlosis-Venereal Disease Sttr-veys: The medical director and nurse
Preventable Diseases
189
consultants have spent the major portion of their time during this period arranging for industrial participation in the surveys conducted in Columbus and Macon. It has been necessary tO arrange and schedule industrial employees for surveys at the site of the industrial operations. The medical dJrector was responsible for the planning and execution of the work carried out in the industrial population. The nursing consultants have assisted in o:ganization and supervision. The major survey areas have been completed; the last one being Augusta. Statistical summaries covering findings in the various industries have been prepared and submitted tO the respective plants.
Stt1vey of Penonnel Practices and Policies: The consultant nurse in cooperation with the American Association of Industrial Nurses participated in a survey of personnel practices and policies of industrial nurses in Georgia. She is now serving on a committee for a similar survey covering thirteen southern states. This will include branches of nursing and will be done in cooperation with the American Nurses Association.
Displays: The medical directOr and consultant nurse assisted in the preparation and presentation of a display at the Chicago meeting of the }.merican Association of Industrial Nurses. This display illustrated the plan and medical records as used by the Manufacturers' Health Clinic of Winder, Georgia. Invaluable technical assistance and materials actually used in preparation of the exhibit were received from the Malaria Control Office of the U. S. Public Health Service. Subsequently, the exhibit has been shown at several meetings in the State, including the State Nurses' Association Meeting in Macon.
l11dustrial Hygiene Exhibit at the 1946 Meeting of the State Nurses' A ssociation
190
Georgia Department of Pttblic Health
Health Edttcation Progr<tm: Health education has been brought to industry (hrough the approach of using a health calendar. By this method some particular importam disease is feamred each month. This program has got(en off to a good start in Hall county and i( appears (hat the same procedure will be applied in other areas as excellent resul(s are being obtained.
Steering Committee: Cooperation with the Steering Committee of (he Atlama Tuberculosis Association continued. This work has been successful in securing united efforts of managemem and labor in the Atlanta area in case finding and comrol of mberculosis and in connection with related industrial health matters.
SUMMARY OF INDUSTRIAL HYGIENE ACTIVITIES
Tbc. & VD. Other
Surveys
Services
Number of establishments given service________________________ 178
llO
Number of workers in (hese esmblishmems____________________ 54,293 46,261
Number of plant visi(S made____________________________________________ 242
153
Number of services reques(ed by managemem and heahh
departmen(S -------------------------------------------------------------------------------- 187
Number of services self-initiated________________________________________________________
72
TOTAL__________________ 259
No. of plants in which service
was given
Type of ser-vice gi-ven Promotional visi(s__________________________________________________ 18 Technical studies of occupational hazards____________ 16 Consulmtions on engineering problems________________ 20 Consultations on nursing services________________________ 29 Medical surveys and consultadons________________________ 29 In-plant feeding surveys________________________________________ 2
Follow-up on compliance with recommendadons 4 Assistance wirh Tbc & VD case-finding surveys 108 Dental assistance-Tbc & VD surveys__________________ 26 Plan( surveys__________________________________________________________ 18
No. of Services Given
18 18 26
33
29 2 5
llO
26 20
Number of Plants
Impro-vements recommended regarding: Working environment____________________________________________ 11 Health and welfare services____________________________________ 100
Improvements carried ottt: Working environment____________________________________________ 6 Health and welfare services____________________________________ 82
No. workers a-ffected
5,914 42,612
3,427 31,613
Preventable Diseases
191
Specific services
Number of chest X-rays and blood tests made of workers in
cooperation with health departments-------------------------------------- 52,895
Samples collected for laboratory analysis____________________________________
80
Field determinations made____________________________________________________________
2
Physical examinations of workers made____________________________________
54
Occupational diseases reporred ----------------------------------------------------
33
Review of ventilation plans for management ____________________________
10
Demal assistance in VD-TBc surveys________________________________________ 4,092
Canst. dererminations__________________________________________________________________
29
SUMMARY OF MONTHLY ACTIVITIES REPORTS OF INDUSTRIAL HYGIENE SERVICE PERSONNEL
I. PUBLIC RELATIONS:
A. Conerences ----------------------- -------------- ------------------------------------- 982
1. Number
2. Average Attendance (not including
I.R.S. personnel)--------------------------------------------------------
3
B. Meetings 1. Number Attended______________________________________________________ 101 2. Number Addressed____________________________________________________ 61
3. Average Attendance Addressed__________________________________ 62
4. Number of Films Shown____________________________________________ 11 C. Literature Distributed____________________________________________________________ 13868
D. Radio Talks----------------------------------------------------------------------------
0
E. Published Articles __________________________________________________________________ 0
II. FIELD VISITS: A. Promotional Visirs__________________________________________________________________ 341 B. Special Services _____________________________________________________________________ _ 160 C. Formal Survey Reports Presented ----------------------------------------- 29
III. ENGINEERING ACTIVITIES:
A. Sanitation Studies__________________________________________________________________
6
B. Ventilation Studies________________________________________________________________ 39
C. Dusr Studies _________:__________________________________________________________________ 42
D. Organic Solvent Studies_________________________________________________ ______ 12
IV. LABORATORY STUDIES:
A. Sampies Collected_________________________________ --------------------------------- 193
B. Physician and Chemical Analyses Made________________________________ 878
C. Special Studies________________________________________________________________________
2
V. MEDICAL & NURSING ACTIVITIES:
A. Conferences with Physicians"----------------------------------------------- 60 B. Conferences with Nurses______________________________________________________ 82
C. Occuparional Disease Cases Reponed.___________________________________ 18
D. Occupational Disease Cases Investigared______________________________ 14
E. Non-Occupational Diseases Investigated________________________________
0
192
Georgi<t Department of Pttblic Health
Social Hygiene
Following is the statistical and narrative report of the act1v1t1es of the Social Hygiene Consultant for the year ending December, 1946:
As we have worked in the program of social hygiene education, it has been gratifying to find that communicy interest in this phase of health work has been growing. There is intense interest in the broad program of health education which includes social hygiene education. Groups, such as teacher groups, civic groups, and church groups, have been concerned with social hygiene education being given more serious consideration from the standpoint of the groups; also, how this education can be made a part of everyday education and everyday living for individuals-beginning with the preschool children, students and adults. Many groups have sponsored group meetings where the subject has been discussed. These groups have organized study and discussion groups which have met at regular intervals during the year. From these beginnings, some of the school administrators in various parts of the state have, in their school planning conferences on curriculum, made plans for sodal hygiene education to be made a part of the curriculum. It has been integrated in health education and in many related subjects. It is a part of the day by day class work rather than a "course" set apart from health education. Out of the interest in this work and our work with these groups along these lines, we are constantly being called in to various types of planning groups on the community level, always in the interest of bringing to cbe attention of community groups the necessity of planning for a broad program of health education. As these groups have met to review community problems and work out possible solutions, invariably the first problem brought out for group discussion is the problem of health. Health being a very broad subject, community groups find that it is necessary for them to have underscanding and interpretation often times of the various phases of health from the standpoint of the local health organization and work carried C'n by the local health department and how community leaders, as well as all the citizens in the community, may understand these problems and work as a group, each finding his own interest and applying his individual ability in working out these solutions.
From the standpoint of interest of those with whom she has come in contact, the Social Hygiene Consultant has had to broaden her activities to include guidance in many phases of health education. We feel that this is a natural outgrowth of the social hygiene program which we have endeavored to carry on for the past several years. Certainly, if people in a community are aware of one particular health problem and have the opportunity to work out some solution for solving that problem, in so doing they find that no part of health work or health education can be isolated, and that a total .program for good health education and practices is needed wherever any thought is given to needs in a community.
We are still carrying on social hygiene education as an opening interest in many communities in the hope that others will realize the importance of a total health program as we have outlined in this narrative.
Preventable Diseases
193
194
Georgia Department of Pttblic Health
SOCIAL HYGIENE CONFERENCES
Two Social Hygiene Conferences were held during the year, one in Atlanta and one in Augusta. These conferences were held under the auspices of the Georgia Social Hygiene Council, the American Social Hygiene Association, the Social Protection Committee, the Georgia Deparrment of Public Health, the U. S. Public Health Service, and the County Health Department concerned.
Atlrmtct Conference, Febrttctry 21....:._This meeting was in the form of a dinner conference. It was not open to the public; only representatives of local associations and agencies attended. The groups represented were informed by their respective leaders of the importance of the conference. Guest speaker for this occasion was Dr. Walter Clarke of the American Social Hygiene Association. The ropic of his address was "Post-War Social Hygiene Problems". Fifty people were present at the dinner.
Attgttstct Conference, iVlct-rch 19-The theme of the Augusta Conference was "Social Hygiene-A Community Responsibility". Local and stare organizations and agencies cooperated in this endeavor. The public was invited. The program participants, each a specialist in his .field, discussed the many phases of community responsibility. Three hundred people attended the meeting.
TB-VD SURVEYS
Colttmbtts-MztScogee Co11nty-The purpose of this survey, as those in other parts of the state, was to .find every case of infecrious syphilis and tuberculosis in Columbus and Muscogee County and to provide for the referral of such cases for treatment to private physicians or public treatment. The program was launched under the supervision of the Columbus-Muscogee County Health Department, the Georgia Department of Public Health, and the U. S. Public Health Service, lasting for 45 days.
The Social Hygiene Consultant was assigned to assist the local commissioner of health in the community organization prior to the beginning of the survey. Letters were sent to organizations, agencies, churches, and individuals, telling them that a survey was to be made and inviting them to a meeting, at which time they would discuss plans for the survey. Prior to the survey, the Consultant conferred with various groups and individuals, requesting their cooperation. A Citizens Committee was formed for carrying forward the plans. Since this demonstration was offered on a voluntary basis, it was necessary that the various groups and individuals encourage the people to the stations for tests.
The project was a success, with various organizations and individuals responding with enthusiasm.
Macon-Bibb Cottnty-This survey was conducted in the same manner as the above survey. It, too, lasted for a forty-live day period, with organizations and individuals cooperating to make this project a success.
Attgttstct-Richmond Cottnty-This survey was also conducted in the same manner as the Columbus-Muscogee County survey, lasting for forry-.five days. The local groups and individuals responded very satisfactorily by aiding in attaining the objective of this demonstration.
P1eventable Disectses
195
HEALTH EDUCATION PROGRAM
]oint Health Edttcation Committee, Georgie& Department of Pttblic Health and Georgia Department of Edttccttion-This commitree consists of representarives from rhe State Department of Public Health and the State Depanment of Education. Those serving on this committee were assigned w it by the direcmrs of each of the pepartments. The chief concern of the committee is to coordinate the health work being done in each department in health education, working with school administrators, reachers, local depanments of health and ocher community groups in the interest of a total health educmion program in communities and in the public schools of the state.
Special work has been done by rhe Coordinator of Health Educarion in several "spot" coumies in the smte. Work has been done in many other counties. This commirtee has aided, w a large extent, in the program of social hygiene education.
The Social Hygiene Consultant is a member of this committee and has 1;1'0rked with the Coordinator in many parts of the state.
Attgttstct-Richmond Cottnty Progrctm-Out of the interest in the TB-VD survey in Augusm-Richmond County, the principal of the Girls' High School invited the Social Hygiene Consultant, the Commissioner of Health of Augusta and a nurse from the Augusta Health Department assigned to work with schools, to confer with her as w how this health education program could be carried over into the school. After many conferences, it was agreed thar the commissioner of health would furnish the services of a nurse (who hod a degree in public health education) to the Girls' High School to conduct a class (full credit course) in health education beginning with the second seme9ter of school in February, 1947.
we await with interest a repon of this work. In our knowledge, it is the first rime in the state that a local health department has participated in this way in a school health program.
COOPERATION WITH STUDENTS, TEACHERS, AND OTHER GROUPS
Stttdents-During the year, the Consulmnt has been invited by various school authorides w give talks and offer guidance in social hygiene w student groups. Printed material and reading lists have been furnished upon request.
T ectchers-Consulmtion service was offered to teachers, offering suggestions as to how social hygiene education could be made a pan of the toml school health program.
Other grottps-The Georgia Social Hygiene Council and the Georgia Congress of Parents and Teachers have contributed to the work in social hygiene.
HEALTH EDUCATION WORKSHOPS
The Social Hygiene Consultant worked in the Health Education Workshop at the University of Georgia in the capacity of Consulmnt during the summer of 1946.
196
Georgia Dep<trtment of Pttblic Health
AcTIVITY REPORT, JANUARY-DECEMBER, 1946
Conferences
January ....
11
February ..
H
March ...
16
April. .....
15
May... .........
5
June ......
2
July. .... ...
10
August ... ......
16
September ..
12
October .... ......
.'}
November.. .....
2
December. TOTAL ..
---108
Meetings Attended other than Addressed
3
4
LECTURES
- - - - - - - - Contacts
Exhibits Literature Displayed Distributed
No.
Au d.
--- ------
I2
115
6,975
6
1,915
1
1, 767
1
6
478
4
1,620
1
7
400
.j
2,885
1
5
285
3
3,516
3
3
1
2,891
1
100
6
1,274
2
9,356
6
7
435
2,,173
2
5
850
1
2,930
3
1
62
1,209
3
170 - - - - - - - -339-
26
43
'!,810
21
2
37,235
Typhus Control Service
For the first six months of 1946 the personnel of the Typhus Control Service consisted of two Sta[e employees (Engineer-Director and one Sanitarian), 130 Federal Civil Service employees, 13 U. S. Public Health
Service commissioned officers and approximately 76 local coupty and city
employees, or a total of 221 full-time employees. For the second half of 1946, the number of employees, consisted of two Sta[e employees, 68 Federal Civil Service employees, six U. S. Public Health Service Commissioned officers, and approximately 42 county and city employees, or a total of 118 fulltime employees.
The activities of the Typhus Comrol Service are directed from the A[lanta Office through the Macon Field Office to [he Regional and coumy personnel. The staff of the Atlanta Office consists of the Engineer Director, one commissioned officer of the U. S. Public Health Service, and two secretaries. The personnel of the Macon Field Office consists of a Field SuperYisor, Field Entomologist, Supervisor of rat,proofing activities, Supervisor of all Federal Typhus Control property and special projects, and Supervisor of the state-wide mobile DDT dusting and rat eradication unit, and one secretary. County activities are directed by Regional Supervisors attached to the East Central, Southeastern, and Southwestern regions of the Sta[e Health Department. Typhus Control activities in the South Central Region are supervised directly by personnel of the Macon Field Office. Activities in [he NoHheastern and Northwestern Regions are supervised directly by personnel in the Atlanta Office.
With the exception of minor changes in operation plans, [he Typhus
Pre,ventctble Diseases
197
Control Program continued throughout che year on or about the same level of anivities as for the last half of 1945. At this time financial assistance was first received chrough the U. S. Public Health Service. Details of the activities for 1946 are reported as follows:
Edttccttional:
This phase of the Typhus Control Program, at the Regional and County level, is conducted principally through the Field supervisory personnel. Activities, in this connection, have been through the media of pamphlets, newspaper articles, film projection, group meetings, personal conferences, and contacts with individuals.
The Training and Education Division of the U. S. Public Health ServiceCommunicable Disease Center rendered invaluable assistance by supplying films and film projecdon equipment. They also furnished literature for free distribution. Strip films and strip film projectors were assigned to the Macon Field Office, each of the Regional Supervisors, and certain County Supervisors. In addition, moving picture projectors and films were supplied by the Atlanta and Macon Offices to all field personnel upon request. This equipment has proven very beneficial in aiding the field personnel in conducting an intensified educational program in the various counties.
The Educadonal Program, during the year, has been highly effective. This was indicated by the great amount of interest shown by counties requesting participation in the Typhus Control Program.
DDT Dttsting ctnd Rctt Erctdication:
DDT dusting, combined with rat eradication acuvmes, was first established in the Georgia Typhus Control Program the latter part of 1945. These cwo control measures are applied together as more expedient in controlling che disease over large areas. The above are considered temporary control measures, and should be applied only periodically until permanent methods can be instigated. DDT dusting of rat runs and rat harborages is directed ac the destruction of the rodent vector of Murine Typhus Fever, namely, rat fleas and possibly other rat ectoparasites. Rat eradication is conducted by means of rodenticides and is directed at the destruction of the rodent reservoir of Murine Typhus Fever.
While the resulrs of one year's operations with DDT dusting as a new type of control measure appears to be very encouraging, it is too early to establish this control measure as an effective weapon against the transmission of Murine Typhus Fever from rat to man.
With the advent of new rodenticides, rat eradication has become ,more effective than ever before. These new rodenticides consist principallv of 1080 (Sodium Fluoroacetate) and ANTU (Alpha-naphthyl-thiourea). They were developed during the war years and made available to health departments shortly after the close of the war. Both are highly effective rodenticides and are currently used in the rat eradication activities of the Typhus Control Program. These rodemicides have limited usage, and therefore do not supplement Red Squill in mass rat eradication.
198
Georgia Dep,trtment of Pttblic He,tlth
The Typhus Control Service renders supervisory services over local progxams. In addition, it supplies DDT dust, 1080 rodenticide, trucks, certain small equipment and supplies. Local participation consists principally of labor, rodenticides other than 1080, rat bait, office space, office equipment and supplies.
DDT dusting and rat eradication programs were conducted on a full-time basis in 21 counties during the year. These counties were: Appling, Bibb, Bulloch, Burke, Chatham, Coffee, Colquitt, Crisp, DeKalb, Dougherty, Fulton, Glynn, Jenkins, Laurens, Richmond, Screven, Telfair, Terrell, Tift, Toombs, and Worth. In addition, 52 counties received part time DDT dusting and
out rat eradication programs. Service was rendered to these 52 counties by the
state-wide mobile DDT dusting and rat eradication unit operating of the Macon Field Office.
Ratproofing:
Ratproofing of buildings is a permanent rat and typhus control measure. It is also known as "Vent-stoppage of buildings", as originated by the Typhus Control Service. Briefly, ratproofing or vent-stoppage consists of dosing or protecting exterior walls of buildings to prevent the ingress or egress of rats. After a building has been ratproofed, rats that might be confined within are eradicated by rodenticides.
Ratproofing projects are financed principally by local funds, and are accomplished through revolving funds established by the local governments. The purpose of revolving funds is to defray the cost of initial construction and rat eradication until reimbursed through charges made to building owners or tenants for work performed.
The Typhus Control Service renders supervisory services over local ratproofing projects and, in addition, mobile work shop units are available to each project supervisor. During the year this phase of the Typhus Control program was slow in expanding. This was clue to the acute shortage of certain materials necessary in ratproof construction, and the inability to employ trained personnel. Material shortages necessitated securing through the U. S. Public Health Service certain materials which, in turn, were supplied to the local projects on a loan basis.
In September of 1946, a field supervisor for this activity was assigned to the Macon Field Office to direct the activities of the local project supervisor, and to organize new projects. In addition to the field supervisor, the personnel of the activity consisted of three project supervisors.
In order that each project supervisor would be qualified to supervise a local project, he was given six weeks intensive training with the Training and Education Division of the Communicable Disease Center, U. S. Public Health Service. This training was supplemented by practical experience on a project in a subordinate position.
During the year ratproofing projects were conducted in the following counties: Fulton (Atlanta and County), Bibb, Crisp and Coffee Counties.
Experience has shown that adoption of local ratproofing ordinances has given support w the successful completion of this type of project. For this
Preventctble Diseases
199
reason, ratproofing ordinances were adopted, during the year, in the following cicies: Decatur, Cordele, Nashville and Douglas.
Sanitary Re/ttse Collection and Disposctl:
This activity is also considered a permanent rat and typhus control measme, and is directed toward the elimination of rats on premises. This is accomplished through the improvement of refuse collection and disposal facilities which destroy rat harborage and food supply.
During the year this activity was conducted on abom the same level as for the previous year. Inability w obtain an engineer for full-time advisory services w communities necessitated limited services in this activity by the engineer-director. The program has also been greatly handicapped through the lack of newly manufactured equipment obtainable by communiries.
Sanitary land-fills were continuously operated in Muscogee County and the City of Valdosta. Initial steps were taken w establish sanitary land-fills by the cities of Thomasville, Manchester and Cairo. Other cities have shown interest in this phase of typhus control and expect to operate sanitary landfills as equipment becomes available.
ln,vestigations:
Epidemiologic-
Medical epidemiologic investigations were made during the year by the Regional Medical :pirectors and County Health Officers.
The limited time available for this activity by medical personnel created a need for lay investigations. These investigations are made by the Field Supervisory personnel of the Typhus Control Service operating under the general supervision of the Regional Medical Directors and County Health Officers. Lay investigations of reported typhus fever cases are confined strictly to obmining non-medical information.
Location of residences and occupations of typhus fever cases are recorded on maps. From these maps the areas are determined in which DDT dusting and rat eradication ~antral measures should be applied.
Although these lay investigations are not tabulated in the accompanying statistical report, it is estimated that the majority of the typhus fever cases reported in counties having full-time DDT dusting and rat eradication progmms during 1946 were investigated.
Rodent ln,vestigations:
The rodent investigative program was organized in January, 1946, under the immediate direction of the Field Entomologist.
The purpose of this activity is to accomplish two objectives:
1. To obtain an index of the ecroparasite infestation of rats and to determine the effectiveness of dusting rat runs with DDT for the elimination of those ecwparasites.
200
Georgia Department of Pttblic 1-lectlth
2. To collect rat blood specimens for serological tescs to decermine che prevalence of murine typhus in rats, particularly with reladon to the effects of DDT in reducing murine typhus infeccions in the rat population.
Rodent investigacions were performed in the following 24 coumies of the stace: Appling, Bulloch, Burke, Chatham, Coffee, Colquitt, Crisp, DeKalb, Dougherty, Early, Evans, Fulton, Glynn, Jenkins, Laurens, Richmond, Screven, Sumter, Telfair, Terrell, Tift, Toombs, Ware and Worth.
Samples of rats were taken from food handling and non-food handling escablishments in both dusted and undusted buildings in each of these conndes. Ectoparasices were combed from the crapped rats, and the eccoparasites were collected and identified. Blood samples were also obtained from all live rats.
Three biological aides were employed to conduce the rodent invescigations. They were trained to trap rats, to comb and collect che parasites, to obcain blood samples and prepare che sample for shipment to the laboratory, and co prepare necessary field reports.
Each biological aide was assigned to a region in the state consisting of about six coumies. One week of each six-week cycle was spent in biological work in each county. Local employees assigned to the DDT dusting program assisted the biological aide with che biological work in each county.
In July 1946, most of the state DDT dusting programs were changed from the individual county system to a mobile dusting unit system. When this change in the plan of dusting operations was made, a full-time assistant for each biological aide was employed to eliminate the need for the assistance of local labor.
In addition to the three biological aides, project supervisors assigned to the DDT dusting programs in Chatham, DeKalb, Fulton and Richmond Coumies were trained to perform biological work. With the aid of local employees assigned to the typhus control program, the project supervisors in chese four counties performed rodent investigations at intervals of about one week out of every six.
Graph No. 1 presents graphically a comparison of rat flea indices from DDT dusted and undusted buildings.
This graph is prepared in two chans, Chart 1 showing rae flea indices of all species of rae fleas, and Chart 2 showing rat flea indices of the principal murine typhus fever flea veccor (X. cheopis).
It may be observed that DDT dusting was more effective in reducing the X. cheopis rat flea indices than for reducing the rat flea indices for all ocher species of rat fleas. However, a substantial decrease may be observed in the rat flea indices from DDT dusted buildings of both charts.
Graph No. 2 presents graphically the monthly variation in the incidence of human cases of murine typhus fever and the infection rate in rats.
It may be observed that the trends are somewhat similar between the
Preventable Disectses
201
human cases reported and the infection rate in rats. It may be funher observed that DDT dusting has apparently caused a considerable decrease in the rate of infection in rats.
It is hoped that DDT dusting will eventually prove effective in controlling rat ectoparasites that transmit typhus fever and, in turn, reduce the infection rate in the rodent population. The present large scale program of DDT dtlSting is based on this assumption.
T homasville lnvestigcttive project:
The Thomasville Investigative Project is operated directly by the Epidemiologic Division of the U. S. Public Health Service, Communicable Disease Center. It is, however, under the general supervision of the Division of Preventable Diseases, Typhus Control Service.
The project is operated independently of other investigative state studies and comprises an area of Brooks, Thomas, Grady and Decatur Counties.
The project is financed almost entirely by Federal funds. However, there are two laborers furnished by Brooks County and four by Thomas County.
The administrative offices of the project are located in five buildings on the grounds occupied by the U. S. Veterans Hospital.
Valuable information is being obtained in regard to the following: human typhus, typhus in rodents, and effectiveness of DDT dusting in destroying rodent ectoparasites.
The preparation of the final analysis of accumulated data is not expected to be made until the latter part of 1947. Publication of data will be made by the cooperating agencies.
TYPHUS FEVER IN GEORGIA
For the year 1946, the incidence of murine typhus fever for the Smte dropped to 585 reported cases as compared with 1,111 reported cases for
1945. This is a decrease of 47.4 Yo in 1946 as comparte! with 1945. This is
the greatest decrease that has occurred in any one year since 1940.
Thirty-three deaths were attributed to murine typhus fever during the year 1946 as compared with 59 deaths in 1945; or a cleC1ease of 44.0% in 1946 as compared with 1945.
The decrease in reported incidence for the year 1946 may be clue in part to control activities as indicated by the accompanying graphs.
Graph No. 3. Comparison of the 1946 case rate incidence of murine typhus fever with that of previous years for twenty-one counties operating full-time DDT dusting and rat eradication programs during 1946.
This group of counties reported 39.2% of the total number of cases reported for the State in 1946 and 55.6% of the tOtal number of cases reported in 1945.
It may be observed that a substantial reduction occurred in the monthly
202
Georgi<t Department of Public Health
case rate incidence of the disease for 1946 as compared with 1945 and the five year period, 1940 to 1944, inclusive.
On the basis of yearly case rates, a decrease of 63% occurred in 1946 as compared with 1945. Comparing the total 1946 case rate with the total five year average case rate a decrease of 60.8% is noted.
From these data, the decrease in the 1946 incidence of murine typhus fever for this group of counties apparently influenced the reduction of the state-wide incidence of murine typhus for the same period. This apparent influence may be analyzed by graphs 4 and 5.
Graph No. 4. Comparison of the percentage variation, by months, in reponed murine typhus fever case rates, per 100,000 population, for 1946 as compared with 1945 for certain county groups. Twenty-four percent of the total number of cases reported for the Smte for the 5 year period 1940 through 1944 occurred during the first six months of the year. Seventy-six per cent of rhe coral number of cases was reported during the second half . of the year.
It may be noted that the statewide curve shows a subsmntial decrease for the second half of the year. This curve follows the same trend of the curve representing the 21 counties that had full-time control programs during 1946. These two curves, compared with the 75 counties in which no control programs were conducted, show a greater decrease than that which occurred for the 75 coumies.
On the basis of yearly case rates, the state-wide case rate decreased 47.4% in 1946 as compared with 1945. The case rate for the same period of the 21 county group decreased 63%. The decrease in the case rate for the 75 county group was 18.9%.
In comparing the percentage decrease in case rates for the 21 county group below thar which occurred for the 75 county group, it is noted that for the same period the 21 county group had a greater decrease of 44.1 %.
Graph No. 5. Comparison of the percentage variation, by months, in murine typhus fever case rates, per 100,000 population, reported for 1946 as compared with 1945 for the 21 counties having control programs in 1946. This group of counties is broken down into two groups as follows: 1. A group of 16 rural counties having a population of less than 35,000 per county. 2. A group of 5 urban counties having a population of 35,000 or more per coumy.
Ir may be observed that the curve for the 16 rural counties has a trend somewhar similar to the 75 counties having fl.O control programs during 1946 as shown in Graph No. 4. The curve for the 5 urban counties shows a subsmntial decrease and has a trend similar to the curve representing the 21 urban and rural counties. It appears that the decrease in murine typhus fever incidence for the 5 urban coumies in 1946 as compared with 1945 is de.finirely responsible for rhe decrease that took place in the 21 urban and rural counties for the same period of time. Ir is indicated from Graph No. 4 that the 21 coumy group was primarily responsible for the decrease in the
Pre-ventable Diseases
203
state-wide incidence of the disease for 1946. This graph shows that the 5 urban counties were responsible for the decrease in the 21 county group. Ir may be assumed that the decrease in rhe 5 urban counties during 1946, as compared with 1945, was primarily responsible for the decrease in rhe incidence of rhe disease for the entire state for the same period of rime. The 5 urban counties are: Fulton, DeKalb, Bibb, Richmond, and Chatham. The decrease in the case rates for these 5 counties for the year 1946 as compared with 1945 is 63.1% greater than the decrease in the case rates reported for rhe 75 counties in which no control operarions have been conducted. While it appears that the control operations in the 5 largest populated counties in the state might have been highly effective in 1946, it is believed [hat one year's data is insufficient to arrive at any conclusion on the effectiveness of control operations at this rime.
The 16 rural counties included in the 21 county group show no significant decrease in case rates below that which occurred in the 75 counties having no control programs. This fact may be accounted for partially by findings of epidemiological and rodent investigarions. Indications are that the disease is widespread in the sparsely settled areas, as well as in the cities and towns. Consideration should also be given to the face char more efficient reponing of the disease may have taken place in 1946 as a result of the interest manifested in the rural control activiries.
Iris believed that the DDT dusting operations played a major role in the murine ryphus fever control programs in the several counties. DDT dusting appears to be encouraging as a new rype of typhus control measure for eradicating rat ectoparasites and lowering the disease incidence.
204
Georgia Department of Pttblic Hectlth
10
CHART I
NUMBER OF FLEAS (ALL
9
SPECIES l PER RAT ON ALL
SPECIES OF RATS TRAPPEO
IN DDT DUSTED OR UN DUSTED
8
BUILDINGS IN 24 COUNTIES.
~
C!:
7
"aw . '
(j)
6
w<t
...J
""0 -
5
Cw!: :<D;
4
/\
I\ I\
"z::l
~3
<t
C!:
>w
<t
2
I I
,_... ,.,.....1
\<::_DUSTED BUILDINGS
\\ \\
I
,"'"' "'',' '~I I I
0
'----- \ \
\-
--
-
.
.
-.....,
~/ ..,.
~'
\ '
\
10
CHART 2.
NUMBER OF X. CHEOPIS
9
FLEAS PER RAT ON ALL
SPECIES OF RATS TRAPPED
IN DDT DUSTED AND UNDUST
8
ED BUILDINGS IN 24 COUNTIES
~
C!:
7
C!:
aw .
(j)
6 UNDUSTED
<t
w
BUILDINGS
...J
""-
5
0
Cw!:
;<:D;:
4
"z::l
w
"<t'
Cw!:
>
<t
2
__ _ ,
DUSTED BUILDINGS
0--------
/ -/
/
.. ______ '
.....
,......,...,.,
.....,.._..._
?
.....................
JAN. FEB MAR. APR. MAY JUNE JULY AUG. SEPT OCT NOV DEC.
GRAPH No. 1
PrePentable Diseases
205
CHART I
MURINE TYPHUS
0
80
FEVER CASES REPORTED FROM 21 COUN TIESHAVING FULL TIME DDT DUSTING
"' AND RAT ERADICATION PROGRAMS
1a:-: 70 DURING 1946
0
0..
"'a::
rn
60
CASES REPORTED
"rn'
5 YEAR AVERAGE -4
<t 0
:;o
1940 TO 1944
a::
INCL
>""..''. 40
rn
::>
,.:1: 30
0..
1-
a::
"'Ill
;:!:
:z:>
10
0
eo
70
>"' 60 E
rn
~
UNDUSTED BUILDINGS
0z
rt::> 40
rn
~
.a.:.:
30
0
""<'t' 20
1z -
"0a:': 10
"'0..
0
\...., ...........
JAN. FEB. ldAR. APR. MAY. JUNE JULY AUG. SEPT. OCT. NOV. DEC.
CHART 2.
PERCENTAGE OF RATS FOUND POSITIVE TO MURINE TYPHUS FEVER IN DDT DUSTED AND UNDUSTED BUILDINGS IN 24 COUNTIES.
GRAPH No. 2
206
Georgia Department of Pttblic Health
MURINE TYPHUS FEVER CONTROL STATE OF GEORGIA
TYPHUS FC:VER ~ATES REPORTED BY MONTHS IN THE FOLLOWING 2/COUNTIES PARTICIPATING IN DOT OUST.. lNG ANORATERRAOIOATION DURING 194G
CASE RATES BASED ON 100,000 POPULATION
II
APPLING
fULTON
BIBB
GLYNN
BULLOCH
JENKINS
BURKE
LAURENS
CHATHAM
RICH MONO
10
COFFEE COLO\JITT
SCREVEN TELFAIR
CRISP
TE~RELL
OEKALB
TIFT
DOUGHERTY
TOOMBS WORTH
9
8
,to_uo_oz 7
<to-
O:<t
tu-'
(fl::l
6
<!"oO
o:"-
->twuooo 5
o"-o0o
::>-
J:o:
[":-aw.
3
2
PERIOD OF ORGANIZING COUNTY OOT OUSTING PROGRAMS 1945
SEPTEMBER THROUGHOECEMBER
I'
I RATES REPORTED->
1945
I
I
./
//
//
/
/
',
\
\ \
\ I
I
\ I I I
\ \
-... ..................
0
JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT. OCT. NOV. DEC.
GRAPH No. 3
100
eo
u
~ 60
ow r
0
!::
40
w
(!)
20
<1:
1z -
w
o0 r w
0..
-20
Pre-ventable Diseases
207
MURINE TYPHUS FEVER CONTROL. STATE OF GEORGIA
COMPARISON OF PERCENTAGE VARIATION,9'f MONTHS,IN REPORTED MURINE TYPHUS FEVER CASE RATES PER IOO,OOOPOPULATION FOr\ 1946 AS COMPARED WITH 19"-5 B'f THE FOLLOWING CUUNTV GROUP CURVES.
-
STATE-WIDE TOTAL-INCLUDES 159 COUNTIES
-
75 COUNTIES WITH NO COMTROL PROGRAM
- - - 21 COUNTIE:S WITH FULL-TIME CONTROL PROGRAMS
DURING 1946
NOTE-63 COUNTIE.:S OF TOTAL 159 NOT INCLUDED DUE TO PARTIALLV CONDUCTED CONTROL PROGRAMS DURING 1945- 194 6
w -40
<Jl
o<w1r: -60 w0
0 -eo
-100
SEMI-ANNUAL VARIATION IN REPORTED STATE-WIDE MURINE TYPHUS FEVER CASES
FIGURES BASEO ON AVERAGE NUMBER CASES REPORTED FOR PERIOD 1940-1944
1 100 I 24% oF rorALNUMBER cAsEsREPoRre:o :~~s
76% oF ToTAL NUMBER cAsEs REPoRre:o ~~~~oJ
D.Ec. JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT. OCT. NOV. DEC.
MURINE TYPHUS FEVER CONTROL. STATE OF GEORGIA
100
eo
COMPARISONOF'PEACENTAGE VARIATIOH~9V MONTHS, If'! REPORTED. MURINE: TYPHUS FEVER CASE: RATES PER IOO,OOOPOPULATJON FOR 194GAS COMPARE:D WITH 194.5 BV THE fOLLOWING GOt.kiTV
GROUP CURVES:
~ 60 ow<1r:
~ 40
-21 URBAN MID AURAL GOUHTIES WITH FULL-TIME COHTROL PROGRAMS DURING 1946.
-
16 RURAL COUNTIES Of 21 COUNT GROUP WITH FULLN
TIME CONTROL PROGRAMS DURING 1946
- - - 5 URBAN COUNTIES OF 21 COUNT GROUP WITH FULL
JME CONTROL PROGRAMS DURING 1946
w
(!)
20
I''''
zw~
I'
o------f-
0 ow r
I I I
0..
-20
I I
II
~..............
-40 w
' ,,,I
<Jl
l5
or
-60
0w
0 -eo
',, '\
', \\\ '
.,. ... ""'.................
..,.""'""'
...........
SEMI-ANNUALVARIATION IN REPORTED MURrNE TYPHUS FEVtm CASES FOI'I~1JRBAN
-100
AND RURAL COUNTIES OPERATING CONTROL PROGRAMS DURli'i"1ff9.fs-
FIGURES BASED ONAVEAAGE NUMBER CASES REPORTED fOR PERIOOIS40 -1944
I 23% OF TOTAL NUMBER CASES REPORTED T:~:IOD 77r;~/o OF TOTAL NUMBER CASES REPORTED ;~~~OO
DEC. JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT. OCT. NOV. DEC. GRAPHS No. 4 and 5
208
Geo1gia Department of Public Hectlth
STATISTICAL REPORT
1. Typhtts Fe-ver Morbidity
TOTAL
No. Typhus Fever cases reported for state (1945) ____________________ 1,106
No. Typhus Fever cases reported for stare ( 1946) ------------------- 594
2. Penonnel
A. Local --------------------------------------------------------------------------------------
42
B. State --------------------------------------------------------------------------------------
2
C. Federal Civil Service -------------------------------------------------------------
68
D. USPHS Commissioned Officers______________________________________________
6
E. Total all personnel __________________________________ ----------------------------- 118
3. No. Comities Service Rendered____________________________________________________
73
Li. No. Field Visits---------------------------------------------------------------------------- 62,584
5. Edttcational A. Personal conferences and contacts._______________________________________ 65,370
B. Meetings attended ----------------------------------------------------------------- 151
C. Meetings addressed ---------------------------------------------------------------
81
D. Number persons addressed-------------------------------------------------E. Radio talks ______________________________________________________________________________ F. Slides and strip films shown __________________________________________________ G. Movies shown __________________________________________________________________________
2,845 1
15 26
H. Newspaper articles ---------------------------------------------------------------
35
I. Literature distributed ------------------------------------------------------------- 42,078
6. In-vestigations
A. Epidemiology
1. Cases investigated
B. Rodent Investigations
1. No. rodents trapped---------------------------------------------------- 5,053
2. No. rodents examined for fleas (dusted areas) ____________ 2,457
3. No. rodents examined for fleas ( undusred areas) ________ 1,873
4. No. fleas recovered from rats (dusted areas) ______________ 3,707
5. No. fleas recovered from rats ( undusted areas) ________ 12,443
6. Flea Index-dusted areas._____________________________________________
1.5
7. Flea Index-undusted areas-----------------------------------------
6.7
8. Percentage reduction of flea index________________________________ 77.7%
9. No. rodent blood specimens examined----------------------- 3,267
10. No. rodent blood specimens positive w typhus fever____ 1,038
11. Percentage of rodem blood specimens positive to
typhus fever ______ ------------------------------------------------------------- 31.6%
7. Legctl-Ordinctnces Adopted
A. Vent-stoppage ( ratproofing) --------------------------- ___________________ _
3
B. Refuse collection and disposaL____________________________________________
0
C. Other -----------------------------------------------------------------------------------
0
8. Control 1\tiectsttres A. Vent-stoppage
Preventable DiseriSeJ
209
1. Surveyed (estimate)
TOTAL
Business establishments................-------------------------------------------- 2,141
Residenrial establishmenrs________________________________________________
Total surveyed................................................................................................................................... 2,141
2. Vent-stopped Business establishments ____________________________________________________ 643 Residenrial establishments________________________________________________ Total vent-stopped____________________________________ . ----------------------- 643
3. Inspected for repairs
Business establishments____________________________________________________
40
Residential establishments________________________________________________
Total inspected________________________________________________________________
40
4. Repaired
Business establishments____________________________________________________
1
Residential establishments_______________________________________________ _
Total repaired..................................................................................................................................
1
B. Rat Eradicarion
1. Number premises rreated Business establishments____________________________________________________ 30,251 Residential establishments________________________________________________ 30,859 Other establishments. ________________________________________________________ 2,699 Total treated...................................................................................................................................... 63,809
2. Poisoning Number gallons poison liquid used ( 1080) ................................ 577.9 Estimated number rats recovered ____________________________________ 12,550 Number pounds bait used (Red Squill)------------------------ 44,930 Estimated number rats recovered____________________________________ 5,944 Number pounds poison bait used (ANTU) ................................ 192 Estimated no. rats recovered.................................................................................. 209 Number pounds poison gas used (A-Dust)-------------------- 234 Estimated number of rats recovered________________________________ 1,241
C. Rat, Flea Eradication (DDT dusting)
1. Number Business Establishments Dusted............................................... 75,094 Residential establishmenrs dusted____________________________________ 70,538 Farm establishments dusted____________________________________________ 2,305
Total dusted......................................................................................................................................... 147,937
2. Amount of DDT dust used (pounds) ____________________________ 577,456
3. Amount of DDT dust per premise (pounds) _______________
3.9
210
Georgia Department of Pttblic 1-lectlth
Venereal Disease Control Service
The Venereal Disease Control Service has been severely handicapped by not having a Venereal Disease Control Officer or physician on the staff. However, the Director of the Division of Preventable Diseases has been formnate in having the able assistance of various representatives of the U. S. Public Health Service.
The rapid treatment center program has continued largely on its own momentum, since there has not been sufficient personnel co make regular visits in the field. However, the program apparently has not suffered since bo~h the Piedmont and Southeastern Cemers operated at capacity or above until they were closed in August, at which time the Alto Medical Cemer started operations. During the year, 12,806 patients were treated in these three centers. Alto Medical Center is one of the largest and most beautiful mpid treatmem centers in the world with a capacity of 700 beds. This hospital had previously been used as the State Tuberculosis Sanatorium, which was moved to Battey General Hospital at Rome on June 20.
Following the successful T. B.-V. D. Case-finding Survey in Savannah during the fall of 1945, plans were made to conduct three surveys in 1946at Columbus, Macon and Augusta. These surveys have been completed and were most successful. 53,456 blood tests, which number represents a very large percentage of the susceptible population, were made in Columbus. Of this number, 403 cases of early syphilis and 1128 of late syphilis were found :Jnd placed under treatment, as were 425 cases of gonorrhea. During the Macon Survey 53,522 blood tests were made. In this Survey 256 cases of early syphilis, 809 of late syphilis, and 435 cases of gonorrhea were found and placed under treatment. 37,258 persons were blood-tested during the survey in Augusta and Richmond County. 546 cases of early syphilis, 393 cases of late syphilis, and 294 cases of gonorrhea were found and placed under treatment.
Table A-Syphilis Cases Reported by Private Physicians-shows a reduction of 112 cases in the number of new cases reported, there being 1,628 compared to 1,740 in 1945. There is no significant difference in the other classifications.
In cable "B"-Syphilis Admissions to Clinics-14,474 new cases were admitted during 1946 as compared with 9,460 during 1945. This is an increase of 5,014 new cases over the previous period and is a tribute to early case finding.
