- Collection:
- Georgia Government Publications
- Title:
- Annual report for the year 1947 [1947]
- 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:
- 1947
- 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 1947
- Metadata URL:
- https://dlg.galileo.usg.edu/id:dlg_ggpd_y-ga-bh700-b-pa1-b1947
- Digital Object URL:
- https://dlg.galileo.usg.edu/do:dlg_ggpd_y-ga-bh700-b-pa1-b1947
- Language:
- eng
- Holding Institution:
- University of Georgia. Map and Government Information Library
- Rights:
-
STATE OF GEORGIA
DEPARTMENT OF PUBLIC HEALTH
T. F. ABERCROMBIE, M.D., Direct:or
ANNUAL REPORT FOR THE YEAR 1947
State Office Building Atlanta, Georgia
TABLE OF CONTENTS
Page
Division of Local Health Organizations____________________________________ 13 Division of Public Health Nursing______________________________________________ 55 Division of Public Health Engineering______________________________________ 69 Division of Dental Health Education________________________________________ 103 Division of Hospital Services______________________________________________________ 113 Division of Industrial Hygiene__________________________________________________ 121 Division of Maternal and Child Health ____________________________________ 141 Division of Public Health Education________________________________________ 161 Division of Preventable Diseases________________________________________________ 175
Cancer Control Service________________________________________________________ 177 Epidemiologic Service__________________________________________________________ 183 Social Hygiene______________________________________________________________________ 231 Typhus Control Service______________________________________________________ 235 Venereal Disease Control Service______________________________________ 253 Division of Tuberculosis ControL_____________________________________________ 269 Battey State HospitaL. _______________________________________________________________ 281 Division of Laboratories______________________________________________________________ 297 Division of Information and Statistics._____________________________________ 357
.I
STATE OF GEORGIA DEPARTMENT OF' PUBLIC HEALTH
T. F. ABERCROMSJE, M. 0 .. DIRECTOR
ATLANTA
To His Excellency Hon. M.. E .. Thompson Acting Governor of Georgia
Dear Sir:
In presenting this, the 1947 Annual Report of the work of the Department of Public Health, I call your attention to the following facta 1 sines this will be thEt last report that I can make a:5 Director d the Department.
In the more tran three decades that I have been privileged to direct the affairs of the Department of Public Health, I have witne.:l.:letd the expeatation of life at birth expand from 46.6 to 67 years. Tuberoulosis has been' reduaed from 143.3 deaths per 100,000 population to 33.2 last year. Typhoid fever, in 1920, had a death rate of 19 per 100,000; in 1947, it was 0.3. Malaria declined from 19.3 to 0.4; smallpox has become non-existent.. Yellow fever has been eliminated from our State. Diphtheria, which once gripped the heart of every mother, has been reduced from 13.8 to 1.3 deaths per 1001000. Infant mortality has been reduced fro~ 88.3 death per 1,000 live birth to 34.3; maternal mortality, 93.0 to 2.6.
I have seen the beds for tuberculosis expanded from an insignificant number of thirty to 2 1 500 now available at Battey State Hospital. I have seen full-'time county health depari;;ments with nurses, engineers, and other necessary personnel, grow from nothing to 43 l'l'ith health officers on duty. The laboratories of the Department have been greatly expanded and three branch laboratories established through'out the State. In 1947, we had three regional buildings erected for State health ailministration.
In closing my career as Direct.or of Public Health, I can see many unsolved health problems. I can also look back with a great deal cf satisfact,ion to improved health standards of the people ol Georgia.
w~
T- F. Abercrombie, M,.D. Director
MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH
C. L. RIDLEY, M.D., Chairman ______________________ ___________________________Macon R. L. ROGERS, M.D., Yice-Chcdrman ______________________________ Gainesville ROBERT F. MADDOX__________________________________________________________________Atlanta B. H. MINCHEW, M.D. _______________________________________________________Waycross C. K. SHARP, M.D. ________________________________________________________________ Arlington J. A. CoRRY, M.D. _____________________________________________________________ Barnesville W. P. HARBIN, JR., M.D. ____________________________________________________________Rome J. M. BYNE, JR., M.D. ____________________________________________________Waynesboro D. N. THOMPSON, M.D. ________________________________________________________ Elberton GEORGE WRIGHT, PH.G, ____________________________________________________________Tifton J. B. BUTTS, PH.G. ________________________________________________________Milledgeville J. G. WILLIAMS, D.D.S. __________________________________________________________Atlanta W. K. WHITE, D.D.s. __________________________________________________________ Savannah J. C. PATTERSON ____________________________________________________________________ Cuthbert
Brief History of Public Health in Georgia
England set a fine example of early public health effort by appropriating, in 1732, 13 guineas ($62.40) for the relief of sick mothers during passage to the province.
Colonial records for 1739 reveal that 40 pounds, 17 shillings, and 6 pence were paid for "physicks" to be given soldiers in General Oglethorpe's Regiment in Savannah.
As early as 1760, there was an act to oblige ships and other vessels coming from places infected with the plague, smallpox, or other contagious diseases to be quarantined. Later, in 1817, a Georgia law was passed prohibiting the sale of unwholesome meat, bread, and liquors. Offenders could be fined for the first offense and imprisoned for the second.
In 1823, a law was passed establishing an office in each county for the purpose of recording births. In fact, Georgia was the second of the States to require registration by law.
In 1843, there was an enactment by the General Assembly requiring that a supply of smallpox vaccine matter be purchased and supplied to the people of the State free. Later, in 1866, the Legislature passed an act for the control of smallpox in Georgia.
In February of 1875, the Legislature passed an act creating a State Board of Health. Agitation in favor of this had been begun by the Medical Association of Georgia at the close of the Civil War. Records showed that more soldiers died of preventable diseases during the war than were killed with bullets. From typhoid fever alone there was one death for every 28 soldiers enlisted.
The law creating the Board of Health authorized the Governor to appoint a physician of experience from each of the nine Congressional Districts. These together with the Comptroller General, Attorney General, and the State Geologist constituted the Board. Dr. V. H. Taliaferro was elected Secretary at a salary of $1,000 a year. The program consisted of prevention of disease, promotion of public health, a?d 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
10
Georgia Department of Public Health
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.
On October 30, 1876, the Savannah Jillorning News stated that 8,000 refugees had left Savannah, and that the loss to the city was over one-half million dollars. The same article stated that Savannah had spent $120,833.00 for charity during the epidemic. That year, only $1,000 was spent for public health in the entire State!
The next outlook for public health work in Georgia was even darker, as no appropriation was made for the continuation of the work in 1877. Records for that period, furnished every ten years by the Census Bureau, show a constant increase in deaths from the more serious public health problems. Typhoid fever, malaria (then called bilious fever), and smallpox raged. Pellagra and hookworm disease were making their appearance.
Georgia was without a public health program twenty-six years. The second State Board of Health was organized September 10, 1903, under an act of Legislature. An appropriation of $3,000 was made and Dr. H. F. Harris was elected Secretary at a salary of $2,000 yearly. The remainder of the appropriation was used in the general work of the Board.
Doctor Harris, using a microscope and other apparatus of his own, began operation in one small room in the basement of the Capitol in 1904. His first work was devoted to bacteriology and the control of smallpox and yellow fever. He also did a vast amount of research in an effort to determine the cause of pellagra.
A laboratory was opened in 1905. With assistance, Doctor Harris expanded his activities to include the manufacture of Pasteur treatment in 1908; diphtheria antitoxin in 1909; and typhoid vaccine in 1912.
The first full-time county health project was established in Glynn County in 1914. Later in the year, the Ellis Health Law was passed, thereby creating a board of health in every county in the State. This law further provides for the employment of a full-time county health officer upon two successive recommendations of the grand jury. Following the passage of this law, Glynn and Floyd Counties adopted its provisions.
At a meeting of the State Board of Health, in January of 1914, Doctor Harris expressed a desire to retire from public health work as soon as he could be relieved of his duties without prejudice to the work, in order that he might devote his entire time to research.
A Brief History
11
At a meeting of the State Board of Health in July of 1917, Dr. T. F. Abercrombie, formerly Commissioner of Health of Glynn County, was elected Secretary.
F.ollowing is a list of the services of the State Department of Public Health, with the date of their establishment:
Laboratory -------------------------------------------------------------------------------- 1905 Field Sanitation (now Local Health Organizations)------------ 1910 Venereal Disease ControL________________________________________________________ 1918
Vital Statistics -------------------------------------------------------------------------- 1919 Maternal and Child Health________________________________________________________ 1920
Sanitary Engineering---------------------------------------------------------------- 1920 Dental Health Education____ -----~------------------------------------------------ 1928
Tuberculosis Control ---------------------------------------------------------------- 1930 Preventable Disease ------------------------------------------------------------------ 1931 Public Health Nursing______________________________________________________________ 1936
Cancer Control -------------------------------------------------------------------------- 1937 Typhus Control -------------------------------------------------------------------------- 1937 Malaria Investigations -------------------------------------------------------------- 1937 Public Health Education ____________________________________________________________ 1938
Nutrition ---------------------------------------------------.--------------------------------- 1940 Industrial Hygiene ------------------------------------------------------------------- 1941 Social Hygiene ----------------------------------------------------------------------- 1943 Hospital Services ---------------------------------------------------------------------- 1947
Division of Local Health Organizations
GUY G. LUNSFORD, M.D., Director J.D. STILLWELL, Assistant Director W. D. CAGLE, M.D., Medical Director__________Northwestern Region W. B. HARRISON, M.D., Medical Director____Northeastern Region S. C. RUTLAND, M.D., Medical Di?ector________West Central Region ____________________________________________________________________________East Central Region
0. F.WHITMAN, M.D., Medical Director______ Southwestern Region H. T. ADKINS, M.D., Medical Director________ Southeastern Region
LOCAL HEALTH SERVICE
STATE OF
GEORGIA
JULY I, 1947
-
COUNTY HEALTH DISTRICTS
-COUNTY HEALTH UNITS
-
NURSING COUNTIES
/
REGIONAL LINES
e
Division of Local Health Organizations
A third of a century has passed since the first county health department was organized in Georgia. Only two other states had county health departments at that time, and in both of these the health departments were organized because of an acute emergency. In Georgia a carefully drawn bill, providing for the establishment of local health departments, was passed by the State Legislature.
Georgia was among the first of the states, if not the first, to enact laws authorizing single-county and multi-county health departments, and our health laws have been used as models by many other states. Due to the vision and foresight of Dr. T. F. Abercrombie and others who wrote these laws in 1914, very few changes have been necessary.
It is generally recognized that local health departments are the foundation and bulwark of efficient and effective health protection. It is the concensus of public health authorities that a minimum efficient local health department should consist of one medical officer to each 50,000 population, a public health engineer or sanitarian to each 20,000, a public health nurse to each 5,000, and sufficient clerical personnel, or one to each 15,000 to 20,000. To this could be added one or more part-time medical clinicians, a part-time dentist, a public health educator, and a nutritionist. The State Department of Public Health has adopted a policy of giving financial assistance on this basis. This means that a county having a population of less than 50,000 may unite with another county or other counties to form a health district. This plan is being carried out as rapidly as personnel can be secured, and is working well. As of December 31, 1947, there were budgetary arrangements for eight two-county, ten three-county, and two four-county health districts, although only eight of these districts were operating with a medical officer in charge.