There was an increase of 4,316 total admissions, which is evidence of intense epidemiology.
In the comparison of total under treatment during the month, it is interesting to note chat only 4,684 were under treacmem in December, 1946 as compared to 6,990 in December 1945, a reduction of 2,306. This is a far cry from the case load in December, 1943 of 25,997. These reductions can be attributed co the rapid treatment center program.
P1eventable Diseases
211
Giant Posters Publicize T.B.-V .D. Case-fin.ding Surve)IS
In table "C" will be found the statistics on gonorrhea. 16,521 cases were reported for the year of 1946 as compared with 9,048 cases for 1945. This is an increase of 7,473 cases and is attributed to the availability of penicillin in beeswax and oil which was not on the market until the latter part of 1945.
Table "D" shows no particular change over 1945 except those points already noted in the preceding tables.
Table "E" and "F"-Drugs Distributed-reflect the reduction in clinic load.
Table "G"-Laboratory tests-shows considerable increase in blood tests, dark-fields and gonococci cultures.
Table "H" shows a marked decrease in our educational activities which is to be regretted. With no physician on the staff and with staff members devoting considerable time to survey work, our educational activities have been much more concentrated than before.
Much credit is due the Division of Laboratories and the Division of Public Health Nursing for their splendid contributions to the Venereal Disease Program.
TABLE I
l'-..l >--'
l'-..l
SYPHILIS CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE
By Privare Physician
UNDER PROGRAM FOR DISTRIBUTION OF FREE ANTISYPHILITIC DRUGS
January- December, 1946
--
January . . .
February . . .
Mareh ................
April. ........ ....
May........
June ....... ...
July .......
... ..
August ........ ..
Sel)tember ... ..
October .... ...........
NEW CASES (Never nre\ icusly treated)
White
Colored
---
TOTAL
OLD CASES !Previously !reate~)
White
Colored
I
TOTAL
M
F.
---
-
-M -
-
-
F
-
-
-
-
-
-
M
-
-
-
-F
-
-
-M
-
F
3
6
31
32
72
2
1
16
12
31
6
2
12
33
53
6
6
7
18
37
4
11
21
17
53
2
2
12
22
38
12
11
110
74
207
14
g
59
69
151
12
11
72
86
181
4
4
13
22
43
16
23
84
141
2M
2
9
33
57
101
14
16
63
146
239
2
8
22
29
61
5
4
24
52
85
2
2
11
13
28
10
11
69
98
188
5
8
19
18
50
6
6
58
114
184
4
4
11
39
58
TOTAL REPORTED
c:;)
White
"' -- ----- C>
Colored
TOTAL ~"'
-
M
-
-
-
F-.
-
M
-
-
-
-F
-
tJ ~
5
7
47
44
103
~
12
8
19
51
90
"~ '
6
13
33
39
91 "'
26
20
169
143
16
15
85
108
358 224
~
;p
<:s--
18
32
117
198
365
~
I 16
24
85
175
7
6
35
65
15
19
88
116
303 ::c
113 238
"~'
10
10
69
153
242
November..
8
4
15
30
57
5
3
12
9
29
13
7
27
39
86
December ..... ......
9 - -10- - -14- - -12- - - -45 - - -1- - -4- - -3- - -10- - -1-8 - - -10- - -14- - -17- 22
63
TOTAL ..
105
115
573
835
1628
49
GO
218
318
645
154
175
791 1153
2273
--
-
-
-
--
-
-
TABLE II
SUMMARY REPORT OF CLINIC ACTIVITIES
Syphilis January- December, 1946
January ...
....
February . . . . . . . . . . . . . . . . . . . . .
MarciL .......
April. ............
May..............
June .........................
July ...... .. . . . . . . . . . . . .
August. ....................
September . . . . . . . . . . . . . . . . . . . .
October .........
November . .
December .....................
TOTAL .........
NEW CASES OF SYPHILIS ADMITTED TO CLINIC
White
Colored
M
F
M
---
32
33
319
108
72
914
68
65
638
46
60
42.5
32
39
320
56
so
445
57
51
417
62
54
357
55
68
429
56
54
489
32
48
252
60
54
363
664
678
5,368
F 456 1,078 920 600 651 701 596 537 6M 748 382 488 7, 764
OLD CASES OF SYPHILIS
DOSES
ADMITTED TO CLINIC
ADMINISTERED
Total Ad- Total Under
missions Rx During
White
Colored
Month
Arsenicals
Heavy
------ ------
Metals :p
-M-
-
-
F -
-
-
-M
-
F
70
49
615
690
93
69
717
808
2,264 3,859
5,685 5,342
"" - - - <li
R,OG3
8,329
~
~
8,193
8,281
:;:,.
;:t
68 110
Go
753
890
98
752
836
3,465 2,927
8,517 5,928
8,517 8,972
8,686 8,845
"t"J
t;
93
so
656
915
2.789
5,365
7,579
"" 7,472
~
90
95
609
706
2, 782
4,848
6,122
6, 705
~
76
84
777
944
3,002
4,863
5,861
5,446
58
65
767
951
2,851
5,243
6, 704
7,078
67
49
712
813
2, 797
4,996
7,889
6,210
86
73
608
R03
2,917
5,275
8,272
8,0RO
53
53
463
587
1,870
4,777
6,558
7. 721
86
51
433
538
2,073
-------------
950
829
7,862
9,481
33,596
4,684 .... . ...
5,255 87.985
6,690 89,543
1..-.-....l
\)J
N......
TABLE III
"""
GONORRHEA CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE By Clinics
January- December, 1946
NEW CASES ADMITTED (Not previously treated)
White I Colored I
OLD GASES ADMITTED
rr
(Previously treated)
White
Colored
TOTAL REPORTED If
White
Colored
Cl
<:>
"""CiQ
:";,'.
Unk Total
Unk Total
Unk Total tJ
""" January . . . . . . . . . . . . . . . . . . . . . .
-M-
-F-
-M-
F --
-
-
-
-
-
-
233 155 551 331 ........ 1,270
-M-
49
-F-
22
M
-67
-F23
-. .-..
-
-
-161
M --
F
--
-M-
-F-
-
-
-
-
-
-
282 177 618 354 1,431
"1::):;,.
~ February . . . . . . . . . . . . . . . . . .
146 103 388 244 ........ 881
"""' March ..... .... ............... 155 108 517 267 ........ 1,047
..._ April. .... ......... 163 113 576 301 ........ 1,153
13 10 40 14 . ...
23 11 28 15 . ...
14
9 22 12 .....
77 159 113 428 258
958
~
77 178 119 545 282 . ....... 1,124
<:>
57 177 122 598 313 1,210
May . . . .
. . . . . . . . . . ...... 189 119 735 365 ........ 1,408
20
3 16
4 . .....
'l::i
43
209
122
751
369 1,451
~ <::;-.<
June . . . .
.... ......
216 123 730 459 ........ 1,528 24
5 36 10
75
240
128
766
469 1,603
~ <-.
July ..... ..................
226 99 794 394
99 1,612
1
2
9
1
13 227 101 803 395
::c 99 1,625
August..... ............
171
September........................ 142
66 738 342 72 590 233
477 1,794 ...... ...... ...... . ....
612 1,649
...... ...... .......
..
171 66 738 342
. ....... 142 72 590 233
"" 477
1,794
:;,. ~
612 1,649 ~
October .....
........ 132 52 474 316
555 1,529
9
4 11
5
3
32 141 56 485 321
558 1,561
November ...
133 71 442 298
828 1.772
7
5
8
1
21 140 76 450 299
828 1,793
December ....
- - - -
-
84 -
-
4-8
248
-14-0 - -35-8 - -87-8
-
4
-
-
-2
-
-3
-
-1
-
-
-
-
-1-0
88 --
50 -25-1 -14-1 - -35-8 - -88-8
TOTAL ............. . . . . . . . . . . . . 1,990 1,129 6, 783 3,690 2,929 16,521 164 73 240 86
3
566 2,154 1,202 7,023 3, 776 2,932 17' 087
TABLE IV
TOTAL VENEREAL DISEASE CASES REPORTED TO THE VENEREAL DISEASE CONTROL SERVICE
January- December, 1946
BY PRIVATE PHYSICIANS
BY CLINICS, HOSPITALS OR OTHER INSTITUTIONS
TOTAL BY ALL SOURCES
White
Colorerl
White
Colored
----1------,--- - - - - Unk
M
F
MI F
MIF
MIF
White
M
F
Colored M IF
~
Unk
Total
<\>
"~"
------------ ------------ --- -------------------- ~
SYPHILIS
Pri. & See..................
81
97
319
Early Latent. ...............
1
22
45
Late & Late Latent...........
23
1R
222
Con~enital. ................. Prenatal.. ...................
....
3
2
..... i39 ..
6
TOTAL ....................... 108
592
552
246
10
164
220
242
6
12
7R8 . ... 664.
166 1,007
916 .......
220 1,322 2,592
262 30
2, 755 284
3,955 301
.................. .......
678 5,368 7. 764 ..........
~
327 165 265 15
772.
263 242
1,326 1.367
1,468 2,602
3,384 2,376
280 2,977 4,175 .......... 7,697
32
.8i7
290 5,960
307
8;552"
..........
644 16,101
~
t;i
~<\>
~ '-;
~
GONOCOCCUS INFECTION
Genito~urinary...............
0 pthalmia Neo. . . . . . . . . . . . . . . Not Stated .................. TOTAL . . . . . . . . . . . . . . . . . . . . .
. ...... . ... 81 81
......
46 46
l. i29 1 6;7831. 1 112:on I ....... .. .... . .......
452 .i28 .. L99o i;
452
128
1,990 1,129
6,783
3;69o
3,690
2;929
2,929
1 1,175 I 7,235 3.818 I 2,g2g 2,071 1,175 7,235 13,818 2,929
17,228 17,228
OTHER VENEREAL DISEASE
Chancroid...................
1 .......
1 ........
161
21
Granuloma Ing.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......
Lvmphogranuloma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 ........
TOTAL.....................
1 ........
1 ........
18
2
253941 36 329
87521
8 165
234
1
2
II . 31
30 295
19:1 . . .. "2"1
I ~~ I 235
59
36
330
165
234
31 30 295
570
165 76 811
l'-.l I-'
V1
J'anuary ... February .. Marr.h .... April.. May ...
June . July ... Au~ust .. September... . October .. . November .... December. TOTAL ... TOTAL NO. OF DOSES ..
[,..)
t-'
0\
TABLE V
FREE ANTISYPHILITIC DRUGS DISTRIBUTED
Venereal Disease Conrrol Service
January- December, 1946
Cl
NEOARSPHENAMINE
II
ARSENOXIDE
-
-.3
-
-
-.45-
-
-.6-
-
-
-. 75-
-
.9 -
-
-
3.0
--
-
-4-.5
-
-
6.0 --
-
10.8
--
-
-
.-045-
-
.067 --
-
.45 --
-
.67
--
-
195
255
3,115
.....
50
-90
430
115
55
635
3,205
25
1,570
""<:::> "'ere,
"~"
.."t.",J.
270
340
2,485
60
120
.....
275 .......... 1,515
3,950
60
1,410 ;~;;.
80
650
2,840
100
90
.......
380
420 . .......
1,210
2,805
360
1, 650 ;:l
30
195
4,040
......
145
.......
85
.580 . .........
280
3,035
30
"",. 665
;:l
240
720
2,530
......
85
......
70
20 ......
770
3,815
30
1,690
<:::> '--;..
120 -5 180
GO 320
1,030 185 420 165 920
2,185 900
3, 785 2,590 3,550
. ....... .....
.......
......
40
150
-60
-90 ..... . ......
150 .......
160
85 . ...... . .. .. ... .......
. .........
......... ...... .. .... ....
...
1,025 730 900 400 740
4,650 6,690 4,190 5,030 4,700
50 60 . ...... 610
1,570 1,040
890
'";:j
"'-<:.:,.-. ""::""c
1,190 510
""~
;~ ::;..
200
650
1,895 ......
..........
660
3,860
10
1,315
-
-300-
-
-3-60-
-
1-, 775-
......
--
-
.....
--
. ..
-
-
--
----.
.......
--
-
-
. .....
--
-
-220-
3,350
---
-
-
20 --
385
----
I I I-uoI I .I5.163[14.1o0I 1
1,990
,990
5
5,890
,890
~ 31,690
140
975
-30
-975 ---=150
875 I 1,410
55
-990
9,0~5
9,085
49,280 49' 280
1,255 12,550
13,885 138,850
~------~-------
TABLE VI
FREE ANTISYPHILITIC DRUGS DISTRIBUTED
Venereal Disease Control Service January- December, 1946
January .. February. March .. April. May. June. July. August ..... . September .. October .. November. December .... TOTAL .. TOTAL NO. OF DORES ..
TRYPARSAMIDE
SULPHARSPHENAMI NE
STOVARSOL
3.0
0.2
0.4
0.6
Tablets
I I -10
-160
II 25
1,650
-15
10
-160
-30
10
III .. ...5.0. .
10 40
20
10
so
.........
.........
40 . .........
100 1,750
50
70
50
30
____ ____ ____ _,
_ _ __ ,
155 ,
90 , -125
3,500
155
90
-125
3,500
FUADIN IISULFATH-1\ IAZOLE
BISMUTH
VACCINES
PENICILLIN
-
Bottles of 5-cc 40 Tablets 30-oo
270
636
117
430
835
139
670
890
149
1,060
471
237
1,140
1,219
287
890
526
200
1,400
742
197
920
450
443
1,240
3,015
478
Frei I Duorey
60-cc
pkg. (10l I pkg. (50l
187
10
14
257 II
17
140
231
10
126
I 16
13
136
14
338
13
132
13
6
15
100.000 units
--
4,806
9,005
~
"'"' 10,240
"';::
"" 7,210
:;:.
11,040 13,359
.~ ..._
"tJ'
!l ,097
~
"~ '
14,970
~
12,936
650
926
293
465
3,868
580
1,234
192
184
6,820
-64-0 -
533 ----
- - -87- - - -49-
- - -12- - - -2-
-3-,33-7
9,890 ---
-1-1,4-77-
-
2,819
---
-
-2,2-51-
-
-
145 --
-
-
-5-7
-
-10-8' 68-8
9,890 459,080
84,570 135,060
1,450
2,850 dosage varies
Total number does of tryparsamide ........ .
Total number doses of neoarsphenamine... . Total number doses of arsenoxides..... . . . Total number doses of sulpharsphenamine. Total number doses of stovarsol. .
0 60,788
209,765 120
3,500
Total number doses of fuadin ...... Total number doses of sulfathiazole.
Total number doses of bismuth ......
Total number tests of frei antigen .................
rrotal number tests of ducrey antigen ...............
9.89J
459,080
4,300
I ,450 2,850
,N_.
-...!
1...'-....l
00
TABLE VII
LABORATORY EXAMINATIONS FOR VENEREAL DISEASES
Performed in Central Laboratory and Two Branch Laboratories
Georgia Department of Public Health
January ........ .........
February ....... March ................................
April. ................ ...... .......
May ........
.... ........
June .................. .....
. July ................. . .. .. . . . . ... ..
August . . . . . . . . . .
September.............
....
Total 31,818 29,355 31,462 31,527 31,607 30,721 33.711 32,265 31,450
January- December, 1946
SEROLOGIC EXAMINATIONS
DARKFIELD EXAMINATIONS
c;]
EXAMINATIONS FOR GONOCOCCI
<::>
""''~.
:;,
Number Number Percent
Number Number Percent
Number Number Percent
Positive
---
-N-ega-tiv-e
Positive
----
-
-Tot-al
-
-Po-sitiv-e
Negative
---
-P-osi-tive-
-T-otal-
-Po-sitiv-e
Negative
---
Positive ---
3, 740 28,078
11.8
11
5
6
45.5
2 447
443
2,004
18.1
tJ
~g
3,550 25,805
12.1
17
12
5
70.6
2,315
365
1,950
15.8
.~....
3,562 27.900
11.3
26
8
18
30.8
2,468
464
2,004.
18.8
- .<::>
3,537 27,990
11.2
29
6
23
20.7
2,490
474
2,016 19.0
'i:i
3, 783 27,824
12.0
18
3,593 27,128
11.7
28
5 10
13 18
27.8
2, 720
35.7
2,540
525 431
2,195 2,109
19.3 17.0
<~ ";":s"-<
<'>
4,239 29,472
12.6
46
20
26
43.5
2,914
477
2,437
16.4
~
4,172 28,265
12.9
39
17
22
43.6
2,556
453
2,103
17.7
~
3,994 27,456
12.6
28
14
14
50.0
2,408
398
2,010
16.5
October ..... ......... ............ 32,471
4,180 28,291
12.9
27
19
8
70.4
2,872
500
2,372
17.4
November . . . .
. . . . . . . . ... . . 27,090
3,319 23,771
12.3
33
13
20
39.4
2,334
398
1,936
17.1
December .............. 25,663
3,169 22,494
12.3
25
7
18
28.0
2,184
360
1,824
16.5
TOTAL . . . . . . . . . . . . . . . . . . .
44.838 369,340
324,474 ~[--;27_1_3_6_ _1_9_1-~ 30,248 5,288 24,960 ~-
January . . . . February ....... . March ..... . April. ..... May ... June .. July ....... . august.... . Sep~ember ....... . October ......... . November............ . December........... .
TOTAL......... .
TABLE VIII
SUMMARY REPORT OF EDUCATIONAL ACTIVITIES
Venereal Disease Comrol Service January- December, 1946
Meetings Addressed
No.
Au d.
Meetings Attended (Not addressed)
Films
No.
Aud.
2
233
200
20
2,040
1,100
382
18
1,635
57
No. of Clinic Visits
No. of Conferences
Exhibits Displayed
15
750
450
12
2
73
6,847
20
17
Literature Distributed
f
9,737 2,646 3,688
-"'"',.<ll
::,.
<""ll"'
6, 911
b
4,575
~
<ll
3,303
~
<ll
1,638
'"'
10,330
6,353
3,526
1,801
3,102
-----
57' 610
N......
\0
Division of Tuberculosis Control
H. C. SCHENCK, M.D---------------------------------------------------------------- ___________Director CLARA B. BARRETT, M.D......... ------------------------------------------------------------ Clinician W'ILLIAM D. MAY, M.D. ______________________________________________________________________ Cfinicimz
Division of Tuberculosis Control
The Division of Tuberculosis Control in expanded services during 1946 participated in the x-ray and imerpretation of 173,775 persons, there being a total of 184,455 x-ray pictures of these individuals interpre(ed. 136,551 persons were x-rayed in combined tuberculosis and venereal disease surveys in Muscogee, Bibb and Richmond Counties. As a result of these three surveys, approximately 900 active and questionably active cases were discovered. An additional 300 arrested cases were found, which require only periodic x-ray examinations. 773 cases were found through the usual services in state clinics in local health departments, interpretation of films made by local health departments, x-rays in the Central Office, and imerpreta(ion of x-rays sent in by priva(e physicians, making a toral of 1,673 cases found.
A study of Table I shows that the highest percentage of cases discovered resulted from the imerpretation of x-rays sem in by physicians and heahh dt:panments. This amounted w 7.2%. Referrals to the Central Office were next highest wi(h the cases found in the group reaching 5.5%. In regular county clinics the percentage amounted to 2.3, and in mass surveys w 0.67% Although the percentage of cases found in mass surveys appears low by comparison with the other measures employed, the fact that such services reach an extremely large percentage of the adult population results in the discovery of cases that would nm otherwise be brought to light, and affords to the health officer an opportunity for closer epidemiological follow-up of (he comacrs to these cases, as well as a chance to institute preventive measures with the communicable cases. If methods can be devised for continued follow-up of communicable cases and contaC(S following surveys, a great step in the reduction of tuberculosis will have been taken. We must keep in mind also that in the remaining population methods of examination or screening, such as might be had with miniature chest x-rays or by tuberculin testing, and provisions for easy x-ray of all who may develop suspicious symptoms or signs of tuberculosis must be set up and maintained. If such . efforts are vigorously employed, a reduction and final elimination of tuberculosis can certainly be accomplished.
Table IV, which is a comparison of some of the local health deparnnent tuberculosis control activities for the years 1945 and 1946, shows that the services lis(ed have been kept up fairly well, that 4,160 cases were admitted through this service, and that 707 admissions to the sanatorium were secured in 1946, as against 580 in 1945. 22 tuberculosis cmtages were built in 1946, as agains( 6 in 1945. 0 course, all of these services could be greatly increased and a considerably greater number of cases could be admitted to such service, if they could be made available w all counties in the Sta(e.
Tables V and VI show that 480 cases received treatment during 1946 under (he State Artificial Pneumothorax Refill Program, wi(h 434 cases remaining as of December 31, 1946. The total cost for this service during me y~ar amounted to $28,103.00.
Following are shown the tuberculosis deaths and death rates per 100,000 population, by number and race, for 1945 and 1946:
224
Georgitt Depcvrtment of P1tblic Hettlth
Year
Number of Deaths Total W'hite Colored
Death Rate Per 100,000 Population
Total
W'bite Colored
1945 1946
1108 434 674
1031 460 571
35.5 21.3 62.1 33.0 22.6 52.6
The figures for the year 1946 are provisional. At present they show 77 fewer deaths than in 1945.
Table VII is a summary of the services rendered by our Tuberculosis Consultant Nurse. Her services were particularly valuable in the mass surveys.
A very important contribution to tuberculosis control was made by the acquisition of Battey General Hospital for a state tuberculosis sanatorium and the transfer of sanatorium activities from Alto w the location in Rome on June 20, 1946. Since then the sanatorium patient load has practically doubled, and more than 1000 cases are being treated there. A section of the Hospital is so arranged that tuberculous prisoners can be isolated and properly cared for, and through an arrangement with the State Prison Board this practice is being carried out. This makes it possible to take care of recalcitrant tuberculosis patients under the provisions of the State Board of Health's regulations governing the quarantine and control of communicable tuberculosis, which provides for forcible quarantine and isolation of such patients. (See Sections 88-112, 88-117, and 88-9916, Georgia Code-1933.)
Considerable work has been accomplished in getting tuberculosis case registers established in a number of health departments in the State. These are located in Fulton County and the City of Atlanta, Richmond County, Augusta, Chatham County, Savannah, and Muscogee County, Columbus. Another case register is soon to be established in Bibb County, Macon. We have been delayed in establishing a State tuberculosis register because of difficulty in determining the best procedme. We hope to get this matter straightened out in the near future and begin the operation of a simple and useful register.
In the plans for 1947, a continuation of combined venereal disease and tuberculosis surveys is contemplated and personnel and equipment are being assembled for this purpose. Pending such time as the district plan described in former reports can be fully carried out, an effort to carry on statewide services is being made by assigning two health regions to each of our three clinicians. Their function is to develop as rapidly as possible all types of case finding and consultation services within these areas. This arrangement would noc be possible were it not for the assignment to the Division of Tuberculosis Control of two physicians by the United States Public Health Service.
Tttberctt!osis Control
225
TABLE I
BRIEF SUMMARY OF CLINICS AND RESULTS Year 1946
Ki111l of Clinics
No. of Clinics
No. of No. of Cases
X-rays
Found Per Ceut
Regular County Clinics ( 14 X 17) --------------------------------7 2
College and High School survey follow-up x-rays ( 14 X 17 ) -------------------------------- 6
Industrial survey follow-up x-rays (14 X 17 ) -------------------- 6
Survey of United States Penitentiary ( 14 X 17 ) ---------- 1
Milledgeville State Hospital Survey ( 14 x 17) -------------------- 1
Three City-County Mass Surveys (14 X 17) follow-up____ 3
X-rays made in Central Office (14 X 17 ) --------------------
4,444
102
?~
--)
291 287 290 1,402 8,410 543
14 14 22 262 900* 30
.25 (1) .07 (2) .86 (3) 2.64 (4) .67 (5) 5.5
Total 14 X 17 x-rays made____
15,667 1344
X-rays sem in by physicians
and local health departments for interpretations________________________________
4,544
329** 7.2
X-rays sent in by physicians and
local health departments on
cases with previous diagnosis find no change shown________________________
2,549
Total Number 14 x 17 x-rays____________ 22,760
70 mm. x-rays made in indusuial surveys ---------------------------------------------- 19,624
70 mm. x-rays made at combined VD and TB surveys__________________________ 136,551
70 mm. x-rays made at college and high school surveys____________________ 5,520
226
Georgi'' Dep"rtment of Pttblic Hedth
TABLE I-Continued
BRIEF SUMMARY OF CLINICS AND RESULTS
YEAR 1946
TOTAL X-RAYS INTERPRETED 184,455
:NuMBER OF CASES FOUND__
1,673
NUMBER OF PERSONS X-RAYED______________ _ 173,775 AVERAGE PERCENTAGE OF CASES____________ 0.96
( 1) % calculated from 5,520 persons x-rayed in the survey ( 2) % calculated on basis of 19,624 persons x-rayed in the survey ( 3) % calculated on basis of 2,554 persons x-rayed in the survey (4) % calculated on basis of 9,924 persons x-rayed in the survey (5) % calculated on basis of 136,551 persons x-rayed in the surveys
*Estimated number of active and questionably active cases. **Includes 22 active prin1ary cases.
Tttbercttlosis Control
227
TABLE II
NUMBER OF X-RAYS MADE 1946
70mm.
X-rays made in 64 counties in 72 clinics organized in health commissioner and county public health nurse counties________________________________________________________
Special clinics:
Milledgeville State Hospital ________________________________ 9,924 Personnel Srate Health Department____________________ 218 Agnes Scott College____________________________________________ 1,268 Adanta University System____________________________________ 1,880 Aldora Mills, Barnesville-------------------------------------- 452 William Carter Mills, Barnesville________________________ 458 Scottdale Mills, DeKalb County-------------------------_ 403 Fort Valley Industrial School & High SchooL_ 678 Georgia Srate College for Women______________________ 1,108 Emory at Oxford & Palmer Stone SchooL________ 586 Railway Express____________________________________________________ 1,324 Southern Bell Telephone Company____________________ 3,524 Montag Company------------------------------------------------ 324 Federal Reserve Bank_________________________________________ _ 443 Muscogee-Columbus Mass Survey________________________ 52,740 Macon-Bibb County Mass Survey________________________ 46,156 Richmond County-Augusta Mass Survey____________ 37,655 United States Penitentiary-Atlanta____________________ 2,554
Consultation films sent in for interpretation from physicians and health departments____________________
X-rays made in Central office of patients referred by county health departments and private physicians
14 X 17
4,444
1,402
*
114 92 19 92 38 25 42 18
**
93 14 31 3,000*** 3,000* ** 2,410 290
7,093
543
TOTALS ----------------------------------------------------------------------161,695 22,760
*H x 17 x-rays included in report of Central Office. **Survey not completed. ***Estimated figures.
228
Georgia Department of Pttblic Health
TABLE III
CONSULTATION SERVICE
Results of Interpretation of Films Referred by Physicians 1946
NEW CASES:
P1 imary ---------------------------------------------------------------------------------:Nfinimal ---------------------------------------------------------------------------------Moderately advanced -------------------------------------------------------------Far Advanced --------------------------------------------------------------------------
Total Posi[ive --------------------------------------------------------------------------
Suspicious --------------------------------------------------------------------------------Ne:gative ---------------------------------------------------------------------------------Diagnosis nm made ----------------------------------------------------------------
22 72 143 92
658 3506
51
Films sent in for review on cases [hat had been previously diagnosed and no change shown --------------------------------------------------------
TOTAL OF ALL FILMS SENT IN FOR INTERPRETATION____
329
4215 2 549 7093
TABLE IV
PUBLIC HEALTH TUBERCULOSIS CONTROL ACTIVITIES OF LOCAL HEALTH DEPARTMENTS
1945
1946
Cases of tuberculosis admitted w service____________________________ 4,186 4,160
Visits to tuberculosis cases, comacts and suspects ______________ 44,932 Visits to cases of mberculosis ____________________________________________ 12,526
38,290 11,147
Office visits by cases of tuberculosis________________________________ 7,045
7,515
Office visits by tuberculosis cases, contacts and suspects ____ 23,612 Admission to Sanatorium____________________________________________________ 580
21,775 707
Number completed tuberculin [ests ------------------------------------ 17,220 Number positive__________________________________________________________ 5,184
Contac [S broken____________________________________________________________________ 1,151
19,741 4,972
1,3 24
Contacts partly broken________________________________________________________ 191
105
Relief secured-Number of cases________________________________________ 251
335
Tuberculosis cottages built__________________________________________________
6
22
T ttbercttlosis Cont,rol
229
TABLE V
STATE REFILL PROGRAM
January 1 through December 31, 1946
Number of pacients under creatmem, January 1, 1946________________ 352 New cases admitted co Service during 1946________________________________ 128
Total cases under creacment during 1946____________________________________
480
Patients dropped from service during 1946: Admitted to Sanatorium____________ 20 Pneumoperitoneum or pneumothorax discontinued 15 Assumed own paymems____________ 1 Moved to other states________________ 4 Deaths -------------------------------------- 6
Total Number Patients under Treatment, December 31, 1946________
-46 434
TABLE VI
A1onth January February March April May June July Augusc September October November December
COSTS STATE REFILL PROGRAM
1946
Total Pcttients T rectted 335 329 347 350 376 398 378 327 397 398 391 367
T otctl Cost Per i\tlonth
$ 2,256.00
2,024.00 2,198.00 2,404.00 2,559.00 2,381.00 2,632.00 2,123.00 2,580.00 2,095.00 2,465.00 2,386.00
TOTAL 'l'mal average per month Average cost per patient rer month
364
$ 6.43
$28,103.00 2,342.00
230
Ge01git Department of Pttblic Health
~
TABLE VII
STATISTICAL REPORT OF SERVICES RENDERED BY TUBERCULOSIS CONSULTANT NURSE
January through December 1946
iVltss Smvey ll:7ark
1. Number of mass survey organizational plans assisted with____________ 17
2. Number of educational programs for surveys promoted________________
8
3. Number of x-ray surveys attended and lended assistance------------ 17
4. Number of conferences held with college and industrial officials__ 32
5. Number (approximately) literature distributed through
colleges and industries-------------------------------------------------------------------- 84,200 6. Number interviews with tuberculosis cases and suspects___________ 2,656
Note: Three of the surveys included were the mass population venereal di,ease and tuberculosis surveys at Columbus, Macon and AuguS<a. Some 2600 cases and suspects were inter-
viewed during these surveys. Tuberculin cests and individual instruct~ons on obtaining specin1ens of sputa were given on n10st: of the cases interviewed and arrangen1ents for hospicalization were made on all diagnosed cases when indicated by the physicians.
Development of Nmsing Service
1. Number of visits made to regional health offices.__________________________
3
2. Number of visits made to county health departments ____ ______________
6
3. Number conferences held with health commissioners ___________________
7
4. Number of co_nferences held with nurses ------------------------------------- 11
5. Number of visits made to State Tuberculosis HospitaL______________
2
(a) Number of conferences with officials________________________________
4
Edttcation,t! W ork
1. Number of meetings attended--------------------------------------------------------
9
2. Number of staff conferences attended____________________________________________
8
3. Number of program plans assisted________________________________________________
4
Battey State Hospital
RUFUS F. PAYNE, M.D. _____________________________________________________________ Sztperintendent
MEDICAL STAFF:
F. C. Welchel, M.D. H. E. Crow, M.D. Fred Crenshaw, M.D.
John Crenshaw, M.D. Grover Brzozowski, M.D.
Battey State Hospital
This reporc, of necessity, will serve to summarize the first six months of 1946 at Alto and the last six momhs at Rome. Since it is a combined report, we have seen no need w attempt w separate the work of the two insdmtions. It does nor appear necessary to deal with a descripdon of Alto as an insritution but rather w describe Battey since previous annual reports have given a very graphic description of Alto and its work.
To those persons not familiar with Battey Hospital it will be necessary m give a brief history of the hospital and the method by which it was acquired. The Army closed the Battey General Hospital in December of 1945 and it was declared surplus soon aher. A committee of Senators and Representarives from the General Assembly of Georgia made an inspection and endorsed the report of a Committee from the State Board of Health who had instructed Dr. Abercrombie w make an effort w secure the facility for use by the State as a Tuberculosis Hospital. After much negotiation the hospital was finally released to the State of Georgia for use, including all equipmem, in April1946. The facility is made up of a complete army general hospital of approximately 2500 beds located on a one hundred-sixry acre tract of land bounding the city limits of Rome on the Northwest corner, and reached from the Chattanooga highway. The. buildings are all of masonry construction, brick, or concrete block, and are completely imerconnected with nn enclosed passageway. There are five kitchens, six cafeterias, laundry, fire departmem, chapel, guest house, club .house, gymnasium, recreation hall, movie theatre, swimming pool, athletic field, incineraror, animal house, warehouses and complete medical facility buildings such as x-ray deparcment, surgery, and also several "lock-up" wards which were used for psychiatric patients by the Army. As would be expected, the buildings are laid our in a very efficiem design and, while we could use many more private rooms, the hospital is quite suitable for a tuberculosis sanatorium. Each ward has a diet kitchen, two nurses' offices and one doctor's office. Floors are hardwood rhroughout, except in kitchens, baths, cafeterias, and medical buildings.
At the April meeting in 1946 the superintendent was instructed w proceed with the necessary renovations and equipping and w transfer the patients from Alto at the earliest possible date, consistent with the "(elfare of the patients and the availability of personnel and material. Patienkwere transferred on June 20, 1946 via Southern Railway special train and the Battey State Hospital was thereby officially opened m the public of Georgia. It has been considered by some that we were somewhat premature in opening the hospital since homes were not completed for the staff and since we had to transport milk from Alto each day for four months. It appeaxs too that we could have done much in the way of painting and other renovations which would have helped but it was felt that the need for additional beds, especially in view of the Columbus and Macon surveys, far outweighed these other drawbacks. Our first step was w make the necessary renovations for the care of the patients. This involved partitioning the colored dining hall so that patients and employees could both be cared for in the same dining
234
Georgia Depctrtment of Pttblic Health
room. Dishwashing equipment was transferred from one of the vacam mess halls so that patient and employee meal service could be separate. Private rooms were built into four of the colored wards so that receiving, surgical, and sick wards could be opened since this section had always been used for ambulant patients. It was necessary that living quarters be constructed for the staff since they are required to live near the hospital. One apartment house with three one-bedroom, and five two-bedroom apartments was converted from one of the Officers' Quarters. Twelve homes are now under construction and will shordy be available. These are all three bedroom homes and are of good, semi-permanent construction. It is somewhat questionable as to whether this will be enough housing for the staff but it is thought that this will be sufficient for our present appropriation. Since the hospital is quite large and is set up to handle a very large number of patients a brief description will be given for each department, both as to personnel and functions.
ADMINISTRATION
The Business Manager has as his direct responsibility the co-ordination of supply and personnel for the hospital. Since all checks are wricren from the Atlanta office he is able to handle the affairs at Rome with a quite small staff. An assistant aids by handling all personnel problems. A supply officer for the hospital supervises the keeping of inventories and ordering of supplies. This department deserves much of the credit for our being able to expand our hospital facilities when most institutions of a similar nature were closing clown beds for lack of personnel ancl supplies.
MEDICAL DEPARTMENT
We are extremely proud of our expanded medical staff at Battey. We are now in the process of applying for approval of teaching residencies in both mberculosis and thoracic surgery and we have every reason to think that the following departments will give us this accreditation. The X-ray Department is headed by the clean of the staff, Dr. Fred Whelchel. Dr. L. P. Holmes of Augusta is our consultant in non-pulmonary roentgenology and visits the hospital regularly. A staff of three technicians is kept quite busy with routine work for 1,000 patients and the consultation cases referred by private physicians. The army left a well equipped x-ray department and we have added a smaller department for the colored patients to save bringing the patients from such long distances.
Dr. Ingrid Stergus has just been appointed as a full time pathologist for the hospital. This will give added impetus to our teaching programs and we 'iVill undoubtedly raise our postmortems from the 20% figure which we had in 1946. Dr. T. F. Sellers of the State Department of Public Health heads our clinical laboratory since making a combination of hospital and regional public health laboratory facilities. Since his office is in Atlanta, Dr. Sellers has delegated the active direction to Miss Reynolds who is rapidly rounding out a well b;tlanced staff of technicians.
Dr. John Crenshaw directs the activities of the department of Thoracic
Bctttey Hospital
235
Surgery. His consultant is Dr. Robert Major from the University of Georgia at Augusta and between the [WO hospitals a residency in thoracic surgery is bting offered. Each resident spends two six months periods at each hospital thereby completing a total of two years experience in thoracic surgery. An accredited three year residency in surgery is a prerequisite. The Army left us with four well equipped operating rooms and these are being used daily for all of [he different surgical procedures in general use for diagnosis and/or treatmem. We have had no immediate or delayed deaths which were in any way due to surgical procedures. One full ward is being used for surgical patients on the white side and one ward on the colored side is used for surgical cases and new admissions. A blood bank has been established and we are considering having blood collected a[ other hospitals in the State and transported here for use with surgical cases since many patients are ur;able to have friends and relatives come such long distances.
Dr. Horace E. Crow is chief of staff and chief of white female medicine. His cohorts are Dr. Frank Blalock and Dr. George Nicholson. Dr. Fred Crenshaw is chief of white male medicine, assisted by Dr. Charles Murphy and Dr. John Barksdale. Dr. Grover Brzozowski is in charge of the colored division and was recently joined by Dr. James Capio who has several years experience in tuberculosis in Spain. When we have secured the services of a full time internis[, the hospital will have a well rounded medical, laboratory and surgical staff. The internist will be expected to have charge of the admission ward and all residents in tuberculosis and internal medicine will receive the major portion of [heir training in diagnosis under his direction. They will be assigned to the chiefs in medicine for training in treatment, surgical collapse and general management of tuberculosis cases. A[ the present time we have two residents for six months experience and there is no one w supervise their work on the admission ward except for the brief time which can be given by the Superintendent. Consulmnt service is being furnished through the University of Georgia School of Medicine at Augusta and by Grady Hospital in Atlanta. The major portion of the consultant service is furnished by the State Medical School and its staff. The following staff members from the University of Georgia School of Medicine are on our visiting staff for regular consultant service:
DR. V. P. SYDENSTRICKER_______________________________________________ -----~ Internet! i\lledicine
DR. PETER B. WRIGHT ________________________________________________________ Orthopeclic Sttrgery
DR. L. P. HoLMES----------------------------------------------------------------------Roentgenology DR. ROBERT MA]OR ________________________________________________________________Thoracic Sttrgery
DR. ROBERT RINKER ---------------------------------------------------------------------------Urology
DR. RICI-IARD ToRPIN----------------------------------------------------------------------Gynecology
DR. EDGAR PUND_____________ ------------------------------------------------------------------Pcttholo gy
Grady Hospital gives us assistance through their allowing us to use their residem in Eye, Ear, Nose and Throat. This gives each patiem the oppormnity to have glasses fitted at the hospital and saves many [tips to their home for this service. Dental Surgery is furnished by Dr. T. D. Worthingcon.
236
Georgict Department of Pttblic Health
NURSING SERVICES
Mrs. Elizabeth Hood is the hospital's director of nursing. All hospitals are extremely short of experienced nurses and we have been no exception. We are fortunate to have been able to expand constantly since arriving at Rome, but it is somewhat doubtful that expansion can continue at the presem rate for an indefinite period. The city of Atlanta closed Battle Hill Sanatorium and we were able to secure a large part of the staff there. In an effort to improve nursing services and to train more nursing personnel we have started a school for practical nurses which is under the direction of Miss Margaret Ferguson.
CULINARY DEPARTMENT
Miss Catherine Dillard is dietitian. Food is transported to the wards in electrically heared food buses and is served directly onto the trays. There is steam sterilization for dishes in the ward diet kitchens, as well as ice boxes and stoves. We have found it economical to maintain a butcher shop in connection with the large meat storage facilities which we have. A bakery and kitchen storeroom are also maintained.
MAINTENANCE
Mr. C. B. Fowler, a graduate engineer, is in charge of maintenance of grounds and buildings.
Steam generation is accomplished through the use of natural gas with fuel oil as a reserve. There are three 450 horse power boilers with two being required in winter and only one being needed during spring, fall and summer months. The power house is located in the rear of the hospital.
Fire protection is furnished by an operating crew of five men to each shift. All wards are protected by sprinkler system and there are automatic alarms scattered throughout the buildings. There were two fire engines left here by the army in addition to the necessary auxiliary equipment.
LAUNDRY
Mr. Freel F. Ford is laundry manager. This service is housed in a brick building on the South West corner of the grounds. Equipment is modem and there is a water softening plant in connection. This laundry served other installations as well as Battey Hospital and is therefore well able to handle a heavier load than we will ever have here from the hospital alone.
FARM AND DAIRY
The hospital's farm and dairy is under the management of Mr. Ralph Davis. In the latter part of June we purchased 975 acres of land on the East bank of the Oostanaula river. A modern 60 cow milk barn with all new and modern equipment has been built as have sleeping barn and silos for 600 tons of ensilage. A modern pasturization plant has been built at the hospital which is capable of handling 1,000 gallons of milk per clay.
Bctttey Hospital
237
PATIENT ACTIVITIES
Through the Georgia Tuberculosis Association, we are being furnished a Coordinator for all patients activities, Mr. Robert Manlove. The patients had organized an association before leaving Alto which is called che Patients Relations Organization and many worthwhile things are being done for che patients which we will enumerate briefly:
Religious accivities are in charge of Reverend Hal C. Keller. In addition to the regular services which are being held in the chapel, he is making regular ward rounds through the hospital and seeing all patients.
We have been unable to secure the services of a full time occupational therapist but Miss Margaret Ferguson has given time to the instruction of volunteers in crafts so that they in turn can organize ward instruction.
All types of recreation for patients are in vogue. The library is in charge of Mrs. Ruby Stuart who has over 5,000 volumes which are catalogued and indexed and regular rounds are made on the wards and patients are assisted in the selection of books. She has very atcracdve displays and many new books and all types of magazines are included in the selections for patients. Movies are held at least weekly in the recreation hall for ambulant patients and are now being shown in the wards for the sicker patients.
A two channel hospital wide radio system is being installed in the hospital and should be completed within the next 60 clays. This means that each patient will have access through headphones w either of two programs which he may desire. We plan to broadcast all religious services, stage shows and other organized recreation programs. A record player is available and we hope to develop a regular daily program for the patients. There are many interesting possibilities and we hope to explore all of them in an effort to provide a:; much entertainment as is consistent with the patients' condition, if ambulant, and a type of entertainment which will help to keep the resdess patient in bed.