During the year most of the time of the director of the division was taken up with his duties as deputy director of the Department, but the assistant director and the public health nurse consultant devoted their full time to the division. The assistant director traveled over four thousand miles in Georgia during the year in behalf of the local health programs. In addition to her routine visits to regional and local health departments and participation in regional conferences, the public health nurse consultant served as a member of the staff of the Health Education Workshop at the University of Georgia for seven weeks during the summer.
16
Ge01gia Department of Public Health
The regional medical directors, who are assistants to the division directo1, and their staffs, did efficient work in supervising the work in counties where there was no commissioner of health and in the capacity of consultants where there was a commissioner of health. One region, the East Central, was without a medical director during the entire year. However, this region did have nursing and engineering consultant services. Additional personnel was added to the regions during the year as follows: a special V. D. investigator in each of the regions, a nutritionist in each of the regions except the Northeastern, and a tuberculosis consultant serving the Northeastern and Northwestern Regions.
The buildings to house the regional offices in Ma~'on, Albany, and Waycross were nearly completed by the end of the year, and were occupied by the regional personnel early in 1948. Plans for these buildings were drawn late in 1946, and construction started the first part of 1947. In addition to the regular activities of the region, these buildings will also house the branch laboratories and provide space for special projects such as the DDT dusting program for insect control.
On December 31, 1947, forty counties had full-time health departments with a health officer, one or more public health nurses, and other public health personnel, and forty-three had budgets adopted for such departments, some of these with a vacancy in the position of health officer after having previously had this service. Seventy-four counties had public health nursing service and fourteen others had budgets for public health nursing service only. There were twenty-six counties without any arrangements for public health service on the local level. However, full-time, complete public health work could be organized in practically every county in Georgia either as single or multi-county units if personnel could be secured.
Over the years there has been a steady increase in the number of public health workers in the local departments, as interest in this field has grown and the program developed. In 1915, five persons were working in the local health departments, only two in number. As of December 31, 1947, there were 741 full-time employees, including those engaged in the program but not professional or technical help, working in seventy-five local health departments. There were forty-two persons employed in the six health regions as members of the regional staffs, and thirty-eight nurses in counties budgeted for pursing service only.
However, very few local departments had an adequate staff of one physician to 50,000 population, one sanitarian to 20,000 population, and one nurse to each 5,000 POP\llation. The need is for forty public health physicians, more than two hundred public
Local Health Organizations
17
health nurses, and at least twenty-five sanitarians to implement the public health program in Georgia.
Few local health departments have suitable quarters to house their activities, although quite a few counties contemplate building new quarters with the aid of Hill-Burton funds. Thirty counties manifested interest in erecting a public health center with help from this source.
The 1947 statistical report of the activities in the regions and local health departments follows. This report gives the 1946 activities for comparison. Practically all items on this report show increases in the services rendered. A marked increase in the tuberculosis services was to be expected because of the mass surveys conducted during the year under the direction of the Division of Tuberculosis Control. All maternal and child health services show considerable increases, as did morbidity services, cancer control services, services to crippled children, and activities for the protection of food and milk and for general sanitation.
I-' 00
RECORD OF COUNTY HEALTH WORK IN GEORGIA
1915-1947
Year
Number* NUJnber Organized Persons Counties Employed
Population Served
1915
2
1920
18
1925
23
1930
34
1935
31
1940
55
1945
61
1946
66
1947
75
* Budgets adopted.
5
17,545
42
436,106
71
598,107
205
1,011,974
233
1,327,018
498
1,893,441
620
1,996,288
690
2,048,650
741
2,188,316
Total Budget
$ 4,637.00 72,695.00 179,812.00 451,217.00 459,292.00
1,066,126.20 1,627,968.30 2,00 1,143.16 2,333,981.01
Per Capita
.26 .17 .30 .45 .35 .56 .82 .98 1.07
C':l
Cl> 0
County Budget
<"~':"Q""
Per
Capita
b
Cl>
'":C;:,l
$ 4,637.00
.26 :.'",:.s".,.
70,895.00
.16 :"C;ls>'
168,272.00 .28 ""'
440,904.00
0
.44 '-+,
399,256.00 785,049.20 1,223,465.39 1,421,189.05 1,756,428.68
.30
~
~
.41
0"
~
.61 '"""'
.69 1::!:: Cl>
.80 .~,..,.
;;:-
CON_DENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
COUNTIES - 1947
.. __
--~0
>.
<a
COMMUNICABLE DISEASE CONTROL Admission to medical service.______________ Consultations with physicians.____________
Field visits ------------------------------------------
Smallpox immunizations ---------------------
Diphtheria immunizations ----------------Typhoid immunizations ---------------------Whooping cough ------------------------------
-------
668 4588 342R 7354 1731
VENEREAL DISEASE CONTROL Admission to medical service-------------
Clinic visits --------------------------------------FNiuemldbevtisoitfs c-l-i-n--i-c----t-r-e--a--t-m---e--n--t-s--.-__-_-_-_-_-_-_-_-_-_-_-_-__-
9483 117247
13473 37628
TUBERCULOSIS CONTROL Admission to medical service._______________ Admission to nursing service_______________
CFileinldic avnisditsoff--i-c-e----v--i-s--it-s--.-.-__-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-__-_-
498 1834 3223 11320
MATERNITY SERVICE Admission to medical service __________________
Admission to nursing service----------- Visits by ante-partum cases to medi-
cal conferences ---------------------------Field and office visits------------------------
56 702
297 1231
INFANT HYGIENE
Admission to medical service ------------Admission to nursing service------------VFiieslidts antod omffeidceicavlisictson__f_e__r_e__n__c__e_s__-_-_-_-__-_-_-_-__-_-_-_-_
985 8918 3110 13092
.c": . ' <"'
456
1371 222 188
1969 121
38 100
2 45
200 223 204 537
65 66
167 172
22 23 39 44
., 0.",'
~
<
120
267 297 262 2283 235
100 293
27 166
141 177 140 273
75 75
267 282
272 274 625 729
.,
0
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23
85 1007
43 2841
18
2
4
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56 63 47 9:l
20 34
34 58
8 27 10 35
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94 282 98 945
28
5 24
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28 51 27 113
25 173
396 604
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117 78
404
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9 32 115 S46 280 3430 217
118 298 264
79
93 97 237 307
168 292
377 641
97 357 234 714
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4 149
11 956
38
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80 154
80 199
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494 160 1546 123
90 39 --------
211 250 260 434
55 62
152 220
46 85 145 254
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
0
COUNTIES -1947
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PRESCHOOL HYGIENE
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Admission to medical service------------Admission to nursing service----------FViieslidt s atnodmoefdfiiccea lv icsoint sfe__r_e__n_c__e_s__-_-_-_-_-_-_-_-__-_-_-_-_-_-_-
Dental inspections--------------------------------
SCHOOL HYGIENE
3101 6131 5475 10198
6
115
6
120
9
460
9
457
3
4
56
5
25
128
3
4
106
5
25
616
91
83
------ (
150
187
6 7 6
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Inspections by physicians or nurses.. 125870
41
Exa1ninations by physicians..--------------- 17708
15
61
272
623
67
276 15
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Admission to nursing service__________ 4832
15
111
6
6
24
60
FDieenldtalanidnspoeffcitcieonvsi_s_i_t_s_.-_-_-_-_-_-_-_-_--_-_-_-_-_-_-_-_-_--_-_-_-_-_-
19289 36492
16
429
10
29
50
67
15 ""'"
34 c
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ADULT HYGIENE
Medical examinations ----------------------- 41899
37
68
460
MORBIDITY SERVICE
Medical visits ----------------------------------- 14283
494
2
Nursing visits ---------------------------------------- 1056
71
424
50
19
18
...~ 654 C' 20 """"'
32
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Admissions to hospitais----------------------- 2032
1
1
22
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SANITATION
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Water supplies approved----------------------
Privies and septic tanks installed--------
30
Food-handling establishments regis-
2 4
5
4
10
1 6
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Dairtyerfeadrm--s---r-e--g--i-s-t-e--r-e-d--_-_-_-_-_-__-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_ Milk plants registered________________________
3126 831 54
22 15
1
Field visits ----------------------------------------- 70976
42
9
31
20
17
18
49
659
67
56
LABORATORY SPECIMENS
Specimens examined ---------------------- 55652
2010
1040
613
990
2713
39
764
92
39
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES - 1947 (continued)
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COMMUNICABLE DISEASE CONTROL Admission to medical service____________ Consultations with physicians _______________
Field visits -------------------------------------------------
Smallpox Diphtheria
imimmmunuinzaiztiaotinosns-_-_-__-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_
Typhoid immunizations -------------------------
Whooping cough ---
VENEREAL DISEASE CONTROL Admission to medical service --------------Clinic visits --------------------------------------------Field visits -------------------------------------------------Number of clinic treatments._________________
TUBERCULOSIS CONTROL Admission to medical service______________ Admission to nursing service ______________
CFileinldic anvdisiotfsfic-e----v--i-s--i-t--s--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-
MATERNITY SERVICE Admission to medical service----------------Admission to nursing service _______________
Visits by ante-partum cases to mediFieldcaal ncdonoffefriecencveissi-t-s--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-
INFANT HYGIENE Admission to medical service_______________
Admission to nursing service----------------Visits to medical conferences-----~------Field and office visits -----------------------------
278 14
601 2053
952 2068
44
2698 42535
3358 34575
1105 1105 2147 2853
1431 1599
5740 2473
1191 1120 2534 1996
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170 239 294 1274 138
49 240 50 120
53 90 53 107
151 163
371 341
64 90 185 253
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182 331 453 3309 202
40 92 99 75
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105 658
9 602
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108 1147
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206 387 380 602
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518 3067
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212 1866
303 1461
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96 729
571 571
1648 1839
238 323 544 919
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
COUNTIES -1947 (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 ____
Exan1inations by physicians -----------------Admission to nursing service --------------Field and office visits --------------------Dental inspections -------------------------------
134 1378 1229 2024
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16111 8289 657 1421 7996
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..0......
ADULT HYGIENE
Medical examinations ------------------------- 3639
--------
--------
142
118
287
289
ll --------
120 -------- ~
MORBIDITY SERVICE Medical visits ---------------------------Nursing visits ---------------------------------------
--------------
-------48
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6
28
3
16
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12
41
18
24
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SANITATION
Water supplies approved -----------------
38
Privies and septic tanks installed ___
879
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1
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6
104
50
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387
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53
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4
10
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18
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1
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Field visits ------------------------------- 14293
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9
153
19
1163
7550
354
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84
LABORATORY SPECIMENS
Specimens examined --------------------------- 10355
984
111
2929
1355
339
1665
4067
1390
1005
924
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
COUNTIES -1947 (continued)
COMMUNICABLE DISEASE CONTROL Admission to medical service -------------Consultations with physicians---------Field visits -------------------------------- Smallpox in1munizations -----------------------Diphtheria immunizations Typhoid immunizations --------------------Whooping cough ---------------------------
VENEREAL DISEASE CONTROL Admission to medical service ------------Clinic visits-----------------------------------------Field visits ----------------------------------------Number of clinic t1eatments ----------
TUBERCULOSIS CONTROL Admission to medical service-----------~-- A~~issi?~ to nursing service-------------Chmc v1s1ts ---------------------- 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 Admission to medical service---------------Admission to nursing service.__________ Visits to medical ('.onference -----------Field and office visits ............................
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8
8
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ADULT HYGIENE Medical examinations ------------------------------
-------
MORBIDITY SERVICE
Medical visits -------------------------------- -------
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SANITATION Water supplies approved.........-------------Privies and septic tanks installed ....--Food-handling establishments regis-
tered -----------------------------------Dairy farms registered--------------------Milk plants registered............................
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1 7
37 3 3
1103
LABORATORY SPECIMENS
Specimens examined.----------------------------
24
11 91 20 280 --------
93
12 189
--------
123
1 59
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281
8
198
209
1237
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600
376
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116
164
543
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES -1947 (continued)
COMMUNICABLE DISEASE CONTROL Admission to medical service._______________
Consultations with physicians ...... ------Field visits -------------------------------------------------Smallpox intmunizations --------------Diphtheria immunizations ---------------------Typhoid immunizations ----------------------Whooping cough -------------------------------------
VENEREAL DISEASE CONTROL Adntission to medical service__________________
Clinic visits --------------------- ---------------------Field 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 ante-partum cases to medi-
c Field
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INFANT HYGIENE Admission to medical service _______________ Admission to nursing service.. ------------Visits to medical conferences_______________ Field and office visits __ ----------------------------
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497 1391 1441 7797 444
112 402 104 236
296 330 296 692
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
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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 Medical examinations ---------.:--------------
MORBIDITY SERVICE Medical visits -------------------------------------Nursing visits --------------------------------Admission to hospitals -----------------------
SANITATION Water supplies approved-------------------Privies and septic tanks installed------Food-handling establishments registered -------------------------------------------Dairy farms registered------------------------Milk plants registered.------------------------Field visits-------------------------------------------
LABORATORY SPECIMENS Specimens exam!ned-----------------------
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VENEREAL DISEASE CONTROL Admission to medical service --------------Clinic visits --------------------------------------------Field visits -----------------------------------------------Number of clinic treatments----------------
TUBERCULOSIS CONTROL Admission to medical service ----------- A~~issi?z: to nursing service--------------Chnlc v1s1ts _-------------------------------------------Field and office visits -----------------------------
MATERNITY SERVICE Admission to medical service--------------Admission to nursing service.________ Visits by ante-partun1 rases to medical conferences -------------------------------Field and office visits----------------------------
INFANT HYGIENE Admission to medical service -------------Admissivn to nursing service -------------Visits to medical conferences ----------------Field and office visits------------------------------
60 30 172 1102 855 3936 242
311 1289
259 1174
222 257 220 410
289 531
837 1109
90 386 247 667
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
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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 __ _ Exan1inations by physicians---------------Admission to nursing service ------------Field and office visits .............................. Dental inspections ....................................
ADULT HYGIENE
Medical exan1inations --------------------------------
MORBIDITY SERVICE Medical visits .........._ ............................... Nursing visits----------------------------------------Admissions to hospitals....-----------------------
SANITATION Water supplies approved ........................ Privies and septic tanks installed--------Food-handling establishments registered .................................................... Dairy farn1s registered ____________________________
Milk plants registered..............- ............. Field visits ......._ ..........................................
LABORATORY SPECIMENS Specimens exatnined------------------------,------
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COMMUNICABLE DISEASE CONTROL Adtnission to medical service ______________ Consultations with physicians. _______________
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VENEREAL DISEASE CONTROL
Admission to 1nedical service ----------Clinic visits ----------------------------------Field visits ----------------------------------------- ________ Nu1nber of clinic treatments. ____
TUBERCULOSIS CONTROL Ad1nission to medical service .. _________
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MATERNITY SERVICE Admission to medical service __ ------------Admission to nursing setvice _______________
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INFANT HYGIENE
Ad1nission to medical setvice -------------Admission to nursing service._________________ Visits to medical conferences ______________ Field and office visits ________________________
3 3 17 618 130 2072 67
21
200 312 200 692
104 137
312 375
75 150 247 398
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MORBIDITY SERVICE Medical visits --------------------------------------Nursing visits -----------------------------------Admissions to hospitals------------------------
SANITATION \Vater supplies approved-----------------------Privies and septic tanks installed __________ Food-handling establishments registered ---------------------------------------------Dairy farms registered.--------------------Milk plants registered----------------------Field visits -----------------------------------
LABORATORY SPECIMENS Specimens examined -----------------
82 117 200 259
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Clinic visits ------------------------------------------Field visits .. --------------------------------------------Number of clinic treatments................
TUBERCULOSIS CONTROL Admission to medical service ------------Admission to nursing service-------------Clinic visits -------------------------------------------Field and office visits ................................
MATERNITY SERVICE Ad1nission to medical service ------------Admission to nursing service-------- Visits by ante-partum cases to mediFieldcaalndcoonfffeicreenvciessits_____-_-_-_-_-_-_-_-_-_-_-__-_-_-_-___-__-_
INFANT HYGIENE Admission to medical service.______________ Admission to nursing service_______________ FViieslidts atnod mofefdiciecavlisciotnsf_e__r_e_n__c_e__s_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_
3 555 66 2671 44
69 348 12'1 348
83 159
83 462
179 182
309 331
34 279
58 601
37 455 475 5131 202
7 56
2 33
495 1271
636
67 72
240 260
70 83 210 246
91 783 426 3629 245
45 114
25 44
63
115
19 28
7 89
10 23 10 97
28
216 1988 1164 8999 871
732 2657
306 767
351 402
1427
79 231
187 62'1
57 297 186 769
2 140 189 2905 95
40 117
80 102
91 91 109 214
314 320
520 721
156 204 202 495
6 888 231 2355
44
33 261
242 2055
40
163
830
65
14
12
228
61
88
20
99
121
92
88
20
139
160
246
5
U7
32
952
8
971
77
105
114
37
180
208
102
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852 23
25 440
7 261
22 41 . 24 66
50 52
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11 21 15 126
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Admission to medical service________________
27
62
3
42
93
Admission to nursing service ---------------
482
69
21
152
107
Visits to medical conferences.______________
40
96-
6
129
191
Field and office visits...---------------------- 1252
105
28
381
284
e Dental inspections------------------------------------
112
77
141
86
2
SCHOOL HYGIENE
Inspections by physicians or nurses....
47
762
538
192
55
Examinations by physicians._________________
82
147
21
Admission to nursing service________________
4
106
7
39
130
Field and office visits----------------------------
8
124
6
110
282
Dental inspections ------------------------------------
30
(i08
. 891
256
25
10
3
32
3
ADULT HYGIENE
Medical exan1inations
11
66
MORBIDITY SERVICE
Medical visits -----------------------------------------
33
Nursing visits ---------------------------------
29
89
Admissions to hospitals----------------------------
17
4
111
352
1
6
26
11
52
SANITATION
Water supplies approved----------------------
Privies and septic tanks installed________
5
Food-handling establishments regis-
Dairtyerfeadrm--s----r-e--g--i-s--t-e--r-e--d--_-_--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_-_-_ Milk plants registered______________________________
Field visits
19
1
7
16
16
11
4
5
42
307
1434
1
2
4
11
2
50
20
62
11
LABORATORY SPECIMENS
Specilnens examined----------------------- --------
667
587
827
2111
303
1174
242
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372
207
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Admission to medical service _____________
3
Consultations with physicians----
1
Field visits ------
10
87
6
Smallpox in1munizations -------------------- 1695
507
189
Diphtheia im1nunizations
322
199
118
Typhoid immunizations
1651
4289
762
Whooping cough ------
214
167
142
VENEREAL DISEASE CONTROL
Adtnission to medical service_________________
10
Clinic visits--------------------------------------------
723
Field visits -------------------------------------------
238
Number of clinic treatlnents ----------------
25
70
67
563
15
140
3
400
TUBERCULOSIS CONTROL
Admission to medical service________________
64
86
43
Admission to nursing service________________ 136
171
48
Clinic visits ---------
84
86
42
Field and office visits-------------------------------
424
290
98
MATERNITY SERVICE Admission to medical service ______________
Admission to nursing service_____________ 130 Visits by ante-partum cases to medi-
cal conferences -------------------------------
Field and office visits-----------------------------
538
10
53
14
127
18
135
27
245
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9 8 67 64 274
1561 149
3 6 41 111 167
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399
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129
141
141
47
203
48
203
1289
876
332
437
314
146
1358
890
410
501
412
182
231
INFANT HYGIENE Admission to medical service._______________
Admission to nursing service---------------;-
90
Visits to medical conft.""rences ......________
Field and office visits ................................