The Patients Relations Organization made a public appeal last summer for funds to open a store. They were successful in securing enough funds to open with an excellent stock and the store has been well managed and has made a substantial profit each month which will be pm back into use for the patients in some manner. The patients are also operating the guest house for the relatives of patients. This venture has also been very successful and is returning a nice profit each month. They have recently voted w handle che head sets for the patients and to maintain service for these sets. In this way the patient will be able to purchase a head set when he enters the hospital and to dispose of it for cash when he leaves, and, in case it should fail to work, he will be able to have it repaired at a reasonable race. Funds were made available to the colored patiems for opening a store and they have been as successful as have the whites. Prevocational education is being attempted as well as vocational training through the Vocational Rehabilitation Branch of the State Department of Education. Ac the present time there is organized instruction in watch repairing, radio repairing, commercial subjects and in a home making course for che women patients. Further instruc-
238
Georgia Department of Pttblic Health
tars will be added at a later date and this branch of the hospital service will take on more and more work as we have more and more patiems ready for this type of service. A full time social worker has been added to assist rhe patiems with their family and economic problems which all have w a greater or lesser degree.
The superintendent has consulted with the Georgia Tuberculosis Association in regard to a demonstration program in one of the larger counties in pre-sanatorium indoctrination so that the patient will be in better shape for a long period of hospitalization. In many instances the patient is not prepared to stay when he arrives here and assumes that he can come and go at will. A great majority of all persons who leave against advice do so early and many of these could have been advised to remain at home as they are obvious misfits for a sanatorium due to their unsocial behavior habits.
Many patients have courses of instruction and experience arranged for on an individual basis which will fit them for well paying jobs of one type or another, that will be suitable for their physical condition. Some of these courses such as practical nursing, practical dietetics, tissue technique, laboratory technique, medical secretaryship and others are taught here in the hospital while others are taught at other places.
DEPARTMENT OF CORRECTIONS
Colored female prisoners are being used now for the first time in the main kitchen, diet kitchens and, in some instances, as maids in housekeeping or nursing departments. Mr. ]. T. May is in charge of the local group and in addition to the female prisoners we also have both white and colored juvenile prisoners. These are being given work experience in most of the skilled trades. Experience is also being offered in butchering, pasteurizing plant, laboratory animal care, pathology assistantship, warehouse and laundry. Recently an instructor has been added by the Department of Corrections to give didactic courses of value in the work experiences offered here at the hospital. At the present time the prisoners are all housed in rhe neuropsychiatric section but will be transferred to the regular barracks as soon as protective wire and window guards have been installed.
The material preceding has listed the various depanments of the hos pital and the work carried on in each department. Many essential irems have noc been described such as post office, telephone operators, medical secretaries and others. All are essential and are rendering outstanding service to the hospital and to the state, and we would not be able to run the institution without them.
Statistical materials relative to hospital operations follow in tabular form with commentaries where indicated. No attempt is made to "compare" Alro and Battey bur materials will be used to show what we consider w be trends in patiems, results and costs.
Battey Hospit?tl
239
TABLE I
The following table shows the number of persons making application for admission to Bactey and Alto during the past five years:
~
1942
1943
1944
1945
1946
White -------------------- Colored .. Total ............ ......................
768
575
5M
'177
964
388
3H
251
298
586
---- 1156
839
775
775
1550
It will be seen that there were twice as many applications in 1946 as there were during 1944 and 1945. This does not mean that twice as many people developed tuberculosis ~:::J. 1946 but only chat applications are made in proportion to the number of cases that are admitted. In other words when Health Deparnnents find that far advanced cases are not being admitted they will stop making applications. When it was found that Batcey was to be opened we had an average of 300 applications per month for abom three months.
TABLE II
The following table shows applications, by age group, for admission ro Battey and Alto during the past 5 years:
Year 1912 19<!3 19<1<1 1945 1946
Under 20
wc
78
50
47
<17
24
53
40
58
62
85
20- 39
wc
369 25<1 302 213 267 136 216 171 '1H 309
40- 59
wc
233
75
179
'17
152
,18
16<1
62
357 171
60 Plus
wc
33
<!7
7
31
H
57
7
131
21
Total
wc
768 388 575 3H 524 251
'177 298 96<! 586
TABLE III
The following table shows the percentage of persons rejected * for ad-
mission in the different age groups in the past five years:
Year 1942 19<13 19<14 1915 19<16
Unde 20
wc
18
58
28
50
33
15
2
33
19
<11
20. 39
wc
H
M
19
49
15
<!2
16
35
12
26
40- 59
wc
20
37
25
53
26
<!0
20
27
1~
27
60 Plus
wc
43
66
53
85
37
28
55
55
'11
33
Total
wc
95 215 125 237 111 125
93 150 87 127
*Rejection Ineans the 1nunber \Vho failed to be acln1itted regardless of cause. l\tiany had been accepted for admission but failed to report. :Many negroes will be admitted during 1947 who applied in 19,!6.
240
Georgia Department of Pttblic Hectlth
The influence of Battey can be noted in the rapid decline in number of applicants who failed w gain admission. This information coupled with the previous table shows that there are many patients being admitted who in former years would have never gained admission.
TABLE IV
The following table shows the number of admissions, by color, for the past five years at Battey and Alto:
1942
1943
1944
1945
1946
White -- ------------ -------------- 586
,125
,125
470
765
Colored --- --------- -------------------- 153
134
121
210
377
Total -------- -------- 739
559
5,16
680
1H2
Although Battey operated for only six months in 1946 there were one and one-half times as many patients admitted as during any previous year.
TABLE V
The following cable shows the munber of patients in the hospital on the first day of each of the past five calendar years:
1-1-44
1-1-45
1-1-46
1-1-47
Total .............................................................. 562
,153
518
986
The cable shows the rather phenomenal growth in mberculosis hospitalization, especially during the past year. The hospital at Alto was full on January 1, 1946 and the growth shown occurred after the move w Battey on June 20, 1946.
TABLE VI
The following table shows the number of admissions, by diagnosis, during the past five years at Alto and Battey:
Diagnosis
1942
wc
Far
advanced 233
88
l\!Iod.
advanced 203
32
Minimal
25
14
Other forms
of Tbcs.
6,1
13
Nontuberculous 61
Total
586 153
1943
wc
159
66
168
39
33
22
43
11
,125 13,1
1944
wc
147
48
173
45
31
8
20
5,1
H
'125 121
1945
wc
183 122
196
49
19
7
14
8
58
24
470 210
1946
wc
,105 232
231
83
26
12
28
15
75
35
765 377
Bctttey Hospitctl
241
It will be seen that there is a direcr rario berween the number of admissions and rhe percentage of far advanced cases admitted. In 1944 only 35% of whire and 40% of colored admissions were far advanced while in 1946, 54% of white and 62% of colored admissions were far advanced cases of mberculosis. It will also be seen that in 1942 there were about 11% of all cases which were not classified in the usual terminology for reinfection mberculosis while in 1946 rhere were less than 4% of such cases. This difference is almosr wholly accounted for by the number of primary cases which were admitted in 1942 but are no longer admitted to the hospiral. It will be noted also that there were very few more cases of minimal tuberculosis admitted in 1946 rhan were admitted in 1942. In view of the large case finding programs which have been carried on in the stare it is only natural to assume that one of two things has happened. There are either remarkably fewer cases of minimal mberculosis rhan formerly or, very few of the minimal"cases are being referred to the hospital for treatmem. Ir is suspected that both things are happening. In this connecrion it must be remembered thar minimal tuberculosis, active, seldom remains in the minimal stage for a very long period of time. A later table will show the difference in hospitalization time required for minimal and far advanced tuberculosis.
TABLE VII
The following table shows the number of admissions, by age groups, during t~e past five years ar Alto and Battey:
1942
Age Group w
c
Under 20 71
24
20- 39
326
96
40- 59
150 31
60 and over 39
2
1943
wc
28 22
251
96
127 15
19
1944
wc
16 13
251
30
137 27
21
1
1945
wc
21
21
351 134
16,1
51
31
'1
1946
wc
39
33
363 217
237 113
71
7
The rable above conforms fairly closely to the findings in the orher tables "''hich show the marked difference in admissions in the older age groups and in the colored. It will be noted that in 1942 only one third of all white patients admitted were above 40 years of age. There has been a constant rise in age group admitted until rhe past year which showed that forty-seven percent of cases were above 40 years of age. This same thing is noted among the colored group although the percentage of colored patients above forty years of age amounted ro only 32% in 1946. Keeping in mind the figures presented in table VI, it will be seen that we are constantly admitting a larger number of patients with far advanced disease, in the older age groups. This means more nursing care is needed and it also means that rhe proportion of patients leaving with a "satisfacrory" response ro treatmem will be far less. It also means thar a longer hospital stay is necessary for rhis group.
242
Georgia Depotrtment of Pttblic Health
TABLE VIII
The following table shows the experience, percentage basis, of different age groups approximately two years after admission to the Sanatorium:
Status Died at Hospital .still in Hospital Home-Sputa Positive*
Home-Sputa Negative*
Under 20
wc
'1 15
22
30
H
7
61 ,18
20- 39
wc
7 20 25 32 19 19 ,17 30
40- 59
wc
10 12
27 42
22
19
'll
27
60 Plus
wc
17 26 19 16 38 41 37
*This refers to the patients' condition on leaving- the hospital. Many have died at home, some are well and many are still living-.
The table shows the difference in the expected mortality of patients in the older age groups among whites. The table would indicate a lower mortality in older negroes but the number of cases is too small to give significant percemage. The chances for converting sputum w negative is much greater in the younger aged groups than it is in the older aged groups. This emphasizes the importance of finding the cases among the younger aged groups. It must be remembered however that the colored have a much poorer prognosis than do the whites.
TABLE IX
Table showing the number of discharges from the hospital at Alto and Battey during the past five years:
white ------------------------------------ Colored .... ---------------- Total --
1942 616 152 768
1943 5'16 129 675
1944 ,131 149 580
1945 376 168 5H
1945 459 159 618
Referring to Table IV it will be noced that discharges exceeded admissions in 1942, 1943 and 1944 when hospital cases were constantly falling. During the past two years however the number of admissions have so far exceeded the discharges that there has been a constant rise in the number of cases in the sanatorium.
Battey H aspital
243
TABLE X
Table showing the smtus of padents at discharge, including the sputum status, during the past live years at Alro and Battey:
Status
Sputum
Quiescen t or Positive
Arrested
Negative
Improved
Positive
Negative
"Unimproved Positive
Negative
Deaths
Total Tbc Non-'I'bc
1942
wc
0 91 26 40 198 2,! 66 17 89 32 65 39
5<19 145 67 7
1943
wc
30 HO 17
38 17 127 31
60 22 75 8 '18 2<1
,191 109 55 10
1944
wc
30 107 52
37 10 1H 35
'!5 23 35 ,!0 13
381 141 50
1945
wc
0 104 28
30 H 65 39 60 16 33 10 32 3,!
32'! 141 52 25
1946
wc
40 88 15 25 12 72 18 87 26 65 20 58 54
399 H5 60 14
TABLE XI
Table showing the discharge smms of patients, percent of total mberculous discharges, during the past live years at Alro and Battey:
1942
wc
Quiescent or
Arrested 17
18
Improved ,!3
21
Unimproved 28
3,1
Deaths
12
27
1943
wc
29
11
3,1
4,!
27
28
10
17
1944
wc
29
37
'10
32
21
21
10
10
1945
wc
32
20
29
37
29
18
10
25
1946
wc
23
10
24
21
38
32
15
37
The selection of poorer risks is reflected in the discharge status of patients during the past two years. Ir will be seen that the percentage of deaths has increased markedly in the colored patients and to a less degree in the whites. It will also be noted that more patients are being kept long enough to reach a quiescent or arrested state rather than an improved status. It is quite probable that the differences in "improved" groups is due to several factors. First, during 1942 and 1943 there were many discharges of primary or childhood cases which would have fallen in this category. At the same time there has been a large number of patients leaving the hospital against medical advice since admission has been relatively easy during the past two y~ars. All of these cases are classified as "unimproved" since practically all of them leave after only a few days or weeks, and re-examination by x-ray is not routine until the third month.
244
Georgi?t Dep,trtment of Pttblic Health
TABLE XII
Table showing length of stay in hospital on a percentage of total cases discharged in different diagnostic categories ac Alto and Batcey during the past five years:
White Patients
Far Advanced Moderately Advanced
Minimal
Year l:ncler 3 Months
1 - 13 Months H - 23 Months l\Iore than 21
'42 '43 '44 '45 '46
30 21 29 39 19
51 49 10 H 35
H 21 10 11 10
5
21
5
'42 '43 '44 '45 '46
28 32 29 42 29
59 52 50 45 16
H 11
18
2 10 1 7
'42 '43 '44 '45 '46
29 18 15 50 31
51 12 31 10 53
17 10 20 10 11
0 0 1
5
The table above shows the length of time which is necessary to bring the ordinary case of tuberculosis under controL As stated above che great majority of cases leaving under three months either left against advice or died. It is noted that almost half of the far advanced cases in 1946 fell in this category, Jt should also be noted that practically none of the minimal cases were required to remain for longer than twenty-four months, whereas approximately 10% of far advanced cases remained longer than this,
TABLE XIII
The following table shows the average survival time, after entering Alto and Battey Hospitals, for patients who died and whose disease was either moderately or far advanced on admission:
Year l:ncler 3 )Ionths
3 - 12 ~Ionths 13 - 21 Months Over 21 iYionths
Year L"ncler 3 Months
3- 12 Months 13 - 21 Months Over 21 Months
White
Far Advanced
'42 '43 '44 '45 '46
21 10
13 29
30 15 13 12 20
12 11
3
1
1
5
5
0
1
Moderately Advanced
'42 '43 '44 '45 '46
1
2
0
0
1
1
0
1
0
1
2
1
0
1
3
Colored
Far Advanced
Moderately Advanced
'42 '43 '44 '45 '46
16
5 20 25
13
12 23
2
7
1
2
1
1
0
1
0
'42 '43 '44 '45 '46
1
1
0
3
2
0
1
0
0
0
1
0
Battey H aspital
245
TABLE XIV
Converting the above table imo percentage basis, we find the following picture as regards the far advanced cases. It is obvious that figures above are wo small to be significant for moderately advanced cases.
Under 3 lllonths 3- 12 :Months 13 - 2! l\Ion ths Over 24 Months
'!iVhite Patients
33 2! 17 16 54
!7 36 37 !3 37
H
29 31 11
7
11 15
0
2
Colored Patients
50 30 50 59 50
JO 35 30 35 46
7 35 10
2
10
0
2
The two tables above show the influence of public health measures for isolation of far advanced hopeless cases. Ir will be noted that during 1946 half or more of patients who died with far advanced disease did so within three months. This same thing is not so obvious for previous years in the white cases but is obvious among the colored cases. One cannot be certain that this isolation was an effective measure in preventing spread since it is quite probable that the far advanced case who dies within three months of admission has already spread to his associates a high proportion of all cases of tuberculosis that they are going to have. Those who live for as long as three to twelve months will undoubtedly have caused considerable spread already but there is the probability that hospital admission will cut clown the number of cases to the point where it will be an epidemiological asset. Table XII is another example of modern treatment in tuberculosis in chat there were no deaths recorded in the five year period which occurred among 'patients who entered as minimal cases and there were very few deaths among persons who entered as moderately advanced disease. With a case finding program which will uncover asymptomatic moderately advanced and even far advanced disease, the death rate can be lowered if patiems can stay in the sanatorium until they are well along in their convalescence. In the past we have sent patients home as soon as sputum was converted and many times before conversion, so rhat new cases might be admitted for creatment. At the presem cime we are making an effort to keep patients in the hospital until they can have at least three to four hours exercise daily. During this time they will be given vocational training, if necessary, to help them when they return home but most important of all they can be observed closely through cheir convalescent periods to see if they can tolerate exercise sufficiently well to be discharged.
246
Georgia Department of Pttblic Health
TABLE XV
The following rable shows trends in treatment procedures in use at the sanatorium in 1942 and at Battey in 1946. The type treatment used is indicated as percemage of total patients discharged alive whose diagnosis on admission falls within the group under which the percentage is listed:
Year
'Nhite Patients
Colored Patients
Fao Advanced Mod. Adv. Min. Far Advanced Mod. Adv. Min.
'42 '46 '42 '46 '42 '46
'42 '46 '42 '46 '42 '46
Bed rest only
21 19 18 12 23 53
20 19 16 28 42 50
Phre11ic Crush
8 1 17 5
0
13 0 33 0
Pneu1nothorax*
29 1 15 5 50 10
46 0 18
25
'rhoracoplasty**
16 5
42
0
12 5
2
Pneumoperitoneum
21 50 16 67
21
20 61 17 55
0 50
Diagnostic only***
10 21
13
7 11
2 15
10
0
*Includes all cases in which pneumothorax was the primary procedure used. It includes all auxiliary procedures such as pneumolysis.
**Includes all cases regardless of other preceding treatment such as pneumothorax or pneumoperitoneum.
***Includes the cases which left against advice before treatment was initiated.
It will be seen from the table above that pneumoperitoneum has almost replaced the other collapse measures in popularity at this sanatorium. These include many cases which were started on pneumothorax and failed to respond and also included many cases which would have gone on to thoracoplasty under ordinary treatment procedures. It will be noted that a large proportion of our patients receive some type of collapse therapy and relatively few are placed on rest alone. There are many references in literature recently on pneumoperitoneum as a method of treatment and we like to think that our work here is partly responsible in that we probably have a larger series of patiems than any other hospital. It is hoped that shortage of staff will not prevent the review and publishing of the data which has been accumulated here.
Battey Hospital
247
TABLE XVI
The following table shows follow-up results of a portion of the cases which have been discharged from the sanatorium during the past five years. This includes all ~ases in 65 of the 159 counties in Georgia, and does not include cases by color, nor does it include non-tuberculous cases.
Died of Tuberculosis--------------------- 336 or 26%
Died of Other Causes______________________ 19
1%
Ar home with Active Disease________ 91
7%
Re-admitted to Hospital_________________ 60
5%
Unknown and moved from County 229
18%
On Rehabilitation or referred for service-presumably well ______________ 302
24%
Suimbly employed or in schooL___ 247 Total ________________________________________1284
19%
It will be noted from the table above that our results appear to have been satisfactory from the standpoint of total patients involved. There have probably been more re-admissions than the figure indicates since it applies only to patients now in the sanatorium. Deaths will also not refer to cases readmitted to sanatorium and dying since these cases were not referred w the strvice. Follow up service is being done jointly by the Georgia Tuberculosis Association and Vocational Rehabilitation Service. It is not yet complere but when all counties are finished it will be made the subject of a special report. Final studies will also uncover many of the unknown cases as rhey have moved to other counties which have not yet been surveyed.
Division of Laboratories
T. F. SELLERS, M.D. ______________________________________________________________________________ Director E. ]. SUNKES, Dr. P.H.__________________________________________________________Assistctnt Director JANIE MORRIS, M.S., Chief Bacteriologist____________________________________Cttltttre Unit MADGE REYNOLDS, A.B., Chief Bacteriologist________________________l\tlicroscopy Unit E. L. WEBB, A.B., Chief Serologist______________________________________________Serology Unit C. S. ADAMS, Director__________________________________________ lVctycross Branch Lctboratory F. H. STUBBS, M.S., Director__________________________________./llbany Branch Lctborato-ry
Dhision of Lctborrttories
251
Division of Laboratories
GROWTH OF LABORATORY WORK BY LABORATOR/ES-1941-1946
CENTRAL ALBANY .WAYCROSS
1946
In presenting the report of the Division of Laboratories for 1946, the first full post war year, ir might be of interest to review briefly the effect of World War II on the laboratory activities. The initial effect was felt during the latter part of 1940 when the Central laboratory in Atlanta began the examinarion of blood specimens submitted for syphilis serology by various local Selective Service Boards throughout the State. From this source 1,091 specimens were received in November, and 4,850 in December. During the year 395,014 specimens were handled by the three laboratories. Reference to Diagram I will show that during rhe next year, 1941, rhe specimen load increased markedly. This increase continued through 1943 when 670,349 specimens were handled, the peak load in the history of the Division of Laboratories. A marked decline occurred in 1944 and continued until 1946 when there was a sharp increase and 509,606 specimens were handled.
::!52
Georgict Depctrtment of Public I-lectltb
DIAGRAM 1
GROWTH OF LABORATORY WORK
1920-1946
- 1920 1925 1930 1935
1940 1941
1942 1943
1944 1945 1946
Reference w Diagram II will show that the impact of war activities was felt chiefly in the syphilis serology units. The demand for blood tests on not only selectees, but on war plant employees, resulted in an unprecedented syphilis serology specimen load which attained a peak of 552,187 in 1943. This represented 82.4% of the entire laboratory specimen load for that year. In February, 1944 syphilis serology examinations of selectees was taken over by the Army except for a certain amount of recheck and demobilization work. This of course resulted in a marked decline in both the serology and rotal specimen loads during 1944. The serology load for this year, however, ( 369,140 specimens) was nearly a third greater than during 1940, the last pre-war year when the load was 232,701.
In contrast the effect of the war on microscopic examinations was a marked diminmion in the specimen load. Whereas in 1940 there were 123,709 microscopic examinations, these decreased to a low of 73,757 in 1943 after which they began to increase. The decline occurred chiefly in the txaminations for malaria and for intestinal parasites. In 1940 the microscopic units examined 36,081 blood films for malaria parasites of which 25,629 were collected in surveys. This decreased to 9,379 in 1944. The decline may be amibuted in part w the almost complete absence of locally acquired
Di,vision of Laboratories
253
malaria and in pan to the tremendous loss of personnel in the Division of Hookworm and Malaria Control and field personnel. Likewise, this loss of personnel resulted in discontinuance of practically all intestinal parasite surveys. Consequently intestinal parasite examinations decreased from 57,512 in 1940, of which 39,591 were survey specimens, m a low of 20,022 in 1944. The specimen load for the microscopic units during 1946 is still low in comparison with 1940; 106,257 specimens being handled this year compared to 123,334 in 1940.
DIAGRAM ll
GROWTH OF LABORATORY WORK BY UNITS /930-/946
600,000
540,000
480,000
420,000
360,000
300,000 240,000 I 90,000
D MICROSCOPY Ell CULTURE
SEROLOGY
120,000
60,000
oJ~
1930
1935
1940
1941
194Z
-YEAR-
lll43
1944
1945
1946
The work of the culture units which included blood and stool cultures, agglutination tests and a miscellany of special bacteriology was least affected by the war. While there were occasional outbreaks of food poisoning in some of the war plants and schools chiefly caused by Staphylococci and Salmonella, the only extensive outbreak occurred in 1942 when 78 persons comracted typhoid, and 80 contracted bacillary dysentery in a mill village. Laboratory studies during this outbreak were a factor in making 1942 the peak war year for the culture units which handled 30,659 specimens. During this year these units handled 32,272 specimens compared to 26,138 in 1940.
The return to civilian practice from military service of many doctors <tnd public health personnel and the resumption of numerous field activities resulted in a total of 509,606 specimens being handled by the laboratories
254
Georgia Department of Public Health
during 1946. This was a gain of 59,772 or 13.3% over the previous year. The Central laboratory handled 69.1% of the specimen load and the two branch laboratories 30.9%. See Diagram III. Not included in the statistical report of the Division of Laboratories are the specimens examined in the Alto Medical Center laboratory. While opened in July, 1946, as a parr of the rapid treatment center organization, it functions under the Division of
Laboratories which provides personnel and supervises the technical work. This laboratory handled 12,167 specimens during the six months it has been in existence. A summary of this work will be found under syphilis serology.
An analysis of the work by types of specimens and a comparison with the preceding year is given in Table I. As shown, the greatest increase occurred in the examinations for intestinal parasites ( +45.3%), stool and urine cultures ( + 37.6%), and in the tests for tuberculosis ( + 30.3%).
TABLE 1
COMPARATIVE CLASSIFICATION OF SPECIMENS-1946-1945
1946
Tuberculosis -------------------------D iphtheria -----------------------------Gonorrhea -----------------------------Malaria -----------------------------------Imestinal Parasites ---------------Rabies -----------------------------------Miscellaneous-------------------------Agglutination Series ______________
20,983 3,140
30,348 7,633
38,722 1,662 3,769 12,669
Blood Cultures ---------------------- 9,880 Stool & Urine Cultures ---------- 11,723 Syphilis Serology -------------------- 369,140
1945
16,108 3,953
26,708 12,691 26,641
1,485 4,307 11,377 9,414 8,521 328,692
lncrectse or Decrease
+ 4,875 813
+ 3,640 - 5,058
+12,081
+ 177 538
1,292
++ 466
+ 3,202 +40,448
+30.3% -20.6%
+13.6% -39.9%
-f-45.3%
+11.9% -12.5%
+11.4% + 5.0% +37.6% +12.3%
GRAND TOTALS* __________ 509,669
MICROSCOPY -------------- 106,257
CULTURE -------------------- 34,272 SEROLOGY ------------------ 369,140
UNSATISFACTORY
MICROSCOPY ______________ 1,018
CULTURE --------------------
79
SEROLOGY ------------------ 5,709
449,897 91,893 29,312
328,692
700 22 4,976
+59,772 +14,364 + 4,960 +40,448
++ 318 57 + 733
+13.3% +15.6%
+16.9% +12.3%
*Contrary to past policy, this report does not include water specimens examined in the laboratories of the Division of Public Hearth Engineering since this data is included in the report of that division.
The Central laboratory handled 69.1% of the specimen load and the branch laboratories 30.9%. See Diagram III. The greatest gain, 35.1% was shown by the Albany Branch laboratory and was clue chiefly to the reactivation of several county health units in the area serviced by this laboratory. See Table 2.
Division of Lctboratories
255
TABLE 2 SPECIMEN LOAD BY LABORATORIES-1946-1945
1946
Central Laboratory, Atlanta ____ 352,197 Southwesrern Branch, Albany__ 89,799 Southeasrern Branch, Waycross 67,673
1945
314,890 66,492 68,515
Increase or Decrectse
+37,307 +23,307
842
+11.8% +35.1% - 1.2%
GRAND TOTALS-------------- 509,669 449,897 +59,772 +13-3%
The consolidated report of rhe three laboratories composing the Division of Laboratories is given in Table 3, while an analysis of rhe examinations made in each laboratory will be found in Tables 4 to 9 inclusive. A hmher analysis of the work is shown in Diagrams IV, V, and VI.
TABLE 3 CONSOLIDATED REPORT FOR 1946
Total
Tuberculosis-Microscopic -------------------------------------------- 18,590
Tuberculosis-Culture ---------------------------------------------------- 1,784
Tuberculosis-Animal Inoculation --------------------------------
609
Diphtheria ---------------------------------------------------------------------- 3,140
Gonorrhea-Microscopic ------------------------------------------------ 20,597
Gonorrhea-Culture ------------------------------------------------------ 9,751
Malaria -------------------------------------------------------------------------- 7,633
Intestinal Parasites-Eggs ---------------------------------------------- 35,713
Imesrinal Parasites-Amebic Dysemery ------------------------
758
Intestinal Parasites-Egg Coums ---------------------------------- 2,251
Rabies-Microscopic ------------------------------------------------------ 1,606
Rabies-Animal Inoculation ------------------------------------------
56
Miscellaneous ------------------------------------------------------------------ 3,769
ToTAL FOR MICROSCOPY ---------------------------------------------- 106,257
Agglutinations ---------------------------------------------------------------- 12,669
Typhoid Fever --------------------------------------------------------------
Typhus (Brill's) Fever ----------------------------------------------
Brucellosis -------------------------------------------------------------------Tularemia -------------------------------------------------------------------Blood Cultures ----------------------------------------------------------------
9,880
Eberrhella Typhosa ------------------------------------------------------
Salmonella -------------------------------------------------------------------Brucella -----------------------------------------------------------------------Others ------------------------------------------------------------------------Stool and Urine Cultures ------------------------------------------------
11,723
Eberthella Typhosa -----------------------------------------------------Salmonella -------------------------------------------------------------------Shigella ------------------------------------------------------------------------
Others -------------------------------------------------------------------------ToTAL FOR CULTURE ---------------------------------------------------- 34,272
Syphilis Serology ------------------------------------------------------------ 369,140 GRAND TOTAL -------------------------------------------------- 509,669
Positive 1,631 135 134 237 3,204 2,084 270
10,421 19
740 30
32 446 181
64
49 4 51 24
86 103
50. 1
256
Georgict Depa,rtnzent of Public Health
DIAGRAM m
SPECIMEN LOAD
BY
LABORATORIES 1946
CENTRAL 352,197 69J'l'.
SEROLOGY 369,140 72,4%
DIAGRAM Ilt
SPECIMEN LOAD
BY
UNITS 1946
Di-vision of Lctboratories
257
DIAGRAM 't
SPECIMEN LOAD BY UNITS IN EACH LABORATORY
1946
SEROLOGY 269,264 76.5%
CENTRAL LABORATORY
SEROLOGY 56,963 65.7%
ALBANY LABORATORY
WAYCROSS LABORATORY
258
Gemgict Depctrtment of Pttblic Health
DIAGRAM:llt
SPECIMEN LOAD BY TYPES 1946
SPECIMEN LOAD HANDLED IN EACH LABORATORY
CENTRAL
269,264 72.9%
SEROLOGY
CENTRAL
19,693 57.5%
CULTURE
CENTRAL
63,220 59.5%
MICROSCOPY
Di,vision of Laboratories
TABLE 4 REPORT OF CENTRAL LABORATORY FOR 1946
Total
Tuberculosis-Microscopic -------------------------------------------- 14,625
Tuberculosis-Culture -------------------------------------------------Tuberculosis-Animal Inoculation --------------------------------
1,672 609
D iphtheria ---------------------------------------------------------------------Gonorrhea-Microscopic -----------------------------------------------Gonorrhea-Culture -------------------------------------------------------Malaria ---------------------------------------------------------------------------Intestinal Parasites-Eggs ----------------------------------------------
2,046 11,515 9,589 3,436 15,166
Intesdnal Parasices-Amebic Dysentery ------------------------
545
Intestinal Parasices-Egg Counts -----------------------------------Rabies-Microscopic ---------------------------------------------------Rabies-Animal Inoculation ------------------------------------------
747 1,047
56
Miscellaneous ------------------------------------------------------------------
ToTAL FOR MICROSCOPY ----------------------------------------------
Agglutinations ----------------------------------------------------------------
2,167 63,220
7,250
Typhoid Fever -----------------------------------------------------------Typhus (Brill's) Fever ----------------------------------------------
Brucellosis --------------------------------------------------------------------
Tularemia -------------------------------------------------------------------Blood Culcures ----------------------------------------------------------------
5,920
Eberthella Typhosa ------------------------------------------------------
Salmonella --------------------------------------------------------------------
Brucella ------------------------------------------------------------------------
Others -------------------------------------------------------------------------Stool and Urine Cultures ------------------------------------------------
6,523
Eberthella Typhosa ------------------------------------------------------
Salmonella --------------------------------------------------------------------
Shigella ------------------------------------------------------------------------
Others -------------------------------------------------------------------------ToTAL FOR CULTURE ---------------------------------------------------- 19,693
Syphilis Serology ------------------------------------------------------------ 269,284
GRAND TOTAL ---------------------------------------------------- 352,197
259
Positive 1,268 123 134 152 1,682 2,064 199 2,931 8
457 30
22 184
93
33
34 1
32 15
62 40 22
1
260
Georgia Department of Pttblic Health
TABLE 5 COMPARATIVE CLASSIFICATION OF SPECIMENS-1946-1945
CENTRAL LABORATORY
1946
1945 Increase or Decrectse
Tuberculosis ---------------------------- 16,906
Diphtheria ------------------------------ 2,046 Gonorrhea ------------------------------ 21,104
Malaria ---------------------------------- 3,436 Intestinal Parasites ------------------ 16,458
Rabies ------------------------------------ 1,103 Miscellaneous ------------------------ 2,167 Agglutination Series -------------- 7,250
Blood Cultures ------------------------ 5,920 Stool and Urine Cultures ________ 6,523 Syphilis Serology ___________________ 269,284
12,085 3,055
19,408 7,508 9,743 1,081 3,191 6,820 5,609 4,947
241,443
+ 4,821
- 1,009
+ 1,696 - 4,072
+ 6,715 + 22 - 1,024
I
I
430
+ 311
+ 1,576
+27,841
+39.9% -33.0% + 8.7% -54.2%
+68.9% + 2.0% -32.1%
+ 6.3% + 5.5% +31.9% +11.5%
GRAND TOTALS------------------ 352,197 MICROSCOPY ------------------ 63,220
CULTURE ------------------------ 19,693 SYPHILIS SEROLOGY ______ 269,284
UNSATISEACTORY
MICROSCOPY ------------------ 830
CULTURE ------------------------
52
SEROLOGY ---------------------- 4,117
314,890 56,071 17,376
241,443
700 22
4,976
+37,307 + 7,149 + 2,317 +27,841
+11.8% +12.7% +13.3% +11.5%
+
130 ----------------
+
30 ----------------
859 ----------------
TABLE 6
REPORT OF ALBANY BRANCH LABORATORY FOR 1946
Total Positi-ve
Tuberculosis-Microscopic -------------------------------------------Tuberculosis-Culture ---------------------------------------------------D iph theria ---------------------------------------------------------------------Gonorrhea-Microscopic ------------------------------------------------
Malaria ---------------------------------------------------------------------------Intestinal Parasites-Eggs ---------------------------------------------Intestinal Parasites-Amebic Dysemery -----------------------Rabies-Microscopic ------------------------------------------------------
.Miscellaneous -----------------------------------------------------------------TOTAL FOR MICROSCOPY ---------------------------------------------Agglutinations ----------------------------------------------------------------
Typhoid Fever -------------------------------------------------------------Typhus (Brill's) Fever ---------------------------------------------Brucellosis --------------------------------------------------------------------
Tularemia --------------------------------------------------------------------
1,740 22
719 5,352 3,226 8,725
106 421 862 21,173 3,811
197 9
48 1,063
44. 2,733
7 202
8 155 45
28
Di-vision of Laboratories
261
TABLE 6-Cominued
Total Positive
Blood Cultures ---------------------------------------------------------------- 2,861
Eberthella Typhosa ------------------------------------------------------
10
Salmonella --------------------------------------------------------------------
3
Brucella -------------------------------------------------------------------------
19
Others -------------------------------------------------------------------------- _
6
Stool and Urine Cultures ------------------------------------------------ 2,971
Eberthella Typhosa ------------------------------------------------------
14
Salmonella ---------------------------- ----------------------------------------
57
Shigella ------------------------------------------------------------------------
-?:~J
ToTAL FOR CULTURE ---------------------------------------------------- 9,643
Syphilis Serology ------------------------------------------------------------ 58,983 GRAND ToTAL ---------------------------------------------------- 89,799
TABLE 7 COMPARATIVE CLASSIFICATION OF SPECIMENS-1946-1945
ALBANY BRANCH LABORATORY
1946
Tuberculosis _____________:______________ 1,762 Diphtheria ------------------------------ 719 Gonorrhea ------------------------------ 5,352 Malaria ------------------------------------ 3,226 Intestinal Parasites __________________ 8,831 Rabies ------------------------------------ 421 Miscellaneous _________________________ 862 Agglutination Series -------------- 3,811 Blood Cultures ------------------------ 2,861 Stool and Urine Cultures ______ 2,971 Syphilis Serology ____________________ 58,983
1945 Inc-rease or Decrease
1,377 514
2,953 4,272
5,718
322
418 3,177 2,479 1,659 43,603
+ 385 + 205 + 2,953 - 1,046
+ 3,113
+ 99
+ 444 + 634 + 382 + 1,312 +15,380
+28.0% +39.9% +81.2% -24.5%
+54.4% +30.7% +106.2% +20.0% +15.4% -1-79.1% +35.3%
GRAND TOTALS------------------ 89,799 MICROSCOPY __________________ 21,173
CULTURE ------------------------ 9,643
SEROLOGY ---------------------- 58,983 UNSATISFACTORY
MICROSCOPY ------------------ 119
CULTURE ------------------------
18
SEROLOGY ------------------------ 864
66,492 15,574
7,315 43,603
85 6
873
+23,307 + 5,599 + 2,328 +15,380
34
++ 12 9
+35.1% +36.0% +31.8% +35.3%
262
Georgia Department of Pttblic Health
TABLE 8 REPORT OF WAYCROSS BRANCH LABORATORY FOR 1946
Total
Tuberculosis-Microscopic -------------------------------------------Tuberculosis-Culture ---------------------------------------------------D iphtheria ---------------------------------------------------------------------Gonorrhea-Microscopic -----------------------------------------------Gonorrhea-Culture -----------------------------------------------------Malaria ---------------------------------------------------------------------------Intestinal Parasites-Eggs ---------------------------------------------Intestinal Parasites-Amebic Dysentery ------------------------
Intestinal Parasites-Egg Counts ---------------------------------Rabies-Microscopic -----------------------------------------------------Miscellaneous -----------------------------------------------------------------ToTAL FOR MICROSCOPY ----------------------------------------------
Agglutinations ---------------------------------------------------------------Typhoid Fever -------------------------------------------------------------Typhus (Brill's) Fever -----------------------------------------------Brucellosis -------------------------------------------------------------------Tularemia --------------------------------------------------------------------
Blood Cultures ---------------------------------------------------------------Eberthella Typhosa -----------------------------------------------------Others --------------------------------------------------------------------------
Stool and Urine Cultures -----------------------------------------------Eberthella Typhosa ------------------------------------------------------
Salmonella -----------------------------------------------------------------Shigella -----------------------------------------------------------------------TOTAL FOR CULTURE ----------------------------------------------------
Syphilis Serology -----------------------------------------------------------GRAND TOTAL --------------------------------------------------
2,225 90 375
3,730 162 971
11,822 107
1,504 138 740
21,864 1,608
1,099
2,229
4,936 40,873 67,673
Posi#ve
166 3
37 459
20 27 4,757
4
81
2 107 43
3
5 3
10 6 5
TABLE 9 COMPARATIVE CLASSIFICATION OF SPECIMENS-1946-1945
WAYCROSS BRANCH LABORATORY
1946
Tuberculosis ----------------------------
Diphtheria ------------------------------
Gonorrhea ------------------------------
Malaria ---------------------------------Intestinal Parasites ---------------Rabies -----------------------------------Miscellaneous ------------------------
2,315 375
3,892
971 13,433
138 740
1945
2,646 384
4,347 911
11,180 82 698
Increase or Decre?tse
331 9
455 + 60 + 2,253 + 56 + 42
-12.5%
- 2.3%
-10.5%
+ 6.6% +20.2%
+68.3% + 6.0%
Di-vision of Lctboratories
263
TABLE 9-Cominued
1946
Agglutination Series -------------Blood Cultures -----------------------Smol and Urine Cultures ______ Syphilis Serology ------------------
1,608 1,099 2,229 40,873
GRAND TOTALS ---------------MICROSCOPY -----------------CULTURE -----------------------SYPHILIS SEROLOGY -----UNSATISFACTORY
MIRCOSCOPY -------------------CULTURE -----------------------SEROLOGY ----------------------
67,673 21,864
4,936 40,873
69 9 728
1945
1,380 1,326 1,915 43,646
Inc-rease m Dec-rease
+ 228 227
+ 314 - 2,773
+16.5% -17.1% +16.4%
6.4%
68,515 20,248
4,621 43,646
842
+ 1,616 + 315 - 2,773
1.2%
+ 8.0% + 6.8% - 6.4%
77
5+ 870
8 4 142
----------------
----------------
----------------
DISCUSSION OF WORK BY UNITS
MICROSCOPY UNIT
Tuberculosis-
Specimens examined for M. mberculosis increased from 16,108 in 1945 to 20,983 in 1946, a gain of 4,875 or 30.3 per cent. This increase is directly attribmable to the tuberculosis studies made in the syphilis-ruberculosis surveys conducted in Columbus, Macon, and Augusra, and those made for the State Tuberculosis Sanatorium. Laboramry studies consisted of microscopic examinations, cultures, and guinea pig inoculations. All specimens other than sputa are. subjected to all three tesrs. On sputa specimens, three negative microscopic reports must be obtained before a fourth specimen is cultured. Should the culture be negative and further studies indicared, a fifth specimen is inoculated imo a guinea pig. Every specimen submitted for animal inoculation is, after concentration, examined microscopically and cultured. Under this policy, 18,590 microscopic tests, 1,784 cultures, and 609 animal inoculations were made. On 615 specimens found negative microscopically and submitted to animal inoculation, 69 positive culmres ( 11.2%) and 130 positive animal inocula dons ( 21.2%) were obtained. Of 1,784 specimens found negative microscopically and cultured for M. tuberculosis, 135 (7.6%) were positive. An analysis of the tuberculosis studies is given in Tables 10 and 11.
264
Georgia Department of Pttblic Hectlth
TABLE 10 EXAMINATIONS FORM. TUBERCULOSIS-1946-1945
Centutl
MICROSCOPIC 1946 -------------------------------------------- 14,625 1945 -------------------------------------------- 10,644
Albany Waycross Total
1'740 1,3 7 6
2,225 2,473
18,590 14,493
+3,981
CULTURES
1946 -------------------------------------------1945 --------------------------------------------
1,672 1,197
+364
22 1
-248 +4,097
90
1,784
173
1,371
ANIMAL INOCULATIONS
1946 -------------------------------------------- 609 1945 -------------------------------------------- 244
-83 +413
609 244
TOTALS
1946 -------------------------------------------- 16,906 1945 -------------------------------------------- 12,085
1'7 62 1,3 77
+365
2,315 2,646
20,983 16,108
+4,821 +385 -331 +4,875 (40.0%) (28.0%) (12.5%) (30.3%)
-- -- ----
TABLE 11 ANALYSIS AUXILIARY TUBERCULOSIS EXAMINATIONS-1946
CULTURES
ANIMAL INOCULATIONS-CENTRAL LABORATORY
TYPE SPECIMEN
Central
Albany
Waycross
Total
Total Pos. Total Pas. Total Pas. Total Pas.
Total
Micro.
-
Neg. Pas.
Animal Neg. Pas.
Culture Neg. Pos.
Sputum ------------------------- 1,092 52 1 1 86 3 1,179 56 156 156 0 P-"J 33 143* 12
Gastric Lavage -------------- 338 44 Pleural Fluid ________________ 99 15 8 4 Urine ------------------------------ 64 4 5 0 Spinal Fluid ------------------ 17 1 2 0 Synovial Fluid ---------------- 24 2 1 0 Perironeal Fluid ------------ 14 1 Miscellaneous ---------------- 24 4 5 4
10 20 10
338 44 302 302 0 226* 68 261
41
tJ "<:"::
~-
107 19 61 61 0 49 12 52*
70 4 41 41 0 J"_?
9 37*
21 1 11 11 0
9
2 10
26 2 12 12 0
9~'
0
11
-8 "c'
3 "c"
1
1-<
:;,
1 :"""cc;:''".''
14 1 14 14 0 12
2 13
"" 1 ~'->
29 8 18 18 0 14
4 15* 2
TOTALS ----------------------- 1,672 P_"J 22 9 90 3 1,784 135 615 615 0 474* 130 542* 69
Cultures for Pathogenicity --------------------------------------------------
4
0
4
TOTAL EXAMINATIONS -------------------------- ------------------- 619 615 0 474* 134
*'l'he difference in numbers is due to an unsatisfactory report-either death of animal ot contamination of culture.
542* - - 69
l'-.l 0\ VI
266
Georgia Department of Pttblic Health
Diphtheria-
During the year 3,140 cultures were examined for diphtheria. There was a decided decline in the number of positive diagnostic cultures as only 197 were obtained, compared with 472 in 1945.
TABLE 12 CLASSIFICATION OF DIPHTHERIA EXAMINATIONS-1946
Positive Negative Dottbtfttl Total
Diagnostic ---------------------------------- 197
Release and Carrier --------------------
37
Virulence ------------------------------------
3
ToTALS __________________________ 237
2,474 415 6
2,895
7
2,678
1
453
9
8
3,140
Gonorrhea-
A marked increase in the number of specimens examined for N. gonorrhoeae was noted during 1946. See Table 13. Microscopic examinations showed a gain of 1,775 or 9.3 per cent. Cultures increased from 7,886 in 1945 to 9,751 in 1946, a gain of 1,865 or 23.6 per cent. Practically all of the cultures made in the Central laboratory originated in the venereal disease clinics of FultOn County and the City of Atlanta. One hundred sixty-two ( 162) cultures submitted from the Ware County Clinic were examined in the Waycross branch laboratory. Since at the present time cultural examinations for gonococci are satisfactOry only when local laboratory facilities are available, there is a definite need tO develop procedures which make this valuable diagnostic service available tO those county health departments which, of necessity, must' send their specimens to distant laboratories. The possibility of inoculating and incubating cultures locally and then mailing them to the State laboratories for examination is being investigated.
A classification of the examinations made in the several laboratOries is given in Table 14.
TABLE 13 MICROSCOPIC EXAMINATIONS FOR N. GONORRHOEAE
FIVE YEAR PERIOD-1942-1946
1942 1943 1944 1945 1946
Number Specimens---------------------- 9,813 11,784 14,133 18,822 20,597 Number Positive ------------------------ 1,593 1,642 2,249 2,650 3,204
Per Cent Positive ------------------------ 16.2% 13.9% 15.9% 14.1% 15.6o/o
Division of Lctborcttories
267
TABLE 14 CLASSIFICATION OF EXAMINATIONS FOR N. GONORRHOEAE-1946
Central
J'vlicroscopic Number Specimens ____________________ 11,515 Number Positive ------------------------ 1,682 Per Cent Posidve ------------------------ 14.6%
Cttltttre
~~:~:~ ~~:f:~;n_~--~~~~~~~~~~~~~~~~~~~~
9,589 2,064
Per cent Positive ------------------------ 21.5%
Albany 1'aycross l"otal
5,352 1,063 19.9%
3,730 459
12.3%
20,597 3,204
15.6%
162 20
12.3%
9,751 2,084 21.4%
Malaria-
Malaria examinations decreased 66.2 per cent in 1946. This is a continuation of the rrend noted in recent years, and is attributable to the low endemicity of the disease. Very few surveys have been conducted, and rhe demand by private physicians for rhis examination has decreased considerably. During the year 270 positive malaria findipgs were reported of which 268 were Plasmodium vivax (tertian malaria) type. Two could not be ryped because of the pauciry of parasites. Information as to the source of infection was obtained on 221 positive findings and of these 217 were from ex-servicemen who had acquired the infection outside the cominental United States. See T abies 15 and 16.
TABLE 15 EXAMINATIONS FOR MALARIA FIVE YEAR PERIOD-1942-1946
1942 1943 1944 1945 1946
Number Specimens -------------------- 19,189 11,951 9,379 12,691 7,633
Number Positive ------------------------ 290
77
41
80 270
Increase o1 Decrease Over Preceding Year
Number Specimens -------------------13,968 -7,238 -2,572 +3,312 -5,058 Number Positive---------------------- -265 -213 -36 +39 +190
TABLE 16 EXAMINATIONS FOR MALARIA-1946
Cent1'ctl
Number Specimens -------------------- 3,436 Number Positive ------------------------ 199
Albany
3,226 44
1'aycross
971 27
Total
7,633 270
268
Georgict Department of Pttblic Health
Intestinal Parasites-
The post war reactivation of the Division of Hookworm and Malaria Services resulted in a marked increase in intestinal parasite examinations. See Table 17. While there was an increase in the number of ova counts, practically all of which were made on specimens from surveys, the tendency is to place less emphasis on this phase of the hookworm studies. There was a marked increase in the number of specimens examined for E. histolytica but the percentage of positives remained low. The intestinal parasite work was fairly distributed among the three laboratories as shown in Table 18.
TABLE 17 INTESTINAL PARASITE EXAMINATIONS
FIVE YEAR PERIOD-1942-1946
1942
Total-Ova -------------- 28,415 Increase or Decrease__-20,937 Ova Counts ______________ 2,469 Increase or Decrease__ -1,385 Amebic Dysentery ____ 679 Increase or Decrease __ -f---98
1943
20,772 -7,643
3,007 -f---538
429 -250
1944
20,022 -750 2,032 -975
441 -f---12
1945 1946
24,057 -f---4,035
2,029 -3 555
-f---114
35,713 -f---11,656
2,251 -f---222
758 -f---203
TABLE 18 INTESTINAL PARASITE EXAMINATIONS-1946
Central Albctny lVctycross Total
Ovct
Positive -------------------Negative -----------------Total -------------------------Ovct Cottnts --------------
2,931 12,235 15,166
747
2,733 5,992 8,725
4,757 7,065 11,822
1,504
10,421 25,292
Amebic Dysentery
Positive ____________________
8
7
4
19
Negative __________________ 537
99
103
739
Total ------------------------ 545
106
107
GRAND TOTAL ---------------------------------------------------------------------
GRAND TOTAL
35,713 2,251
758 38,722
A classification of the intesdnal parasite findings is given in Table 19.
Di,vision of Labo,ratories
269
TABLE 19 CLASSIFICATION OF INTESTINAL PARASITE FINDINGS-1946
SINGLE INFECTION
Worms for Identification -----------------------------------------------------------Hookworm ---------------------------------------------------------------------------------Round Worm -----------------------------------------------------------------------------pin Worm ---------------------------------------------------------------------------------Whip Worm -----------------------------------------------------------------------------Dwarf Tapeworm -----------------------------------------------------------------------Others ------------------------------------------------------------------------------------------
22
9,925 263 248 63 83 7
DOUBLE INFECTION
Hookworm and Pin Worm --------------------------------------------------------
84
Hookworm and Dwarf Tapeworm --------------------------------------------
22
Hookworm and Round Worm ----------------------------------------------------
68
Hookworm and Whip Worm ----------------------------------------------------
13
Round Worm and Pin Worm ----------------------------------------------------
2
Whip Worm and Dwarf Tapeworm------------------------------------------
1
Pin Worm and Whip Worm ----------------------------------------------------
1
TRIPLE INFECTION
Hookworm and Pin Worm and Whip Worm--------------------------
1
Hookworm and Round Worm and Pin Worm------------------------
2
Hookworm and Pin Worm and Dwarf Tapeworm--------------------
1
Total Specimens Positive for Ova of Hookworm ----------------------------
Round Worm -----------------------------------------------------------------------------pin Worm ---------------------------------------------------------------------------------Whip Worm -----------------------------------------------------------------------------Dwarf Tapeworm ---------------------------------------------------------------------Others ------------------------------------------------------------------------------------------
10,116
335 339
79 107
7
Rabies-
The rabies situation during the past year has been alarming due primarily to a widespread increase of the disease among foxes. Of the 740 animal heads found positive during the year by the State laboratories 241 were foxes. See Table 20. This was an increase of 128 or 113.3 per cent compared with 1945. During the year various municipal laboratories throughout the state found 25 fox heads positive. See Table 21. Rabid foxes were reported in 66 counties which are listed in Table 22. In contrast during 1945 only 29 counties were involved. Antirabic treatment was given to 106 persons bitten by rabid foxes.
Of the 864 dog heads examined by the State laboratories only 367 were positive. This was 34 fewer than were found in the previous year. Positive findings in cattle increased from 37 in 1945 to 54 during the past year. Laboratory results, however, do not present the true picture where the
270
Georgia Department of Pttblic Health
disease has become highly endemic in foxes. Only a small percentage of rabid foxes reach the laboratory for examination. Because of rhe expense and difficulry of getting the heads of suspected rabid catde to rhe laboratory, the laboratory examines only a small percentage of the catde acrually rabid. However, we know that the loss of domesric animals, as a resulr of the epizootic in foxes, has been quite high. Based on reports received from rabies inspectors and veterinarians in 77 counties alone, this loss wa> $138,678.75. The acmalloss was undoubredly much higher.
Rabies control measures have included rhe vaccination of dogs throughout the State, the destruction of unvaccinated dogs and a reduction of the fox population. Under the law passed in 1945, rabies control was placed under the Georgia Department of Public Healrh. However, appoimmem of a rabies control inspector in each county is a function of the County Board of Health. Mosr of rhese boards appoimed inspectors. They reponed 187,611 dogs vaccinated. Two hundred fifty-eight thousand (258,000) rags and certificates were disrributed by our department. Since a number of inspectors failed to make reports, it is probable that over 200,000 clogs were vaccinated during the year. However, the vaccination was exceedingly spotty. In some counties, a high percentage of the dogs were vaccinated while 'in others no attempt has been made to enforce the law. There is need for revision of rhe rabies control law and this will be attemprecl ar the next session of the legislature. Control of rabies in foxes has been effected in a number of counties through reduction of the fox population. This work was supervised by a representative of the Federal Fish and Wild Life Service. He has trained many people to destroy foxes by trapping, using poison bait and gas bombs in their dens, and huming them wirh packs of fox . hunters. The destruction of foxes has been increased through the payment by the effected counties of bounties running from $2.00 to $5.00 per head. Under this program, $9,655.75 in bounties was paid for 4,377 heads. It is hoped that a more effective enforcemem of the rabies control law throughout the State, and a continuation of the fox control program during 1947, will result in a better comrol of the disease.
In addition to the microscopic examinations for rabies 56 specimens were subjecrecl w the mouse inoculation tests. An analysis of this work is
given in Table 23.
Division of Lotborottories
271
272
Georgia Department of Pttblic Health
TABLE 20 CLASSIFICATION OF ANIMAL HEADS-1946 EXAMINED MICROSC::OPICALLY FOR RABIES-STATE LABORATORIES
Animal
CENTRAL
Specimens
Pos.
Dog ---------------------------------------- 666
297
Cat ------------------------------------------ 166
41
Hog ---------------------------------------- 6
------
Cow and Calf -------------------------- 49
26
Fox ------------------------------------------ 124
86
Mule and Hor.se ---------------------- 9
4
Squirrel ---------------------------------- 11
------
Rabbit ------------------------------------ 3
------
Rae ------------------------------------------ 2
Goat ---------------------------------------- 4
2
Deer ---------------------------------------- 1
------
Wildcat ---------------------------------- ------
------
Chipmunk ------------------------------ 1
Pole Cat ----------------------------------
------
Hawk -------------------------------------- 1
------
Opossum -------------------------------- ------
Unclassiiied ---------------------------- 4
1
GRAND TOTALS ------------- 1,047
457
ALBANY
Specimens
Pos.
137 49
------
38 183
6
s
------
------
------
1
------
1 ------
1 ------
36 16
------
27 121
1 ------
------
------
------
-----------
1
------
-----------
421
202
WAYCROSS
Specimens
Pos.
61
34
34
ll
2
------
3
1
34
34
3
1
------
------
------
------
------
------
------
------
------
------
------
------
------
------
------
1
------
------
138
81
TOTALS
Specimens
864 249
8 90 341 18 16
3 2 4 1 1 1 1 1 2 4
1,606
Pos.
367 68
0
"'
------
54 241
6
.."""~""."'''_''
1-<
"' ------ <:so<
------
------
2
"~"""ll'''.-'. "'<.,
1
1
740
l-0
-....j \.)0
274
Geo1gia Department of Pttblic Health
TABLE 21 CLASSIFICATION OF ANIMAL HEADS-1946 EXAMINED MICROSCOPICALLY FOR RABIES-MUNICIPAL LABORATORIES
Animal
COLUMBUS SAVANNAH AUGUSTA MACON
TOTALS
Spec. Pos. Spec. Pos. Spec. Pos. Spec. Pos. Spec. Pos.
Dog ---------------- 20 2 35 8 17 8
72 18
Cat ------------------
7
3 10
3 10
2
27 8
Fox ------------------ 104 25
104 25
Racoon ----------
1
1
Horse --------------
1
1
Monkey ----------
1
1
Squirrel ----------
3
3
Rat -----------------Unclassified ----
1
1
74 12 74 12
GRAND ToTALs 133 30 49 11 28 10 74 12 284 63
TABLE 22
EXAMINATION OF Fox HEADS FOR RABIES-BY COUNTIES-1946 (State and Municipal Laborarories)
Cottnty
Totals
Appling
4
Bacon ---------------------------------------------------------------------- 11
Baldwin ------------------------------------------------------------------ 2
Bleckley ------------------------------------------------------------------ 3 Brooks ----------------------------------------------------- _______________ 4
Clinch -------------------------------------------------------------------- 1
Coffee ---------------------------------------------------------------------- 5 Colqui tt ------------------------------------------------------------------ 4
Crawford ---------------------------------------------------------------- 1
Crisp ---------------------------------------------------------------------- 1
Decatur ------------------------------------------------------------------ 2
DeKalb ------------------------------------------------------------------ 2
Dodge ------------"------------------------------------------------------- 11
Dougherty -------------------------------------------------------------- 11
Fulton -------------------------------------------------------------------- 2
Grady ---------------------------------------------------------------------- 2
Habersham -------------------------------------------------------------- 1
Harris ---------------------------------------------------------------------- 4
]asper ---------------------------------------------------------------------- 20
Positi-ves 3 2 1 3 4 1 5 4 1
2
9
7
2
2 9
Di-vision of Laboratories
TABLE 22-Continued
Cottnty
Totals
Jones ---------------------------------------------------------------------- 1 Lamar ---------------------------------------------------------------------- 2 Lnurens ------------------------------------------------------------------ 1 Lee -------------------------------------------------------------------------- 43 Marion -------------------------------------------------------------------- 21 1!eriwether ------------------------------------------------------------ 5 Mitchell ------------------------------------------------------------------ 4 Monroe ------------------------------------------------------------------ 45 11ontgomery ---------------------------------------------------------- 3 Muscogee ---------------------------------------------------------------- 105 Newton ------------------------------------------------------------------ 2 Peach ---------------------------------------------------------------------- 4 Pierce ---------------------------------------------------------------------- 7 Pike ------------------------------------------------------------------------ 1 Putnam ------------------------------------------------------------------ 5 Quitman ------------------------------------------------------------------ 2 Randolph ---------------------------------------------------------------- 33 Schley ---------------------------------------------------------------------- 2 Seminole ---------------------------------------------------------------- 1 Spalding ---------------------------------------------------------------- 1 Stewart -------------------------------------------------------------------- 3 StJmter -------------------------------------------------------------------- 5 Taylor ---------------------------------------------------------------------- 2 Telfair -------------------------------------------------------------------- 9 Terrell -------------------------------------------------------------------- 9 Thomas ------------------------------------------------------------------ 9 1'oombs ------------------------------------------------------------------ 6 Treutlen ------------------------------------------------------------------ 2 Upson ---------------------------------------------------------------------- 23 Walton ------------------------------------------------------------------ 1 Ware ---------------------------------------------------------------------- 4 Warren ------------------------------------------------------------------ 2 Washington ------------------------------------------------------------ 1 Wayne -------------------------------------------------------------------- 5 Webster ------------------------------------------------------------------ 23 Wilkinson -------------------------------------------------------------- 2 Worth -------------------------------------------------------------------- 2
GRAND ToTALs ------------------------------------------------- 487
275
Positives
1 2 1
35 14 5 4 17
1
26
1 3 7
5 1 21 2
1 3 3 2
9 9 9 6
1 8
4
5 4 2 2
269
l-.j
--..J 0\
TABLE 23 ANIMAL INOCULATIONS FOR RABIES
Type Specimen
Micro.Mouse-
Dog ------------------------------------------ l l Car -------------------------------------------- 5 Fox -------------------------------------------- ---Cow ------------------------------------------ 2 Goar ------------------------------------------ 1 Human -------------------------------------- ---pig -------------------------------------------- 2 Mule ------------------------------------------
GRAND TOTALS-------------------- 21
Micro.Mouse+
8 5 1 6 ---1 1 1
_? ")
Micro. ? Mouse-
----
----
----
----
-------
----
Micro. ? Mouse+
2 1 ----
----
----------
----
3
Micro. Uns. Micro. Uns. Mouse- Mouse+
3
2
----
----
2
1
----
----
----
----
----
----
----
----
Micro. + Checks
-------------
----
1 ----
----
5
3
1
c;)
""Cl
~ :";:".
Total \::1
26 ""~"""'
ll
"~ '
4 8
;"::";
-"C'.l
1
:'i;::,:i
~
2 3 1
~
:":c "~"
<::;-.
--
56
Division of Labor?ttories
277
Miscellaneous-
Table 24 shows the miscellaneous examinations made during the year. The statistics given for Vincent's organisms are on specimens submitted for this examination only and do not include the positive findings on specimens submitted primarily for gonorrhoeae examination. Neither do the figures for Trichomonads represent the actual totals since the finding of these organisms in pus smears submitted primarily for gonorrhoeae examinations are not tabulated. An unusual finding in spinal fluids was the fungus Torula histolytica recovered in the Waycross laborarory. Other isolations were as nmed below:
Central Alb?tny Waycross Total
N. intracellularis ------------------------ 7
7
D. pneumoniae -------------------------- 5
2
1
8
H. influenzae ------------------------------ 12
3
15
T. histolytica ------------------------------
1
1
TOTAL ------------------------------------ 24
5
2
31
In the Central laboratory, 30 examinations for Donovan's bodies (Lymphogranuloma inguinale) were made with 3 positive and 1 doubtful findings. These specimens were all received from the Atlanta Health Center V. D. Clinic. During the year 1,258 heterophile antibody tests for glandular fever (Infectious mononucleosis) were made. The Waycross laboratory performed 504 of these and the Central laboratory 754. Since most of the requests for this test have originated in the northern part of the State, rhe test has, since May, been performed only in the Serology unit of the Central laboratory.
TABLE 24 CLASSIFICATION OF MISCELLANEOUS EXAMINATIONS
Toktl
Vincent's ------------------------------------------------------------------ 457 Trichomonads ---------------------------------------------------------- 460 Chancroid (B. ducrey) ----------------------------------- ________ 109 Darkfield (T r. pallid um) ---------------------------------------- 327 Spinal Fluids for Meningitis ------------------------------------ 143 Glandular Fever (Heterophile Antibody Test) ______ 1,258 Examinations for Type of Organisms -------------------- 212 Cultures -------------------------------------------------------------------- 359 Unclassified -------------------------------------------------------------- 444
GRAND TOTAL ------------------------------------------------------ 3,769
Positive
226 105 24 136
31 311
CULTURE UNIT
Cultural studies which included blood, stool and urine cultures, agglutination tests, and a miscellany of special bacteriology, increased from 29,312 specimens in 1945 to 34,272 in 1946, a gain of 4,960 or 16.9%. See Table 25.
278
Georgict Department of Pttblic Health
TABLE 25 CULTURAL STUDIES-1946-1945
Agglutination Series ____________ Blood Culture ______________________
Stool and Urine Culmres ____
1946
12,669 9,880 11,723
1945
11,377 9,414 8,521
Increase or Decrease
+1,292 + 466 +3,202
+11.4% + 5.0% +37.6%
GRAND TOTALS -------------- 34,272
29,312
+4,960
+16.9%
The marked gain in stool and urine cultures was due to extensive laborawry studies made in several outbreaks of food poisoning, which occurred during the year.
A smdy of Tables 26, 27, and 28 will show the remarkable and continued decrease in positive findings for typhoid in recent years culminating in an all-time low during 1946. In contrast there was a fairly marked increase in salmonella isolations from srool cultures due to the occurrence of several rather extensive ourbreaks of food poisoning. Positive findings for Endemic typhus have also decreased sharply in recent years due to the effective comrol measures that have been applied in infected areas. For example in 1936 we obtained 1,080 positive reactions whereas in 1946 we had only 446.
TABLE 26 POSITIVE AGGLUTINATION TESTS
1942
Typhoid ------------------------------------ 111 Typhus (Endemic) Fever ________ 796 Brucellosis -------------------------------- 153 Tularemia -------------------------------- 78
1943
106 839 96
84
1944
92 705 163
46
GRAND ToTALs ____________________ 1,138 1,125 1,006
1945 1946
55
32
632
446
186
181
55
64
928
723
TABLE 27 POSITIVE BLOOD (ULTURES
1942
E. cyphosa -------------------------------- 184 Salmonella -------------------------------- 15 Brucella ------------------------------------ 38 Other Organisms ---------------------- 21
GRAND ToTALs ------------------ 258
1943
115 19 30 16
180
1944
93 14 53 10
170
1945 1946
73
49
12
4
60
51
12
24
157
128
Di-vision of Lotborcttories
279
TABLE 28 POSITIVE STOOL AND URINE CULTURES
1942
E. typhosa ---------------------------------- 500 Salmonella -------------------------------- 28 Shigella -------------------------------------- 240 Other Organisms ----------------------
GRAND ToTALs ------------------ 768
1943
162 52 203
2
419
1944
143 200 135
478
1945 1946
191
86
79
103
108
50
1
378
240
A highly imponant but time-consuming activity of the Central laboratory culture unit is the critical typing of Typhoid, Salmonella, Brucella and Shigella isolations. An extensive variety of diagnostic sera and reagents is required for this work and, consequently, it can best be undertaken in the Central laboratory. During the year, 143 cultures of E. typhosa, 117 cultures of Salmonella, 58 Brucella isolations, and 117 Shigella cultures were typed. These were all isolated in State laboratories. In addition, typing was done on 131 cultures received from other laboratories within the State and from State laboratories in Indiana, Texas, Idaho, Missouri, Tennessee, and the District of Columbia. An analysis of the typing studies is given in Tables 29 through 34.
Included in the isolations from miscellaneous cultures in the Central
laborarory were the following fungi: Candida albicans-1 isolation; Trich-
ophyton-1 isolation; Microsporum audouini-4 isolations; as reported
ttnder miscellaneous examinations the Waycross laboratory isolated Torula
histolytica from a spinal fluid. During 1945 several of the personnel from
the Central laboratory culture unit received special training in mycologic
technic at the Fourth Service Command Laboratory. Shortly thereafter several
isolations of fungi were made. Of especial interest was the finding of Sporo-
trichum schenkii in cultures from a chain of ruptured nodules on the arm of
a patient living in Clarkesville, whose condition had remained undiagnosed
over a period of six weeks. The laboratory findings resulted in a satisfactory
clearing up of the infection. Since then the demand for mycologic studies has increased rapidly.
In 1945 we instituted Lactobacillus counts on saliva specimens and during the year 102 counts were made. The demand for this service dropped considerably during the current year, only 10 having been made.
1'-.l 00 0
TABLE 29 ISOLATIONS OF E. TYPHOSA-1946
Type
CENTRAL Blood- Feces-1 nd.*
A
7 8 13
c
4 14 9
E
11 19 18
F
244
J
233
Bera, Gamma,
W Forms ---------------- 8 14 14
TOTALS ------------------ 34 62 61
*Duplications are not excluded. **Peritoneal exudate.
ALBANY Blood- Feces- Ind.*
375 1 ---- 1 224 ---1 ---- 1
352
10 14 13
WAYCROSS Blood- Feces-1 nd.*
---- 3 2 22 1
---1 ---- 1
---- ---- ----
24 3
597
OTHER LABS. Blood- Feces- Ind.
112
1 1 ** 2
213 ---- ---- ----
2
2
639
c;]
...<1)
<::>
Ot>
TOTALS
~
Blood-Feces- Ind.
t:::J
~
11 19 22
:;:, ~
8 17 13 ~
<1)
15 22 34
25 5
;t
."<.::_>'
3
3
4
'"1::1 1.:::
<::s-
~
15 23 21 :":'c
<1)
55 88 90
:;:, ~
~
Division of Laboratories
TABLE 30 TYPHOID CASES AND CARRIERS-1946
E. typhosa __Iype
Cases'''
A
18
c
10
E
21
F
5
J
4
Beta, Gamma, W forms 18
ToTALs________________________ 76
*Duplications excluclecl.
New Carrier
2 2
4
Old Carrier
1
3
1
5
281
Total
21 12 24
5
4 19
85
TABLE 31
'0'"0
l'>.l
SALMONELLA lSOLATIONS-1946
Group A B
c
D E
Type
S. paratyphi A
S. paratyphi B S. typhi murium S. derby S. california S. !Jrcdency
S. cholerae suis S. oranienburg S. barcilly S. montevideo S. newport**** S. mucnchcn S. litchfield
S. enteritidis S. scndai S. panama S. pensacola
S. give S. anatum S. meleagridis S. illinois
CENTRAL Blood Feces
ALBANY Blood Feces
WAYCROSS Blood Feces
OTHER LABS. Blood Feces
TOTALS
I sol.
Ind.
2
--
--
-
-
-
1
--
-
-
12*
--
10
---
--
1**
2
l
1
1
Cl
25
18
~""'
;~;:..
11
-
1***
4
1
l
11
2
--
...
--
--
4
-
2
1
4
1
-
1
-
1
1*****
1
-
14
3
\:I
~ "'
13
11
.~..;.
~
12
7
,"".''
2
2
.."......
12
4
'1::1
10
6
"".<,:s_o<
":"::'c
2
2
";;:'.
~
<:s-
5
5
1
1
TOTALS
40
3
57
117
75
*1 Double infection with S. oranienburg. **Isolated from autopsy material (large intestine and liver). ***Same as Albany. ****1 Double infection with E. typhosa. *****Fron1 spinal fluid.
Group A B
c
D E Misc. TOTALS
Salmonella
paratyphi paratyphi A paratyphi paratyphi B typhi murium derby bredeney san diego california cholerac suis oranienburg bareilly montevideo tennessee georgia newport muenchen litchfield manhattan enteritidis sendai panama pensacola give ana tum meleagridis newington illinois rubislaw poona worthington minnesota
TABLE 32 SALMONELLA TYPES ISOLATED IN GEORGIA-1942-1946
1942
1 --8
14 2 1
.... ---6 3
---
3 ------1 ---1
---
---
----
1 2 1 ---
1943
4
20
10 1
---5 6 ---2 2 1 - 3
--9
5 1
-
1944
2
--
9
---
162 9 1 1 1 8 8
---
3
-- 3 2 1
----
1
-
3
--
2
1945
---
---
15
ll 3 5 1 1 13 41 6 1
21 1
---2
1
3 5
1
Total No. 1946 Isolations Blood
From Stool
Total No. Urine Individuals
7
7
-
4
2
2
--
2
1
52
20
32
26
1
1
1
25
222
4-
218
162
2
17
---
17
14
14
21
2
19
-
6
2
---
2
----
2
tJ
1
3
--
3
3
"<:':":
3
35
27
8
---
33
13
34
7
27
--
26
<::;
"c'
2
3
----
3
----
3
1
15
4
10
1
12
-"c " .
3
1
2
2
1-<
---
1
-
12
37
37
1
---
1
--
23
"'~
.c...
2
8
-
8
6
!;;
12
14-
--
14-
----
6
c....
----
2
-
2
1
"~"
10
10
2
8
1
6
17
2
15
5
20
-
20
-
18
1
3
--
3
---
3
-
3
--
3
---
3
3
-
-
3
3
--
6
---
6
---
-
2
----
---
2
1
1
3
l'-l
2
00
\.)J
44
72
221
100
ll7
554
ll4
439
1
384
284
Georgia Department of Public Health
TABLE 33 SHIGELLA IsoLATIONS-1946
Type
Central
FJexner V ---------------------- 1 W ---------------------- 8 X ---------------------- 1 y ---------------------- 2
z ----------------------
88 ---------------------- 1 103 -------------------- 1
V, Z ------------------
Sh. sonnei ---------------------- 5
Sh. Boyd P 274
1
Sh. ambigua -------------------- 1
Sh. dispar ------------------------ 1 Sh. alkalescens ______________ 37
Albany
10 2
1
2 7
1 12
Waycross
2 2
1
Others'''
4
4
1
9
ToTALs __________________ 59
35
5
18
*Isolations made in other laboratories, typed in Central laboratory.
Total
11 16
1 2 1 ? 1 2
16 2 1 3
58
117
TABLE 34 BRUCELLA lSOLATIONS-1946
Type
Central
Albany Wavcross Other Labs. Totals
lsol. Ind. lsol. Ind. lsol. Ind. lsol. Ind. lsol. Ind.
B1. aborms __________ 9 8
33
4 4 16 15
Br. suis ---------------- 23 19 16 11
3* 2 42 32
ToTALs ________ 32 27
*1 same as Central laboratory.
19 14
7 6 58 47
SYPHILIS SEROLOGY
The syphilis serology load for rhe division of laboratories amounted to 369,140 specimens during 1946. This was an increase of 40,448 or 12.3% over 1945. See Table 35. Included in these specimens were 577 submitred from small children on which the Micro Kahn test was performed.
Beginning January 1, 1946, the Quantitative Kahn resr was applied routinely to all specimens giving four plus, atypical, or zone type reactions by the Standard Kahn test. Although ir has added considerably w the amount of work in the serology unit, it is felt thar the application of the quantitative
Di-visio11 of Laborato-ries
285
test, as indicated above, is a well advanced step in the present-day serologic methods. A total of 25,084 quantitative tests was performed in the rhree laboratories.
A special syphilis serology service rendered by the Central laborawry is rhe performance of multiple serologic tests on selected specimens submitred by physicians from cases suspected to be showing non-specific reacrions in repeated routine resrs. This battery of tesrs was applied as follows:
Kahn Presumptive__________________________________________ 254
Kahn Standard------------------------------------------------ 442 Kahn Quantirarive__________________________________________ 217 Kolmer Complement-Fixation________________________ 354
~~~;in~~~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~
Eagle Flocculation ------------------------------------------ 327 Hinton Flocculation --------------------------------------- 312 Cardiolipin V.D.R.L. (experimental)____________ 402
GRAND ToTAL________________________________________ 3,31 5
During the year the Central laboratory again panicipated in the annual national evaluation study of serologic tests for syphilis conducted by the United States Public Health Service. A credirable raring of performance in both sensitivity and specificity was obtained in all of the several tests evaluared. Table 36 shows the comparative ratings of our laborawry wirh the laboratories of the author serologists.
TABLE 35 SYPHILIS SEROLOGY-1946
BLOOD 1946 -----------------------------1945 ------------------------------
Central
268,504 240,281
Increase or Decrease ______
SPINAL FLUID 1946 -----------------------------1945 ------------------------------
+28,223
780 1,162
Increase or Decrease ______
-382
BLOOD AND SPINAL FLUID
1946 -----------------------------1945 ------------------------------
269,284 241,443
Increase or Decrease ______ +27,841
Albany
58,602 43,231 +15,371
381 372
+9
58,983 43,603 +15,380
Waycross
40,725 43,502 -2,777
148 144
+4
40,873 43,646 -2,773
Total
367,831 327,014 +40,817
1,309 1,678 -369
369,140 328,692 +40,448
286
Georgia Department of Public Health
TABLE 36 NATIONAL SEROLOGY EVALUATION STUDY-1946
Test
Georgia Laboratory Author Serologist Laboratory Sensitivity Specificity Sensitivity Specificity
Kahn Presumptive -------------- 91.8%
Kahn Srandard -------------------- 83.2% Kline Diagnostic ________________ 83.3% Kol~er. Complement-
F1xatwn -------------------------- 81.2% Eagle Microflocculation ______ 87.3%
Hinton Flocculation ------------ 84.6% Mazzini Flocculation ____________ 87.7%
97.4% 100.0%
99.6%
100.0% 98.0% 100.0% 98.9%
88.9% 83.1% 81.8%
88.4% 85.9% 84.6% 84.0%
100.0o/a 100.0% 100.0%
100.0%
98.5 o/o
99.3% 100.0o/a
During the year, the Intra-State Serology Evaluation Study was continued with nineteen laboratories, exclusive of ~he Srate system, participating. Twenty test specimens were submitted w these laboratories by the Central laborawry each momh over a ten-month period. As a result of this study, approval was given to sixteen of these laboratories in accordance with the provisions of the State prenatal law.
The serology unit of the Central laboratory trained and furnished the technical staff of the serology laboramry in the syphilis-tuberculosis surveys conducted in Macon, Columbus, and Augusta. This laboratory examined 142,679 specimens.
In July, 1946, the laboratory of the Alto Medical Center was opened. During the year 12,167 specimens were handled. The bulk of the work consisted of blood and spinal fluid testing for evidence of syphilis, and cultures for N. gonorrhoeae. See Table 37.
TABLE 37 EXAMINATIONS PERFORMED BY ALTO MEDICAL CENTER LABORATORY
Blood -----------------------------------------------------------Spinal Fluid -------------------------------------------------Gonococcus Culmres -----------------------------------Urinalyses ---------------------------------------------------Miscellaneous ----------------------------------------------
5,908 3,841 2,165
194
59
GRAND ToTAL ------------------------------------ 12,167
Preparations are being made to begin, in the early part of 1947, blood grouping and Rh testing. An attempt will be made w limit requests for this service to specimens from prenatal patients and related cases.
BIOLOGICS AND DRUGS Table 38 shows the biologics and drugs distributed during the year. A
number, especially some of those used in the diagnosis and treatment of various venereal diseases, were available only to state clinics and were not distributed m private physicians.
Di-vision of Lttborat01ies
287
TABLE 38
BIOLOGIC PRODUCTS AND DRUGS DISTRIBUTED
PRODUCT
CENTRAL ALBANY WAYCROSS
SERA AND VACCINES
Diphtheria Antitoxin, units-----------Diphtheria Toxoid, cc. _______________ _ Diphtheria Schick Tests, tests________ _
Ducrey Vaccine, cc-----------------Pertussis Vaccine, cc. vials___________ _ Smallpox Vaccine, points____________ _ Tetanus Antitoxin, Wlits_______________
Tetanus Toxoid, cc.------------------Tuberculin, Diluted, cc.______________ _ Tuberculin, PPD, tests_______________ _
Typhoid Vaccine, cc----------------- (l) Anthabic T1eatments (pe1sons
treated)--------------------------Immune Serum Globulin, cc---------- Diphthe1ia-Penussis-Tetanus, cc. ______ _ Diphtheria-Pertussis Toxoid __________ _
'1.8,711,000 73,050 '13,540 290 4-,503
114,160 8,885,500
360 12,320 10,300 521,550
1,735 10,450
500 200
'1,979,000 5,960 970
--------
307' 7,820 858,000
--------
---------------
46,'1-30
880
----------------------
5,283,000 7,160 3,800
--------
201 6,330 510,000
--------
---------------
39,600
491
--------
--------
DRUGS
(3) Arsenicals, ampules _______________
(2) Bismuth Subsalicylate in Oil, cc._ Brewers Yeast, pounds_______________ _ Clinitest, tablets _____________________ _ (4) Distilled Wat(tr, cc.______________ _ Fuadin, ampules_____________________
Hexylrescorcinol Crystoids, vials______ _ Lygranum, tests_____________________ _
Pan~~-'s_ Solut.ion, oz. ________________ _ Pemcdlm, umts_____________________ _ Silver Nitrate, ampules________________ Stovarsol, tablets_____________________ _ Sulfathiazole, tablets, 4.0s____________ _
Tetrachlorethylene, capsules, (8 minim)
135,250 232,530
15,552 22,800 1,837,600 10,000
104 1,460
28 2,167,700,000
82,3,].2
3,500 459,080
25,751
975 1,,110
---------------
58,350
--------
-----------------------------
3,527
---------------
2,800
-----------------------------
38,650
-----------------------------
-------3,955
---------------
5,200
Delacillin, cc------------------------
39,850
--------
--------
Plasma, cc--------------------------
'].,'119,000
--------
--------
Streptomycin, 1 gm.------------------
50
--------
--------
Gentian Violet, tablets-----;:-----------
Procaine Solution, cc._______________-_-
-
-
-
-
-
-
-
2,008
--1-0-0
-
-
-
-
--------
----------------
-
-
-
-
-_-__-_-_-_-_--..,. -------
(1) The figures given for the Branch laboratories do not represent complete treat ments. Four vials of vaccine are supplied by the Branch laboratories for each patient for whom treatment is requested. The remainder of the treatment is sent from the Central laboratory.
(2) Distributed in 30 cc. and 60 cc. bottles.
(3) Equivalent to 292,351 doses of 0.6 gm. or Jess.
(<!) Distributed in 50 cc. and 100 cc. bottles.
Of unusual interest was the marked increase in the quantity of immune serum globulin disrribured. This biologic is a by-product derived from pooled normal human plasma collected during the war by the American Red Cross, and is used in the prevention and modification of measles. Distribution by our department was begun in 1945 when 1,680 cc. were furnished doctors. During the past year, 3,938 vials or 10,450 cc. were distributed.
288
Georgia Department of Public Healtb
SNJen tbousand five bmulred packages of blood plasma were transferred bJ' tbe American
Red Cross to tbe Geo rgia Healtb Department for distribution to bospitals ove1 tbe State.
Jolm J. Komp (rigbt ), Georgia State Relations Officer for tbe Red Cross, is sbown presenting
tbe plasma to Dr. T . F. A bercrombie, State Healtb Director.
Di-vision of Laborcttories
289
In February, 1946, we began the distribution of dried blood plasma
furnished us by the American Red Cross. An initial consignment of 2,581 packages was shipped, on request, to 109 hospitals and clinics, 16 private physicians, and 3 health departments, in 76 counties. During the year, 11,621 packages or 4,419,000 units were distributed. Private physicians may obtain the plasma from hospitals but when such service is not available, the product may be obtained directly from our department. There is no charge to the patient for plasma other than the cost of administering it.
TABLE 39
BIOLOGICS SHOWING MARKED INCREASE OR DECREASE OVER
1945 DISTRIBUTION
Product
1946
1945
Increase or Dec1.. ease
SEHA AND VACCINE
Diphtheria Antitoxin, units-----------Diphtheria Toxoid, cc, _______________ _
Pertussis Vaccine, cc---------------- Typhoid Vaccine, cc.________________ _ Smallpox Vaccine____________________,
118,711,000 73,050 90,160 521,550 11'1,160
77,072,000 106,300 115,020
+ 517',010 + 108,970
28,361,000 33,250 24.,860 '1,5110 5,190
DRUGS
Arsenicals, ampoules_________________ ,
135,250
Bismuth, Subsalicylate in oil, cc._______ Fuaclin, ampoules____________________
232,530 10,000
Stovarsol, tablets, 0.25 gm,____________
3,500
Penicillin, units---------------------- 2,167,700,000
Delacillin, cc.________________________
39,850
Clinitest Tablets______________________ Silver Nitrate Amps._________________,
22,800 82,3,12
Te trachlorethy1ene ___________________ .
25,751
Su1Jathiazole_________________________
459,080
139,'115 377,940
5,590 7,360 10,6110,100,000 6,8'10 12,600 63,371 21,659 559,'140
4.,165
+
145,'110 4,4.10
3,860
+-3,'172,4<00,000 33,010
+++
10,200 13,971 11,092
100,360
The marked decrease in the quantity of arsenicals and bismuth distributed, which has been noted since the advent of penicillin therapy of syphilis, continued during the past year. See Table 39. There were 135,250 ampoules of arsenicals, equivalent to 291,401 closes of 0.6 gm. or less, distributed during 1946 compared to 139,415 ampoules or 609,342 doses in the preceding year. There were 232,530 cc. of bismuth subsalicylate in oil distributed in 1946 compared to 377,940 cc. in 1945. The distribution of sterile distilled water decreased from 2,446,900 cc. in 1945 to 1,837,600 cc. in 1946.
During the latter part of the year, a small supply of streptomycin became available and 50 grams were furnished to State institutions. This was distributed at cost price.
Gentian violet (medicinal) in 3/20 gr. and 1/2 gr. tablets, used in the treatment of pin worm (Enterobius) infections, was added to the list of drugs distributed. Because of the number of tablets required for each treatment, it is not anticipated that there will be very much of a demand for this product.
290
Georgia Department of Pttblic Health
HUMAN ANTIRABIC TREATMENTS
During the year, 1,735 antirabic treatments for humans were distributed, a decrease of 691 (28.5%) as compared with 1945. Treatment was adItlinistered to 106 persons bitten by foxes. This drop is undoubtedly due to a policy instituted during the year of endeavoring, whenever possible, to discourage antirabic treatment for all exposures other than actual bites. It is our opinion, based on actual experience over a long period of years, that for all exposures other than actual tooth wounds the danger of treatment sensitization and reactions is greater than that of rabies. There were three human deaths from rabies during the year. Two of these died during or after treatment. One had no treatment. A comparison of treatment distribution and human mortality is given in Table 40, while Table 41 gives a classification according to type of the treatments distributed during the past 2 years.
TABLE 40
ANTIRABIC TREATMENTS AND RABIES MORTALITY
1942
Hmnan Treatments ____________
Human Deaths During or After Treatment ____________
Human Deaths Without ~ Treatment ________________________
2,130 2* 2
1943
2,296 1
1944
2,784 2 2
1945
2,426 3 2
1946
1,735 2 1
Total Deaths ______________________
4
1
4
5'~*
3
*One patient bitten in Georgia, treated and died in South Carolina. **One patient bitten in Georgia, not treated, and cUed in Florida.