248
24
39
28
117
50
85
72
232
207
111
54
54
74
87
166
207
114
150
193
157
96
168
542
338
48
139
109
163
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239
469
410
357
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tJ:-
COUNTIES - 1947 (continued)
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Admission to medical service--------------Admission to nursing service________________ Visits to medical conferences.___________ Field and office visits ______________________________ Dental inspections ___________________________________
SCHOOL HYGIENE
3
3 --------
10
3
--------
37
12
43 --------
37
37
7
--------
127
67
58 --------
220
--------
--------
--------
64
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65
52
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207
78
2
87
70
60
314
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13
31 38
43 45
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66
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Inspections by physicians or nurses ___
89
39
Examinations by physicians ________________
Admission to nursing service ..______________ Field and office visits _______________________________
--------
1
--------
2
286
--------
1146
--------
16
--------
47
20
196
758 4 5
30
Dental inspections ----------------------------------- --------
701
-------
-------
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1
631 516
50 182
593 40
556
ell
199 ~
1 39
43 245 487
97 --------
140
488
-------
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ADULT HYGIENE Medical examinations _______________________________
MORBIDITY SERVICE Medical visits --------------------------------------ANdumrsiisnsgionvsistiots ho--s--p--i-t-a--l--s--_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-
SANITATION Water supplies approved..---------------------Privies and septic tanks installed _______ Food-handling establishments registered ---------------------------------------------Dairy farms registered....-----------------Milk plants registered......----------------------Field visits------------------------------------------------
--------
2 ------
---------------------
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1
1 11 --------
13 --------
--------
26
--------
2 46
--------
3
--------------
4
-------
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1 12
-------
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85
32
9()
1
----------------------
--------
---------------
145
13 10 --------
5 40
4 996
6
--------
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--------
--------
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85
140
28 99 14
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4
1 25
3
9 167
14 1
1357
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48 678 <::
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80 220
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18
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3
13
408
LABORATORY SPECIMENS
S!_lecilnens exa1nined -------------------------------- 1041
244
569
8
1810
1526
746
564
2409
1008 3149
CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
CouNTIES - 1947 (continued)
COMMUNICABLE DISEASE CONTROL Ad1nission to medical setvice --------------Consultations with physicians --------------Field visits -----------------------------------------------Smallpox immunization::; --------------------Diphther)a immunizations -----------------Typhoid immunizations _____________________ ------
Whooping cough -------------------------------------
VENEREAL DISEASE CONTROL Admission to 1nedical service ________________
Clinic visits ---------------------------------------- __ Field visits ------------------------------------------------Nu1nber of clinic treatments __________________
TUBERCULOSIS CONTROL Adn1ission to medical Sel'vice ---------------"A,hnission to nursiug service-------------- Clinic visits --------------------------------------------Field and office visits -----------------------------
MATERNITY SERVICE Admission to 1nedical setvice ----------------Admission to nursing se1vice ----------------Visits by ante-partum cases to n1edical conferences ---------------------------------Field and office visits ---------------------------
INFANT HYGIENE
Admission to medical setvice ----------------Admission to nursing setvice ---------------Visits to medical conferences----------------Field and office visits._______________________________
."".J''
--------
100 41
737 59
71 243 121 170
27 55 34 90
222 224
f,09 735
149 174 258 440
~
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105 3
303 290 285 2029 124
86 214
89 102
73 88 148 227
142 164
328 402
146 197 335 476
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1057
417
1744
75
652
63
683
727
3201
12
238
23
1707
123
3359
78
25
36
1126
1
769
72
829
39
17367
126
101<1
15
383
49
383
18
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162
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162
38
544
132
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
COUNTIES - 1947 (continued)
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 Medical examinations ______________________________
MORBIDITY SERVICE Medical visits------------------------------------------ANdumrsiisnsgionvsisittos h--o---s-p---i-t-a--l--s--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_
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 ------------------------------
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68 69 143 282 --------
181 22 15
329
--------
455
--------
--------
--------
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55
927
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167 174 420 514 --------
273 62 26
180 76
86
22 53 3
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3786 31!1 660
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346
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY COUNTIES -1947 (continued)
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COMMUNICABLE DISEASE CONTROL Admission to medical service _________
Consultations with physicians _______________
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-------------------
Smallpox immunizations ___ ------------------- _
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Typhoid immunizations --------------------------Whooping cough ...........................
VENEREAL DISEASE CONTROL Admission to medical service _____ Clinic visits ---------------- ---------------Field visits -------------------- --------------Numbet of clinic treatn1ents ---------------
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 ante-partun1 cases to medical conferences ___________________
Field and office visits ________________________
INFANT HYGIENE Admission to medical service _______ Admission to nursing service _____ Visits to n1edical conferences ______________
Field and office visits -------------------------------
5 4 31 531 385 2083 128
139 1032
222 527
98 122 91 270
197 251
549 617
189 213 278 320
... "
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411 754 287 4030 153
116 2006
27 1346
2 2 45 110
305 280
605 866
63 66 65 119
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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 ___ Exatninations by physicians---------------Admission to nursing service---------------Field and office visits....- ........................ Dental inspections ------------------- --------------
ADULT HYGIENE Medical exmninations ---------------------------
MORBIDITY SERVICE Medical visits .............................................. Nursing visits ------------------------------------------Admissions to hospitals.-------
SANITATION Water supplies approved---------------------Privies and septic tanks installed .......
Food-handling establish1nents regisDairtyerefadr~-~--~:~g-i~-t~~=~d~=~~~~~~~~~~~~~~~~~~:::=~~ Milk plants wgistered ........................_.__ Field visits -----------------------------------------
LABORATORY SPECIMENS Specin1ens examined --------------------------------
356 436 506 777 --------
16 112 193 252 --------
61
24 195 --------
-------------
1 --------
10
957
-----------------------------------
------------------------------------
--------
---------------
---------------
---------------
36
--------
73 73
74 --------
957 335
5 72 --------
22
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49
---------------
245
1618
43 72 53 72 --------
14 13 15 47
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12
3 21 --------
4 63
12
314
567
9 25 10 72 -----
451 --------
16 5
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41
457
21 78 28 158 ------
76
15 20 --------
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1 276 ------
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---------------
59
587
--------
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45
--------
900 3223 4171 8454 --------
6614
1251 2055 1525
2363
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187
335 62 2
7359
31608
68 85 --------
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11 36 --------
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
CoUNTIES -1947 (continued)
COMMUNICABLE DISEASE CONTROL Admission to medical service._________________ Consultations with physicians_______________
Field visits ------------------------------------------Smallpox immunizations ---------------------Diphtheria immunizations--------------------WTyhpohoopidingimcnotuugnhiz_a__t_i_o__n__s___-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-
VENEREAL DISEASE CONTROL Admission to medical service ______________
Clinic visits-----------------------------------------------FNiuemldbveirsiotsf --c--l-i-n--i-c----t-r-e--a--t-m---e--n--t-s--.-_-__-_-_-_-_-__-_-_-_-_-_-_
TUBERCULOSIS CONTROL Admission to medical service ---------Admission to nursing S-'rvice ______________
Clinic visits -------------------------------------Field and office visits--------------------------------
MATERNITY SERVICE Admission to medical service _______________
Admission to nursing ser\?ice ------------
Visits by ante-partum cases to medi-
F
cal ield an
dcoonfffeicreenvciessits-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-
INFANT HYGIENE Admission to medical service ----------Admission to nur:;;ing service.______________
Visits to medical conferences--------------Field and office visits----------------------------
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247 2993
197 1757
196 3566
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
0
COUNTIES -1947 (continued)
PRESCHOOL HYGIENE Admission to 1nedical service-----------Admission to nursing service ______ Visits to medical conferences ________ Field and office visits _ -------Dental inspections ______ ---------------------
SCHOOL HYGIENE Inspections by physicians or nurses Examinations by Jlhysicians Admission to nursing service ____ Field and office visits _ Dental inspections _______ --------------------
ADULT HYGIENE Medical examinations ________________________
MORBIDITY SERVICE Medical visits _____________ -----------------Nursing visits Admission to hospitals ______________
SANITATION Water supplies approved_ Privies and septic tanks installed
Food-handling establishn1ents regis-
tered ------------------------------------
Dairy farms registered _____ ---------------------
Milk plauts registered _____ -----------------------
Field visits --------------------
-----------------
LABORATORY SPECIMENS Specimens examined ______
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
COUNTIES -1947 (continued)
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COMMUNICABLE DISEASE CONTROL Admi::::sion to medical service ---------------Consultations with physicians----------Field visits -------------------------------------------Smallpox immunizations -------------------Diphtheria in1munizaiions ------------------Typhoid immunizations ---~---------------------Whooping cough -----------------------------------
VENEREAL DISEASE CONTROL Admission to n1edical service--------------Clinic visits ----------------------------------------------FNiuemldbveirsiotsf -c-l--i-n--i-c----t--r-e--a--t--m---e--n---t-s--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-
TUBERCULOSIS CONTROL Adn1ission to medical setvice --------------Admission to nursing setvice ------------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 Admission to medical service----------------Admission to nursing service _____________ Visits to medical conferences.______________ Field and office visits ___________________________
--------
173 2698 1707 11801
447
1668 8348
219 7422
1179 1256 2856 3303
998 110
5237 2319
885 1833 2512 6528
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PRESCHOOL HYGIENE Admission to medical service --------------Admission to nursing service ________________ Visits to medical conferences._____________ Field and office visits--------------------------Dental inspections ----------------------------------
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ADULT HYGIENE Medical examinations -------------------------
MORBIDITY SERVICE Medical visits -----------------------....--------Nursing visits ----------------------------------------Admissions to hospitals ------------------------
SANITATION Water supplies approved---------------------Privies and septic tanks installed __________ Food-handling establishments regisistered ------------------------------------------------Dairy farms registered------------ ______________ Milk plants registered--------------------------Field visits -------------------------------------------------
LABORATORY SPECIMENS Specimens examined ___________________________
343 792 911 2323
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555 110
4 22676
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
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COMMUNICABLE DISEASE CONTROL Admission to medical service______________ Consultations with physicians ------------Field visits ------------------ ------------------------------Smallpox immunizations _--------------------Diphtheria imn1unizations Typhoid immunizations Whooping cough -------------------------------------
VENEREAL DISEASE CONTROL Admission to medical service -------------Clinic visits Field visits ---------------------- ------------------------Number of clinic treatments ________________
TUBERCULOSIS CONTROL Ad1nission to medical service ________________ Ad1nission to nursing service-------------Clinic visits ---------------------------------------------Field and office visits ________________________________
MATERNITY SERVICE Admission to medical service ________________ Admission to nursing service._____________ _ V!sits by ante-partum cases to tnedical conferences -------------------------------Field and office visits--------------------------
INFANT HYGIENE Adn1ission to 1nedical service.---------Admission to nursing service-------------Visits to medical conferences _______________ Field and office visit:: _____________________________
10 3
399 2039
156 2018
64
187 72 4
15 75 98
3 20
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Dental inspections ----------------------------
SCHOOL HYGIENE Inspections by physicians or nurses ___ Examinations by physicians _________________ FAidemldisasniodn otfoficneurvsiisnitgs __s_e__r_v__i_c_e__-_-_-__-_-_-_-__-_-_-_-_-__-_-_-_-_
Dental inspections ---------------------------------
ADULT HYGIENE Medical examinations -------------------------------
MORBIDITY SERVICE Medical visits ---------------- -------------------------Nursing visits ------------------------------------------- Admissions to hospitals--------~---------------
SANITATION \Vater supplies approved ______________________ Privies and septic tanks installed._________ Food-handling establishments registered ---------------------------------------Dairy farms registered-------------------------Milk plants registered Field visits -----------------------------------------------
LABORATORY SPECIMENS Specimens examined -----------------------------
44 15
8 22
2'i'
15 1124
104
91
121
59
107
131
131
104
105
287
13
9
207
335
473
2430
747
1481
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7
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COUNTIES -1947 (continued)
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0
Admission to medical service------------Consultations with uhysicians ______________
-------1 --------
40 ---------------
4
102 --------
3
125
--------
7 3
45 2
---------------
--------
--------
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Field visits ------------------------------------------
27
--------
Smallpox immunizations ---------------------
128
--------
172
686
1024
15
104 --------
68
747
1082
--------
1524
44.1 389
--------
--------
106 513
::ti
Diphtheria immunizations -----------------Typhoid immunizations ----------------------Whooping cough -------------------------------
354 1890
260
--------
-------
--------
160 3136
79
8 1762
11
508 4433
187
594 4315 1193
----------------------
481 4298
232
172 2458
88
41
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1412 28
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VENEREAL DISEASE CONTROL Admission to medical service._______________
Clinic visits -------------------------------------Field visits -----------------------------------------Number of clinic treatments ------------
121 34
--------
--------
--------
---------------
170 1437
107 654
--------
--------
-------
--------
125
518
-------- '"'"' 232
280
2470
--------
605
22
11
211
249
1989
--------
254
51 277
59 40
---------------
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7 46 32 16
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TUBERCULOSIS CONTROL
Admission to ntedical service --------------
--------
101
--------
5
113
--------
Admission to nursing service---------------
50
--------
301
18
185
113
2
90 90
67 107
--------
--------
.... 1 .G<,:.:'<!..