TABLE 41
CLASSIFICATION- ANTIRABIC TREATMENT BY TYPE
TYPE TREATMENT
1946 Numbel' Pel' Cent
Precautionary -------------------------- 714
41.2
Mild ---------------------------------------- 890
51.3
Intensive -------------------------------- 124
7.1
Drastic ------------------------------------
7
0.4
TOTAL ---------------------------------- 1,735
1945 Numbel' Per Cent
1,051
43:3
1,234
50.9
124
5.1
17
0.7
2,426
HUMAN CASES OF RABIES
Complete histories of the three human cases occurring during the year were obtained and are given below in abbreviated form.
Di,vision of Laboratories
291
292
Georgia Depc~rtment of Pttblic Hectlth
CASE I-N. F. B., white, female, age 51, of Atlama (Fulmn County) Georgia. Binen by a stray clinically rabid dog on November 29, 1945, receiving two severe wounds. The mild type antirabic treatmem was administered. Characteristic symptoms of rabies developed on April 9, 1946, more than four months after exposure. Death occurred April 16, autopsy was obtained and the clinical diagnosis confirmed by laboratory examinations.
CASE II-T.L.S., white, male, age 26 of Lawrenceville (Gwinnett County), Georgia. Early in April this patient attempted to medicare a neighbor's sick dog which shortly afterwards disappeared and was never located. He had no recollection of the animal having bitten or scratched him with his teeth although he admitted having several lacerations of various ages and imensity on his fingers at the time medication was anempred. On May 11 he developed symptoms of rabies and became progressively worse until death ensued on May 21. A clinical diagnosis of rabies was made. No aumpsy was obtained.
CASE III-D. R., white, male, age 3 of Atlanta (Fulton Coumy), Georgia. This child was bitten June 5 receiving four severe puncture wounds on the cheek and one in the mouth, made by a stray dog which escaped and was never subsequently located. Intensive amirabic treatment was instituted the following day (June 6). On June 19 he apparently developed a cold but two days later he displayed the initial symptoms of rabies. He became progressively worse and died on June 24. Autopsy was performed and the diagnosis of rabies was confirmed by laboratory tests.
No cases of treatment paralysis involving Georgia patients occurred during the year although one case-a North Carolina child, was admitted to Grady Hospital, Atlanta. This patient recovered.
TABLE 42 DISTRIBUTION OF SPECIMEN OUTFITS BY LABORATORIES-1946
CENTRAL
~-Keidel Tubes ------------------------------------ 166,876
Keidel Butts -------------------------------------- 185,951
*Darkfield Outfits --------------------------------
816
Throat Culture Outfits ---------------------- 3,657
Intestinal Parasite Outfits, Routine ____ 15,959
*lntestinal Parasite Tins, Survey __________ 31,100
Slide Outfits -------------------------------------- 17,384
Slides --------------------------------------------------
720
Sputum Outfits ---------------------------------- 23,717
Stool Culture Outfits ------------------------ 8,740
N. I. H. Outfits ----------------------------------
253
Dental Caries Outfits ------------------------
4
ALBANY
20,112 38,207
285 903 6,667 4,738 4,291 2,806 2,737 2,783
WAYCROSS
4,260 18,804
332 360 1,278 9,836 2,234 900 2,234 3,619
Di-vision of Laboratories
293
TABLE 42-Continued
NEEDLES
19 Gauge, 2 inch ---------------------------22 Gauge, 1-1/2 inch ______________________ 24 Gauge, 3/4 inch -----------------------26 Gauge, 3/8, 1/2 & 5/8 inch ______ 13 Gauge, 2 inch Spinal Needle ____
SYRINGES
1 cc. Tuberculin ---------------------------2 cc. Hypodermic -------------------------5 cc. Hypodermic -------------------------10 cc. Hypodermic --------------------------
169 dz. 193 dz, 290 dz. 390 dz.
16 only
109 only 802 408 816
*Statistics for Central Laboratory include items sent to the Albany and -waycross Branch Laboratories.
TABLE 43
MEDIA AND VACCINE UNIT
CENTRAL
MEDIA - IN cc.'s
Meat Infusion Double ---------------------- 93,000 Meat Infusion Broth________________________ 39,400
Beef Extracc Broth -------------------------- 68,000
Sugar Broth ------------------------------------ 5,300
Tetrathionate Broth ------------------------ 14,300 Tryptose Phosphate Broth ______________ 17,000
Meat Infusion Agar ------------------------ 115,600
Beef Extract Agar ---------------------------Desoxycholace Citrate Agar ____________
Endo's Stock Agar -------------------------Kligler's Triple Sugar Iron Agar ______
12,700 24,000 23,050
McConkey's Agar ---------------------------- 13,500 Peizer's Stock Agar ------------------------ 78,300
Chocolate Agar -------------------------------S. S. Agar ------------------------------------------
Tryptose Agar ---------------------------------Wilson Blair Agar -------------------------Conradi's Bile ---------------------------------Loeffler's Blood Serum ---------------------Petragnani's -------------------------------------Miscellaneous Media ----------------------
20,000 22,600 114,000 116,000
9,492 22,000 18,540
ALBANY 'vVAYCROSS
1,000
4,750 3,900 4,000 8,100
6,325
6,300 6,550
6,975 1,500 69,825 72,000
5,050
1,700 300
7,000
3,000 3,850
1,600 2,800
3,200 3,650 3,000 18,650 29,400
1,000
294
Georgia Department of Pttblic Health
TABLE 43-Cominued
CENTRAL
ALBANY
SOLUTIONS AND INDICATORS
Indicators for Media ------------------------
350
Dyes for Media -------------------------------- 2,200
Reagents for Media ------------------------ 23,250 Bismuth Sulfite Mixture ________________ 24,000
Glycerine Salt Solution -------------------- 50,000
Salt Solution ------------------------------------ 754,000
Silver Nitrate Solution -------------------- 54,000 Miscellaneous Solutions __________________ 54,768
42,000 82,000
1% SIVER NITRATE
Number ampules made ____________________ Number ampules filled -------------------Number ampules distributed __________
1946
80,000 94,000 84,000
1945
80,000 77,500 77,500
WAYCROSS
2,200 100 325
18,000 154,000
4,000
Increase or Decrease
+16,500 +6,500
STERILE DISTILLED WATER
Water filled, cc. -------------------------------- 1,900,600 Water distributed, cc. ---------------------- 1,953,300
2,890,400 2,960,000
-989,800 -1,006,700
DILUTED TUBERCULIN (OLD)
Tuberculin diluted, cc. -------------------- 13,000 Tuberculin distributed, cc. ______________ 12,745
10,400 9,885
+2,600 +2,860
REGIONAL LABORATORY BUILDING PROGRAM
As the year closed, plans had been completed for the erection of regional administrative and laboratory buildings at Waycross, Albany, and Macon. Building sites have already been procured and a general architect employed. These laboratories will function very much as do the present branch laboratories except that they will be physically larger and can take care of an increasingly larger specimen load and of a broader scope. It is anticipated that the Macon laboratory will be next in size and activity to the Central laboratory.
Building sites have been procured for similar buildings in Athens and Augusta. It is ultimately planned to include Columbus and Savannah in the regional plan.
PERSONNEL
While there was still a rather high turnover in personnel the problem of maintaining an adequate staff was not quite as severe as during recent
Di,vision of Lttboratories
295
years, There has been a noticeable increase in the number of applicants for training for technical positions permitting a gradual expansion of the technical staff. Applications for clinical positions have been greater than the demand. While the turnover in unskilled personnel continued, the replacements secured appeared above (he average of those obtainable during the war years. During the year there were 34 resignations and 51 appoimments. These were classified as follows:
Dieners
8
Porte,s
RESIGNATIONS Technical
15
Clerical
11
Total
34
APPOINTMENTS
9
2
29
11
51
VISITORS
Registered in the laboratory Guest Book for 1946 are the names or records of 274 visitors. This compares with 358 in 1945. They were classified as follows:
1. Visitors from foreign countries, Uruguay, Philippines, Ireland, China, Ecuador, Holland, Greece, India, Korea, Mexico, Dominican Republic, Bolivia, Colombia, Italy, Puerto Rico, Canada, Ceylon, and Alaska, 21.
2. Visitors from States in U.S. excluding Georgia, 67.
3. Visitors from Georgia, 185. 4. Military personnel, 1.
Division of Information and Statistics
RICHARD BREWER__________________________________________________________________________________ Directm lEALON M. lACY-----------------------------------------------'------------------- 0 ffice Sttper-visor ROY ANDERSON----------------------------------------------------------------------- Field Sttperllis or
Division of Information and Statistics
The Division of Vital Statistics is responsible for the collection and preservation of a cerrificate for each birth, death and stillbirth which occurs within the State of Georgia and the training and supervision of the large field force of local registrars required to collect vital statistics records in the counties. The field agems have greatly aided registration by directing and conducting liaison work for the department with ordinaries, registrars, doctors, funeral homes, hospitals, midwives, health offices, and county nurses throughout the State.
CURRENT BIRTH CERTIFICATES. The procedure for filing a certificate for a current birth is as follows: the parent files a birth certificate with the local registrar who transmits it directly to the Deparrment. The Departmem makes a photostat of the record and sends it to the proper county so that the local record is exactly the same as the State record. At the same time the doctor or midwife fills om a medical report of the birth giving all the medical information required. This report is sent directly from the doctor to the Health Departmem and is a confidential report not open to public inspection. In this manner more accurate medical information is obtained.
DEATH CERTIFICATES. Death certificates are filed with the local registrar by the funeral directors. The funeral director secures the personal information ;~nd 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. The Department makes a photostat of the record and sends it to the proper county for their record.
STILLBIRTHS. The stillbirth certificate is handled in the same manner as the death certificate.
DELAYED BIRTH CERTIFICATES. The number of delayed birth certificates filed by the county Court Order procedure declined from 17,460 in 1945 to 9,823 in 1946. 6,317 certificates were placed on file by the State delayed procedure during 1946 as compared with 12,605 filed in 1945. This gives an over-all decrease of 13,925 certificates in the State as a whole over 1945.
CERTIFIED CoPIES. During 1946 the number of certified copies of birth certificates declined to 22,680 as compared with 32,669 certified copies issued for the year of 1945. The number of certified copies of death certificates increased from 1,588 in 1945 to 2,044 in 1946.
STATISTICS
NATURAL INCREASE IN POPULATION. A record breaking 85,699 live births were registered in Georgia for the year 1946. This was a net increase of 10,705 births over 1945, and 7,372 over that of 1943, the highest previous year in the history of Georgia Vital Statistics. At the same time only 27,405 deaths occurred in the State, the lowest death rate recorded, or a decrease of 3.7 percem from 1945. The 58,294 excess of births over deaths, or 313 births
300
Georgict Department of Pttblic Health
per 100 deaths, provides Georgia with its largest namral increase in population recorded in any one year.
DEATH RATE. There was a decrease of 3.7 per cem in rhe death rate in 1946 or a change from 911.0 per 100,000 population in 1945 to 877.3 in 1946. The 28,456 total deaths in 1945 dropped to 27,405, or a net decrease of 1,051 deaths.
BIRTH RATE. There was an increase of 14.3 percem in the birth rate in 1946. The rate increased from 24.0 in 1945 to 27.4 in 1946. The number of birrhs registered in 1946 was 85,699 as compared with 74,994 in 1945. Some of this increase is probably due to the efficiency of the new system of parent registration.
STILLBIRTHS. The stillbirth rate again slightly declined. The rate decreased from 29.4 in 1945 to 28.3 in 1946 or 4.0 percent.
INFANT MORTALITY. There was a further drop in rhe infam mortality rate in 1946 to 35.8 as compared with 42.4 in 1945. A decrease of 15.6 percent.
MATERNAL MoRTALITY. A decrease of 19.8 percem was shown in maternal mortality when the rate dropped from 3.3 in 1945 to 2.7 in 1946.
CAUSE OF DEATH
TYPHOID FEVER. The number of typhoid fever deaths decreased from 27 in 1945 to 11 in 1946. The rare decreased from 0.9 to 0.4 or 58.8 percent.
TYPHUS FEVER. Typhus fever declined from 59 deaths in 1945 to 33 deaths in 1946. Rate dropped from 1.9 in 1945 to 1.1 in 1946 or 44.1 percent.
MALARIA. Malaria showed a sharp decline-12 deaths in 1946 against 26 deaths in 1945. The rate dropped 54.2 percent.
SMALLPOX. No deaths were recorded for smallpox in 1946. Only one death was recorded in 1945.
DISEASES OF CHILDHOOD. Measles deaths increased from 7 in 1945 to 44 in 1946. Scarlet fever deaths decreased from 5 in 1945 to 1 in 1946. Whooping cough declined from 65 deaths in 1945 to 60 in 1946.
DIPHTHERIA. The number of deaths from this disease decreased from 71 in 1945 to 45 in 1946. The rate decreased from 2.3 in 1945 to 1.4 in 1946 or 36.6 percent.
INFLUENZA. Influenza deaths decreased from 473 deaths in 1945 to 423 in 1946. The rate decreased from 15.1 in 1945 to 13.5 in 1946 or 10.6 percent.
DYSENTERY. The deaths and death rates from this condition show a decrease of 40.1 percent, a rate of 1.2 in 1946 compares with 1.9 in 1945. The number of deaths dropped from 60 in 1945 to 36 in 1946.
POLIOMYELITIS. Deaths from poliomyelitis decreased from 10 in 1945 to 8 in 1946. The rate dropped 21.9 percent.
Information and Stcttistics
301
LETHARGIC ENCEPHALITIS. The deaths and dearh rates from this disease show a decrease of 59.1 percem, a rate of 0.1 in 1946 compares with 0.2 in 1945. The number of deaths dropped from 7 in 1945 to 3 in 1946.
MENINGOCOCCUS MENINGITIS. In 1946 a decrease of 18.2 percem was shown in the death rate from this cause. The number of deaths reported in 1946 was 31 as compared with 38 in 1945.
TUBERCULOSIS, ALL FORMS. A decrease is shown in the death rare from this cause from 35.5 in 1945 to 33.5 in 1946 or a decrease of 5.4 percem. In 1946 the number of deaths reported was 1,048 as compared with 1,108 in 1945.
SYPHILIS. A decrease in the reporred dearh rare from syphilis cominued rhrough 1946. There was a 13.7 percent decrease or a rate of 9.9 in 1946 as compared with 11.5 in 1945. The number of deaths reported in 1945 was 358 against 309 in 1946.
CANCER. A decrease of 0.9 percent is shown in rhe death rate from cancer. The rate decreased from 78.1 in 1945 ro 77.5 in 1946. The number of deaths decreased from 2,441 in 1945 to 2,420 in 1946.
DIABETES MELLITUS. The dearh rare from this disease is slightly on the upward trend. The death rate showed an increase of 12.6 in 1946 over 12.2 in 1945 or 3.9 percent increase. The number of deaths reporred in 1946 was 395 as compared with 380 in 1945.
PELLAGRA. The number of deaths from pellagra decreased from 106 in 1945 to 93 in 1946. The rate of 3.0 in 1946 compared with 3.4 in 1945.
CEREBRAL HEMORRHAGE, EMBOLISM, AND THROMBOSIS. The deaths from this condition decreased 10.1 percent when 2,819 deaths were reported in 1946 as compared wirh 3,137 in 1945. The rare in 1946 being 90.2 compared with 100.4 in 1945.
HEART DISEASE. The leading cause of death in Georgia, as well as the nation, took 5,961 lives in 1946, an increase of 3.1 percent over the 5,779 deaths in 1945. The rare increased from 185.0 in 1945 to 190.8 in 1946.
PNEUMONIA. Very recent years have shown a steady, slight decrease in deaths from pnewnonia which continues on through 1946. The rate dropped from 48.0 in 1945 to 42.9 in 1946. The number of deaths in 1945 was 1,500 as compared wirh 1,341 in 1946.
DIARRHEA AND ENTERITIS (-2 YEARS) The number of dearhs from this condition decreased from 312 in 1945 to 148 in 1946. The rate decreased from 10.0 in 1945 to 4.7 in 1946 or 52.6 percent.
CIRRHOSIS OF LIVER. There was a slighr increase in rhe deaths due to this cause. The number of deaths increased from 157 in 1945 ro 183 in 1946. The rate increased from 5.0 in 1945 to 5.9 in 1946 or 16.5 percent.
APPENDICITIS. Deaths from appendicitis are on the decrease according to reports in 1946. The number of deaths fell from 171 in 1945 to 117 in 1946, a decrease of 31.6 percent.
302
Georgia Department of Pttblic Hectlth
NEPHRITIS. The number of deaths from chis cause decreased from 2,863 in 1945 to 2,576 in 1946. The rate decreased from 91.7 in 1945 to 82.5 in 1946 or 10.0 percent.
MALFORMATION AND EARLY INFANCY DISEASES. Deaths from these causes slightly increased according to reports in 1946. The number of deaths increased from 1,761 in 1945 to 1,859 in 1946. The rate increased from 56.4 in 1945 to 59.5 in 1946 or 5.6 percent.
SUICIDE. The number of suicidal deaths increased from 212 in 1945 to 234 in 1946. The rate increased from 6.8 in 1945 to 7.5 in 1946 or 10.5 percent.
HoMICIDE. There was an increase of 16.3 percent shown in deaths by homicide. The number of deaths reported in 1945 was 485 as compared wich 564 in 1946.
MOTOR-VEHICLE AcciDENTS. There was an increase in the death rate from 22.0 in 1945 to 25.8 in 1946 or 17.3 percent. The number of deaths reported in 1945 was 688 as compared with 807 in 1946.
ALL OTHER AcciDENTS. A slight increase is shown in the number of deaths from other accidents by the rate of 41.9 in 1945 to 42.9 in 1946 or 3.1 percent. The number of deaths reported in 1945 was 1,300 as compated with 1,341 in 1946.
UNKNOWN AND ILL-DEFINED CAUSES. The death rate from ill-defined causes dropped 11.2 percent or from 30.5 in 1945 to 27.1 in 1946. The number of deaths reported in 1945 was 952 as compared with 845 in 1946.
ALL OTHER CAUSES. The crude death rate, or deaths from all other causes decreased 6.6 percent or from 124.6 in 1945 to 116.4 in 1946. The number of deaths decreased from. 3,897 in 1945 to 3,636 in 1946.
Information ctnd Statistics
303
TABLE I
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
WITH THE PERCENT INCREASE OR DECREASE IN THE RATES, IN GEORGIA:
1945 AND 1946
Causa of Death
Number
1946
1945
Rate
1946
1945
Per Cent Increase
or Decrease
ALL CAUSES .....
Typhoid Fever.. .
Typhus fever ... .
Malaria ...... .
Smallpox ..... .
Measles .... .
Scarlet Fever . .
Whooping cough.
Diphtheria..... .
Influenza.... .
Dysentery.... .
Poliomyelitis ....... .
Lethargic encephalitis
Meningococcus meningitis ...
Tuberculosis . ...... .
Syphilis .... .
Gonorrhea
Cancer . . . . .
Diabetes mellitus................ .
Pellagra.............. .
Cerebral hemorrhage, embolism and thrombosis.
Heart diseases . . . . . . . . . . . . . . . . . .
. ......... .
Pneumonia .......... .
Diarrhea and enteritis (-2 yrs.) ..
Appendicitis ...
Cirrhosis of liver . ............. .
Nephritis..... .
lvfalformation and early infancy diseases .....
Suicide... . . . . .. . . . . . . .. . . . . . . . .
. .......... .
Homicide ................ .
Motor-vehicle accidents ..
All other accidents........ .
Unknown and ill-defined causes ..... .
All other causes ....
27,405 11 33 12
44
60 45 423 36
31 1,048
309
2,420 395 93
2,819 5, 961 1,341 148 117 183 2,576 1,859 234 564 807 1,341 845 3,636
28,456 27 59 26 1
65 71 473 60 10
38 1,108
358 5
2,441 380 106
3,137 5, 779 1,500
312 171 157 2,863 1, 761 212 485 688 1,300 952 3,892
LIVE BIRTHS..................................... .
STILLBIRTHS...
. ..................... .
INFANT MORTALITY.............
.. ......... .
MATERNAL MORTALITY....................... ..
85,699 2,421 3,068
229
74,994 2,208 3,181
250
877.3 0.4 1.1 0.4
1.4 0.03 1.9 1.4 13.5 1.2 0.3 0.1 1.0 33.5 9.9 0.1 77.5 12.6 3.0 90.2 190.8 42.9 4. 7 3. 7 5.9 82.5 59.5 7.5 18.1 25.8 42.9 27.1 116.4
911.0 - 3.7
0.9 - 58.8
1.9 - 44.1
0.8 - 54.2
0.03 ...
0.2 +536.4
0.2 - 81.3
2.1 - 7.7
2.3 - 36.6
15.1 - 10.6
1.9 - 40.1
0.3 - 21.9
0.2 - 59.1
1.2 - 18.2
35.5 - 5.4
11.5 - 13.7
0.2 - 62.5
78.1 - 0.9
12.2 + 3.9
3.4 - 12.4
100.4 - 10.1
185.0 + 3.1
48.0 - 10.6
10.0 - 52.6
5.5 - 31.6
5.0 + 16.5
91.7 - 10.0
56.4 + 5.6
6.8 + 10.5
15.5 + 18.5
+ 22.0 + 17.3
41.6
3.1
30.5 - 11.2
124.6 - 6.6
27.4
24.0 + 14.3
28.3
29.4 - !.0
35.8
42.4 - 15.6
2.7
3.3 - 19.8
NOTE: These figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurring in other states.
Rates based on the 1940 Census Enumerated Population.
304
Geo1'gia Depa1'tment of Pttblic Hectlth
TABLE 2
DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS AND STILL-
BIRTHS WITH RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1946
lniant
Year
Mortality
1920 . . . . . . . . . . . . . . . . 1921 ................
1922 . . . . . . . . . . . . . . . . 1923 ................ 1924 . . . . . . . . . . . . . . . . 1925 . . . . . . . . . . . . . . . . 1926 ................ 1927 ................
1928 ................ 1929 ................ 1930 . . . . . . . . . . . . . . . . 1931. ............... 1932 ................ 1933 ................ 1934 . . . . . . . . . . . . . . . .
1935 ................ 1936 ................ 1937 ................ 1938 ................ 1939 ................ 1940 . . . . . . . . . . . . . . . .
1941 ................ 1942 . . . . . . . . . . . . . . . . 1943 ................ 194<1 . . . . . . . . 1945 . . . . . . . . . 1946 . . .
5,305 4,905 <1,937
5,384 5,674
4,704 4,405 4,578 4,875 4,464 4, 713 4,231
4,097 4,079 5,086 4,316 4,319 3,968 4,352
3,817 3,737 3,955 3,559 3, 61)1
3,393 3,181
3,068
Number Maternal Mortality
558 568 658 573 708 641 485 578 622 549 658 616 620 163 505 458 491 <171 <121 356 342 315 299 303 271) 250 229
Stillbirths
3,389 3,820 3,862 3,958 3,864 3,455 2,972 3,836 3,478 3,541 3, 796 3,678 3,847 3, 700 4,120 3,987 3,666 3,677 3,390 3,228 3,078 2,903 2,786 2,664 2,523 2,208 2,421
Infant Mortality
88.3 73.9 75.9 84.5 89.5 78.9 87.2 73.5 80.9 76.3 78.1 63.5 64.3 61.2 78.7 68.2 70.1 62.0 67.7 58.8 57.8 53.3 <19.3 1il.7 44.1 42.4 35.8
Rate Maternal Mortality
9.3 8. 6 10.1 9.0 11.2 10.8 9.6 9.3 10.3 9.4 10.9 10.0 9.7 7.6 7.8 7.2 8.0 7.'1 6.5 5.5 5.3 4.6 4.1 3.9 3.6 3.3 2.7
Stillbirths
56.4 57.5 59.3 62.2 61.0 58.0 58.9 61.6 57.7 60.5 62.9 59.5 60.4 60.9 63.8 63.0 59.5 57.4 52.7 49.7 47.6 <12.8 3S. 6 31.0 32.8 29.4 28.3
TABLE 3
BIRTHS AND DEATHS (EXCLUSIVE OF STILLBIRTHS) WITH RATES PER
1,000 POPULATION AND BIRTHS PER 100 DEATHS, IN GEORGIA: 1920-1946
Number
Year
Births
1920 . . .
1921
1922 . . .
1923 ... . ..........
1924.
1925. ..............
1926
1927 .. 1928.
1929 . ...............
1930 1931
.
..
.............................
1932 ... .............
1933.
1934. 1935 .
...
1936 . .
. .....
......................... ..............
1937 .. ................
1938.. ... 1939 ..... 1940 . . .
.......................... .............
1941 ..... .............
19<12..... .............
1943 ..... 1944 . . .
1945 . . . . . . . .
1946 ....
60,061 66,378 1)5,082
63,681 63,386 59,610 50,493 62,246
60,259 58,521 60,318 61,774 63,690 60, 74<1
64,615 63,290 61,617 64,012 64,307 64,910 64,695
67' 785 72,189 78,327
77,018 74,994 85,699
Deaths
32,243 29,552 31,714 34,082 34,797 31,278 29,906 31,869 36,085 35,340 35,188 32,989 32,122 31,184 35,590 34,313 37,293 34,411 33,617 31,856 32,285 31,579 28,807 29,488 28,803 28,456 27,405
Rate Birth3
20.7 22.9 22.5 22.0 21.8 20.5 17.4 21.4 20.7 20.1 20.7 21.0 21.5 20.4 21.5 20.9 20.2 20.8 20.7 20.8 20.7 21.6 23.1 25.1 24.7 24.0 27.4
Deaths
11.1 10.2 10.9 11.8 12.0 10.8 10.3 11.0 12.4 12.2 12.1 11.2 10.8 10.5 11.8 11.3 12.2 11.2 10.8 10.2 10.3 10.0
9.2 9.4 9.2 9.1 8.8
Births Par 100 Deaths
181) 225 205 187 182 191 169 195 167 166 171 187 198 195 182 184 165 186 191 204 200 215 251 266 267 264 313
lnformcttion and Stcttistics
305
TABLE4
DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS, ILLEGITIMATE BIRTHS (EXCLUSIVE OF STILLBIRTHS) AND STILLBIRTHS WITH RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1946
INFANT MORTALITY
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1913 1944 1915 1916
NUMBER
Total White Col.
5305 4905 4937 5384 5674 4704 4405
4578 4875 4464 4713
4234 4097 4079 5086 4316 4319 3968 4352 3817
3737 3955 3559 3661 3398 3181 3068
2961 2606 2509 2938.
2989 2486 2299 2334
2574 2343 2468 2137 2122 2119 2628 2227 211<! 2014 2267
1960 1851
1988 1756 1911 1761 1728 1694
2344 2299 2428 2446 2685 2218 2106 2244 2301 2121
2245 2097 1975 1960 2458 2089 2205 1954
2085 1857 1886 1967 1803 1750 1637 1453
1374
Total
88.3 73.9 75.9 84.5 89.5 78.9 87.2 73.5 80.9 76.3 78.1 68.5 64.3 67.2 78.7 68.2 70.1 62.0 67.7 58.8 57.8 58.3 49.3 46.7 <14.1 42.4 35.8
RATE
White Col.
71.1
58.5 59.1 58.4 72.2 65.0 71.3 59.4 67.5
65.5 66.6 56.9 55.5 59.4 68.6 59.6 58.2 52.7
58.7 50.4 47.6 48.2 38.9 38.1
35.6 36.4 30.1
127.1 105.3 107.4
108.3 122.0 103.9 115.3
97.7 104.0 93.1
96.5 86.5 77.5 78.2 93.5 80.5 87.2 75.6
81.1 71.5 73.1
74.2 66.8 62.1 59.4
52.7 46.8
MATERNAL MORTALITY
NUMBER
Total White Col.
558
267 291
568
266 302
658
316 342
573
288 285
708
362 346
641
299 342
485
222 263
578
291 287
622
312 310
549
284 265
658
361 297
616
322 294
620
310 310
463
227 236
505
262 243
458
230 228
491
251 240
471
210 231
121
198 223
356
175 181
342
1<!6 196
315
133 182
299
1<!6 153
303
150 153
276
122 154
250
102 148
229
85 144
RATE
Total White Col.
9.3 6.4 15.8 8.6 6.0 13.8 10.1 7.4 15.1 9.0 7.0 12.6 11.2 8.7 15.7 10.8 7.8 16.0 9.6 6.9 14.4 9.3 7.4 12.5 10.3 8.2 14.0 9.4 7.9 11.6 10.9 9.7 12.8 10.0 8. 6 12.1 9. 7 8.1 12.2 7.6 6.4 9.4 7.8 6.8 9.2 7.2 6.2 8.8 8.0 6.9 9.5 7.'1 6.3 8.9 6.5 5.1 8.7 5.5 4.5 7.0 5.3 3.8 7.6 1.6 3.2 6.9 4.1 3.2 5.7 3.9 3.0 5.4 3.6 2.5 5.6 3.3 2.2 5.4 2.7 1.5 4.9
ILLEGITIMATE BIRTHS
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 1945 1946
NUMBER
Total
2695 3077 3606 4045 4089 4014 3155 4089 3868 1061 4141 4429 5125 5101 5089 5031 4878 4739 4724 4960 5046 5131 5038 4911 4885 5385 5292
White Col.
474 2221 516 2561 500 3106 543 3502 57<1 3515 534 3480 461 2694 637 3452 !82 3386 515 3546 512 3629 547 3882 600 4525 582 4519 651 4!38 643 4388 598 1280 526 4213 580 4H4 596 !364 565 4481 607 4527 578 4460 537 4374 592 1293 721 4664 683 4609
Total
44.9 46.4 55.4 63.5 64.5 67.3 62.5 65.7 64.2 69.4 68.7 71.7 80.5 84.0 78.8 79.5 79.2 74.0 73.5 76.4 78.0 75:7 69.8 62.7 63.4 71.8 61.8
RATE
White Col.
11.4 11.6
11.8 13.2
13.9 14.0 14.3 16.2 12.6
1!.4 13.8 14.6 15.7 16.3 17.0 17.2
16.5 13.8 15.0 15.3 14.5
1!. 7 12.8 10.7 12.0 15.2 12.1
120.4 117.4 137.4
155.0 159.7 163.0 147.5 150.3 153.0
155.7 156.1 160.1 177.6 180.4 168.9 169.1
169.2 163.1 161.3 167.9 173.8 170.8
165.2 155.2 155.8 169.2 157.1
STILLBIRl HS
Total
3389 3820 3862 3958 3864 3455 2972 3836 3478 3541 3796 3678 3847 3700 4120 3987 3666 3677 3390 3228 3078 2903 2786 2664 2523 2208 2421
NUMBER
White Col.
1608 1720 1716 1802 1675 1435 1246
1604 1335 1374 J.J54 142<!
H92 1382 1673 1532 H57
H99 1386 1337 1326 1276 1268 1238
1137 1036 1161
1781
2100 2H6 2156 2189 2020 1726
2232 2143 2167 2312 2254
2355 2318 2447 2455 2209
2178 2004 1891 1752 1627
1518 1426
1386 1172 1260
RATE
Total
56.4 57.5 59.3 62.2 61.0 58.0 58.9 61.6 57.7 60.5 62.9 59.5 60.4 60.9 63.8 63.0 59.5 57.4 52.7 49.7 47.6 !2.8 38.6 31.0 32.8 29.4 28.3
White Col.
38.6 38.6
40.4 43.9 40.5 37.5 38.7 40.8
35.0 38.4 39.2 37.9
39.0 38.7 43.6 <!1.0 !0.1
39.3 35.9 34.3 34.1
30.9 28.1
24.7 23.0 21.8 20.6
96.6 96.2 94.9 95.4 99.5 94,6
94.5 97.2 96.6 95:2
100.7 93.0 92.4 92.5 93.1 94.6
87.3 84.3 78.0
72.8 67.9 61.4 56.2 50.6
50.3 42.5 42.9
306
Georgict Department of Pttblic Health
TABLE /1-Continued
DEATHS AND BIRTHS (EXCLUSIVE OF STILLBIRTHS) AND RATES PER
1,000 POPULATION, IN GEORGIA: 1920-1946
BIRTHS
NUMBER
RATE
Year Total White Col. Total White Col.
1920 1921 1922
1923 1924
1925 1926 1927 1928 1929 1930 1931 1932 1933 1934
1935 1936 1937 1938 1939 1940 1941 1942
1943 1944 1945 1946
60061 66378 65082 636S1 63386 59610 50493 62246 60259 58521 60318 6177!
63690 60744 64615 63290 61617 64012 64307 64910 6<!695
67785 72189 73327 77018
74994 85699
41618
44555 !2475 41088 41379 38254 32226 39231 38135 35751 37064 37531
38209 35692 38333 37345 36320 38181 38613 38923 38911 41277
45192 50149 49464 47422
56354
18443 21823
22607 22593 22007 21356 18267
22965 22124 22770 23254 24243 25481 25052 26282 25945 25297 25831 25694 25987
25784 26.108 26997 28178
27554 27572 29345
20.7 22.9 22.5 22.0 21.8 20.5 17.4 21.4 20.7 20.1 20.7 21.0 21.5 20.4 21.5
20.9 20.2 20.8 20.7 20.8 20.7 21.6 23.1
25.1 24.7 24.0 27.4
2<1.5
26.0 24.6 23.6 23.6 21.6 18.1 21.9 21.0 19.6 20.1 20.4
20A 18.8 20.1 19.4
13.7 19.4 19.5 19.5 19.1 20.1 22.2 24.6
24.3 23.3 27.6
15.4
18.4 19.3 19.5 19.2 18.8 16.3 20.7 20.2 21.1 21.7 22.5
2~.5
23.0 2<!.0
23.6 22.9 23.2 23.0
23.1 23.8 24.4 24.9 26.0 25.4 25.4
27.0
DEATHS
NUMBER
RATE
Total White Col. Total White Col.
32243 29552 31714 34082 34797 31278
29906 31869 36085 35340 35188 32989 32122 31184 35590 34313 37293 34411 33617 31856 32285
31579
28807 29488 28803
28456 27405
17212 15439 16540 17763 17750
15860 15141 16230 186<!2 18245 18036 17012 16813 16847 19157 18677
20156 18403 18109 17<!86 17313 16717 15820
16414 16118 111310 16160
15031 14113 15174
16319 17047 15418 14765 15639 174<13 17095 17152 15977 15309 14337 16433 15636 17137 15918 15508 14370 14972 1481)2
12987 13074 12685 12146
11245
11.1 10.2
10.9 11.8 12.0 10.8 10.3 11.0 12A 12.2 12.1 11.2 10.8 10.5 1!.8 11.3 12.2 11.2 10.8
10.2 10.3 10.0 9.2 9.4
9.2 9.1
8.8
10.1 9.0 9.6 10.2 10.1
9.0 8.5 9.0
10.3 10.0 9.8 0.2
9.0
8.9 10.0 0. 7 lOA 9.4 9.1 8. 7 8.5 8.1 7.8 8.1
7.9 8.0 7.9
12.5 11.9 12.9 14.1 14.9 13.6 13.2 14.1 15.9
15.8 16.0
14.8 14.1 13.2
15.0 14.2
15.5 14.3 13.9 12.8 n.8 13.7
12.0 12.0 11.7 11.2 10.4
TYPHOID
NUMBER
RATE
Year Total White Col. Total White Col.
1920 549 274 275 19.0 16.2 22.9
1921 798 351 447 27.5 20.5 37.7
1022 714 326 388 24.6 18.9 33.1
1923 601 244 357 20.7 14.0 30.8
1924 681 292 339 23.5 16.7 33.9
1925 675 264 411 23.3 14.9 36.2
1926 519 181 328 17.9 10.7 29.3
1927 653 285 368 22.5 15.9 33.2
1928 444 182 262 15.3 10.0 23.9
1929 340 140 200 11.7 7.7 18.5
1930 500 207 293 17.2 11.2 27.3
1931 513 201 312 17.5 10.8 28.9
1932 363 133 230 12.3 7.1 21.2
1933 251 105 146
8.4 5.5 13.4
1934 316 110 206 10.5 5.8 18.8
1935 261 100 161
8. 6 5.2 14.6
1936 195
68 127
6.4 3.5 11.5
1937 139
54
85
4.5 2. 7 7.6
1938 121
51
70
3.9 2.6 6.2
1939 83
38
45
2. 7 1.9 4.0
1940 68
27
41
2.2 1.3 3.8
1941 55
22
33
1.7 1.1 3.0
1942 24
6
18
0.8 0.3 1.7
1943 23
8
15
0. 7 0.4 1.4
1944 24
9
15
0.8 0.4 1.4
1945 27
11
16
0.9 0.5 1.5
1946 11
6
5
0.4 0.3 0.5
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 1.2
63
45
18
2.0 2.2 1.7
59
46
13
1.9 2.3 1.2
33
25
8
1.1 1.2 0.7
Information rtnd Strttistics
307
TABLE 4-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1946
MALARIA
NUMBER
RATE
Year Total White Col. To tar White Col.
1920 559 242 317 19.3 1'1.3 26.4
1921 468 195 273 16.2 11..4 23.0
1922 584 256 328 20.2 14.8 27.9
1923 489 201 288 16.9 11.6 2'1.8
1924 440 181 259 15.2 10.3 22.6
1925 285 102 183
9.8 5.8 16.1
1926 288 107 181
9.9 6.0 16.2
1927 296 113 183 10.2 6.3 16.5
1928 582 253 329 20.0 14.0 30.1
1929 677 322 355 23.3 17.6 32.8
1930 442 186 256 15.2 10.1 23. o
1931 307 119 188 10.5 6.5 17.4
1932 316 136 180 10.7 7.2 16.6
1933 364 193 171 12.2 10.2 15.7
1934 418 212 206 13.9 11.1 18.8
1935 387 186 211 12.8 9.1 19.2
1936 606 321 285 19.8 16.5 25.7
1937 235 113 122
7.6 5.8 11.0
1938 146
63
83
4.7 3.2 7.4
1939 101
40
61
3.2 2.0 5A
1940 89
35
54
2.8 1.7 5.0
1941 75
29
46
2.4 1.'1 '1.2
1942 70
24
52
2.4 1.2 4.8
1943 37
15
22
1.2 0.7 2.0
1944 34
12
22
1.1 0.6 2.0
1945 26
12
14
0.8 0.6 1.3
1946 12
6
6
0.4 0.3 0. 6
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 !9.0 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.'!
31
26
5
1.1 1.4 0.5
128
g,!
3,1
4.4 5.1 3.2
62
37
25
2.1 2.0 2.3
15
6
9
0.5 0.3 0.8
72
50
22
2.4 2. 6 2.0
540
401 139 18.0 21.0 12.7
25
15
10
0.8 0.8 0.9
8
5
3
0.3 0.3 0.3
10
8
2
0.3 0.4 0.2
157
118
39
5.1 6.0 3.5
51
21!
27
1.0 1.2 2.4
23
14
9
0. 7 0. 7 0.8
157
94
63
5.0 4.6 5.8
GO
23
37
1.9 1.1 3.4
27
20
7
0.9 1.0 0.6
08
,10
19
2.2 2.4 1.8
7
3
4
0.2 0.1 0.4
4,1
20
2'1
1.4 1.0 2.2
SCARLET FEVER
NUMBER
RATE
Year Total White Col. Total White Col.
1920 32
31
1
1021 28
25
3
1922 24
20
4
1923 20
17
3
1924 20
16
'1
1925 11
8
3
1926 13
12
1
1927 25
20
5
1928 36
29
7
1929 10
33
7
1930 38
33
5
1931 46
38
8
1932 19
17
2
1933 19 193,1 17
19 16
'j
1935 23
21
2
1936 14
11
3
1937 11
10
1
1938 13
11
2
1939 10
16
3
1940 16
15
1
1911 9
8
1
1942 2 1943 6
2 5
.i
1944 2
1
1
1945 5
4
1
1946 1
1
1.1 1.8 0.1
1.0 1.5 0.3
0.8 1.2 0.3
0.7 1.0 0.3
0.7 0.9 0.4
0.4 0.5 0.3
0.5 0. 7 0.1
0. 9 1.1 0.5
1.2 1.6 0. 6
1.4 1.8 0. 6
1.3 1.8 0.5
1.6 2.0 0.7
0. 6 0.9 0.2
0.6 0.6
1.0 0.8
o:i
0.8 1.1 0.2
0.5 0.6 0.3
0.4 0.5 0.1
OA 0.6 0.2
0.6 0.8 0.3
0.5 0. 7 0.1
0.3 0.4 0.1
0.1 0.1
0.2 0. 2 0.1
0.1 0.0 0.1
0.2 0.2 0.1
0.03 0.04
Total
373 183 130 254 435 313 141 229 163 280 257 113 112 223 33,1 149
67 142 225 134 108 140 101 170 65
65 60
WHOOPING COUGH
NUMBER
RATE
White Col. Total White Col.
240 133 12.9 ,,1.2 11.1
93
90
6.3 5.4 7.6
51
79
4.5 3.0 6. 7
116 138
8.8 G. 7 11.9
203 232 15.0 11.0 20.2
167 146 10.8 9:4 12.9
74
67
4.9 4.2 6.0
118 111
7. 9 G. 6 10.0
99
6,1
5.6 5.5 5. 9
171 109
9. 6 9.'1 10.1
121 136
8.8 6.6 12.7
59
54
3.8 3.2 .5.0
52
GO
3.8 2.8 5.5
116 107
7.5 6.1 9.8
169 165 11.1 8.8 15.1
77
72
'!.9 'J.O 6.5
30
37
2.2 1.5 3.3
75
07
'1. 6 3.3 6.0
112 113
7.3 5.7 10.1
01
73
'!.3 3.1 6.5
52
56
3.5 2.6 5.2
69
71
4.5 3.4 6.5
35
66
3.2 1.7 6.1
76
94
5.4 3. 7 8. 7
25
40
2.1 1.2 3. 7
44
21
2.1 2.2 1.9
28
32
1.9 1.4 2.9
308
Georgitt Depttrtment of Pttblic Health
TABLE !!-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1946
DIPHTHERIA
NUMBER
RATE
Year Total White Col. Total White Col.
1920 401 283 118 13.8 16.7 9.8
1921 415 291 121 14.3 17.2 10.2
1022 411 277 131 11.2 16.1 11.'1
1923 271 100
75
0.5 11.4 6.5
1924 230 167
63
7.0 0.5 5.5
1025 185 110
66
6.'1 6. 7 5.8
1926 251
199
52
8.6 11.2 4.6
1927 272 187
85
9.4 IDA 7. 7
1928 240 177
63
8.3 0.8 5.8
1929 183 139
14
6.3 7.6 1.1
1930 135 102
33
1.6 5.5 3.1
1931 158 122
36
5A 6.6 3.3
1932 160 130
30
5. 7 7A 2.8
1033 187 152
35
6.3 8.0 3.2
1934 188 152
36
6.3 8.0 3.3
1935 161 116
45
5.3 6.0 4.1
1036 123
83
40
4.0 4.3 3.6
1937 108
66
42
3.5 3A 3.8
1938 106
H
32
3A 3. 7 2.9
1930 95
65
30
3.0 3.3 2.7
19!0 59
4!
15
1.9 2.2 !A
1941 63
36
27
2.0 1.7 2.5
!942 55
!2
13
1.8 2.1 1.2
19!3 47
32
15
1.5 1.6 1.4
19<14 JO
3!
6
1.3 1.7 0.6
1945 71
51
20
2.3 2.5 1.8
1916 45
32
13
lA 1.6 1.2
INFLUENZA
NUMBER
RATE
Total White Col. Total White Col.
2581 278 1014
1500 886 1384 H93 971 20!1 2543 96! 1301 1170 1237 1009 1357 1842 1436 802
950 924 994 !82 624
742 !73
!23
1516 150 615 880 512 773 800 !80 1204 1<150 532 703 60! 60! 563 781 1058 739 393 !95 503 433 200 319 342
206 101
1055 119 300 620 371 611 693 491 837 1093 !32 598 !76 543 !46 576 78! 697 409 !55 421 511 282 305 400 267 232
89.1 9.6
35.0 51.7 30.5 47.7
51 A
33.! 70.2 87.5 33.1 J4.3
39.5 41.5
33.6 44.8 60.3 !6.7
25.9 30.4 29.6 31.6 15.4 20.0 23.8 15.1 13.5
89.1 0.3 35.7 50.6 29.2 13. 7 44.9 26.7 66.5 79.4 28.9 37.8 37.0 36.6 29.5 40.5 54.4 37.6 19.8 24.8 24.7 23.5 9.8 15.7 16.8 10.1 9.!
88.7
10.0 34.0 53.'! 32.6 53.9 61.8 41.3 76.5 101.1
!0.3
55 A
43.0 !0.8 40.7 52.3 70.8 62.6 36.6 !0.5 38.8 47.0 26.0 28.1 36.9 24.6 21.4
DYSENTERY
NUMBER
RATE
Year Total White Col. Total White Col.
1920 170 116
54
5.9 6.8 4.5
1921 H6
88
58
5.0 5.1 LD
1022 112
60
43
3.0 4.0 3. 7
1923 151
90
61
5.2 5.2 5.3
1924 187 104
83
6.5 5.9 7.2
1925 194 119
75
6.7 6. 7 6.6
1926 207 129
78
7.1 7.2 7.0
1927 277 172 105
9.5 9.6 9.5
1928 30!
189
115
10.5 lOA 10.5
1929 204
90 105
7.0 5A 9. 7
1930 305
158
1<17
10.5
8.6 13.7
1931 177
86
91
6.0 J. 6 SA
1932 lll
85
56
4.R 4.5 5.2
1933 153
86
67
5.1 4.5 6.1
1934 219 123
96
7.3 6A 8.8
1935 163
8fi
77
5.] !.5 7.0
1936 156
78
78
5.1 J.O 7.0
1937 130
67
(i3
4.2 3.! 5.7
1938 192 107
85
6.2 5A 7.6
1939 127
65
62
4.1 3.3 5.5
1940 126
57
59
4.0 3.3 5.4
1941 109
52
57
3.5 2.5 5.2
19!2 86
,!3
43
2.8 2.1 4.0
19!3 79
42
37
2.5 2.1 3.4
1944 63
2!
30
2.0 1.2 3.6
1945 60
28
32
1.9 l.'l 2.9
1946 36
19
17
1.2 0.9 1.6
TUBERCULOSIS (ALL FORMS)
NUMBER
RATE
Total White Col. Total White Col.
2362 882 1480 81.6 52.0 123.3
2531 802 1639 87A 52.1 138.1
2683
991
1692 92.6 51 A 144.2
2642 965 1677 91.1 55.5 1<14.5
2620 017 1703 00.3 52.3 H8.4
24<18 872 1576 84.4 !9.3 139.0
2278 807 1471 78.5 45.3 131.2
2307 798 1509 79.4 44.4 136.2
2375 832 1543 81.7 45.9 HI.O
2100 742 H48 75.3 !0.6 133.9
2175
774
HOI 7<1.6 42.0 130.6
2165 700 H65 73.7 37.7 135.8
1933 665 1268 65.3 35.4 116.9
1777 675 1102 50.6 35.6 101.1
1772 (i05 1167 58.9 31.7 106.5
1731 6!9 1082 67.1 33.6 98.2
1713 6!8 1065 56.1 33.3 96.2
15!9 559
990 50.3 28.5 89.0
1612 602 1010 52.0 30.4 90.3
1533 5!3
990 !9.1 27.2 88.1
1533 54!
989 49.1 26.7 91.2
1385 501
881 44.0 2!.3 81.3
1265 !65
800 40.5 22.8 73.7
1304 !99
805 41.7 24.5 7<!.2
1107 JlS
689 35.4 20.5 63.5
1108 434
674 35.5 21.3 62.1
10!8 467
581 33.5 22.9 53.5
Information and Statistics
309
TABLE 4-Cominued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1946
SYPHILIS
NUMBER
RATE
Year Total White Col. Total White Col.
1920 204
34 170
7.0 2.0 14.2
1921 296
56 240 10.2 3.3 20.2
1922 421
70
351
H.5 4.1
29.9
1923 371
73 298 12.8 <1.2 25.7
1924 425
81
344
14.7 4. 7
30.0
1925 454
72 382 16.6 <J. 1 33.7
1926 409
59 350 14.1 3.3 31.2
1927 <!57
65 392 15.7 3.6 35.'1
1928 494 100 39<1 17.0 5.5 36.0
1929 461
82 379 15.9 4.5 35.0
1930 <129
77 352 H.7 4.2 32.8
1931 413
54
359
1<1.1 2.9
33.2
1932 425
73 352 14.'1 3.9 32.5
1933 391
57 334 13.1 3.0 30.6
1934 <144
87 357 14.8 4. 6 32.6
1935 403
85 318 13.3 4.'! 28.9
1936 444
77 367 14.5 4.0 33.2
1937 496
96 400 16.1 4.9 35.9
1938 478
77
401
15.4 3.9
35.9
1939 473
61
412
15.1 3.1
36.7
1940 587 127 460 18.8 6.2 42.4
1941 503 110 393 16.0 5.3 36.2
1942 462
97 365 H.S 4.8 33.6
1943 435
102
333
13.9 5.0
30.7
1944 372
98 274 11.9 4.8 25.2
1945 358
76 282 11.5 3. 7 26.0
1946 309
59 250
9.9 2.9 23.0
CANCER
NUMBER
RATE
Total White Col. Total White Col.
1124 1210 1212
1263 1393 1311 1257 1470 1510 1456 1552 1580 1531
1647 1762 1715 1751 1797 1929 2003 1959 2139 2120
2097 2256 2441 2420
766 358 803 407 782 430 870 393 913 480 891 420 860 397 995 475 1013 497 988 468 1105 4<17 1106 474 1052 479 1213 434 1272 190 1239 476 1239 512 1320 477 1343 586 1426 577 1380 579 1473 666 1509 611 1547 550 1616 640 1735 706 1731 689
38.8 41.8 41.8 43.6 48.0 45.2 43.3 50.6
52.0 50.1
53.3 53.8 51.7 55.2 58.6 56.6 57.3 53 A 62.2 64.1
62.7 68.0 67.9 67.1 72.2
78.1 77.5
<15.2
46.9 45.3 50.0 52.1 50.4 48.2 55.4 55.9 54.1
60.0 59.5 56.1 64.0 66.5 64.2 63.7 67.2 67.8 71.3
67.7 71.6 74.0 75.9 79.3 85.1 8<1.9
29.8 34.3 36.6 33.9 <11.8
37.0 35.4 <12.9 <15.4
<13.3
41.7 43.9 44.2 39.8 44.7 43.2 46.3 42.9 52.4 51.3 53.4
61.3 56.3 50.7 59.0 65.0 63.5
DIABETES MELLITUS
NUMBER
RATE
Year Total White Col. Total White Col.
1920 182 139
<13
6.3 8.2 3.6
1921 202 144
58
7.0 8.4 4. 9
1922 255 182
73
8.8 10.6 6.2
1923 249 182
67
8.6 10.5 5.8
1924 247 161
86
8.5 9.2 7.5
1925 234 174
60
8.1 9.8 5.3
1926 223
138
85
7. 7 7.7 7.6
1927 259 177
82
8.9 9. 9 7.4
1928 329
227
102
11.3 12.5
9.3
1929 302
201
101
10.4 11.0
9.3
1930 352
240
112
12.1 13.0 10.4
1931 322 224
98
11.0 12.1
9.1
1932 343 260
83 11.6 13.9 7. 7
1933 349
241
108
11.7 12.7
9.9
1934 389 275 114 12.9 14.4 10.4
1935 388 297
91
12.8 15.'1
8.3
1936 391
299
92 12.8 15.'! 8.3
1937 392
281
111
12.7 14.3 10.0
1938 420
311
109
13.5 15.7
9. 7
1939 368 247 121 11.8 12.4 10.8
19<10 349 258
91 11.2 12.7 SA
1941 376 278
98 12.0 13.5 9.0
1942 370 275
95 11.8 13.5 8.8
1943 430 325 105 13.8 15.9 9. 7
1944 375 249 126 12.0 12.2 11.6
1945 380 289
91
12.2 14.2
8.4
1946 395
281
111
12.6 13.8 10.5
PELLAGRA
NUMBER
RATE
Total White Col. Total White Col.
432
210 222 14.9 12.4 18.5
512
234 278 17.7 13.7 23.4
527
249 278 18.2 14.'1 23.7
4<1<1
227 217 15.3 13.1 18.7
337
181
156
11.6 10.3 13.6
366
181
185
12.6 10.2 16.3
425
225 200 H.6 12.6 17.8
617
292 325 21.2 16.3 29.3
846
358 488 29.1 19.8 44.6
871
334 537 30.0 18.3 49.7
713
255 458 24.5 13.8 42.7
563
192 371 19.2 10.3 3<1.4
492
205 287 16.6 10.9 26.5
421
179
242
H.1
9.5 22.2
351
163 188 11.7 8.5 17.2
365
190 175 12.0 9.9 15.9
391
18<1 207 12.8 9.5 18.7
370
175 195 12.0 8.9 17.5
365
170 195 11.8 8.6 11A
271
134 137
8.7 6. 7 12.2
235
118 117
7.5 5.8 10.8
204
106
98
6.5
5.1
9.0
181
104
77
5.8
5.1
7.1
175
89
86
5.6 4.4 7.9
131
74
57
4.2 3.6 5.3
106
77
29
3.4
3.8
2.7
93
67
26
3.0 3.3 2.4
310
Georgict Depctrtment of Pttblic 1-lectlth
TABLE 4-Cominued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1946
CEREBRAL HEMORRHAGE
NUMBER
RATE
Year Total White Col. Total White Col.
1920 1921 1922 1923 1924
1925 1926 1927
1928 1929
1930 1931
1932 1933
1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946
1336 1449 1563 1724
1766 1995
2006 2171 2394 2299 2523 2340 2382 2159 2310 2,110
2638 2636
2727 3048 3035 3033 2873 2945 2974 3137'
2819
807 839 887 1002
963 1044
1078 1195 1297 1257 1317 1256 1269 1195 1222 1337 1425 1444 1465 1598
1574 1513
1538 1469 1523 1655 1523
529 610
676 722 803 951 928
976 1097 1042
1206 1084 1113
964 1088 1073 1213 1192 1262 1450 1461 1520 1335 1476
1451 1482 1296
46.1 50.0 53.9 59.5 60.9 68.7 69.1 74.7 82.4 79.1 86.6 79.7 80.5 72.4 76.8 79.5 86.4
85.7 R8.0
97.6 97.2 96.4 92.0 94.3 95.2 100.4 90.2
47.6 49.0 51.'1 57.6 54.9 59.0 60.5 66.5 71.6 68.8 71.5 67.6 67.6 63.1 03.9 69.3 73.2
73.5 73.9
79.9 77.2 73.5 75.5 72.1 7<!.7 81.2 74.7
44.1 51 A 57.6 62.2 70.0 83.9 82.8 88.1 100.2 96.3 112.'1 100.5 102.6 88.4 99.3 97.4 109.6 107.1 112.8
129.0 134.6 139.9 123.0 136.0 133.7 136.5 119.4
HEART DISEASE
NUMBER
RATE
Total White Col. Total White Col.
1892
1768 1996 2388 2424 2297 2429 2929 3307 3691
4099 3948 4102 3993 5019
5071 5606 5284 5246 5<117 6176 5780 5251 5775
5678 5779 5961
1053 923 1953 1186 1165 1077 1198 1497 1717 1923 2109 2101
2308 2360 2901 2961
3270 3132 3059 3240 3662 3316 3165 3662 3620 3805
3927
839 845 943 1202 1259 1220 1231 1432 1590 1768 1990 1847 1794 1633 2118 2110 2336 2152
2187 2177 2514 2464 2086 2113 2058 1974 203,!
65.3
61.0 68.9 82.3 83.5 79.1 83.7 100.9
113.8 126.9 140.6 134.4 138.6 133.8 166.9 167.3 183.6 171.7 169.2 173.5 197.7
183.8 168.1 18,!. 9
181.8 185.0 190.8
62.1 69.9 54.0 71.2 61.0 80.3 68.2 103.6 66.4 109.7 60.9 107.6 67.2 109.8 83.3 129.3 94.8 145.3 105.3 163.5 114.5 185.4 113.0 171.2 123.0 165.5 124.6 149.8 151.8 193.3 153.5 191.6 168.0 211.0 159.5 193.4 154.4 195.6 162.1 193.7 179.6 231.7 161.1 226.7 155.3 192.2 179.7 194.7 177.6 189.6 186.7 181.9 192.7 187.4
PNEUMONIA
NUMBER
RATE
Year Total White Col. Total White Col.
1920 1921 1922
1923 1924 1925 1926 1927 1928 1929 1930 1931
1932 1933 1934 1935 1936
1937 1938 1939 1940 1941 1942 1943
1944 1945 1946
2766 1925 2664
3199 2922 2335 2442 2132 2776 2316 2580 2465 2444
2314 3030 3035 3803 3077
2731 2299 2055 1714 1612 1734 1581
1500 1341
1470 1050 1447 1596 1382
1135 1180 1015 1441 1165 1240 1255 1204
1172 1580 1572 2012 1490 1321 1209
1019 800 737
796 747 713
684
1296
875 1217 1603 15<10
1200 1262 1117
1335 1151 1340 1210 1240 1142 1450
1463 1791 1587 1410 1090 1036
914 875 938 834 787 657
95.5 66.4 91.9
110.3 100.7 80.5 84.1 73.4 95.5 79.6
88.5 83.9 82.5
77.6 100.8 100.2 124.6 100.0 88.1
73.6 65.8 54.5 51.6 55.5 50.6 48.0 42.9
86.7 61.4 83.9 91.8 78.8
0'!.2 66.2
56.5 79.5 63.8 67.4 67.5 64.1 61.9 82.7
81.5 103.4 75.9 66.7
60.5 50.0 38.9 36.2 39.1 36.6
35.0 33.6
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
95.5 84.1
80.6 86.4 76.8 72.5 60.5
DIARRHEA AND ENTERITIS (UNDER 2 YEARS)
NUMBER
RATE
Total White Col. Total White Col.
1252 759 493 43.2 44.7 41.1
1230 722 508 42.5 42.2 42.8
1175 686 489 40.5 39.8 41.7
1183 698 485 40.8 40.1 41.8
1322 736 586 45.6 42.0 51.1
949 510 439 32.7 28.8 38.7
873 462 411 30.1 25.9 36.7
810 440 370 27.9 24.5 33.4
730 434 296 25.1 24.0 27.0
526 292 234 18.1 16.0 21.6
721 453 268 24.7 24.6 25.0
545 291 254 18.6 15.7 23.5
390 254 136 13.2 13.5 12.5
493 324 169 16.5 17.1 15.5
651 378 273 21.7 19.8 24.9
507 308 199 16.7 16.0 18.1
549 303 246 18.0 15.6 22.2
480 247 233 15.6 12.6 20.9
691 385 306 22.3 19.4 27.4
416 217 199 13.3 10.9 17.7
395 215 180 12.6 10.6 16.6
435 218 217 13.8 10.6 20.0
284 138 146
9.1 6.8 13.5
292 132 160
9.3 6.5 14.7
340 172 168 10.9 8.4 15.5
312 159 153 10.0 7.8 14.1
148
58
90
4.7 2.8 8.3
Information and Statistics
311
TABLE !!-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1946
APPENDICITIS
NUMBER
RATE
Year Total White Col. Total White Col.
1920 236 152
84
8.2 9.0 7.0
1921 276 190
86
9.5 11.1 7.3
1922 300 208
92 10.'1 12.1 7.8
1923 281
183
98
9. 7 10.5 8.4
1924 318 210 108 11.0 12.0 9.1
1925 357 212 145 12.3 12.0 12.8
1926 289 178 111 10.0 10.0 9.9
1927 330
211
119
11.4 11.7 10.7
1928 364 236 128 12.5 13.0 11.7
1929 330 228 102 11.3 12.5 9.4
1930 333
211
122
11.4 11.5 11.4
1931 347
234
113
11.8 12.6 10.5
1932 358
255
103
12.1 13.6
9.5
1933 323 218 105 10.8 11.5 9.6
1934 339 226 113 11.3 11.8 10.3
1935 300 202
98
9.9 10.5 8.9
1936 312
201
111
10.2 10.3 10.0
1937 319 230
89 10.<! 11.7 8.0
1938 287 194
93
9.3 9.8 8.3
1939 280 186
94
9.0 9.3 8.4
1940 276 159 117
8.8 7.8 10.8
1941 230 135
95
7.3 6.6 8. 7
1942 174
102
72
5.6 5.0 6.6
1943 188 1J8
70
6.0 5.8 6.4
1914 175 105
70
5.6 5.2 6.4
1945 171
89
82
5.5 4.4 7. 6
1946 117
62
55
3. 7 3.0 ,s.J
CIRRHOSIS OF LIVER
NUMBER
RATE
Total White Col. Total White Col.
93
61
32
3.2 3.6
2.7
83
52 31
2.9 3.0
2.6
78
43 35
2.7
2.5
3.0
90
M
36
3.1 3.1
3.1
98
69 29
3.4 3.9
2.5
117
77 10
4.0 4.4
3.5
99
62 37
3.4 3.5
3.3
125
75
50
J.3
4.2
4.5
102
61 41
3.5 3.4
3.8
128
7<J 54
4.4 J.l
5.0
134
80 54
4.6 4.3
5.0
124
87 37
4.2 4. 7
3.4
91
61
30
3.1 3.3
2.8
ll6
73 43
3.9
3.9
3.9
110
73 37
3. 7 3.8
3.4
142
97 15
4.7 5.0
1.1
139
87 52
1.6 4.5
4.7
151
95 56
4.9 4.8
5.0
141
100 Jl
4.5 5.0
3.7
152
Ill 41
1.9 5.6
3. 6
H5
102 43
4.6 5.0
4.0
154
110 41
4.9 5.3
4.0
157
123 34
5.0 6.0
3.1
152
104 48
4.9 5.1
4.4
159
108 51
5.1
5.3
5.7
157
113 41
5.0 5.5
4.1
183
137
46
5.9
6. 7
J.2
NEPHRITIS (ACUTE AND CHRONIC)
NUMBER
RATE
Year Total White Col. Total White Col.
1920 1921 1922 1923 1924 1925
1926 1927 1928 1929 1930 1931 1932
1933 1934 1935 1936 1937 1938 1939 1940
1941 1942 1943 1944 1945 1946
2200 2416 2903 3139
3449 3228 3385 3620 4105 1003 3787
3226 3216 3118 3301 3155 3446
3458 3531
3041 3348 3381 3187 3139
2901 2863 2576
1258 "1347
1592 1684 1787 1715 1721
1970 2162 2187 2060 1794 1753
1769 1903 1803 1910 1919 1996
1771 1848 1816 1766 1749 1589 1558 1417
912 1099 1311 H55 1662 1513
1664 1650 1943 1816 1727
1432 H63 1349 1398 1352 1536 1539 1535
1270 1500 1565 1421
1390 1312 1305 1159
.76.0 84A 100.1 108.2
118.9 111.2 116.6 124.6 141.3 137.7 129.9 109.8
108.6 104.5 109.8 101.1 112.9 112.4
113.9 97.4 107.2 107.5
102.0 100.5 92.9
91.7 82.5
74.2 78.7 92.3
96.8 101.9
97.0 96.5 109.6 119.3
119.8 111.9
96.5 93.4 93.4 99.6 93.5 98.1
97.7 100.7 83.6
90.7 88.2
86.6 85.8 78.0 76.4
69.5
78.5 92.6 111.7 125A 144.9 133.'1 148.4 148.9 177.5
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
130.9 128.1 120.9 120.2 106.8
MALFORMATION, EARLY INFANCY
NUMBER
RATE
Total White Col. Total White Col.
1878
2480 2842 2878 2995 2526 2239
2192 1859 1742 1890 1827 1662 1639 1904
1736 1797 1663 2431 2155 2034
2163 2020 2018 1855 1761 1859
1215 1446 1505 1636 1674
1434 1251
1241 1132 1050 1185
1111 1021 994 1126 1076 1064
1028 1289 1199 1098 1206 1137 1234 1102 1108 1229
fi33
1034 1337 1212
1321 1092
988 948 727 692
705 716 638 645 778 660
733 635 1142 956 936 957 883 814
753 653 630
64.8 85.6 98.4
99.2 103.2
87.0 77.1 75.5 64.0 59.9
64.8 62.2
56.1 54.9 63.3 57.3 58.8 54.1
78.'1 69.0 65-.l 68.8 64.7 65.6
59.4 56.4 59.5
73.4 84.5 87.2 94.0 95.4 81.1 70.2 69.5 62.5
57.5 64.3 59.7 54.6 52.5 58.9 55.8 54.7 52.3 65.1
60.0 53.9 58.6 55.8 60.5 54.1
54.4 60.3
52.7 87.1
113.9 107.0 115.1
96.3 88.1
85.6 66.4 64.0 65.7 66.4 58.8 .50.2
71.0 59.9 66.2 57.1 102.1
85.1 86.3 88.1 81.3 75.0 69.4 60.2
58.0
312
Georgia Department of Pttblic Health
TABLE 4-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1946
SUICIDE
NUMBER
RATE
Year Total White Col. Total White Col.
1920 128 110 18 1921 167 142 25 1922 181 152 29 1923 166 150 16 1924 195 173 22 1925 189 169 20 1926 154 134 20 1927 198 179 19 1928 243 210 33 1929 287 268 19 1930 296 273 23 1931 313 282 31 1932 304 279 25 1933 312 276 36 1934 297 265 32 1935 300 270 30 1936 311 284 27 1937 315 288 27 1938 295 266 29 1939 316 290 26 1940 282 246 36 1941 236 212 24 1942 219 203 16
1943 165 152 13 1944 185 167 18 1945 212 188 24 1946 234 218 16
4.4 6.5 1.5 5.8 8.3 2.1 6.2 8.8 2.5 5. 7 8.6 1.4 6. 7 9.9 1.9 6.5 9.6 1.8 5.3 7.5 1.8 6.8 10.0 1.7 8.4 11.6 3.0 9. 9 14.7 1.8 10.2" 14.8 2.1 10.7 15.2 2. 9 10.3 14.9 2.3 10.5 14.6 3.3 9.9 13.9 2.9 9.9 14.0 2. 7 10.2 14.6 2.4 10.2 14.7 2.4 9.5 13.4 2.6 10.1 14.5 2.3 9.0 12.1 3.3 7.5 10.3 2.2 7.0 10.0 1.5 5.3 7.5 1.2 5.9 8.2 1.7 6.8 9.2 2.2 7.5 10.7 1.5
HOMICIDE
NUMBER
RATE
Total White Col. Total White Col.
479
100 379 16.5 5.9 31.6
549
143 406 19.0 8.4 34.2
564
146 418 19.5 8.5 35.6
505
125 380 17.4 7.2 32.7
562
155 407 19.4 8.8 35.5
464
141 323 16.0 8.0 28.5
395
97 298 13.6 5.4 26.6
510
141 369 17.6 7. 9 33.3
512
159 353 17.6 8.8 32.3
523
149 374 18.0 8.2 34.6
569
158 411 19.5 8.6 38.3
597
179 418 20.3 9.6 38.8
554
175 379 18.7 9.3 35.0
670
208 462 22.5 11.0 42.4
720
205 515 23.9 10.7 47.0
661
156 504 21.8 8.1 45.8
589
155 434 19.3 8.0 39.2
641
136 505 20.8 6.9 15.4
582
131 451 18.8 6.6 40.3
560
109 451 17.9 5.5 40.1
616
111 505 19.7 5.4 46.5
649
120 529 20.6 5.8 48.7
519
102 417 16.6 5.0 38.4
438
102 336 14.0 5.0 31.0
454
107 347 14.5 5.2 32.0
485
103 382 15.5 5.1 35.2
564
127 437 18.1 6.2 40.3
MOTOR-VEHICLE ACCIDENTS
NUMBER
RATE
Year Total White Col. Total White Col.
1920 140 100
40
4.8 5.9 3.3
1921 132 108
24
4.6 6.3 2.0
1922 203 142
61
7.0 8.2 5.2
1923 267 189
78
9.2 10.9 6. 7
1924 313 239
74 10.8 13.6 6.5
1925 348 238 110 12.0 13.5 9.7
1926 370 266 104 12.7 14.9 9.3
1927 433 288 145 14.9 16.0 13.1
1928 473 319 154 16.3 17.6 14.1
1929 531 335 196 18.3 18.3 18.1
1930 612 425 187 21.0 23.1 17.4
1931 655 428 227 22.3 23.0 21.0
1932 585 426 159 19.7 22.7 14.7
1933 675 473 202 22.6 25.0 18.5
1934 809 574 235 26.9 30.0 21.4
1935 942 646 296 31.1 33.5 26.9
1936 991 692 299 32.4 35.5 27.0
1937 964 680 284 31.3 34.6 25.5
1938 789 545 244 25A 27.5 21.3
1939 669 433 186 21.4 21!,2 16.5
1940 802 556 246 25.7 27.3 22.7
1941 946 657 289 30.1 31.9 26.6
1942 673 474 199 21.5 23.3 18.3
1943 606 421 185 19.1 20.7 17.0
1944 644 454 190 20.6 22.3 17.5
1945 688 481 207 22.0 23.6 19.1
1946 807 595 212 25.8 29.2 19.5
ACCIDENTS rTOTAU
NUMBER
RATE
Total White Col. Total White Col.
1603 1456 1508 1575 1772 1682 1585 1831
1901 1978 1992 2010 1914 1992 2251
2428 2775 2413 2125 1350 2057 2208
2056 1925 2011 1990 2148
853 750 788 668 846 662 850 725 9,15 827 947 735 928 657 1035 796 1090 811 1113 865 1164 828 1243 767 1182 732 1213 779 1389 862 1453 975 1682 1093 1495 918 1309 816
1186 664 1217 840 1412 796 1328 728 1192 733 1249 762 1275 715 1452 696
55.3 50.3 52.0 54.3 61.1
58.0 54.6 63.0
65.4 68.0 68A 68.4 64.6 66.8 74.9 80.1 90.9
78.4 68.6 59.2 65.9 70.2 65.8 61.6 64.4 63.7
68.7
50.3 46.1
49.0 48.9
53.9
5~.6
52.1
57.6 60.2 60.9 63.2
66.9 63.0 64.0 72.7 75.3 86.4 76.1 66.1 59.4
59.7 68.6 65.2 58.5 61.3 62.5 71.2
62.5
56.3 56.4 62.5 72.1 64.8 58.6
71.9 74.1 80.0 77.2 71.1 67.5 71.5
78.7 88.5 98.7 82.5 73.0 59.0 77.4 73.2 67.1 67.5 70.2 65.0 64.1
Information and Statistics
313
TABLE 5
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: 1945
Cause of Death
Total
Number White Colored
Total
Rate White Colored
ALL CAUSES ... .................
Typhoid fever ...... ..................
Typhus fever ...
Malaria . . .
Smallpox ..
Measles . . . . . . . . . ...........
Scarlet. fever . ... ...........
Whooping Cough ...
Diphtheria....... .............
Influenza . .
. . . . . . . . . ...
Dysentery.....
Poliomyelitis ....
............
Lethargic Encephalitis. ...............
lv!eningococcus Meningitis ...
Tuberculosis, all forms.
Syphilis ...
Gonorrhea . .
Cancer . . . . .
Diabetes Mellitus ...
Pellagra........ Cerebral hemorrhage, embolism and thrombosis
Heart disease::> . ....
Pneumonia .......
Diarrhea, Enteritis (-2 yrs.).
Appendicitis .... . . . . . . . . . . . . . . ..
C:irrhosis of liver . ....................
Nephritis
...........
Malformation and early infancy diseases . .
Suicide ...
Homicide ..
Motor-vehicle accidents.
All other accidents..
Unknown and ill-defined causes.
All other causes.
28,456 27 59 26 1
65 71 473 60 10
38 1,108
358 5
2,441 380 106
3,137 5, 779 1,500
312 171 157 2,863 1, 761 212 485 688 1,300 952 3,892
LIVE BIRTHS... STILLBIRTHS ...
INFANT MORTALITY..
MATERNAL MORTALITY ..
74,994 2,208 3,181
250
16,310 11 46 12
12,146 16 13 14
4 44 51 206 28 10
27 434'
76
1,735 289 77
1,655 3,805
713 159
89 113 1,558 1,108 188 103 481 792 342 2,148
47,422 1,036 1,728 102
4
21 20 267 32
4 11 674 282
5 706 91 29 1,.482 1,974 787 153
82 44 1,305 653 24 382 207 508 610 1,744
27,572 1,172 1,453 148
911.0 0.9 1.9 0.8 0.03 0.2 0.2 2.1 2.3 15.1 1.9 0.3 0.2 1.2 35.5 11.5 0.2 78.1 12.2 3.4
100.4 185.0 48.0 10.0
5.5 5.0 91.7 56.4 6.8 15.5 22.0 41.6 30.5 124.6
24.0 29.4 42.4 3.3
800.2 0.5 2.3 0.6
0.1 0.2 2.2 2.5 10.1 1.4 0.5 0.1 1.3 21.3 3. 7
85.1 14.2 3.8 81.2 186.7 35.0 7.8
4.4 5.5 76.4 54.4 9.2 5.1 23.6 38.9 16.8 105.4
1119.0 1.5 1.2 1.3 0.1 0.4 0.1 1.9
. 1.8 24.6 2.9
0.4 1. 62.1 26.0 0.5 65.0 8.4 2. 7 136.5 181.9 72.5 14.1 7.6 4.1 120.2 60.2 2.2 35.2 19.1 46.8 56.2 160.7
23.3
25.4
21.8
42.5
36.4
52.7
2.2
5.4
NOTE: These figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurring in other states.
314
Georgia Department of Pttblic Hectlth
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 BIR'THS,
BY COLOR, IN GEORGIA: 1946
Cause of Death
Total
Number Whit a Colored
Total
Rate White
Colored
ALL CAUSES........... .............. 27,405
Typhoid fever ... Typhus fever ....
.... ..........
11 33
Malaria .....
12
Smallpox . . . .
. ................
Measles.... ..............
41!
Scarlet fever. . . . . . . . . . . . . . . .
Whooping Cough
................
60
Diphtheria.
...........
45
Influenza ...
423
Dysentery.
... . .. .. .. . .. .............
36
Poliomyelitis ....
.. .. ... ..... ...
8
Lethargic Encephaliti" ..
............
3
Meningococcus Meningitis
...........
31
Tuberculosis. .......
1,048
Syphilis ...
309
Gonorrhea Cancer.
2
............ 2,420
Diahet.es Mellitus ..... Pellagra ..
395 93
Cerebral hemorrhage, embolism and thrombosis . . 2,S19
Heart diseases . ......
5,961
Pneumonia .........
1,341
Diarrhea and enteritis (-2 yrs.).
Appendicitis.
....................
Cirrhosis of Liver . ..... . . . . . . . . . . . ......
Nephritis ............ ...................
H8 117 183 2,576
Malformation and ear1y infancy diseases . ....... 1,859
Suicide....
............. 234
Homicide.........
564
Motor~vehicle accidents ......
807
All other aecidents .............
1,341
Unknown and ill-defined causes . . . . . . . . .
845
All other causes ....
3,636
LIVE BIRTHS... STILLBIRTHS.... INFANT MORTALITY...... MATERNAL MORTALITY .................
85,699 2,421 3,068
229
16,160 6
25 6
20 1 28 32 191 19
21 467 59
1,731 281 67
1,523 3,927
6S4 58 62
137 1,417 1,229
218 127 595 857 301 2,060
56,354 1,161 1, 694
85
11,245 5 8
24
32 13 232 17
10 581 250
2 689 114 26 1,296 2,034 657 90 55 46 1,159 630 16 437 212 484 544 1,576
29,345 1,260 1,374
H'J
877.3 0.4 1.1 OA
792.8 0.3 1.2 .03
1036.0 0.5 0. 7 0.6
1.4 0.03 1.9 1.4 13.5 1.2 0.3 0.1 1.0 33.5 9.9 0.1 77.5 12.6 3.0 90.2 190.8 42.9 4.7 3. 7 5.9 82.5 59.5 7.5 18.1 25.8 '12.9 27.1 116.4
21A 28.2 35.8 2.7
1.0 0.04 1.4 1.6 9.4 0.9 0.4 0.1 1.0 22.9 2.9
84.9 13.8 3.3 74.7 192.7 33.6 2.8 3.0 6.7 69.5 60.3 10.7
6.2 29.2 42.0 14.8 101.1
27.6 20.6 30.1 1.5
2.2
2.9 1.2 21.4 1.6
0.9 53.5 23.0 0.2 63.5 10.5 2.4 119.4 187.4 60.5 8.3 5.1 4.2 106.8 58.0 1.5 'J0.3 19.5 '14.6 50.1 145.2
27 .o
42.9 46.8 4.9
NOTE: These figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurrh)g in other states.
Rates based on the 1940 Census Enumerated Population.
Informcttion and Statistics
315
TABLE 7
CENSUS ENUMERATED POPULATION As OF APRIL 1, 1940,
BY COLOR AND COUNTY, IN GEORGIA
County
Total
White
Colored
County
Total
White
Colored
TOTAL... . . . . 3,123,723 2,038,278 1,085,445
Appling ..
14,497 11,851)
2,641
Atkinson.
7,093
5,422
1,1)71
Bacon ......
8,096
7,042
1,054
Baker....
7,344
3,049
1,295
tBaldwin . . . . . .
11l,411
7,713
8,698
Banks........
8, 733
8,072
Bill
Barrow .......
13,064 10,605
2,459
Bartow ......
25,283 21,073
4,210
Ben Hill......
14,523
9,1l74
4,849
Berrien ......... 15,370 13,033
2,337
Bibb........... 83,783 48,239 35,544
Bleckley.
9,655
1),331
3,324
Brantley .....
6,871
5,727
1,1<J4
Brooks . . . . . . . .
20,497
9,990 10,507
Bryan ........
6,288
3,735
2,553
Bulloch ......... 26,010 11l,11l8
9,842
Burke .....
26,520
ll.ll54 19,81)6
Butts ........
9,182
4,891
4,291
Calhoun . . . . . .
9,382
2,810
1),572
Camden . . . . . . .
5,910
2,486
3,424
Candler ........
9,103
5,996
3,107
Carroll . . . . . . . . .
34,151)
26,903
7,253
Catoosa ....
10,899 10,576
323
Charlton ......
.'),256
3, 760
1,496
Chatham...... 117,970 65,027 52,943
Chatt 'chee ...... 5,138
3,110
2,028
Chattooga . . . . .
18,532 16,720
1,812
Cherokee ......
20,121l 19,229
897
Clarke .....
28,398 18,335 10,063
Clay......
7,064
2,077
4,987
Clayton ....
11,655
8,671
2,984
Clinch ....
1),437
3,938
2,499
Cobb . . . . . .
38,272 31,990
6,282
CoiTee ..
21,541 11l,165
5,371)
Colquitt .....
33,012 24,955
8,057
Columbia .......
9,433
3, 769
5,664
Cook .......
11,919
8, 728
3,191
Coweta .....
26,972 16,149 10,823
Crawford ...
7,128
3,105
4,023
Crisp ....
17,540
9,426
8,114
Dade ........
5,894
5,597
297
Dawson ...
4,479
4,415
64
Decatur ...
22,234 11,473 10,761
DeKalb ...
86,942 72,973 13,969
Dodge . . . . . .
21,022 14,045
6,977
Dooly .....
16,886
7,555
9,331
Dougherty ..
28,51)5 13,028 15,537
Douglas.
10,053
7,880
2,173
Early ..
19,735
9,564 10,171
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 . . . . . . . JefJerson . ....... Jenkins .... Johnson ......... Jones ....... Lamar ......... Lanier .......... Laurens ......... I.~ee ............. Liberty ........ I.~incoln . ... Long . . . Lowndes .... Lumpkin ..... McDuffie . . . . . . . . Mcintosh ........ Macon ..... Madison ......... Marion . . . . . . . . . . Meriwether ......
2,964 9,641) 19,618 23,517 7,401 14,752 8,170 56,141 11,322 15,1l12 392,886 9,001 4,547 21,920 18,445 19,654 13,709 29,087 14,771 34,822 12,764 14,377 11,128 15,512 8,610 15,119 11,303 12,936 20,089 8,772 8,841 20,040 11,843 12.953 8,331 10,091 5,632 33,1)06 7,837 8,595 7,042 4,086 31,860 6,223 10,878 5,292 15,947 13,431 6,954 22,055
tBaldwin County population excludes the State Nlilledgeville Hospital.
1,899 5,644 11,887 15,201) 4,908 14,1)75 5,503 47,500 11,281 13,342 21l9, 743 8,952 3,321l 13,351) 17,242 12,930 6,554 25,751 14,104 31,483 3,581 12,853 4,626 11,551 1),023 7,955 3,984 8,178 16,548 3, 777 7,231 8,583 5,306 8,029 3,250 5,668 4,017 19,861 1,895 3,077 3,423 2,625 17 ,181) 6,003 5,51)5 2,135 5,053 10,826 3,129 10,334
1,065 4,002 7, 731 8,311 2,493
77 2,667 8,641
41 2,270 123,143
49 1,221 8,564 1,203 6,724 7,155 3,331)
667 3,339 9,183 1,524 1),802 3,961 2,537 7,164 7,319 4, 758 3,541 1,995 1,610 11,457 6,537 4,924 5,081 4,423 1,615 13,745 5,942 5,518 3,1ll9 1,41)1 14,674
220 5,313 3,157 10,894 2,605 3,825 11,721
316
Georgia Depctrtment of Pztb!ic Health
TABLE 7-Continued
CENSUS ENUMERATED POPULATION As OF APRIL 1, 1940,
BY COLOR AND COUNTY, IN GEORGIA
County
Miller . . . . . . Mitchell .... Monroe ... Montgomery .. Morgan ... Ivfurmy . ... Muscogee . . Newton .. Oconee . . . . Oglethorpe ... Paulding. Peach ...... Pickens .... Pierce Pike. Polk. Pulaski Putnam .... Quitman .. Rabun ..... Randolph ... Richmond. Rockdale .. Schley .... Screven . .. Seminole. Spalding. Stephens .. Stewart. .. Sumter . . .
Total
White Colored
9,998 23,261 10,749 9,668 12,713 11,137 75,494 18,576 7,571) 12,!30 12,832 10,378
9,13fl 11,800 10,375 28,167
9,829 8.5H 3,435 7,821 16,609 81,8(i3 7, 724 5,033 20,353 8,492 23,427 12,972 10,603 24,502
6,753 10,996 4,596 5, 788
5,936 10,756 19,!78 12,15! 5,317
6,934 11,534 4,012 8,656 9,346
5,310 23,o98 4,!70 3,417
1,057 7,686 5,205 48,194 5,274 1,999 8,746 5,035 19,485 11,116 2,882 9,504
3,245 12,265 6,153 3,880
6,777 381
26,016 6,422 2,259 5,496 1,298 6,366
480 2,154 5,065 4,769 5,359 5,097 2,378
135 11,404 33,369 2,4>18 3,034 11,607 3,457
8,912 1,856 7,721 14,998
County
Total White
Colored
Talbot.. Taliaferro. Tatt.nall .. Taylor. Talfair .. Terrell .. Thomas. Tift.. Toombs. Towns ... Treutlen. Troup .. Turner . . Twiggs Union. Upson .. Walker Walton Ware .... Warren ... washington ...... Wayne. Webster. Wheeler. White. Whitfield .. Wilcox. Wilkes. Wilkinson. Worth ..
8,141 6,278 16,243 10,768 15,145 16,675 31,289 18,599 16,952 4,925 7,632 43,879 10,846 9,117 7,680 25,064 31,024 20,777 27,929 10,236 21,230 13,122 4, 726 8,535 6,417 21),105 12,755 15,084 11,025 21,374
2,460 1,997 12,076 5,586 10,358 4,714 17,309 13,101) 12,434 4,925 5,333 27,527 7,036 3,253 7,669 17,377 28,789 14,168 20,389 3,571 10,357 10,328 1,83! 5,855 6,050 24,640 7,879 6,041 5,1)18 11,397
5,681 !,281 4,167 5,182 4,787 11,961 13,980 5,493 4,518
2,299 16,352 3,810 5,864
11 7,687 2,235 6,609 7,540 6,665 13,873 2,794 2,892 2,680
367 1,465 4,876 9,0,13 5,407 9,977
Informtttion and Statistics
317
TABLE 8
LIVE BIRTHS AND RATES PER 1,000 PoPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
County
LIVE BIRTHS
Number
Rate Per 1,000 Population
STILLBIRTHS
Number
Rate Per 1,000 Live Births
1946
1945 1946 1945
TOTAL.........
Appling . . . . . . . . . . . . . .
Atkinson ..............
Bacon .................
Baker.........................
Baldwin . . . . . . . . . . . . . . . . . . . . . . .
BBBBaeaarnnrrtkools:wwli.!...!...........................................................................................
Berrien . . . .
............
Bibb ........ B!cck!ey ..... Brantley ....
.................................
Brooks . . . . . . . . . . . . . . . . . . . . . . . .
Bryan.........................
BuHoch .......................
Burke...............
Butts .........................
Calhoun .......................
Camden ..................
Candler ...............
Carro!! ........................
Catoosa .......................
Charlton ......................