32
Clinic visits ------------------------------------------
35
-------
271
Field and office visits -----------------------------
124
--------
592
112
213
21
451
459
2
84 286
68 269
---------------
2 64
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MATERNITY SERVICE
Adntission to medical service--------------
--------
Admission to nursing service-------------
94
--------
Visits by ante-pal-tum cases to medi-
36 -------
175
188
--------
411
49
-------
294
188
-------
491
37 --------
7
42
--------
15
cal conferences --------------------------------
--------
90 -------
575
415
--------
1144
73 --------
8
Field and office visits---------------------------
191
--------
118 -------
882
412
--------
1434
105
--------
51
INFANT HYGIENE
Admission to medical service-------------Admission to nursing service_______________
25
---------------
6 --------
143
152
--------
363
72
1
201
152 --------
514
VFiieslidts atondmeodffiiccael vcoisniftesre__n_c_e__s_-_-_--_-_-_-_-_-_-_-_-_-_-_-
1 63
---------------
12 213
342
481
--------
1306
2
820
438
--------
1906
23 --------
3
24 --------
9
44 --------
3
68
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CONDENSED REPORT OF ACTIVITIES OF LOCAL HEALTH DEPARTMENTS BY
COUNTIES -1947 (continued)
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Admission to medical service____________
Admission to nursing service----------------
5
Visits to medical conferences--------------
Field and office visits......------------------------
92
Dental inspections----------------------------------
SCHOOL HYGIENE
Inspections by physicians or nurses....
127
Examinations by physicians ---------------
4
Admission to nursing service------------
4
Field and office visits----------------------------
89
Dental inspections
ADULT HYGIENE Medical examinations --------------------------
MORBIDITY SERVICE
Medical visits................... --------------------------
6
Nursing visits ----------------------------------------
55
Admissions to hasp itals --------------------------
1
SANITATION
Water supplies approved-------------------Privies and septic tanks installed....
Food-handling establishments regis-
tered ----------------------------------------Dairy farms registered.------------------------
Milk plants registered ...--------------------
Field visits -----------------------------------------------
20
LABORATORY SPECIMENS
Specimens examined -------------------------------
484
7 73 3 211
235
33 86 60
27
2 13
5 47
31
333
2204
104
304
219
304
102
375
220
495
861
180
165
500
22
38
28
54
1845
16
1250
26
4
5075
16
84
18
102
37
285
35
8
2
462
54
5599
52
14250
213
6
144
6
87
9
223
9
75
189
1941
192
1
196
201
258
747
47
1 18
1
2
2
4
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28
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48
3074
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47
CONDENSED REPORT OF ACTIVITIES
OF LOCAL HEALTH DEPARTMENTS
BY COUNTIES -1947 (continued)
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COMMUNICABLE DISEASE CONTROL Admission to medical service ___ Consultations with physicians_
Field visits ---------------------------------
Smallpox immunizations -------Diphtheria immunizations ------Typhoid immunizations
':'fhooping cough -------------------------
25
25
3
87
68
2
1415
187
112
148
15
53
4818
1311
819
75
21
25
VENEREAL DISEASE CONTROL
Admission to medical service---
314
47
171
Clinic visits ---------------------------------
Field visits -----------------------------------
!17
6
20
537 29
869 169
Number of clinic treatments ___
137
78
533
TUBERCULOSIS CONTROL
Admission to medical service ....
Admission to nursing service
Clinic Field
vis and
i
tosffi-c--e----v--i-s--i-t--s--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-
141
60
105
185
147
113
1543
113
111
158
306
169
MATERNITY SERVICE Admission to medical service.... Admission to nursing selvice____ Visits by ante-partum case~ to medical conferences________
Field and office visits------------------
25
62
73
30
74
71
19
172
191
101
191
176
INFANT HYGIENE Admission to medical service____
Admission to nursing service____ Visits to medical confelences____ Field and office visits_________________
180
41
26
202
58
33
294
122
44
645
169
49
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26 2
99 917 301 2019 240
192 1025
47 220
164 169 261 324
208 251
273 578
218 294 442 651
48
Georgia Department of Public Health
CONDENSED REPORT OF ACTIVITIES
OF LOCAL HEALTH DEPARTMENTS
BY COUNTIES -1947
"~
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PRESCHOOL HYGIENE
Admission to medical service ___ Admission to nursing service.... Visits to medical conferences .. Field and office visits ---------------Dental inspections------------------------
493
H
10
518
,j
10
502
4
19
543
10
17
SCHOOL HYGIENE Inspections by physicians or nurses _______ ---------------------------Examinations by physicians ___ Admission to nursing service . Field and oftice visits _______ Dental inspections ________
1638
175
673
94
47
18
35
56
81
32
18
ADULT HYGIENE
Medical examinations
631
MORBIDITY SERVICE
Medical visits ---------------------Nursing visits Admissions to hospitals-----------
37
145
171
423
1
SANITATION
Water supplies approved _________
Privies and septic tanks
installed
--------------------
Food-handling establishments
registered -----------------------------
'JO
Dairy farms registered ________________
Milk plants registered ___________
Field visits ----------------------------------
10
990
75
12
LABORATORY SPECIMENS Specimens examined -----------------
2686
480
528
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58 68 90 132
202
~
8 80
H6
82 2
40 39 606 1470
Locctl Health Organizations
49
COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC
HEALTH WORK IN GEORGIA, 1946-1947
Organized Counties
1946
1947
COMMUNICABLE DISEASE CONTROL AdmJss~ons ~o medi_cal serv~ce..........................
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.......................................
............
Hool{worm ------- Typhus ....................................................
Other communicable diseases..............
Total field visits for communicable disease control ...............................................
Persons treated for hookworms Admission to hospitals:
Diphthel'ia ............................................................ Typhoid fever and paratyphoid fever ..........
Scarlet fever................. ----------- Smallpox .............................................................. Other communicable disease patients ad-
mitted to hospitals..........................
7,863 8,413 9,698 1,119
1,015 285
1,464 32
1,355 602 86
2,692 200
2,345
10,07<1 3,389
53 27 16
8,044 10,028 10,265
233
2,357 314
1,133 90
1,451 1,295
127 4,526
240 3,094
14,627 4,831
131 83 10
Total admissions to hospitals for commu.. nicable disease control.. .............................
IMMUNIZATIONS (persons immunized)
Smallpox ............................................................. Diphtheria-under 1 year................................ Diphtheria-l through 4 years
Diphtheria-5 years and over..........
Total diphtheria immunizations... Schiel< tests given...............
Typhoid fever ....................................................
Whooping cough-under 1 year.................... Whooping cough-over 1 year.............. .
'l'otal whooping cough immunizations........ Public lectures and talks ....................
Attendance ....................................... Persons tested in surveys.... .............................
VENEREAL DISEASE CONTROL
Admissions to medical se1vice... .
Admissions to nursing service....................... .
Total admissions to medical and/or nurs-
ing service
Cases transferred to private physicians..
Clinic visits (by patients) ...............
Field visits (to patients) .........
Number of clinic treatments................
Dismissed from service........................................
Office visits--Rapid Treatment Center....
Public lectures and talks..................
Attendance ..............
...........................
100
53,150 11,274
6,566 9,709
27,549 8,362
238,047 8,790 4,<118
13,208 216
3,252 63,517
49,728 31,359
51,950 3,374
327,592 32,411
185,355 15,996 5,657 119 6,215
570
62,468 12,553 12,548 11,592
36,693 9,896
261,283 10,935 1,388
15,323 952
13,660 68,190
36,546 39,825
52,679 2,185
281,964 21,571
132,693 20,292 11,221 200 6,063
All Counties
1946
1947
8,621 9,693 11,018 1,196
l,H1 352
1,542 35
1,101 617
1,105 3,882
207 2,660
12,9<15 4,393
57 28 16
1
412
8,678 11,857 12,086
301
2,794 385
1,225 97
1,482 1,388
300 5,891
264 3,933
17,759 6,015
144 91 11
350
51>1
68,133 13,551 15,554 11,471
40,579 9,217
322,273 10,7>13 5,220
15,963 372
5,123 65,154
52,573 34,601
55,191 3,563
358,581 35,1<13
208,109 16,639 6,759 121 6,274
596
84,500 15,594 15,996 13,919
15,509 10,681 349,761 13,506
7,409
20,915 1,068
13,991 70,062
38,35>1 42,82"3
55,722 2,629
298,659 2>1, 7>19
138,821 21,266 13,891 329 6,204
50
Georgia Depa'Yiment of Public Health
COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC
HEALTH WORK IN GEORGIA, 1946-1947 (continued)
Organized Counties
1946
1947
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....................
CXl-irnaiyc evxiasmitsina(tbioynspa--t-i-e-nt-s--)-_______-________
Visits to State clinics (by patients) Visits to private physicians (by patients) Visits to private physicians (health officer
or nurse) ................................... --------- Visits to others (health office1 or nurse)
Field Visits -------------------------------------------------------Visits to cases of tuberculosis........................ Visits to tuberculosis suspects........................
Visits to contacts------------------------------------Office visits................ ................................... Office visits of cases of tuberculosis.......... Office visits of tuberculosis suspects Office visits of contacts.................. Admissions to sanatoria .............................. . Number tuberculin tests completed Numbe1 positive................................ Number negative (completed tests) ___________ _
CCoonnttaaccttss pbraorktelny-----b--r--o--k--e--n--_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_
Relief ,secured for tuberculosis cases.......... . Cottages. sleeping porches, etc. (Number
built) ___ ------------ --------------------------------------Public lectures and talks__ _
Attendance ------------------------------------
MATERNITY SERVICE Cases admitted to prenatal medical service Cases admitted to- prenatal nursing service Cases admitted to medical and/or nursing se1vice ......................................................
Visits by prenatal cases to medical con-
ferences .......................................................... Visits by prenatal cases to- private physi-
cians ................................................................. Field visits to prenatal cases....................... Office nursing visits by prenatal cases...... Cases attended by nurses for delivery
se1vice ....................;......................................... Cases given postpartum medical examina-
Catsieo~n g--i-v--e--n------p--_--o--~--t--p-a--r--t--u--m-----e--x--a---m---i-n---a--t-i-o---n-----b---yprivate pbys1c1ans ..............................
Cases admitted to postpartum nursing service .............................................................
Visits to postpartum cases........................... Permanent Health Centers__ ------------------------INtiunmehraenr t ohfealstehssicoennst.e..r..s.._._._._._._._._._._._._._._._._.__._________________ _
Sessions held----------------------------------------------------Midwives registered for formal instruction
11,269 2,204 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 34,254 9,919 6,274 18,061 19,523 7,041 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
2,748
136
16,787 32,845
132 3,358
1 4 973
14,202 5,297 4,414 7,080
20,698 3,013 5,152
12,190
20,851 3,396
11,873 11,60<1
3,320 97,664 69,998 39,617
500
925 1,217 37,626 10,563 6,621 16,730 124,525 12,633 7,534 11,256 1,046 19,403 24,335 14,997 1,273
170 386
1 49 3,066
18,873 20,386
20,515
51,889
718 17,756 47,397
223
2,881
121
18,219 35,344
144 3,304
4 235 3,108
All Counties
1946
1947
12,718 2,409 3,466 6,843
17,452 3,459 4,122 9,871
20,158 4,160 5,007
10,991 3,748
27,176 27,274
4,181 735
1,361 1,212 38,290 11,147 6,997 20,146 21,775 7,515 5,703 8,557
707 19,741
4,972 14,769
1,324 105 335
22 50 4,381
16,934 5,606 5,154 8,973
25,812 3,752 6,659
15,345
26,426 4,200
13,408 15,037
3,582 101,968
74,132 43,475
660
1,090 1,424 44,627 12,244 8,031 20,668 127,960 13,185 8,645 13,138 1,266 23,583 25,237 18,333 1,435
188 423
4 58 3,623
17,687 22,627
23,546
53,324
925 20,060 48,292
49
3,115
166
18,138 35,147
154 5,056
1 4 1,312
21;120 24,347
24,541
58,086
784 19,786 55,906
298
3,247
169
19,878 37,916
180 4,277
40 237 3,477
Local Health Organizations
51
COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC
HEALTH WORK IN GEORGIA, 1946-1947 (continued)
Organized Counties
1946
1947
Midwife meetings............................................... .
c:t A~t;ndance
J?1eetings;:
VISits for mtdwife superVISIOn........................
Public lectures and talks..-----------------------------
Attendance ------------------------------------------------Enrollment in maternity classes...... .
Attendance --------------------------
INFANT AND PRESCHOOL HYGIENE Infants: Individuals admitted to medical service...... Individuals adrnitted to nursing service...... Individuals admitted to medical and/or nursing service............................ Permanent health centers.............. Number of sessions.....
SIteisnseioranns t hehleda__l_t__h______c__e_n__t_e_r__s_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-------
Visits to medical conferences (by patients) Visits to private physicians (by patients)
Field visits ............................... ------- Office nursing visits.............................. Consultations with parents...........
Preschool: Individuals admitted to medical service...... Individuals admitted to nursing service...... Individuals admitted to medical and/or nursing service......................... ..................... Per1nanent health centers............................... Number of sessions...................... Itinerant health centers ________ -------------------- __ _ Sessions held______________________________________________________._
Visits to medical conferences (by patients) Visits to p1ivate physicians (by patients)
OFifeflidce vnisuitrs-s--i-n--g----v--i--s-i--t-s----(-b--y----p--a--t--i-e--n--t--s-)--_-_-_-_-_-_-_-_-_-_-_-_----
Inspections by dentists or dental hygienists Prophylaxis by dentists or dental hygienists Consultations with parents...........................
Public lectures and talks..-----------------------------Attendc;nce ............................................................ Enrollment in infant and preschool classes
Attendance ----------------------------------------
SCHOOL HYGIENE Inspections by physicians or nurses..... . Examinations by physicians............................ Examinations by physicians with parents present ............................................................ Individuals admitted to nursing service...... Field visits .......................................................... Office visits..................................... Inspections by dentists or dental hygienists Prophylaxis by dentists or dental hygienists
Public lectures and talks__ ------------------------------
Attendance ------------------------- ---------------------------Classroom health talks __ _ Attendance
ADULT HYGIENE
Medical Examinations:
Milk-handlers --------------
Other food-handlers ------------- --------------------
Midwives .....................
..........................
Teachers ..........................................................
Other adult medical examinations.....
Total adult medical examinations___________________ _
608 4,99'1 ? ?66 -,l22 1,313
525 1,230
9,94<1 27,248
27,793 258
5,663 37 98
23,313 262
,14,396 27,525 33,582
10,'190 21,882
23,082 216
4,593 124 2Vl
17,641 10,1
29,237 21,643
602 588 26,100 425 4,542 42
,12
255,183 50,Vl6
3,227 16,871 21,659 16,296 50,322
2,570 512
24,478 2,692
101,276
1,047 54,823
331 1,879 20,986
79,066
655 4,782 2,176
186 1,013
614 1,389
13,049 31,8,17
31,862 199
3,186 34
263 31,127
144 38,650 37,946 ,10,984
13,417 25,571
26,702 171
5,222 147 397
22,916 65
31,132 29,092
846 100 31,559 552 8,435
26
1,077,646 271,291
'1,051 18,888 21,87'1 30,705 56,105
2,388 1,570 20,607 7,404 91,293
1,718 49,775
381 1,352 23,2<12
76,468
All Counties
1946
1947
900 6,572 2,976
138 1,4<14
525 1,230
1,033 6,261
2,956 208
1,08'1 639
1,H2
10,914 29,7,18
30,341 268
6,307 37 98
25,234 298
,17,388 29,846 35,590
14,489 35,231
35,398 228
3,872 39
275 35,069
174 42,9,10 41,843 43,008
10,963 23,223
24,426 220
5,068 125 221
18,352 138
30,596 22,688
602 588 26,959 426 '1,573
60 125
14,23'1 27,229
28,42,1 199
5,757 17<1 429
24,2Vl 79
32,960 30,979
888 129 32,931 557 8,489
.1!2
268,611 50,815
3,358 17,276 22,023 16,841 52,107
2,747 575
28,123 2,856
109,197
1,093,891 272,111
4,457 19,787 22,728 31,692 58,626
2,507 1,636 22,95,1 7,605 99,059
1,093 55,154
351 1,879 21,124
79,601
1,739 50,055
381 1,352 23,372
76,899
52
Georgia Department of Public Health
COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC
HEALTH WORK IN GEORGIA, 1946-1947 (continued)
Organized Counties
1946
1947
All Counties
1946
1947
MORBIDITY SERVICE Admissions to medical service Admissions to nursing service Admissions to 1nedical andjm nursing service Clinic visits (by patients)
Field medical visits------- Field nursing visits ____________ ......................
Office nursing visits .......... Total admissions to hospitals..... Total patient-days of hospital service........ Individuals admitted to dental service........ Refractions ........................................ Tonsil and adenoid operations Other defects corrected...........
15,883 6,372
20,497 26,266
1,354 9,178 5,870 10,,125 65,056 4,780
633 764 3,456
CANCER CONTROL
Admissions to medical service.. .
430
Admissions to nursing service.. .
234
Admissions to medical and/or nursing
service ..........
508
Office visits .......................................................
928
Field visits------------------------ ...................
509
Applications for State aid
275
CANCER CONTROL (continued)
Cases receiving diagnostic service at State-
aid clinics......
............................... .
725
Cas~s rec7i~ing treatment service at State-
atd chn1es.................
571
CRIPPLED CHILDREN SERVICE Individuals reported................................ Individuals examined at diagnostic clinics Individuals L>eated.............................................. Individuals admitted to nursing service... . Visits to diagnostic clinics (by patients) .. .
Nu'rsing visits------------------- ---------------------Public lectures and talks Attendance .....................................................
767 931 675 981 1,019
2,28'1
OTHER ACTIVITIES
Conferences with physicians or dentists....
Personal conferences with others..
Newspaper articles ....................
Bulletins distributed................
Circular letters................... .
Miles traveled on duty........
. . ......
Days <>ff duty.............................. .
Conferences with official groups..
Attendance ........................
Public lectures and talks
Attendance ...................................................
Home Hygiene and Red Cross Classes (Ses-
sions) ............................................
Attendance ...
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
GENERAL SANITATION
Water: Approved individual water supplies installed
Individual water supplies improved..... . Public water supplies improved......
Connection to public water supplies Sewage:
New privies installed................ Wood privies installed at homes....
Concrete privies installed..... . ..... . Wood privies installed at schools...... . Conc1ete privies installed at schools Wood privies installed at other public
places ...............................................................
644 1,179
160 7,484
1,475 760 472 29 54
15
18,710 7,831
22,633 29,405
720 8,396 11,254 10,954 66,036 8,707
511 1,606 2,351
592 321
665 1,342
407 432
1,397
897
833 1,711
947 1;134 1,611 3,060
16,344 141,574
2,075 497,879
95,592 2,110,288
2,483 2,325 25,529
638 22,316
2,097 17,041
896 883 161 9,307
1,140 652 315 177 77
15,971 7,345
21,573 26,415
1,367 11,196
8,808 10,47<1 65,498 4,901
662 773 3,475
449 321
595 1,0,13
656 343
18,986 8,941
23,700 29,72,1
769 10,137 14,078 10,996 66,447
8,820 512
1,621 2,362
623 402
743 1,425
494 501
735
578
865 961 685 1,186 1,055 2,651
1,405
917
910 1,750
977 1,616 1,656 3,393
18,820
20,496
158,526
164,683
6,223
2,297
125,192
509,644
73,601
105,265
2,545,291 6,771;115'/z
4,203'/z 2,949'/.;
2,090
3,569
22,074
28,941
1,072
889
42,710
31,720
1,736 6,453
2,136 17,152
697 1,489
236 7,729
1,721 872 575 35 56
38
1,105 1,161
226 9,635
1,434 715 412 197 81
11
Local Health Organizations
53
COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC
HEALTH WORK IN GEORGIA, 1946-1947 (continued)
Organized Counties
1946
1947
All Counties
1946
1947
GENERAL SANITATION (continued) Sewage: Concrete privies installed at other public
places ---------------------------------------------------------------NP reiwv i e ss e prteipc a i rt aendk s( o ri n sitma lpl erdo v__e__d___)_._.__._._._._._._._._._._._._._._._._. ._ 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 p1emises..................................... Camp sites.............................................................. S\vimming 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....
Insect control: Buildings mosquito~proofed ............................ Minor drainage-linear feet completed...... Linear feet ditch cleared......--------------- Anopheles breeding places eliminated.......... Acres drained........~............................................. Anopheles breeding places controlled....
Miscellaneous: Public lectures and talks................................ Attendance ----------------------- Posters, charts, exhibit models completed.. Sanitation or malaria maps completed......
Rodent control: Premises surveYed for rodent control.......... Buildings rat-proofed...............-----------------Buildings improved............................................ Premises improved............................................ Pounds of poison bait distributed....