Chatham . . . . . . . . . . . . . . . . . . . . . .
Chattahoochee .................
Chattooga.....................
Cherokee . . . . . . . . . . . . . . . . . . . . . .
Clarke ......
...........
Clay . . . . . . . .
Clayton . . . . .
............
Clinch ..... Cobb ...... Co~ee ......
.
.
.
.
.
.
.
.
...........
Colquitt.......................
Columbia . . . . . . . . . . . . . . . . . . . . . .
Cook .........................
Coweta . . . . . . . . . . . . . . . . . . . . . . . .
Crawford .....................
Crisp .........................
Dade .........................
Dawson .......................
Decatur................
DeKalb .......................
Dodge .....................
Dooly . . . . . . . . . . . . . . . . . . . . . . . . .
Dougherty....................
Douglas . . . . . . . . . . . . . . . . . . .
Early .........................
Echols ........................
Efllgham ....................
Elbert . . . . . . . . . . . . . . . . . . . . . .
Emanuel ......
Evans .......... :::::::::::::.
Fannin .....................
Fayette .............
Floyd .........................
Forsyth .................
Franklin . . . . . . . . . . . .
Fulton Gilmer
.................................
Glascock ..................
85,699 433 215 262 183 449 193 325 702 ,103
459 2,779
252
200 577
160 657 712 207 255 195 218
826 270 141 3,626 51
572 531 807 191
354 172 1,491 725 1,028 212
332 696 179 <!62
202 93 621 2,509 522 395 958 245 538
54 230
474 524 173 384 171 1,589 272 400 10,708 275 92
74,994 387 155 266 173 394 140 223 575 317 348
2,313 2<!1
170 465 138 588 685 183 274 150 167 682 237 124 3,591
69 465 <]83
625 190 270 120 1,286 618 893 207 300 581 163 <]54
162 61 544
2,100 <!96
387 842
197 516 54 219 410 486 182 347 137 1,278 246 313 8,650 220
89
27.'! 29.9 30.3 32.4 24.9 27.4 22.1
24.9 27.8 27.7 29.9 33.2 26.1 29.1
28.2 25.4 25.3 26.8 22.5 27.2 33.0 23.9 24.2 24.8 26.8 30.7 9.9 30.9 21.4 28.4 27.0 30.4 26.7 39.0 33.7 31.1 22.5 27.9 25.8 25.1 26.3 34.3 20.8 27.9 28.9 24.8 23.'! 33.5
24A 27.3 18.2
23.8 24.2 22.3 23.4 26.0 20.9 28.3 24.0 25.6 27.3 30.6 20.2
24.0 26.7
21.9 32.9 23.6 24.0 16.0 17.1 22.7
21.8 22.6 27.6 25.0 24.7 22.7
21.9 22.6 25.8 19.9 26.3 25.4 18.3 20.0
21.7 23.6 30.4 13.4 25.1 2<!.0 22.0 26.9 23.2 18.6 33.6 28.7 27.1
21.9 25.2 21.5 22.9
25.9 27.5 13.6 24.5
24.2 23.6 22.9 29.5 19.6 27.6 18.2 22.7 20.9 20.7 24.6 23.5 16.8 22.8
21.7 20.0 22.0 24.4
19.6
1946
1945 1946 1945
2,421 10 4 3 5 8 2 5 20 10 4 93 9 6 24 6 18 15 4 13 5 7 23 7 2 163 1 18 12 25 7 8 2 38 26 35 7 9 15 4 19 2
16 65 8 10 27
6 18
14 13 12 9 9 7 36 10 8 307 4 1
2,208
8 4 7 6 8 6 8 19 10
8 79
4
6 23 11 18 18 10 11
9 5 25 4 <]
149 2 3 9 27 12
5
~
27 11 20 5 3 6 3 22
2 6 17
36
8 17 37 4 15
1 11 12 H
4 J:;
5 26
2 3 240
1 2
28.3
2&.1 18.6 11.5 27.3 17.8 10.4 15.4 2d.5 24.8 8.7 33.5 35.7 30.0
'!1.6 37.5 21.']
21.1 19.3 51.0 25.6 32.1 21.8 25.9 14.2 45.0 HJ.6
31.5 22.6 31.0 36.6 22.6 11.6 25.5 35.9 54.0 33.0 27.1 21.6 22.3 41.1
9.9
25:8
25.9 15.3 25.3 2d.2 24.5 33.5
ao:o
27A 22.9
5~.0
23.4 40.9 22.7 36.8 20.0 28.7 14.5
10.9
29.4 2J.7 25.8 26.3 34.7 20.3 <!2. 9
35.9 33.0 31.5 2J.O 34.2 16.6 35.3 49.5 79.7 30.6 26.3 54.6 40.1
-60.0 29.9 36.7 16.9 32.3 41.5 29.0 6.5 18.6 43.2 63.2 1S.5 25.0 21.0
17.8 22.4 24.2
10.0 10.3 18.4
48.5 12.3 98.4 31.3 17.1 16.1 <!3.9
43.9 20.3 29.1 18.5 50.2 29.3 28.8 22.0 37.5
36.5 20.3 8.1 9. 6 27.7 4.5 22.5
318
Georgia Department of Pttblic 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: 1945 AND 1946
LIVE BIRTHS
STILLBIRTHS
County
Number
Rata Par 1,000 Population
1946
1945 1946 1945
Glynn .....
Gordon ...
Grady .....
Greene ......
Gwinnett. ....
Habersham ....
Hall ......
Hancork.
Haralson.
Harris ..
}!art....
Heard ......
Henry .....
Houston.
Irwin ......
Jackson .....
Jasper.
Jeff Davis.
Jefferson ..
Jenkins ...
Johnson ..
Jones ....
Lamar ....
Lanier .....
Laurens ....
Lee........
Liberty .....
Lincoln .....
Long .......
Lowndes .....
Lumpkin ...
McDuffie . . . . . .
Mcintosh ....
Macon ......
Madison.
Marion ......
Meriwether. ..
Miller .......
Mitchell ..
Monroe .....
Montgomery ..
.Morgan ...
Murray ...
Muscogee ....
Newton .....
Oconee . . . . . . . . . .
Oglethorpe .......
Paulding ...
Peach . . . . . . . . . .
Pickens ............
P.ierce ..............
Pike .............
Polk ............
Pulaski.. ........ Putnam ..........
Quitman .........
Rabun ..........
lhndolph .........
Richmond .........
Rockdale........... Schley ........................
820 458 476 299 625 445 932 3I9 3I6 287 325 I48
389 586 299 55! 167 288 533 309 303 I86 278 107
853 220 266
155 102 924 161 303 191 383 283 I9I 620
295 6<17
260 188 332 278 2,906 <195
133 293
308 251 207 372 233 711 266
180 94 252 418 2,294 I82 115
952 37.4 43.4 332 24.8 I8.0 506 24.2 25.7 265 21.8 I9.3 465 21.5 16.0 366 30.I 24.8 8I2 26.8 23.3 32I 25.0 25.1 266 22.0 I8.5 243 25.I 21.3 246 21.0 I5. 9 110 I7 .2 I2.8 389 25.7 25.7 524 51.8 46.4 293 23.1 22.6 477 27.4 23.7 181 19.0 20.6 240 32.6 27.1 442 26.6 22.1 259 26.1 21.9 296 23.4 22.9 209 22.3 25.I 200 27.5 19.8 117 19.0 20.8 758 25.4 22.6 226 28.1 28.8 265 30.9 30.8 134 22.0 19.0 107 25.0 26.2 929 29.0 29.2 146 25.9 23.5 254 27.9 23.3 !59 36.1 30.0 430 24.0 27.0 278 21.1 20.7 224 27.5 32.2 540 28.I 24.5 249 29.5 2<1,9 550 27.8 23.6 236 24.2 22.0 150 19.4 15.5 322 26.I 25.3 24I 25.0 21.6 2,517 38.5 33.3 <162 26.6 2<1.9 114 17.6 I5.0 269 23.6 21.6 239 24.0 I8.6 273 24.2 26.3 I48 22.7 16.2 335 31.5 28.4 20I 22.5 19.4 620 25.0 21.8 224 27 .I 22.8 210 21.1 24.7 82 27.4 25.9 I93 32.2 24.7 387 25.2 23.3 2,098 28.0 25,6 I 56 23.6 20.2 112 22.8 22.3
Number
Rata Par 1,000 Live Births
1946
1945 1946 1945
25
41 30.5 43. I
4
5 8. 7 I5.I
I3
17 27,3 33.6
5
7 16.7 26.4
I9
I7 30.4 36.6
14
11 31.5 30.I
33
17 35.4 20.9
5
7 15.7 21.8
3
6 9.5 22.6
4
8 I3.9 32.9
IO
5 30.8 20.3
2
3 I3.5 27.3
15
I6 38.6 4l.I
16
17 27:3 32.4
IO
12 33.4 41.0
7
4 12.7 8.4
3
17 18.0 93.9
8
8 27.8 33.3
I3
24 24.4 54.3
7
7 22.7 27.0
I2
11 39.6 37.2
5
4 26.9 19.1
3
7 10.8 35.0
4
4 37.4 34.2
28
21 32.8 27.7
10
3 45.5 I3.3
4
9 15.0 34.0
5
6 32.3 44.8
1
4 9.8 37.4
25
20 27.1 21.5
4
I 24.8 6.8
10
5 33.0 19.7
11
3 57.6 I8.9
11
6 28.7 14.0
9
3 31.8 I0.8
6
7 31.4 31.3
I5
21 24.2 38.9
6
3 20.3 I2.0
2<1
I9 37 .I 34.5
8
6 30.8 25.4
I
3 5.3 20.0
12
H 36.I <13.5
6
5 21.6 20.7
73
76 25.I 30.2
I7
9 34.3 19.5
2
I5.0
6
8 20.5 29.7
9
2 29.2 8.4
1
5 4.0 I8.3
5
2 24.2 I3.5
8
I2 21.5 35.8
<1
2 17.2 IO.O
23
I9 32.3 30.6
14
5 52.6 22.3
6
6 33.3 28.6
1
1 IO. 6 12.2
3
3 11.9 15.5
9
I8 21.5 <16.5
48
70 20.9 33.4
4
5 22.0 32. I
3
4 26.1 35.7
Informcttion ctnd Statistics
319
TABLE 8-Continued
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
LIVE BIRTHS
STILLBiilTHS
County
Number
Rate Per 1,000 Population
Number
Rata Par 1,000 Live Births
1946
1945
1946 1945
1946
1945 1945 1945
Screven . ............
Seminole ...........
Spalding ............
Stephens ............
Stewart .............
Sumter ..............
Talbot ...............
Taliaferro ............
Tattnall...................
Taylor ....................
Telfair ........................
Terrell ................
Thomas . . . . . . .
Tift............ .............
Toombs ........ . ..........
Towns .........
Treutlen .......
Troup .........
Turner . . . . . . . . .
Twiggs.........
Union .......... ...........
Upson ........
Walker ........
. ..........
Walton . . . . . . . . . .
Ware ...........
\Varren . .......
Washington .....
Wayne..........
Webster..............
Wheeler.............
White..............
Whitfield . . . . . . . . . . .
Wilcox ..............
Wilkes ...............
Wilkinson ............
Worth ..............
Military Reservations
515 239
794 411 227 733 213 105 405 234
335 457 850 586 394
71 153 1,275 233
277 205 689 955 604 827 284
560 413 117
144 156 854
258 372 246 616 153
439 140
580 357 266 613
208 119 306 270
308 479 859 497 402
97 154 1,073 182 250 172 531
749 490 756 243 546 416 121 153 142 681
198 352 199 574
77
25.3 28.1 27.9 31.7 21.4 29.9 26.2 16.7
24.9 21.7 22.1 27.4 27.2 31.5 23.2
1<1.4 20.0 29.1 21.5 30.4 26.7 27.5 30.8 29.1
29.6 27.7 23.1 31.5 24.8 16.9 24.3 32.7
20.2 24.7
22.3 28.8
21.6 16.5 20.4 27.5 25.1 25.0 25.5 19.0
18.8 25.1 20.3 28.7 27.5 26.7 23.7 19.7 20.2
24.5 16.8 27.4 22.4 21.2 24.1 23.6 27.1 23.7
22.5 31.7 25.6 17.9 22.1 26.1 15.5
23.3 18.0 26.9
14
15 27.2 34.2
3
5 12.6 35.7
31
22 39.0 37.9
4
8 9. 7 22.4
7
8 30.8 30.1
25
26 34.1 42.4
10
9 46.9 43.3
6
4 57.1 33.6
19
11 46.9 35.9
3 11
6
12.8 32.8
i9:5
16
19 35.0 39.7
27
,!3 31.8 50.1
32
18 54.6 36.2
19
15 48.2 37.3
1
2 14.1 20.6
2
13.0
31
34 24.3 3'1. 7
6
6 25.8 33.0
10
7 36.1 28.0
7
2 34.1 11.6
20
H 29.0 26.'!
17
6 17.8 8.0
15
H z,J.8 28.6
20
'12 24.2 55.6
6
7 21.1 28.8
28
19 50.0 34.8
8
7 19.4 16.8
8
3 68.4 24.8
4
3 27.8 19.6
4
5 25.6 35.2
15
18 17.6 26.4
4
4 15.5 20.2
11
2 29.6 5.7
13
8 52.8 40.2
18
19 29.2 33.1
2
NOTE: These figures exclude nonresidents of Georgia and include residents of Georgia with birth occurring in other states. Live Birth rates based on the 19,10 Census Enumerated Population.
320
Georgia Department of Pttblic Health
TABLE 9
INFANT AND MATERNAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
INFANT MORTALITY
MATERNAL MORTALITY
County
Number
Rate Per 1,000 Live Births
Number
Rate per 1,000 Live Births
1946
1945
1946 1945
TOTAL. ................
Appling ... ............
Atkinson.
Bacon ..
Baker ...
Baldwin.
Banks ...
Barrow
Bartow.
Ben!Iill. ...
Berrien ....
Bibb ......
Bleekley
Brantley Brooks ..
....
Bryan ......
Bulloch ... .............
Burke
Butts ......
Calhoun .....
Camden .....
Candler .....
Carroll. ...
Catoosa ....
Charlton ...
Chatham ......
. Chattahoochee.
Chattoo~a. . . . . . . . . . . . .
Cherokee ..
Clarke ..
Clay ...
Clayton ...
Clinch ...
Cobb ....
Coffee .....
Colquitt ..
Columbia.
Cook .......
Coweta ....
Crawford ..
Crisp ....
Dade ....
Dawson ..
Decatur..
DeKalb ..
Dodge .....
Doo!y .......
Dougherty ..
Dou~las .. . . . . . . . . . . . . .
Early ......
Erho!s .....
Effingham ..
Elbert. ....
Emanuel.. .............
Evans .....
Fannin ....
Fayette ... ...........
Floyd . . . . .
Forsyth .....
Franklin ....
3,068
5 5 5 3 21 8 17 39 17 12 91 16
7 26
9 28
21 6 9 8 2
39 19 4 170
2 13 16 33 7 10 I Jl 34 31
3 11 23
7 31
11 ! 25 52 5 13 33 4 11
4 12
11 2! 8 20
9 53
9
9
3.181 2 8 16 6 18 12 9 40 16 8
118 5 7 17 11 27 1<J 7 15 10 6 36 1<J 6
196 6
25 17 29 10 12 3 28 37 36 14 11
9 7 18 6
26 89 7 H 31
5 9
8 17 26 5 19 13 62 7
5
35.8 11.5 23.3
19.1 16.4 53.5 41.5 52.3 55.6
12.2 26.1
32.7 63.5 35.0 45.1 56.3 42.6 33.7 29.0 35.3 41.0
9.2
17 .2 70.4 28.4
46.9 39.2 22.7 30.1 10.9 36.6 28.2 23.3 27.5 46.9 30.2 H.2 33.1
33.0 39.1
67.1 51.5 43.0 40.3 20.7 9. 6 32.9 31.4 111.3 20.4
74.1 52.2 23.2 45.8 46.2 52.1 52.6 33.4 33.1 22.5
12.4 5.2
51.6 60.2 34.7 45.7 85.7 40.4 69.6 50.5 23.0 51.0 20.7 41.2 36.6 79.7 15. 9 20.4 38.3 54.7 66.7 35.9 52.8 59.1 48.4 M.6 87.0 53.8 35.2 46.'1 52.6 44.4 25.0 21.8 59.9 40.3 67.6 3(\. 7 15.5 12.9 39.6 37.0
47.8 42.'1 H.1 36.2 36.8 25.4 17.4
36.5 41.5 53.5 27.5 54.8 94.9 48.5 28.5 16.0
1946
1945
1946 1945
229 1 1 2
1 I 1 2 9 1 1 4 1 1 2 1
13 1
6 1 2 1
3 2 2
1 4 1 1 3 1 1
2 3 1
2
1
250 I 3
1
1 1 1 1 7 1 2 5
3 1 1
1 18
2 1 1
2
2 4 3 1 5 1 3 1 1 1 1 2 1 2 3
2. 7 3.3 2.3 10.3 4.7 19.4 7.6
5.8 2.2
3.1 4:5
5.7 1.7 2.5 3.2 4.4 2.9 3.2 3.0 4.0 1.1 5.0 11.8 6.9 10.8 6.3 1.5 1.7 2.8 8.8 4.8 5.5
5.1 20.0 1.6 6.0
1.5 3. 7
8.1 3.6 5.0 19.6
4.1 3.7 1.6 5.2 5.3
!.0 1.6 1.4 3.2 1.9 2.2 4.7
3.3 4.3 11.2 12.3 4.3
1.6 3. 7 1.6 1.9 1.9 6.0 2. 5 2.6 3.1 5.9 !.1 5.1 1.9 5.8
18.5 4. 6 4.2 2.4 5. 7 2.1 5.8 11.0 2.9 14.6 1.3 2.3
2.5 6.4
Information and Statistics
321
TABLE 9-Continued
INFANT AND MATERNAL MORTALITY WI'fH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
County
INFANT MORTALITY
MATERNAL MORTALITY
------~-~--~--
Number
Rate Per 1 ,000 Live Births
Number
Rate per 1,000 Live Births
1946
1945 1943 1945
1946
1945
1946 1945
Fulton_.
399
Gilmer ..
11
Glascock.
3
Glynn ........
66
Gordon .... _.
12
Grady ....
25.
Greene ...
11
Gwinnett
29
Hahersham ..
17
Hall .........
28
Hancock ....
8
Haralson ..... ...........
11
Harris .....
8
Hart ...
7
Heard .....
6
Henry ... _.
9
Houston ....
16
Irwin ......
13
Jackson ..
15
Jasper ........
5
Jeff Davis._ ..
6
Jefferson . ......
12
Jenkins . ....
11
Johnson ....
8
.Tones ......
7
Lamar ....
12
Lanier ....
Laurens ...
33
Lee . . . . . . . . .
5
Liberty.- ..
9
Lincoln .....
1
Long . . . . . . . . Lowndes ....
. .. .. .. .. . .. .
1 39
Lumpkin ...
6
McDuffie ..
8
Mcintosh_
6
Macon.
20
Madison ..
6
Marion ....
7
:Meriwet~er.
14
Miller . . . . . .
6
illitchell ....
20
Monroe ...
9
Montgomery ...
1
Morgan.
9
Murray.
7
Muscogee.
126
Newton.
15
Oconee . . . . .
i
Oglethorpe.
10
Paulding ..
8
Peach ..
16
Pickens ....
5
Pierce ....
12
Pike .....
12
Polk .......
23
Pulaski ...
11
Putnam ....
11
Quitman.-.
6
Rabun ....
3
389 37.3 45.0
9 40.0 40.9
2 32.6 22.5
74 80.5 77.7
8 26.2 24.1
20
52.5 .~9.5
15 36.8 56.6
24 16. 4 51.6
21 38.2 57.4
27 30.0 33.3
9 25.1 28.0
12 34.8 45.1
12 27.9 49.4
2 21.5 8.1
11 40.5 100.0
16 23.1 41.1
27 27.3 51.5
5 13.5 17.1
13 27.2 27.3
11 29.9 60.8
11 20.8 45.8
12 22.5 27.1
ll 35.6 42.5
7 26.4 23.6
12 37.6 57.4
10 13.2 50.0
3
25.1;
36 38.7 47.5
10 22.7 44.2
7 33.8 26.4
4
6.5 29.9
9.8
33
42.2 ~5.5
4 37.3 27A
12 26.4 47-2
7 31.4 44.0
33 52.2 76.7
9 21.2 32.1
7 36.6 31.3
17 22.6 31.5
2 20.3 8.0
20 30.9 36.'!
10 34_ 6 12.'!
3
5.3 20.0
13 27.1 40.4
8 25.2 33.2
110 43.4 43.7
19 30.3 .U.1
1 30.1 3'5.1
16 34.1 59.5
6 26.0 25.1
12 63.7 44.0
7 24.2 47.3
19 32.3 56.7
7 51.5 34.8
21 32.3 33.9
12 41.4 53.6
11 61.1 52.4
6 63.8 73.2
1 11.9 5.2
13
17
1.2 2.0
1
3.6
6.1 6.3
6.0
2
1.0
2
6.7
1
1.6 2.2
1
2.2
1
1.1 1.2
1
3.1
10.5 1.1
4.1
20.3 9.1
2
5-1
3
3
5.1 5.7
2
6.7
1
1.8 2.1
3:5
11.0 4.2
13.1 2.3
3. 9
3.3
1
3. 6 5.0
8.5
4. 7 2.6
4. 5
18.9
3
4.3 3.2
2
6.6 7.9
I
5.2 12.6
2
5.2 2.3
1
4.5
2
1
3.2 1.9
1
2
3A 8.0
4
2
6.2 3.6
2
7.7
i
4.1
4
7
JA 2.8
2
2
4.0 1.3
1
3A 11.2
1
J.O 3. 7
1
4.8 6.8
2
5.4 9-0
"5
8.1
1
4.5
5.6
322
Georgia Department of Pttblic 1-1ealth
TABLE 9-Continued
INFANT AND MATERNAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
INFANT MORTALITY
MATERNAL MORTALITY
County
Number
Rate Per 1,000 Live Births
Number
Rate per 1,000 Live Births
1946
1945 1946 1945
1946
1945
1946 1945
Randolph.
25
Richmond ....
54
Rockdale ...
l
Schley . .
6
Screven . ..
12
Seminole.
4
Spalding ..
26
Stephens.
9
Stewart ...
7
Sumter . . .
31
Talbot ...
8
Taliaferro.
l
Tattnall ...
9
Taylor ...
6
Telfair ......
10
Terrell .....
21
Thomas.
36
Tift .....
18
Toombs ..
14
Towns ....
2
Treutlen.
1
Troup . . .
54
Turner . . .
6
Twiggs ..
11
Union ..
6
Upson ..
32
Walker. ..
3!
1iValton ..
23
Ware ....
23
warren ..
18
\:Vashington ...
29
Wayne ...
15
Webster ...
4
Wheeler ..
5
White ....
4
Whitfield.
38
Wilcox ....
3
Wilkes ..
13
\Vilkinson .' .
3
Worth. Residents.
~f
G~o;gi~;
d~atl~
-~cc-ur~
20
ring in other states . .
*
14 59.8 36.2
93 27.9 44.3
3 22.0 19.2
4 52.2 35.7
17 23.3 38.7
7 16.7 50.0
20 32.7 50.0
6 21.9 16.8
5 30.8 18.8
35 42.3 57 .I
10 37.6 48.1
7 38.1 58.8
3 22.2 9.8
7 25.6 25.9
12 29.9 39.0
20 46.0 41.8
46 42.4 53.6
19 30.7 38.2
9 35.5 22.4
1 28.2 10.3
7
6.5 45.5
!0 50.2 37.3
6 25.8 33.0
11 39.7 44.0
6 29.3 34.9
30 46.4 56.5
34 35.6 45.'!
23 38.1 46.9
23 27.8 30.4
10 63.4 41.2
34 51.8 62.3
7 36.3 16.8
13 31.2 107.4
3 34.7 19.6
10 25.6 70.4
25 4!.5 36.7
3 11.6 15.2
18 34.9 51.1
4 12.2 20.1
23 32.5 !0.1
10
7.2 5.2 1.3 3.8
2
8. 7 17.9
I
7. 8 2.3
2
14.3
2
6.3 3.'!
I
2.8
I
4.'! 3.8
2
6.8 3.3
1
4.8
1
9. 5 8.4
3
9.8
1
3. 7
1
3.0 3.2
1
2.2 2.1
2
3.5 2.3
2
1.7 4.0
1
2.5
3.1 0.9 !.3 3.6 4.0
2.9 3.8
1.0 5.3
6.6 4.1
2
2.4 2.6
4.1
1.8 1.8
4.8
6.5
1.2
5. 7
.j,J
5.0
6. 5 7.0
* Residents of Georgia, death occuring~in otbe(states whrre allocated to county of residence inJ946.
NOTE: These figures e.xclude nonresidents of Georgia and include residents of Georgia with death occuring in other statrs.
Informcttion and Stcttistics
323
TABLE 10
DEATHS AND DEATH RATES PER 1,000 POPULATION IN EACH COUNTY IN GEORGIA: 1945 AND 1946
DEATHS
County
Number
Rata Par 1,000 Population
1946 1945 1946 1945
TOTAI.. ...... 27,405 28,456
Appling ........... 88
86
Atkinson .......... U
45
Bacon............. 63
GO
Baker........... 33
45
Baldwin........... 168 167
Banks ............. 44
47
Barrow ............ 116 111
Bartow ........... 275 234
Ben Hill'. .....
137 141
Berrien ............ 111 100
Bibb.............. 966 1,103
Bleckley........... 87
85
Brantley .......... 52
48
Brooks............ 169 156
Bryan ............ 59
G8
Bulloch ........... 20G 182
Burke............. 211 231
Butts ............. 96
93
Calhoun ........... 90 97
Camden........... 55
63
Candler ........... 51
71
Carroll............ 2G4 280
Catoosa . . .
72
66
Charlton ...
33
47
Chatham.......... 1,561 1.679
Chattahoochee..... 17
24
Chattooga......... 123 148
Cherokee.......... 153 149
Clarke ............ 307 259
Clay.............. 58
47
Clayton ........... 91
99
Clinch ............ 30
24
Cobb ............ 362 363
Coftee............. 202 188
Colquitt........... 218 229
Columbia.......... 74
59
Cook............ 93
85
Coweta........... 204 165
Crawford.......... 37
55
Crisp ............. 163 150
Dade ............. 18
43
Dawson ........... 20
18
Decatur........... 208 232
DeKalb ........... 782 815
Dodge ............ 115
93
Dooly............. 128 129
Dougherty......... 329 353
Douglas ........... 72
52
Early ............. 131 121
Erhols ............ 18
21
Effingam .......... 97
86
Elbert ............ 146 170
Emanuel. ......... 163 186
Evans............. 54
57
Fannin ............ 124
76
Fayette ........... 64
61
Floyd ............. 424 446
Forsyth ........... 75
42
Franklin .......... 100
86
8.8 6.1
5.8 7;8
4.5 10.2 5.0 8.9 10.9
9.4 7.2 11.5 9.0
7.6 8.2 9.4 7.9 8.0 10.5 9. G 9.3 5.6 7.7 6.G
6.3
13.2 3.3 6. 6
1.G
10.8 8.2 7.8 1.7 9.5 9.4 6.6 7.8 7.8
7.6 5.2 9.3
8.1 !.5
9.4 9.0 5.5 7.6 11.5 7.2 6.6 6.1 10.1 74 6.9 7.3 8.4 7.8 7.6 6.6
6.4
9.1
5.9 G.3
7.4 G.1 10.2 5.4 8.5 9.3 9.7 6.5
13.2 8.8 7.0 7.6 10.8 7.0 8.7 10.1 9.3 10.6 7.8 8.2
6.1 8.9 14.2 4.7 8.0 7.4 9.1 6.7 8.5 3.7 9.5 "8.7 6. 9 6.3 7.1 6.1
7.7 8.6
7.3 4.0 10.4 9.4
4A
7.6 12.4 5.2
6.6 8.1 8.9 ~7
7.9 7.7 5.2 7.5 7..9 3.7 5.5
DEATHS
County
Number
Rata Per 1,000 Population
1946 1945 1946 1945
Fulton ............ 4,377 4,441 11.1
Gilmer............ 67
G5 7.4
Glascock ......... 31
28 7.5
Glynn............. 305 359 13.9
Gordon ........... 109 108 5.9
Grady............. 13G 149 6.9
Greene ............ HG 133 10.6
Gwinnett.......... 226 251 7.8
Hahersham ........ 117 103 7.9
Hall .............. 233 Hancock .......... 99
228 "' 6.7 75 7.8
Haralson .......... 85
90 5.9
Harris ............ 119
97 10.4
Hart.............. 82
60 5.3
Heard ............. GO
70 7.0
Henr_,: ... ......... 125 156 8.3
Houston .....
130 127 11.5
Irwin ............. 81
64 6.3
Jackson ........... 139 102 6. 9
Jasper . ........... 97
80 11.1
Jeff Davis.
G3
50 7.1
Jefferson .. .....
119 141 5.9
Jenkins ........... 131 108 11.1
Johnson........... 71
G4 5.5
Jones . ............ 70
73 8.4
Lamar . ........... 110 107 10.9
Lanier ............ 28
36 5.0
Laurens ........... 298 310 8.9
Lee............... 66
67 8.4
Liberty ........... 70
82 8.1
Lincoln .......... 20
31 2.8
Long.............. 29
23 7.1
Lowndes .......... 296 306 9.3
Lumpkin .......... 48
35 7. 7
McDuffie .......... 80
76 7.4
Mcintosh .......... 66
83 12.5
Maron ............ 142 165 8.9
Madieon .......... 90
98 6. 7
Marion............ 59
68 8.5
Meriwether. ....... 170 190 7.7
Miller............. 66
71 6. 6
Mitchell.. ......... 190 189 8.2
Monroe ........... 118 106 11.0
Montgomery....... 44
34 4.6
Morgan ........... 107 115 8.4
Murray .......... 86
69 7. 7
Muscogee ......... 806 806 10.7
Newton ........... 142 185 7.6
Oconee............ 67
71 8.8
Oglethorpe ........ 82 120 6.6
Paulding .......... 81
7G G.3
Peach ............. 124 124 11.9
Pickens ........... 64
62 7.0
Pier('e.... ......... 76
88 6.4
Pike ............. 89
73 8.6
Polk............. 205 205 7.2
Pulaski. ........... 63
64 6.1
Putnam ........... 82
66 9.6
Quitman .......... 22
32 6.4
Rabun .......... 3G
31 !.6
11.3 7.2 G.2
1G.4 5.9 7.G
9.7 8. 6 7.0 6.5 5.9
6.3 8.5 3.9 8.1 10.3 11.2 4.9 5.1 9.1 5.7 7.0 9.1 4.9 8.8 10.6 6.4 9.2 8.5 9.5
4.4 5.G
9.6 5.6
7.0 15.7
10.3 7.3 9.8 8.6 7.1 8.1 9.9 3.5 9.0 6.2 10.7 10.0 9.4 9. 7 5.9 11.9 6.8
7.5 7.0 7.2 6.5 7.8 9.3 4.0
324
Georgict Department of Pttblic Hectlth
TABLE 10-Continued
DEATHS AND DEATH RATES PER 1,000 POPULATION IN EACH COUNTY IN GEORGIA: 1945 AND 1946
DEATHS
DEATHS
County
Number
Rate Per 1,000 Population
County
.--Number
Rate Per 1,000 Population
1946 1945 1946 1945
Randolph ......
136 154
Richmond ......
930 1,011
Rockdale . . . . . .
70
77
Schley..........
47
37
S('reven . ......
101 133
Seminole .......... 65
68
Spalding .......... 284 275
Stephens .......... 69
63
Stewart ........... 97
79
Sumter........
275 266
Talbot ...... ..... 85
75
Taliaferro ......... 47
47
Tattnall.........
99
77
Taylor .....
GO
77
Telfair ......
91
98
Terrell ........
168 157
Thomas .....
294 355
Tift .........
154 193
Toombs ........... 118 127
rrowns. 0
14
8
Treutlen ......
41
35
Troup . . . . . . . .
402 404
8.2 11.4
9.1 9.3 5.0 7.7 10.0 5.3 9.1 11.2 10.4 7.5 6.1 5.6 6.0 10.1
9.4 8.3 7.0 2.8 5.4 9.2
9.3 12.3
10.0
7.4 1!.5 8.0 9. 7 4.9 7.5 10.9 9.2 7.5 4.7 7.2 6.5 9.4 11.3 10.4 7.5 1.6
4.6 9.2
1946 1945 1946 1945
~u~ncr ...... .
58
53 5.3 4.9
1WJggs.......
69
67 7.6 7.3
Union ......
30
22 3.9 2.9
Upson .....
215 194 8.6 7. 7
Walker . . . . .
223 241 7.2 7.8
Walton ....
172 190 8.3 9.1
Ware .....
265 289 9.5 10.3
\Ynrren .......
100
96 9.8 9A
Washington ..
194 227 8.0 9.4
Wayne . . . . .
104
87 7.9 G. 6
Wehster . . . .
32
45 6.8 9.5
Wheeler . . . .
43
48 5.0 5.6
White ............. 30
56 !. 7 8.7
Whitfield .......... 220 191 8.1 7.3
Wilcox ..........
49
51 3.8 4.0
Wilkes ............ 117 126 7.8 8.4
Wilkimon ......... g2
87 7.4 7.9
Worth ....
134 !56 6.3 7.3
R.esirlents of
Georgia, death oc-.
curing in other
states........... *
186
NOTE: Rates Based on the 1940 Census Enumerated Population. These figures exclude nonresidents of Georgia and include residents of Georgia with death occuring in other states.
* Residents of Georgia, death occuring in other states were allocated to county of residence in 1946.
Informcttion and Statistics
325
TABLE 11
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND TYPHUS IN EACH COUNTY IN GEORGIA: 1945 AND 1946.
County
TYPHOID
Number
Rate per 100,000 Population
TYPHUS
Number
Rate Per 100,000 Population
1946
1945
1946 1945
1946
1945 1946
1945
TOTAL.... .. .. 11
27
Appling.... . . . .
.,.
Atkinson. . . . .
. ...
Bacon.... . ...
Baker....
..
Baldwin.. . . . . . . . .
Banks.....
..
Barrow.... . . . . . ...
Bartow...... .
BenHill.... ..
..
2
Berrien..... . .
Bibb........ ..
..
Bleckley.. .. . . .
..
Brantley... . . . . . . . ...
Brooks ...
~~~~i;... :... .. .. i
Burke.... . . . .
. ...
Butts..... .
Calhoun..... . .
Camden.. . . . .
..
Candler. . . . .
Carroll.. . ..
Catoosa.. . .
Charlton.
.. .... ..
Clmtham...... . . . .
Chattahoochee.
Chattooga.. . .
. ..
Cherokee...
.. ..
Clarke.
Clay......
.. ..
Cla.vton.
..
Clinch.
Cobb....
. .....
Coffee......... . . . .
Colquitt...... .. .. .. ..
Columbia.... . . . .
Cook.
..
Coweta....... . . . .
Crawford... . . . .
..
Crisp.
....
..
Daae... ..
..
Dawson....... . .
Decatur.... . .
. ..
DeKalb.
..
. ...
Dodge. . .
.... ..
Dooly.........
..
Dougherty..... . .
Douglas.
..
i
Early...... .. .. ..
Echols..... . . . . . .
Effingham. .. ........ ..
~~;~t~ei: ...... .. .. i 2
Evans....
..
Fannin.. . .
..
1
Fayette... . .
. . . .. 1
Floyd........ .. .. . ...
Forsyth......
. ..
Franklin. . . . . . .
0.4 0.9
33
6.1
13.8 1.2
3.8
11.0
59
1.1
1.9
i4:i
14.1
12.4
2
1.2
2.4
14.6 4.9
2
7. 7
9. 6
11.0 2.9
i2
10.2
3.0
5. 7
4.5
1
1
1
1
'1.3 8.5
6.8 12.2
i:i:!i
2.6 9.3
3.0
33.6
2
11.4
4:5
1.2
2.3
4.8
5.9
5.1
i
10.4
i
8.5
4.3
2
27.0
326
Georgit Depotrtment of Pttblic 1-letlth
TABLE 11-Cominued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND TYPHUS IN EACH COUNTY IN GEORGIA: 1945 AND 1946.
County
TYPHOID
Rate per 100,000
Number
Population
TYPHUS
Number
Rate Per 100,000 Population
Fulton .. . Gilmer .. . Glascock. Glynn........ . Gordon ..... . Grady ..... .
Greene.. . . Gwinnett. .. .
Habersham. Hall....... . Hancock ...... . Haralson ...... . Harris ....... .
Hart......... . Hearrl....... . Henry .... . Houston, ...... . Irwin .......... . Jackson ........ . Jasper .......... .
Jeff Davis . . . . . . . . . Jefferson. , .... . Jenkins., ....... .
Johnson ....... . Jones ...... . Lamar .... . Lanier .... . Laurens .. Lee....... . Liberty ....... . LinP.oln ....... .
Long .......... .
Lowndes ..... . Lumpkin .... .
McDuffie ...... . Mcintosh .. . Macon ...... . Madison .... . Marion ...... . Meriwether . . . Miller .... Mitchell Monroe ..... . Montgomery .. Morgan .. . Murray .. . Muscogee. Newton .. . Oconee ... . Oglethorpe. Paulding .. Peach ... . Pickens .... . Pierce ..... .... . Pike .......... . Polk .......... . Pulaski......... .
Putnam ... . Quitman ...... .
Rabun ....... .
1946
1945
1946 1945
1946
1945 1946
1945
0.5
5
0.5
1.3
7.3
. 6:8
2.9
.7:o
8.8
5.1
5.1
2.9
5.0
5,0
2
"7:7
12.0
7, 7
22.6 5.0 8.4
9.9 17.8
i7:s
"id
14.4 4.5
10.0 4.3
10.9 io:il io:2
Information and Stcttistics
327
TABLE 11-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND TYPHUS IN EACH COUNTY IN GEORGIA: 1945 AND 1946.
County
TYPHOID
Rate per 100,000
Number
Population
TYPHUS
Number
Rate Per 100,000 Population
1946
1945
1946 1945
1946
1945 1946
1945
Randolph ...... . Richmond ....... .
.i
Rockdale........ .
Schley .................... ..
Screven .................... .
Seminole ..... .
Spalding................ .
Stephens ... .
Stewart ..
Sumter...... .
Talbot ..... .
Taliaferro ... .
Tattnall..... .
Taylor ...... .
Telfair .... ..
Terrell........ . ......... .
Thomas...... .
Tift....... .
Toombs .... .
Towns .......... .
Treutlen ........ .
Troup...................... .
Turner..................... .
Twiggs..................... .
Union ................. . Upson ................. .
'j
1
Walker................ .
Walton............... .
Ware .......... . Warren........ .
.i
Washington................. .
Wayne.................... .
Webster.................... .
Wheeler................... .
White...................... .
Whitfield................... .
Wilcox . . . . . . . . . . . . . . . . . . . . . .
Wilkes .................... ..
Wilkinson .............. .
Worth ................. .
1.2
6.0
3.2
2
4.0 4.0
. o.s
1
3.5
6.2
1
6.6
1
6.0
1
6.4
3.2
1
5.4
1
5.9
2.3
3
3.6
10.7
4.1
7. 6
7.6
11.7
NOTE: Rates based on the 1940 Census Enumerated Population. 'fhese figures exclude nonresidents of Georgia and include residents ofGeorgia with death occurring in other states.
328
Georgia Department of Pttblic Hettlth
TABLE 12
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM MALARIA AND TUBERCULOSIS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
MALARIA
TUBERCULOSIS
County
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1946 1945
1946
1945
1946 1945
1946
1945
TOTAL
12
26
OA
0.8
Appling ...
Atkinson ..
Bacon .....
Baker ....
2
27.2
Baldwin ...
Banks ...
Darrow . .
Bartow ....
Ben Hill. .....
6.9
Berrien .....
Bibb ....
Bleckley
Brantley. Brooks ...
. 9:8
Bryan .....
Bulloch .....
Burke Butts .....
'i
7.5 10.9
Calhoun ..
Camden ..
Candler .....
Carroll .....
Catoosa .... Charlton ... Chatham . . . . . . .
.i .i
19.0 0.8
Chattahoochee.
Clmttooga . . .
Cherokee.
Clarke ......
Clay....
Clayton ...
Clinch .... Cobb .....
.i .i .2:6 '2".5
Coffee ....
Colquit.t. ...
Columbia ..
Cok ... Coweta ...... Crawford ... Crisp ....
Dade .... Dawson .. Decatur ..
............
2
28:i
Del\alb ....
Dodge ....
Dooly . . . . . . .
Dougherty ..
Douglas . . .
Early .....
Echols .....
Effingham ..
Elbert .....
Emanuel ...
Evans ...
Fannin ....
Fayette ....
Floyd . . . . . . . . . . . .
Forsyth ........
'Franklin .......
1,0<18 3 1 2
~
7
13 2 2 40 3 I 9 4 7 3 2 1 4 2 9 4
1,108 2 2 3 2 7 1 2 14 4 2 52 1 3 3 2 4 11 3
3
8 3
70
70
i7 8
4
2
9
13
3
1 12
io
7
7
6
9
3
3
1
3
6
I
~
7
4
1
2
5
9
33
32
4
2
I
1
12
I7
1
I
IO
5
1
2
4
9
3
<1
6
2
6
26
32
2
5
33.5 20.7 14.1 24.7 40.8 42.7
51.4 I3.8 I3.0 <17.7 31.1 14.6 43.9 63.6 26.9 11.3 21.8 10.7 67.7 22.0 26.3 36.7
59.3
91.7 19.9 31.7
25.7 15.5 31.4 32.5 18.2
25.2 11.1 H.O 39.9 67.9 22.3 22.5 38.0 19.0 5.9 42.0 9.9 50.7
2o:7
45.9 17.0 27.0 40.7
46.3 17.7 32.0
35.5 13.8 28.2 37.1 27.2 42.7 11.5 I5.3 55.4 27.6 I3.0 62.1 I0.4 43.7 I4.6 31.8 15.4 41.5 32.7
so:s
23.4 27.5
59:3
43.2 9. 9 45.8
26:i
32.5 27.3 31.8 8.4 22.2 :!S.I 45.6
44:7
<10.5 36.8
9.5 5.9 59.5 9.9 26.8 33.7 41.5 15.3 25.5
47.5
57.0
iiJj
Information and Statistics
329
TABLE 12-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM MALARIA AND TUBERCULOSIS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
MALARIA
TUBERCULOSIS
County
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1946 1945
1946
1945
1946 1945
1946
1945
Fulton ..........
Gilmer ..
Glascock .. : .....
Glynn........
Gordon ......
Grady ......
Greene . . . . . . .
Gwinnett . . .
Hahersham ..
Hall ........
Hancock ...
Haralson ....
Harris ......
Hart. ...
HearJ ..
Henry ..
Houston
1rwin .....
Jackson ....... ,.
.Jasper . .........
Jefi' DaYis.
.Jel-l'erson . ......
.Jenkins ........
Johnson .... Jones ......
.
.
.
.
.
.
.
.
.
.
..
Lamar Lanier
... .....
.
.
.
.
.
.
.
.
.
.
.
.
..
TJaureus.
'j
lJee . . . . . . . .
Libertv ........
Lincoln .........
Long .........
Lowndes .....
Lumpkin ......
McDuffie ......
Mcintosh .....
Macon ......
Madison ......
Marion .......
Meriwether . . .
Miller.........
Mitchell. ......
N!onroe .........
Montgomery .......
Nlorgan ...........
Murray ........ Muscogee .....
Newt.on ...... Oconee . . . . . . .
Oglethorpe.
Paulding ....
Peach .......
Pickens .....
Pierce . . . . . . .
Pike .........
Polk .........
Pulaski .................
Putnam ................
Ouitman ...............
Rabun .................
0.3
0.3
3.4
17.8 3.0
3.1 6.3 30.0
10.2
212 225
3
5
1
2
9
9
5
3
2
6
5
!
2
9
3 fi
5
5
6
5
2
3
I
I
3
6
!
4
1
I
2
2
1
7
1
2
5
2
7
()
I
4
4
!
3
4
1
12
~
3
3
1
1
2
I
12
13
1
1
3
2
2
~
l
5
3
4
1
7
8
1
2
7
3
I
35
3S
4
5
1
1
4
7
2
I
2
I
2
2
2
s
11
1
1
1
2
54.0 33.3 22.0 41.0 27.1 10.2 36.5
6.9 20.3 17.2 39.2 34.8 26.3
ii:6
39.7 35.4 7. 7 10.0 79.8 22.6 25.0 59.1 7. 7 48.0 29.7
23.8
34.9 14.2 48.9 37.7 16.1 27.6 37.8 25.1
43.1 18.1 10.0 30.1 74.4 10.3 15.7 26.9 46.4 21.5 1H.2 8.0 31.2 H7.5 10.9 8.5
19.~
2q.l
10.2 11.7 58.2
57.3 55.5 44.0 41.1 16.3 30.5 29.2 30.9
14.4 47.0 13.9 8.8
34.8 26.5 8.R 15.5
5.0 11.4
10.0 50.7 30.9 48.0 39.6 17.8 35.7
38.~
34.9 14.2 24.5 40.8 16.1 18.4 56.7 31.4 ~~. 9
27.2
27.9
55.1 9.0 50.3 26.9
40.2
19.~
21.9 16.9 19.3
~R.Ii
10.2
liii:4
12.8
330
Georgia Department of Pttblic Hectlth
TABLE 12-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM MALARIA AND TUBERCULOSIS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
MALARIA
TUBERCULOSIS
County
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1946 1945 1946
1945
1943
1945 1946
1945
Randolph ....... Richmond .......
.... ....................
.i
"i:2
Rockdale .... Schley ......
.... ....
............
Screven . ....................
Seminole ..........
23.6
Spalding.....................
Stephens ....................
Stewart .... ............
Sumter......
.i
!.1
Talbot. ... Ta!iaferro .
..... .....
..
...........
Tattnall..... ................
. rraylor ........
Telfair ........
Terrell ........ Thomas .......
... .. .
...................... . .. .. .... .
Tift.. .......... Toombs ....
ii:S
Towns ......
Treutlen ....
TTTUUwurpnorsiionugonegpnrs...............................................
11.0
Walker..........
Walton . . . . . . . . .
Ware ..........
Warren ....... Washington ...
........... .i
. i:i
4.1
Wayne......................
7.6
WWheebeslteerr................ ...................... . .
White ..........
Whitfield .... Wilcox ....
...........
2
7.8
15.7
Wilkes ... Wilkinson.
..................
Worth ......................
Residents of Georgia, death oc-
curring in other states . ......
1
9
53
5~
1
3
1
3
6
6
2
7
9
4
1
6
3
11
10
1
3
2
2
2
4
2
4
2
5
4
10
5
5
3
5
3
1
1
2
15
14
1
2
3
1
8
9
8
18
5
7
13
7
3
5
4
2
1
1
1
18
11
3
1
3
2
3
2
6
2
* 57
6.0 61.1 12.9 19.9 29.5 23.6 24.6 30.8 56.6 44.9 12.3 31.9 12.3
26.4 30.0 32.0 26.9 29.5 20.3 13.1 34.2 9.2 32.9
31.9 25.8 24.1 46.5
20.6 15.2 21.2
69.0 23.5 19.9 27.2 28.1
54.2 61.1 38.8 59.6 29.5
31.7 7. 7 28.3 10.8 36.9 31.9 24.6 18.6 13.2 24.0 16.0 16.1 17.7
26.2 31.9 18.'! 11.0
:i5:9
58.0 33.7 25.1 29.3 16.5
21.2 11.7
42.1 7.8 13.3
18.1 9.4
NOTE: Rates based on the 1940 Census Enumerated Population. These figures exclude nonresidents of Georgia and include residents of Georgia with death occurring in other states.
* Residents of Georgia, death occuring in other states were allocated to county of residence in 1946.
Information ?tnd Statistics
331
TABLE 13
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM CANCER AND PELLAGRA IN EACH COUNTY IN GEORGIA: 1945 AND 1946
CANCER
PELLAGRA
County
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1946 1945
1946
1945
1946 1945
1946
1945
TOTAl.. Appling ..
Atkinson. Bacon .. Baker.....
Baldwin .. Banks .... Barrow ..... Bartow . . . . Ben Hill ..... Berrien . ... Bibb . . . . . Bleckley . . . . . . Brantley .... Brooks ...
Bryan ... Bulloch ... Burke ... Butts ....... Calhoun ....
Camden . . . Candler ... Carroll . . . . Catoosa ..... Charlton ... Chatham ..... Chattahoochee .. Chattooga ..
Cherokee .. Clarke .. Clay . . . . Clayton ...
Clinch ... Cobb .... Coffee .... Colquitt. .. Columbia .. Cook .... Coweta ... Crawford .. Crisp .... Dade .... Dawson ... Deratur .. DeKalb .. Dodge ... Dooly ..... Dougherty .. Douglas ..
Early .... Echols ... Effingham Elbert .... Emanuel. Evans . . . . . . Fannin ... Fayette ... Floyd . . . . . . Forsyth Franklin.'.: ..
2,420 7
6 3 14 3 10 26 10 6 88 6 6 11 l 8 14 7 6 5 7 26 10 6 142
15 15 31 4 10 1 46 12 17 7 9 23 1 5 3 3 9 97 6 9 26
5 13
8 17 13 7 11
7 54 5
2
2,441 2 4 4 4 21 5 18 15 13 5 95 6
13 7 8 20 10 10 1 3 31 7 4 132
... iil
17 23 8
9 1 25 11 18 3 5 8 2 3 4 2 16 94 6 5 28 5 10 2 7 12 8 3 J 4 52 5 9
77.5 48.3
74.1 40.8 85.3 34.4 76.5 102.8 68.9 39.0 105.0 62.1 87.3 53.7 63.6 30.8 52.8 76.2 57.5 84.6 76.9 76.1 91.8 114.2 120.4
80.9 79.5 109.2 56.6 85.8 15.5 120.2 55.7 51.5 74.2 75.5 85.3 14.0 28.5 50.9 67.0 40.5 111.6 28.5 53.3 91.0 49.7 69.6
82.9 86.7 55.3 94.6 74.6 85.7 96.2 44.2 12.8
78.1 13.8 56.4 49.4 54.5 128.0 57.3 137.8 59.3 89.5 32.5 113.4 62.1
63.4 111.3 30.8 75.4 108.9 95.8
16.9 33.0 90.8 64.2 76.1 111.9
102.5 84.5 81.0 113.3 77.2 15.5 65.3 51.1 54.5 31.8 41.9 29.7 28.1 17.1 67.9 44.7 72.9 108.1 28.5 29.6 98.0 49.7 53.5 67.5 72.6 61.2 34.0 40.5 27.1 49.0 92.6 44.2 57.6
93 106
3.0
3.4
2
13.8
1
6.1
'i
. 7:7
4.0
6.9
2
13.0
1
3
1.2
3.6
2
. 9:8
1
15.9
2
3.8
7. 7
1
3.8
3.8
19.2
1
11.0
3
5
8.8
14.6
2
l
1.7
3.4
1
1
19.5
19.5
2
10.8
1
5.0
2
28:3
2
. 5:2
2.6
4.6
6.1
8.4
1
3. 7
1
22.3
1
4.5
J
4
J. 6
4.6
'2
7.0
7.0
5.4
.i
10.1
.3 "i
12.8
i3:5
.i
1 i2:2
6.8
1
1.8
5.3
1
8.8
332
Gemgict Department of Pttblic Health
TABLE 13-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM CANCER AND PELLAGRA IN EACH COUNTY IN GEORGIA: 1945 AND 1946
CANCER
PELLAGRA
County
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1946 1945
1946
1945
1946 1945
1946
1945
Fulton ..................... . 424 446 107.9 113.5
Gilmer ..................... .
3
4
33.3
44.4
Glascock ................... .
1
3
22.0
66.0
Glynn ...................... .
17
20
77.6
91.2
Gordon..................... .
9
7
48.8
38.0
Grady .....................
11
14
56.0
71.2
Greene..................... .
H
17 102.1 124.0
Gwinnett.... ............... .
28
27
96.3
92.8
Habersham ................. .
8
14
M.2
94.8
Hall. ...................... .
14
26
'!0.2
74.7
Hancock ................... .
4
9
31.3
70.5
Haralson ................... .
4
6
27.8
!1. 7
Harris...................... .
10
15
87.5 131.3
Hart....................... .
3
5
19.3
32.2
Heard ..................... .
7
4
81.3
46.5
Henry ..................... .
14
15
92.6
99.2
Houston.................... .
12
3 106.2
26.5
lrwjn, .............. ....... .
10
4
77.3
30.9
Jackson .................... .
14
12
69.7
59.7
Jasper ..................... .
7
7
79.S
79.8
Jeff Davis .................. .
6
2
67.9
22.6
Jefferson . . . . . . . . . . . . . . . . . . . .
11
8
54.9
39.9
Jenkins .................... .
6
7
50.7
59.1
Johnson .................... .
.j
7
30.9
54.0
Jones ...................... .
5
4
60.0
48.0
Lamar . . . . . . . . . . . . . . . . . . . . . .
9
12
89.2 118.9
Lanier ..................... .
6
3 106.5
53.3
Laurens .................... .
18
11
53.6
32.7
IJCC, . . . . . . . . . . . . . . . . . . . . . . .
5
3
03.8
38.3
Liberty .................... .
5
9
58.2 104.7
Lincoln .................... .
4
2
56.8
28.4
Long ....................... .
1
1
24.5
24.5
Lowndes ................... .
24
22
75.3
69.1
Lumpkin ................... .
2
6
32.1
96.4
McDuffie................... .
8
6
73.5
55.2
Mcintosh .................. .
2
7
37.8 132.3
Macon . . . . . . . . . . . . . . . . . . . . . .
12
14
75.2
87.8
Madison ................... .
6
6
44.7
44.7
Marion..................... .
2
2
28.8
28.8
Meriwether................. .
18
8
81.6
36.3
Miller...................... .
4
8
'10.0
80.0
Mitchell................... ..
13
10
55.9
43.0
Monroe .................... .
H
11 130.2 102.3
Montgomery ................ .
4
3
41.4
31.0
Morgan .................... .
7
5
55.1
39.3
Murray .................... .
7
5
62.9
44.9
Muscogee .................. .
60
75
79.5
99.3
Newton .................... .
18
23
96.9 123.8
Oconee..................... .
4
6
52.8
79.2
Oglethorpe ................. .
7
12
56.3
96.5
Paulding ................... .
10
H
77.9 109.1
Peach ...................... .
10
15
96.4 H4.5
Pickens . . . . . . . . . . . . . . . . . . . . .
5
'!
54.7
43.8
Pierce ...................... .
7
4
59.3
33.9
Pike ...................... ..
10
12
96.4 115.7
Polk....................... .
14
27
'19.2
94.8
Pulaski..................... .
4
40.7
Put.nam .................... .
6
4
70.5
47.0
Quitman ................... .
1
3
29.1
87.3
Rabun ..................... .
6
2
76.7
25.6
2.3
2.3
22.2
4.6
5.4
5.4
5.1
7.3
2
2
6. 9
6.9
3
2
20.3
13.5
1
2
2. 9
5. 7
.i
8.8
1
8.8
7. 7
2
5.0
10.0
57.0
3.'1
.i "i i2:o 12.0
1
9.9
1
il:o
2
i4:9
2 2 9.1 2o:o
2
8.6
2
i5:7
7.9
1
9.0
2
2
2.6
2.6
1
5.4
"i
7.8
"i
10.9
8.5
3.5
"i
11.7
Information ctnd Statistics
333
TABLE 13-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM CANCER AND PELLAGRA IN EACH COUNTY IN GEORGIA: 1945 AND 1946
CANCER
PELLAGRA
County
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1946 1945
1946
1945
1946 1945
1946
1945
Randolph ...................
13
Richmond ...................
115
Rockdale ..... Schley, .......
6 5
Screven .......
9
Seminole ......
7
Spalding .....
31
Stephens ...
4
Stewart.... . . . . . . . . . . . .
7
Sumter.... .. ... . .. .. . .. .. .
29
Talbot ......
10
Taliaferro ....
2
Tattnall....
3
Taylor ......
2
Telfair ...
4
Terrell ....
7
Thomas .....
28
Tift ........
8
Toombs ....
9
Towns ......
1
Treutlen ....
6
Troup .....
38
Turner . . . .
4
Twiggs .......
5
Union ........
Upson .....
J9
Walker ...
27
Walton ..
9
Ware ....
21
warren ......
7
-washington.
14
Wayne ...... Webster .... Wheeler . . . . White ....
...............
6 3 4 3
Whitfield ...
30
Wilcox ..... ...............
4
Wilkes ......
4
Wilkinson ...
6
Worth . . . . . . . . . . . . . . . . . . . . . .
8
Residents of Georgia, death oc-
curring in other states ......
*
10
78.3
60.2
81
1<10.5
98.9
7
77.7
90.6
4
99.3
79.5
11
44.2
51.0
7
82.4
32.4
26 109.1
91.5
7
30.8
54.0
6
66.0
56.6
28 118.4 1H.3
5 122.8
61.4
4
31.9
63.7
3
18.5
18.5
3
18.6
27.9
7
26.4
46.2
18
42.0 107.9
28
89.5
89.5
9
13.0
48.1
11
53.1
61.9
2
20.3
10.6
1
78.6
13.1
37
86.6
8-!.3
3
36.9
27.7
3
54.8
32.9
2
26.0
13
75.8
51.9
23
87.0
71.1
10
13.3
48.1
26
75.2
93.1
8
68.4
78.2
16
57.8
66.0
12
15.7
91.4
3
63.5
63.5
2
46.9
23.4
3
16.8
46.8
21 11<1.9
BOA
3
31.4
23.5
10
26.5
66.3
3
54.4
27.2
7
37.4
32.8
51
6.0
5
6.1
3.7
2
7.0
7.0
4.1
1
6.2
1
6.0
6.0
1
3.2
3.2
5.4
4.6
1.6
3
12.0
1
3.2
1
1
4.8
4.8
1
2
3.6
7.2
1
9.8
2
8.3
4.1
2
42.3
1
7.7
3.8
2
18.1
1
l. 7
*
NOTE: Rates based on the 1940 Census Enumerated Population. These figures exclude nonresidents of Georgia and include residents of Georgia with death occurring in other states.
* Residents of Georgia, death oeeuring in other states were allocated to county of residence in 1946.
334
Georgict Depctrtment of Public Health
TABLE 14
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM PNEUMONIA
AND MOTOR-VEHICLE ACCIDENTS IN EACH COUNTY IN GEORGIA:
1945 AND 1946
PNEUMONIA
MOTOi'l-VEHICLE ACCIDENTS
County
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1945
1945
1945
1945
1946 1945 1946 1945
TOTAL............ .
Appling....... . ......... .
Atkinson ..... . Bacon ........ . Baker........ . Baldwin...... . Banks...................... . Barrow ........ . Bartow ..................... . Ben Hill.... . Berrien ........ . Bibb........ . ............ . Blcckley................... .
Brantley ... . Brooks..... . Bryan ..... . Bulloch ..... . Burke.................. . Butts ......... . Calhoun...... . Camden...... . Candler........ . ......... . Carroll........... . Catoosa .......... . Charlton .......... .
Chatham....... . Chattahoochee...... . Chattooga.......... .
Cherokee ........... . Clarke ........... . Clay............. . Clayton .................... . Clinch .............. . Cobb ............ . Coffee................... . Colquitt................. . Columbia........ . ... . Cook ...................... . Coweta .................. .
Crawford................... . Crisp ............. . Dade ............. . Dawson ........ . Decatur........... . DeKalb .......... . Dodge............ . Dooly...................... . Dougherty.................. . Douglas.................... .
Early ................ . Echols ..................... . Effiingham .......... . Elbert ..................... . Emanuel. .................. . Evans.................. . Fannin ..................... . Fayette .................... . Floyd....... . Forsyth .... .
1.341 3 4 9 3 18 1
3 13 5 4 43 12
1
7 3 9 14 4 4 3 2 11 3 2 71
2 4 10
9 4 5 2 19 10 9 7 6 9 1 11 2
2 8 30 5 9 11 3 7
2 6 6 6 8 2 15 3
1,500 7 2 1 2 15 5 4 12 12 4 55 7 1 8 4 10 6 5 4 1 3 13 10 3 97 3
9 15 13
<1
12 3
13 10 19 3 5 9 3
5 2
17 33 3
9 19
3 9
6 5 12 3 5 3 23
42.9 20.7 56.4 111.2
<1~.8
109.7 11.5 23.0 51.4 34.4 26.0
51.3 124.3 14.1)
34.2 47.7 31.6 52.8 43.6 42.1l 50.8 22.0 32.2 27.5 38.1 60.2 38.9
2l.ll 49.7 31.7 51l.6 <12.9 31.1 49.6 46.4 27.3 74.2 50.3 33.4 14.0 62.7 33.9 44.7 36.0
34.5 23.8 53.3 38.5 29.8 35.5
20.7 30.6
25.5 81.1
54.2 24.5 26.7 26.5
48.0 48.3 28.2 12.4 27.2 91.4 57.3 30.1)
47.5 82.6 26.0 65.7 72.5 14.6 39 .. 0 63.6 38.4 22.6 54.5 38.3 16.9 33.0 38.1 91.8 57.1 82.2 58.4 <18.1) 74.5 45.8 51l.ll 103.0 16.6 34.0 46.4 57 .ll 31.8 11.9 33.4 42.1 28.5 33.9
76.5 38.0 14.3 53.3 1)6.5 29.8 48.2
62.2 25.5 51.0 40.5 33.9 31).7 41.0 17.7
807 1
1 2
3 18 2
5 22
1 1 6 3 7 5 4 2 1
8 2 1 27 3 4 5 12 2 6
19 6 9 3 1 12 1 7 2 1 8 15 5 4 5 5 7
5 4 2 1 1 1 11 6
638
,'j
1 5 7 1 2 25 1
3 5 1 10 5 1
ll 11
1 3 39 4 2 7 4 2 5 1 20 2 5 1 1 5 6 2 2 2 2 17 1 3 7
3
1 7 11 1
4 5
25.8 6.9 28.2
13.1l 12.2
23.0 71.2 13.8 32.5 21l.3 10.4 H.ll 29.3 47.7 26.9 18.9 43.6 21.3 16.9
23A 18.4 19.0 22.9 58.4 21.6 24.8 42.3 28.3 51.5
,io:o
27.9 27.3 31.8
8.4 <1<!.5 14.0 39.9 33.9 22.3 3fi.O 17.3 23.8 23.7 17.5 19. 7 35.5
51.8 20.4 8.5 13.5
6.8 12.2 19.6 53.0
22.0
42:3
24.7
30.5 11.5 33.3 27.1
6. 9 13.0 29.8 lOA
14.6 79.5
3.8 37.7 54.5
9. 6
101.5 32.2 9.2 57.1 33.1 77.9 10.8 34.8 14.1 28.3 42.9 15.5 52.3
9.3 15.1 10.6 8.4 18.5 84.2 11.4 33.9 44.7
9. 0 19.6 4.8 17.8 24.5
16.1
10.4 35.7 46.8 13.5
7.1 44.2
Information ?tnd Statistics
335
TABLE 14-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM PNEUMONIA
AND MOTOR-VEHICLE ACCIDENTS IN EACH COUNTY IN GEORGIA: 1945 AND 1946
PNEUMONIA
MOTOR-VEHICLE ACCIDENTS
County
Number
Rata Per 100,000 Population
Number
Rate Per 100,000 Population
1946
1945
1946
1945
1946 1945 1946 1945
Franklin .. Fulton .... Gilmer ....
...................
Glascock ... Glynn ...... Gordon .... Grady .....
Greene .... GwinneLL ...
Habersham.
Hall .........
Hancock .....
Haralson ....
Harris . . . . . . .
HarL .....
Heard ....
Henry .......
Houston ....
Irwin ....
Jackson ....
Jasper . ....
Jeff Davis ..
Jefferson . ... : .
Jenkins ......
Johnson ...... Jones ........
Lamar . IJanier . IJaurens
.. .. ..
. .
. .
. .
. .
Lee..... LiberLy .
.. ...
.
J.Jincoln . ......
Long . . . . . . . . .
Lowndes .....
Lumpkin .....
McDuffie ...... Mcintosh ....
:Macon .......
Madison .....
Marion..... .
Meriwe<her ........
Miller........
Mitehell .......
Monroe ......
Montgomery.
Morgan ...... Murray ......
........
...
lvluscogee .... Newton ......
.
.
. . .........
Oconee ................
Oglethorr-e ...........
Paulding ..............
Peach . . . . . . . . . . . . . . .
Pickens ............
Pierce.... .........
Pike .......... ...........
Polk ..........
Pulaski. ......
Pu<nam . . . . . . .
8
5
51.2
32.0
185
185
47.1
47.1
5
3
55.5
33.3
2
44.0
21
38
95.8
173.'1
8
7
43.4
3S.O
5
7
25.4
35.6
H
12 102.1
87.5
8
10
27.5
34.4
8
3
54.2
20.3
12
12
3<1.5
34.5
3
5
23.5
39.2
1
7
27.8
48.7
5
2
43.8
17.5
5
7
32.2
15.1
5
4
58.1
46.5
9
15
50.5
99.2
7
8
61.9
70.8
1
2
30.9
15.5
10
13
49.8
64.7
2
3
22.8
34.2
7
79.2
56.6
5
2
25.0
10.0
8
11
67.6
84.'1
3
1
23.2
30.9
3
3
36.0
36.0
8
7
79.3
69.4
18
15
53.6
44.6
3
2
38.3
25.5
1
4
11.6
46.5
1
24.5
11
8
34.5
25.1
2
2
32.1
32.1
5
4
46.0
36.8
4
10
75.6
91.9
10
9
62.7
56.4
6
3
44.7
22.3
2
2
28.8
28.8
7
11
31.8
49.9
2
3
20.0
30.0
10
9
43.0
38.7
7
2
65.1
18.6
4
1
41.4
10.3
5
4
39.3
31.5
5
6
44.9
53.9
42
48
55.6
n3.6
8
10
43.1
53.8
4
3
52.8
39.6
1
5
8.0
40.2
8
5.
62.3
39.0
5
3
48.2
28.9
2
2
21.9
21.9
2
3
16.9
25.4
7
1
67.5
9.6
9
11
31.6
38.6
5
6
50.9
61.0
7
5
82.2
58.7
3
2 19.2 12.8
78
75 19.9 19.1
1
i3
.i 11.1 22.0
13 59.3 59.3
7
6 38.0 32.5
4
1 20.4 5.1
2
3 14.6 21.9
12
7 41.3 24.1
1
2 6.8 13.5
16
3 45.9 8.6
4
5 31.3 39.2
2
4 13.9 27.8
5
2 43.8 17.5
5
1 32.2 6.4
3
31.8
2
5 13.2 33.1
5
1 44.2 35.'1
4
1 30.9 7. 7
5
6 24.9 29.9
2
4 22.8 45.6
4
45.2
4
3 20.0 15.0
4
5 33.8 42.2
1
7. 7
10
3 120.0 36.0
3
2 29.7 19.8
2
2 35.5 35.5
8
7 23.8 20.8
4
1 51.0 12.8
5
9 58.2 104.7
2
28.4
2
5 48.9 122.4
9
3 28.2 9.4
5 7
'j
80.3 64.4
9.2
4
3 75.6 56.7
1
1 25.1 6.3
6
1 44.7 i.4
1
1 14.4 14.4
7
8 31.7 36.3
1
10.0
7
2 30.1 8.6
5
6 16.5 55.8
1
1 10.3 10.3
3
5 23.6 39.3
5
3 44.9 26.9
22
15 29.1 19.9
5
2 26.9 10.8
4
4 52.8 52.8
3
21.1
2
2 15.6 15.6
4 4
.i
38.5 43.8
io:9
3
3 25.4 25.4
1
1 9. 6 9.6
6
4 21.1 14.1
2
4 20.3 40.7
3
1 35.2 11.7
336
Georgia Depctrtment of Pttblic Health
TABLE Ill-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM PNEUMONIA
AND _MOTOR-VEHICLE ACCIDENTS IN EACH COUNTY IN GEORGIA:
1945 AND 1946
PNEUMONIA
MOTOR-VEHICLE ACCIDENTS
County
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1946
1945
1946
1945
1946 1945 1946 1945
Quitman ....
2
29.1
5~.2
Rabun ....... Randolph .....
4
1
~
24:i
12.8 13.1
1 25.6 12.8 2 6.0 12.0
Richmonrl. ....
46
66
56.2
80.6
22
15 26.9 18.3
Rockdale . . . . . . . . .
5
9
64.7
116.5
1
12.9
Schle)' ...........
2
39.7
3
1 59.6 19.9
Sr.reven .........
5
8
24.6
39.3
4
1 19.7 4.9
Seminole ........
2
4
2~.6
47.1
I
1 11.8 11.8
Spalding ........
13
17
45.7
59.8
17
8 59.8 28.1
Stephens .....
6
4
46.~
30.8
2
10 15.4 77.1
Stewart .... . . . . . . . . . . ' .
6
4
56.6
37.7
2
18.9
Sumter.....
13
18
5~.1
73.5
3
3 12.2 12.2
TTaallibaofet.rr.o....
5
4
61.4
49.1
2
2 24.6 24.6
3
~
47.8
47.8
2
3 31.9 47.8
Tattnall. ...
5
5
30.3
30.8
2
2 12.3 12.3
Taulor. . . . . . . . . . . . . . .
5
3
46.4
27.9
1
2 9.3 18.6
Telfair.
4
~
26.4
19.8
2
4 13.2 26.4
Terrell ..
7
9
42.0
54.0
2
I 12.0 6.0
Thomas.
16
16
51.1
51.1
10
5 32.0 16.0
Tift.
5
8
26.9
43.0
9
10 48.4 53.8
Toombs.
8
~
47.2
17.7
1
4 5.9 23.6
Towns ...
Treutlen .... Troup ... . .
...
.
.
.
.
.
.
.
.
.
.
.
.
2
1
40.6
20.3
4
1
52.4
13.1
1
23
2~
52.4
45.6
10
13.1 i3:i
22.8 13.7
Turner.
...........
Twiggs .....
5
46.1
1
4
4
43.9
43.9
3
9.2 32.9
ii:o
Union ...... Upson ...
4 6
2
52.1
2~
23.9
26.0 79.8
i2
7 47.9 27.9
Walker . . . . . Walton ......
8
13
25.8
41.9
Jl
10
52.9
48.1
3
5 9. 7 10.1
5
8 24.1 38.5
Ware ... Warren .
... .......
.
.
.
.
.
.
.
.
.
.
.
.
.
10 4
11
35.8
7
39.1
39A ll8.4
6
17 21.5 60.9
3
2 29.3 19.5
Washington ....
9
9
37.1
37.1
11
6 45.4 24.8
Wavne . . . . .
5
38.1
5
5 38.1 38.1
Webster.. ............... Wheeler.. ...................
2
42.3
3
35.1
:ii;:i
1
1 21.2 21.2
1
11.7
White . . . . . . . .
1
1
15.6
15.6
1 46.8 15.6
Whitfield ..........
ll
ll
42.1
42.1
8 26.8 30.6
Wilcox . . . . . . . . . . . .
4
7
31.4
54.9
1
7. 8
Wilkes .............
3
3
19.9
19.9
l
1 26.5 6. 6
Wilkinson ......
5
6
15.4
54.4
6
4 54.4 36.3
Worth ......................
11
7
51.5
32.8
3
l 14.0 18.7
Residents of GBorgia, death oc-
curring in ot.Jwr states.....
19
NOTE: Rates based on the 1940 Census Enumera~ed Population. Deaths from motor-vehicle accidents are allocated to county of accident instead of county of residence. These
figures exclude deaths of military personnel killed from motor-vehicle accidents while on maneuver or on a military reservation.
Information and Statistics
337
TABLE 15
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM DIPHTHERIA IN EACH CoUNTY IN GEORGIA: 1945 AND 1946
DIPHTHERIA
Number
Rate Per 100,000 Population
1946 1945 1946 1945
DIPHTHERIA
Number
Rate Per 100,000 Population
1946 1945 1946 1945
TOTAL .....
45
71 1.4 2.3
Appling ...
Atkinson ..
Bacon . . . . . . . . . . .
12.4
Baker...........
Baldwin . . . . . . . . .
6.1
Banks...........
Barrow..........
Bartow..........
BenHill.. .......
Berrien ..........
Bibb............
1.2
Bleckley........ Brantley .......
2 14.o 29.1
Brooks..........
Bryan ..........
Bulloch .........
Burke...........
Butts ...........
Calhoun . . . . . . . . .
Camden . . . . . . . . .
Candler .. Carroll. ....
1 5.9 2.9
Catoosa .... Charlton ........ Chatham........
.o:s 19.0
1 0.8
Chatt.ahoochee ...
Chattooga.......
Cherokee........ Clarke ..........
.i
3.5
Clay............
Clayton .........
Clinch .......... Cobb ........... Coffee ...... Colquitt..... ::::
2
5.2
4.6
1 3.0 3.0
Columbia . . . . . . . .
Cook ............ Coweta.......... Crawford ........
37
I
14.0
Crisp ........... Dade ......
17.0
Dawson ......... Decatur.........
'i
DeKalb .........
I
Dodge ..........
2
Dooly...........
Dougherty .......
Douglas.........
Early ..........
4.5
1.2
9.5
2
11.8
2
7.0
I
9.9
3
16.1
Echols ..........
Effingham ......
Elbert .....
Emanuel. .......
2
2 8.5 8.5
Evans . . . . . . . . . . . Fannin ..........
2 6.8 13.6
Fayette ......... Floyd . . . . . . . . . .
1
1.8
Forsyth ...
Franklin........
6.4
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 ..... }.;incoln . .... Long ...... Lowndes .....
Lumpkin ... McDuffie ..... Mcintosh ... lv!acon ....... Madison ..... Marion .......... Meriwether...... Miller........... Mitchell. ........ .Monroe .. Montgomery .....
Morgan .. ....... 1\t!urray .. Muscogee . . . . . . . . Newton ......... Oconee . . . . . . . . . . Oglethorpe ...... Paulding . . . . . . . .
Peach . . . . . . . . . . . Pickens ......... Pierce . . . . . Pike ...... Polk ... Pulaski. ....... Putnam ....... Quitman ........ Rabun ..........
.i
0.3 11.1
11.1
22.0
I
I 'i;j 5.1
I
7.3
I
4 3.4 13.8
I
I 6.8 6.8
I
I 2.9 2.9
'i
7.0
.i
8.8
7.7
'i
11.3
I
5.0
1
SA
2
24.0
1
9. 9
'i 3.0 3.0
.i
16.1
.i
1 6.3 6.3
I
7A
'4:5
10.0
4.3
I
9.3
9.0
1.3 2.6
5.4
26.<1
1
8.0
2
I 16.9 8.5
3.5
338
Georgi?t Dep?trtment of Pttblic Health
TABLE IS-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM DIPHTHERIA IN EACH COUNTY IN GEORGIA: 1945 AND 1946
DIPHTHERIA
DIPHTHERIA
Number
Rate Per 100,000 Population
Number
Rate Per 100,000 Population
1946 1945 1946 1945
1946 1945 1946 1945
Randolph ..
Richmond. Rockdale... . Schley .... . Screven . ... . Seminole ...... . Spalding ..... .
Stephens .. . Stewart .... . Sum tor..... . Talbot .... . Taliaferro. Tattnall.. . Taylor ..... . Telfoir ..... . Terrell ..... .
Thomas .... . Tift....... . Toombs. Towns.
2.4
3.5 4.1 6.2
3.2 6.4 10.8 10.8
20.3
Treutlen. Troup .. . Turner... . Twiggs . . Union .... . Upson .. .
Walker ..
Walton ... . \Vare .. . Warren. Washington .. \Vayne .... Webster . . wheeler.. .
White.... . Whit:"ield ..
Wilcox.
Wilkes ..... Wilkinson.
Worth.
2.3
4.0 4.0 4.8
7.2 4.1 7. 6
31.2 7. 7 3.8
4. 7
NOTE: Rates based on the 1940 Census Enumerated Population. These figures exclude nonresident-s or' Georgia and include residents of Georgia, death occurring in other states.
--
Information ctnd Statistics
339
TABLE 16
NUMBER AND PERCENT OF BIRTHS (EXCLUSIVE OF STILLBIRTHS) BY
PERSON IN ATTENDANCE AND COLOR, IN GEORGIA: 1929-1946
Total
Number Physician Midwife Other
Total
Percent Physician Midwife Other
Total
1929 ........ 58,521 38,448
19,956
117 100.0
65.7
34.1
0.2
1930........ 60,318 39,416
20,728
174 100.0
65.3
34.4
0.3
1931. ....... 61,774 38,~22
23,315
137 100.0
62.0
37.7
0.3
1932 ........ 63,690 37,981
25,578
131 100.0
59.6
40.2
0.2
1933 ........ 60,744 35,112
25,396
236 100.0
57.8
41.8
0.4
1934........ 64,615 39,498
25,043
74 100.0
61.1
38.8
0.1
1935........ 63,290 37,312
25,737
241 100.0
59.0
40.7
0.3
1936........ 61,617 36,659
24,661
297 100.0
59.5
40.0
0.5
1937 ........ 64,012 39,510
24,262
240 100.0
61.7
37.9
0.4
1938........ 64,307 40,111
23,970
226 100.0
62.4
37.3
0.3
1939 ........ 64,910 10,856
23,769
285 100.0
62.9
36.6
0.5
1940........ 64,695 41,637
22,807
251 100.0
64.4
35.3
0.3
1941. ....... 67,785 44,872
22,715
198 100.0
66.2
33.5
0.3
1942 ........ 72,189 50,099
21,968
122 100.0
69.4
30.4
0.2
1943 ........ 78,327 57,192
21,018
!17 100.0
73.0
26.8
0.1
1944 ........ 77,018 57,582
19,348
88 100.0
74.8
25.1
0.1
1945........ 74,994 55,896
19,023
75 100.0
74.5
25.4
0.1
1946 . . . .
85,699 66,505
19,142
52 100.0
77.6
22.3
0.1
White
1929 ........ 35,751 32,229
3,42f
93 100.0
90.1
9.6
0.3
1930........ 37,064 33,240
3,695
129 100.0
89.7
10.0
0.3
1931. ....... 37,531 32,663
4, 761
107 100.0
87.0
12.7
0.3
1932........ 38,209 32,169
5,94!
96 100.0
84.2
15.6
0.2
1933 ........ 35,692 29,597
5,919
176 100.0
82.9
16.6
0.5
1934........ 38,333 33,052
5,226
55 100.0
86.2
13.6
0.2
1935........ 37,345 31,798
5,373
174 100.0
85.1
14.4
0.5
1936........ 36,320 31,111
4,998
211 100.0
85.7
13.8
0.5
1937........ 38,181 33,412
!,615
154 100.0
87.5
12.1
0.4
1938........ 38,613 34,014
4,473
126 100.0
88.1
11.6
0.3
1939 ........ 38,923 34,448
4,275
200 100.0
88.5
11.0
0.5
1940........ 38,911 34,907
3,830
174 100.0
89.7
9.8
0.5
1941. ...... 41,277 37,612
3,544
121 100.0
91.1
8.6
0.3
1942........ 45,192 42,077
3,035
80 100.0
93.1
6.7
0.2
1943 ........ 50,149 47,795
2,277
77 100.0
95.3
4.5
0.2
1944 .....
49,464 47,556
1,853
55 100.0
96.2
3.7
0.1
1945........ !7,422 45,708
1,664
50 100.0
96.4
3.5
0.1
1946........ 56,354 54,680
1,645
29 100.0
97.0
2.9
0.1
Colored
1929........ 22,770 6,219
16,527
2! 100.0
27.3
72.6
0.1
1930........ 23,254 6,176
17,033
45 100.0
26.5
73.2
0.3
1931. ....... 24,243 5,659
18,554
30 100.0
23.3
76.5
0.2
1932 . . .
25,481 5,812
19,634
35 100.0
22.8
77.1
0.1
1933 ...
25,052 5,515
19,477
60 100.0
22.1
77.7
0.2
1934 . . .
26,282 6,446
19,817
19 100.0
24.5
75.4
0.1
1935 . .
25,945 5,514
20,364
67 100.0
21.3
78.5
0.2
1936 ..
25,297 5,548
19,663
86 100.0
21.9
77.7
0.4
1937 ........ 25,831 6,098
19,647
86 100.0
23.6
76.1
0.3
1938 . .
25,694 6,097
19,497
100 100.0
23.7
75.9
0.4
1939 ........ 25,987 6,408
19,494
85 100.0
24.7
75.0
e.3
1940........ 25,784 6,730
18,977
77 100.0
26.1
73.6
0.3
1941 ........ 26,508 7,260
19,171
77 100.0
27.4
72.3
0.3
1942........ 26,997 8,022
18,933
42 100.0
29.7
70.1
0.2
1943 ........ 28,178 9,397
18,741
40 100.0
33.3
66.5
0.1
1944 ........ 27,554 10,026
17,495
33 100.0
36.4
63.5
0.1
1945........ 27,572 10,188
17,359
25 100.0
37.0
63.0
0.0
1946........ 29,345 11,825
17,497
23 100.0
40.3
59.6
0.1
NOTE: Figures prior to 1929 not available.
340.
Georgia Department of Pttblic Health
TABLE 17
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES IN GEORGIA FOR THE YEARS 1850-1946
Cause of Death
Number of Deaths
1850 1860 1870 1880 1890 1900 1920 1930 1940 1946
ALL CAUSES ....... 9,925 12,813 13,606 21,549 21,174 26,941 32,243 35,188 32,285 27,405
Typhoid fever .............. 557 887 772 987 1,000 1 ,766 549 500
68
11
Malaria . . . . . . . . .
185 568 705 1,060 937 1,226 559 442
89
12
Smallpox . . . . . . . . . . Measles . . . . . . . . . . .
74
8 47
18 270
2 196
44o
46 201
3 61 128
23
!4
Scarlet fever ....
202 217
12
31
8
44
32
38
16
1
Whooping cough .....
385 334
92 650
89 222 373 257 108
60
Diphtheria ................. 314 440 417 1,309 553 819 401 135
59
45
Dysentery, diarrhea and
enteritis . . . . . . . . . . . .
654 1,061 1,414 2,011 2,353 2,235 1,725 1,317 693 245
Tuberculosis . . . . . . . .
379 550 996 l ,882 2,324 2,830 2,362 2,175 1,533 1,048
Cancer.......... ....
60
81 131 240 293 382 1,124 1,552 1,959 2,420
Pneumonia ........
651 1,268 1,303 1,685 1'738 2,598 2, 766 2,580 2,055 1,341
Heart diseases........
603 723 274 1,451 1,405 2,127 1,892 4,099 6,176 5,961
All other causes ......
5,831 6,629 7,142 9, 745 10,03! 12,445 20,396 21,935 19,506 16,217
Rates Per 100,000 Population
1850 1860 1870 1880 1890 1900 1920 1930 1940 1946
ALL CAUSES ........ 1095.3 1211.9 1149.0 1397.3 1152.4 1219.11 1113.2 1207.4 1033.5
Typhoid fever .. Malaria .............
61.5 83.9 65.2 64.0 54 A 79.9 19.0 17.2 2.('1' 20.4 53.7 59.5 68.7 51.0 55.5 19.3 15.2 :;
Smallpox ............ Measles . . . . . . . . . . . .
8.2
0.8 1.5
1.5 22.8
0.1 32.2
2:1:o
2.1 9.1
0.1 2.1
. 4:4
0.7
Scarlet fever . . . . . . . .
22.3 20.5 1.0 2.0 0.4 2.0 1.1 1.3 0.5
Whooping cough .....
42.5 31.6 7.8 42.1 4.8 10.0 12.9 8.8 3.5
Diphtheria................. 38.0 41.6 25.2 84.9 30.1 37.1 13.8 4.6 1.9
Dysentery, diarrhea and . ....
enteritis . . . . . . . . . . .
72.2 100.'1 119.4 130.4 128.1 101.1 59.6 46.2 22.2
'fuberculosis .......... ..... 41.8 52.0 8<!.1 122.0 126.5 128.1 81.6 74.6 49.1
Cancer.................... 6.6 7.7 11.1 15.6 16.0 17.3 38.8 53.3 62.7
Pneumonia ................ 71.8 119.9 ll5.1 109.3 94.6 117.6 95.5 88.5 65.8
Heart diseases .............. 66.5 68.4 23.1 94.1 76.5 96.2 65.3 140.6 197.7
All otlm rauses ............ 643.5 627.0 603.2 631.9 546.1 563.1 701.2 752.7 624.4
877.3 0.'1
1.4 0.03
1.9 1.4
7.8 33.5 77.5 42.9 59.6 519.2
NOTE: Figures for the year 1910 not available.