PROTECTION OF FOOD AND MILl< Food-handlin_g_ establishments registered for superviSion ................................................ Field visits to food-handling establishments Dairy farms registered for supervision...... Fiell 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................................ A t t e l t d a n c e ................ -------------------------
115 2,068 3,605 3.'112
12
151 619 3,691 220
52 1,518 5,196 5,260
142
193 596 16,651 159
146,493 713 471 174
2,191 489 986
02,741
204,258
70,964 1,979 714 163 2,865 659 743
161,604
239,691
8,673
4,669
265,941
360,037
971,037 1,933,107
215
282
79,23<1%
214
716
605
44 2,893
62 5
2,137 5,965
3,219 1,816
27,400 5,235
995 27,145
36,881'12
56,809 7,731
16,305 42,122
48,620
7,427 70,613
1,361 13,486
95 3,919 4,556
239,890 21,384
407 9,018
7,758 72,709
2,383 16,609
484 3,676 9,337 225,782
25,656 507
3,732
1<15 2,206 4,114 3,861
20
233 642 3,794 221
58 1,643 6,029 6,032
151
227 648 16,803 166
148,092 947 485 175
2,527 839
1,072 52,818
206,985
81,000 3,436 1,289
185 3,646 1,000
858 162,019
253,433
8,673
270,942 1,071,238
215
79,234'1< 720
4,677 360,187 1,933,107
282 214 605
76 4,551
63 7
2,144 6,453
3,309 1,858
28,115 5,235 1,325
27,342 39,386,
56,830 7,731 16,305 42,122
49,076
7,427 70,688
1,361 13,591
95
3,932 4,556
239,890 21,384
407 9,018
7,874
73,469 2,392
17,065 490
3,714 9,313 225,875
25,703 507
3,732
54
Georgia Depc~rtment of Public Health
COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC
HEALTH WORK IN GEORGIA, 1946-1947 (continued)
Organized Counties
1946
1947
Pos.
Neg. Pos.
Neg.
All Counties
1946
1947
Pos.
Neg.
Pos.
Neg.
LABORATORY
Specimens examined:
Water-bacteriological ...... 986
MWialktero-rchmemilikcaplrod;;~t~::::::
31 917
Other foods ........................ 10
Typhoid: blood cultures.. 14
Typhoid: Typhoid:
sWtoiodlaleuit-~~~-~~---.-.
25 87
Typhoid: urine cultures 34
Diphtheria cultures
241
Syphilis-serological ........5<1,024
3yphilis-darkfield
278
Uudulant fever (h;;;;;;,:;;) 8<1
Bangs disease (animal) .... 157
Typhus fever -- 246 "I'ularemia --------- 19 Malaria ................................ 118
Gonorrhea ........................ 10.387
TFuecbeesrcufolorsisparasites..........
1. 723 4,790
Urinaly Rabies
sis ----
3,677 272
Pneumococcus typing ......
3
DOythseenr telarboyr;,:t;;~::;.
37
specimens examined 1,738
4,732 1,172
376
97
15,918
965
122
22
270
11
1,819
8
7,525
<15
2,685
20
<1,585
886
207,1<15 37,923
599
316
1,608
76
778
23
1,496
155
113
<15
2,831
50
55,733 7,735
11,783
11,228 37,265
2,041
6,594 3,958
599
205
92
4
644
13
19,969 39,890
5,369 656
19,500 464 222
1,764 6,885 2,122 4,305 216,629 1,349 1,<111
794 1,356
78 1,857 3<1,230 14,7<16 14,884 38,341
243 16
1,253
216,824
Total laboratory specimens examined ....79,898 389,915 102,284 585,298
1,171
33 917
10 19 25
98 34 272
56,800 29<1
96 158 259
19
126 10,593
1,857 7,601 4,031
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 56,6<16
13,423 13,122
41,889
612 92 735
2,019 20,144
1,310 97 965 22 12
9 65 20 982 <11,440
366 87 24
173 50
94 7,87<1
2,271 21,478
4,659 256 4
16
6,321
656 19,500
464 25<1
1,777 7,535 2,293 4,953 228,600 1,380
1,439 79<1
1.381 115
2,556 35,227 16,719 18,223
44,536 293
16 1,346
<10,003 217,125
86,746 414,'107 122,277 613,503
Division of Public Health Nursing
MISS THEODORA A. FLOYD, R.N.; B.A.; M.A. ____________________Director MRS. BESSIE F. SWAN, R.N.; B.S.Ed.; M.S.P.H. ____Asso. Director
Division of Public Health Nursing
Census of N~trses
The annual census of nurses shows a total of 408 nurses at the end of the year as compared with 362 nurses at the end of 1946. There are about 140 industrial nurses in Georgia.
Changf}s in Personnel
There appears to have been a little more stability in the nursing staff during the past year. 90 nurses were appointed during 1947. Thirty-four of these had had at least six months of special training in public health nursing. During this same time there were forty-five resignations, fifteen of whom had at least four and one-half months of training in public health nursing.
Vacancies
At the end of the year there were approximately 113 vacancies in public health nursing positions in Georgia, for which there is budgetary provision. These included all types:of positions as assistant director, local supervisory and staff nurses.
Mrs. Abbie R. Weaver, who established the Public Health Nursing Division and was Director for eleven years, died August 6, 19Ll7. Mrs. Weaver's leadership in public health, as well as other branches of nursing, was a tremendous factor in the development of nursing programs in Georgia and throughout the entire South.
Recruitment
Because of the larger number of nurses who have chosen public health nursing positions in Georgia during 1947, we are encouraged in relation to the possibilities of securing more nurses. It is hoped that with the increase in nursing salaries which went into effect July 1, 1947, there will be a still greater increase in nurses available for positions in the future.
The major emphasis during 1947 has been the recruitment of public health nursing students, as well as nurses prepared to enter the public health nursing field. Some of the methods used in recruitment have been through correspondence, interviews with the prospective students, and field advisory visits. During the year one of the efforts which was started late in 1946 and continued in 1947 was to publicize in a simple but attractive 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 such as maternity, pediatric, and tuberculosis. By the end
58
Georgia Department of Public Health
FORMER NOW!
PAY SCALE
EMERGENCY NURSES
GRADUATE NURSE
STAFF NURSES 6 MONTHS PREPARATION IN PUBLIC HEALTH
$t55-170
PLUS $50 CAR
ALLOWANCE FOR TRAVEL
$175-190 PLUS $50 CAR ALLOWANCE FOR
s2oo-24o
PLUS CAR ALLOWANCE FOR TRAVEL
FOR INFORMATION WRITE:
DIRECTOR,DIVISION OF NURSING GEORGIA DEPARTMENT OF PUBLIC HEALTH
12 CAPITOL SQ. S.W. ATLANTA, GEORGIA
Public Health Nursing
59
of the year we had received a total of 463 requests for information regarding these scholarships. Of these, 139 requests were for training in public health nursing. Many of our present nurses
who were previously employed as pubHc health nurses but who desired advanced training in public health have requested scholarships for advanced training when they learned of the availability of the scholarships. One other method of recruitment
has been to publicize to public health nursing courses and in schools of nursing in Georgia the increase in salaries for public health nurses. There has been a revision of our leaflet "A Career in Public Health Nursing." Since many of the requests regarding training in public health nursing contained a question as to the duties of public health nurses, it was decided that this leaflet should contain some of the activities of the public health nurse. For that reason the name was changed to "Services of Public Health Nurses In Georgia", and the content was changed accordingly.
~ Training of Pe1"Sonnel
Stipends were given for the different types of training as listed below:
Public Health Nursing
Winter Spring
Summer Fall
14 ( 5 White, 9 Negro) 10 (10 White)
9 ( 8 White, 1 Negro) 19 (14 White, 5 Negro)
Total
52
Senior Cadet Nurses 6 White Nurses
Premature Care 6 White Nurses
Obstetrics 3 Hospital Nurses
PediatTic Nursing 1 White Nurse
Industrial Hygiene 1 Nurse
Orientation
13 Nurses
A total of :fifty-two nurses received training in public health nursing during the year. The fact that the State Health Department revised its policy in relation to length of public health training has resulted in more public health nurses choosing to attend colleges for two semesters instead of two quarters as
Five hundred p1emature incubators were available to ho spitals and homes through th e State Health Depar tment. Th e Public Health Nurse helps supervise premature care in
-- ,__ . .~
m
0
'<J c~
"l
(Q
~-
0
~ ~
~
~
;:3
~
..c.....,
;?
.0,._"
'<":'>" ::r::
~
~ ;~ ;:.-
."'
P~tblic H ea,lth Nursing
61
previously had been done. The liberalization of the policy of the Federal Agency has made it possible for the State Health Department to offer further training to public health and hospital nurses who are needed in teaching or supervisory positions either in public health or hospitals.
Six nurses received training in Premature Care. Three hospital nurses had training in Obstetrics. One of these was a Negro nurse and two were white nurses. Six senior cadet nursing students had supervised experience in public health nursing in the following counties: Whitfield, Muscogee, Colquitt, Fulton, Walton.
Thirteen nurses have had orientation of approximately a month prior to being assigned to counties. The majority of these are nurses who have not had public health training and for whom a period of observation was considered advisable.
Educational and Field Activities
WORK WITH REGIONAL CONSULTANT NURSES
A four-day conference was held for regional consultant nurses and local supervisory nurses. The Associate Director of the Nursing Division assumed responsibility for the planning, development, and execution of this working conference. An attempt was made to evaluate the outcome of this conference. The Associate Professor of Public Health Nursing at Medical College of Virginia gave inspirational leadership through planned group meetings and individual conferences with nurses. Briefly, it is believed that the following may be listed as the general outcome of the conference:
1. The content of this conference will furnish the first steps for a manual on supervision in public health nursing.
2. The beginnings of the development of group thinking which will contribute to the success of working together. This is particularly important for state consultant nurses and
local supervisory nurses.
3. A recognition of the need for consultant and supervisory nurses to improve their techniques in carrying on the program of supervision.
REGIONAL OFFICES
Visits were made to all the regional offices. Public Health Nursing activities were reviewed and suggestions made in relation to particular needs of the area covered. Some examples of these activities are as follows:
62
GeoTgia DepaTtment of Public H ealth
Public H ealth Nurses h elp plan cmcl provide for convalescent ca?e in the home.
Public H ectlth Nursing
63
1. A consultant nurse in one region was advised to continue her efforts in analyzing the case load of nurses and assisting in the selection of patients for home visits on the basis of need; encourage the use of family folders on selected families; participate in the VD-TB survey at the request of county health departments to the extent that the generalized work in the region permits; spend the necessary time in planning work to facilitate activities and formulate the objectives for the nursing service of individual counties and for the region as a whole.
2. Discussed with two regional consultant nurses the contents of narrative reports which were as follows: a. The purpose of the visit to the counties should be stated. b. The problems which were encountered on this visit. c. Steps which were taken to help solve the problems. d. Plans for further visits to counties, both long and short term plans.
3. Advised regional consultant nurses as to counselling given in relation to making up deficiencies in basic training, as well as the procedure for taking the National League of Nursing Education test to determine the deficiencies in basic training.
4. Discussed the use of a check sheet to evaluate the nurses' visits to Tuberculosis cases.
5. Assisted regional consultant nurses in the division of the region. To do this adequately it was necessary to consider the following factors:
Number of nurses in each section of the region; number of health departments; number of vacancies in nursing positions; and number of emergency nurses in each region. It was necessary to secure the approval of the regional medical director before this division was final. It is significant that five of the regions in the State Health Department have been divided between the two regional consultant nurses. The only region which has not yet been divided is the Southeastern Region. We are confident that the division of regions makes it possible to carry on a more effective program with the county personnel. It is more economical in that nurses have a certain area in which they travel so that travel time is not duplicated.
6. Assistance was rendered the consultant nurse and a committee of staff nurses in planning the staff education programs for county nurses.
7. Participated in the in-service education program planned in the regions. The four following are examples in which
64
Georgia Department of PubUc Health
the Public Health Nursing Division has participated during the past year :
a. An all-day meeting in the form of a panel discussion with school and public health officials participating.
b. Participation in a day's meeting in which the organization and teaching of classes for prospective mothers was discussed.
c. Participated in an all-clay conference in which the various phases of school health work were discussed. It was discussed from the point of view of medical engineering and nursing participation in carrying on a good school health program.
d. Participated in a staff meeting in which the Massachusetts vision testing equipment was demonstrated, as well as the Group A Audiometer Test.
VISITS TO COUNTY HEALTH DEPARTMENTS
Sixty-nine visits were made to counties in which health departments or public health nursing services were carried on. These were usually made in the company of the regional consultant nurse. Some of the activities which were carried out on these visits were as follows :
1. Reviewed activities of nurses assigned by the United States Public Health Service to make it possible for county nurses to take educational leave. The main purpose of these visits was to work with the regional consultant nurse in the evaluation of the nurse's activities in order to write efficiency reports of the nurses assigned to us on a loan basis.
2. Visits were made to three county health departments in relation to the possibilities for developing field training centers for public health nursing students and basic nursing students who would like to secure supervised experience in public health nursing, as well as affiliating students from schools of nursing. During these visits the need for adequately trained supervisory and staff nurses, a suitable place for instruction and individual conferences with students, a record system which is acceptable to the best interests of the patients cared for, and a well-balanced service including all the major services in a well-developed health department were stressed. Four counties in addition to Fulton County have been used for supervised experience in public health nursing for senior cadet nurses. However, only one county in addition to Fulton County has been used for the training of public health nursing students. This is Musc6gee County.
3. A visit was made in one county for observation of a class for prospective mothers and giving specific suggestions to
Public Health Nursing
65
the county nurse with reference to ways in which this group teaching could be improved. This work was done in conference with the regional consultant, local supervisory and county public health nurses.
4. The need for continued stimulation and professional growth on the part of the county nurses, particularly those who have been on the staff for a period of years, was emphasized on field visits. Regional consultant nurses were encouraged to have these nurses take an active part in program planning and participation in staff meetings. In five of the regions the consultant and supervisory nurses are to be commended for their efforts in this direction and for their painstaking efforts in introducing new staff nurses, both trained in public health nursing and untrained to the field of public health nursing.
5. Visits were made in Thomas and Walton Counties particularly to observe the nurse midwifery program in these counties. The purpose of these visits was to help show the need for correlation of the midwifery service into the generalized public health program. Regional consultant nurses have been advised to use the nurse midwifery program as a method of enriching the obstetrical content of nursing visits to other counties as well as those in which the midwifery program is carried on.
6. A real effort has been put forth to visit new nurses who have secured training under stipends from the State Health Department in an effort to determine whether or not the training meets the needs in problems which the nurse encounters when she attempts to put into practice the theory which she has learned during her training. It is expected that a summary of this evaluation will be sent to the university at which the nurse trained, as well as the field training center, so that the training of the nurses will be as practical as possible.
In addition to these contacts with county nurses in their counties, many nurses have come to the State Office to discuss with us their needs as to further education, additional supervised experience, and supervisory experience necessary to prepare them to accept positions with responsibility.
WORK WITH HOSPITALS
Two schools of nursing have been given assistance at their request in relation to the integration of the social and health aspects in the basic nursing curriculum. Visits have been made to these schools where conferences were held with directors of nursing and instructors on ways and means of developing this
66
Georgia Department of Public H ealth
T eaching by demonst1ation is the Public H ealth NuTse's con tribu tion in the chi ld health conje1ence.
program of study. Talks have been made on the field of public health nursing, particularly from the standpoint of a career in nursing.
Several groups of student nurses have made trips to the State Department of Public Health with their instructors for the purpose of seeing the physical set-up and learning something of the organization and functions of the different divisions. Considerable interest in public health nursing has been manifested on the part of student nurses. This interest has been evidenced by the number of nurses who have requested supervised experience in public health nursing during their senior cadet period.
Another activity with hospitals has been the cooperation of the Public Health Nursing Division with the Maternal and Child Health Division in an effort to develop a supervised experience in Premature Care at Crawford Long Hospital. Progress has been made in this proposed plan. Since 1942, the Georgia State Department of Health has realized the need for facilities for providing supervised practice in Premature Care for public '~.ealth nurses, institutional, and student nurses. A large number of nurses have been sent to New York City and Chicago to secure this training. This has necessitated funds for travel and additional time away from work as a result of the distances. Becaus~ of the higher birth rate in the South, it is a logical conclusion that there are more premature infants in this part of the country.
Public Health Nursing
67
(This is based on the fact that from 5 to 7 percent of all births are premature.) These prematures need the best possible care if they are to survive. While this care is being given to them, they could, at the same time, be used as teaching material for all types of nurses within the State. Crawford Long Hospital has been chosen because of the interest of the hospital in participating in such a plan, as well as the fact that it has the largest census of maternity cases, as well as premature, of any hospital in the State.
BATTEY HOSPITAL
The development of an affiliation for basic nursing students at Battey State Hospital has been one of the aims of the Division. It now seems probable that the end result of efforts in this direction will be an eight weeks affiliation in tuberculosis which will be of sufficient educational value to attract the requests of schools of nursing throughout the State for participation in such a program. A similar affiliation at Alto Medical Center is desirable.
Special Activities
The Director and Associate Director of the Nursing Division were requested to serve as members of the North Carolina Merit System Oral Examination Board. During this time all types of public health workers were interviewed.
Public Health Nursing" Week was observed April 20- 26, 19L17, throughout the nation. It was sponsored in Georgia by the Georgia State Organization for Public Health Nursing. The Associate Director in the Public Health Nursing Division was State Chairman and in this capacity assisted in formulating objectives for the week, appointed local chairmen, assembled and distributed publicity materials, and gave suggestions for activities during the week. The annual report of Public Health Nursing Week was given at the annual business meeting of the Georgia State Organization for Public Health Nursing. In addition to these activities, a radio skit was written.
At the request of'the National Organization for Public Health Nursing, this division planned and carried on a conference to discuss methods of expanding and improving field training centers for public health nurses. There were nurse representatives from Emory University, Peabody College, University of North Carolina, University of Georgia, Vanderbilt University, local health departments, and regional offices. Minutes of this meeting, with recommendations, were sent to those who attended the meeting. Excellent recommendations came out of this meeting and we are hoping that they will be a factor in the improvement and expansion of field training centers for public health nursing in Georgia.
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Georgia Department of Public l-1ealth
The division was represented at the series of lectures on Mental
Hygiene given by Dr. George Preston, Maryland State Depart-
ment of Health. Meetings attended during the year included the
American Public Health Nurses Association; the Georgia Public
Health Association; the Biennial Association of Colored Gradu-
ate Nurses; the Board of Directors of the National Organization
for Public Health Nursing; the National Nursing Structural
Study Groups; the Fifth District Meetings of the Georgia State
Nurses Association; Georgia State Organization for Public
Health Nursing; Georgia League of Nursing Education; Georgia
Citizens Council; and the Women's Auxiliary of Fulton County
Medical Society.
The Public Health Nursing Division had membership in the following boards and committees:
1. Atlanta Registry Committee
2. The State Nurses Association Legislative Committee
3. The Board of Directors of the State League of Nursing Education
4. Board of Directors of the National Organization for Public Health Nursing. (Member of executive committee)
5. Education committee of the National Organization for Public Health Nursing
6. Chairman of the committee of Maternal and Child Health
7. Committee of the State League of Nursing Education.
Summary of Activities
Visits to: Regional Offices. _____________________________________________ ------ 30 Health Departments_____________________________________ ----___ 69 Hospitals __________________________________________________ ---- -------- 15 Clinics ______________________________ ---------- __________ -~ ______ ---- ___ _ 6 Schools ______________________________________________________ ------- __ ___ 5 Homes __ __ ____ __ ____ ___ ______ _____ ___ ___ ____ __ __________ ____ ___ ____ ___ __ __ 8 Meetings Attended ______ ____ ____ __ __________ __ ____ __ ____ __ __ __ __ 56 Addresses ___ ____ _____ ______ ____ _____ ___ ___ ___ __ __ __ _____ ___ __ __ _____ __ _ 21
Division of Public 1-Iealth Engineering
L. M. CLARKSON----------------------------------------------------------------------Director
Public Health Engineering
Public Health Engineering which is established in all state health departments is a normal function of federal, state, district, county, and municipal services. In Georgia, it is available to the public from the following sources: (a) Central administration of the Georgia Department of Public Health at Atlanta, (b) regional public health engineers located at six regional offices in the state, (c) county and district public health engineers and sanitarians in organized county and district health departments, and (d) municipal engineers functioning in the larger city health departments. In counties without health departments, regional engineers render public health engineering service. In its very broad application it is a public service beneficial to every person in the state.
The general services of the Division of Public Health Engineering of the Georgia Department of Public Health are listed in order of twelve major activities as follows:
1. Water, Sewerage, and Related Problems
Studies of needs for satisfactory development of water and sewerage facilities; approval of engineering design and sanitary supervision of the operation of municipal, institutional, public and semi-public recreational and industrial water and sewerage plants and systems; certification of water supplies for interstate carriers; swimming pools; operation of engineering laboratory; stream pollution and other related activities.
2. Malaria Control
Malaria surveys and plans for malaria control, including larviciding, drainage, impounded water permits and control on such areas; program coordinated with U.S. Public Health Service on county and community insecticiding of homes and other places.
3. School Sanitation
Service chiefly on school water supplies and sewerage, food and milk sanitation and grading school lunchrooms; conformance to regulations adopted by the State Board of Health; examination and approval of plans for school sanitary facilities.
4. Housing, Community and Rural
Private home sanitation, reviewing plans for subdivisions where public water supplies and sewerage are not available; providing standard plans for home sewage disposal and
72
Georgin Depwrtment of Public H enlth
home water supplies; working with Federal Housing Administration and other agencies conforming to State Health Department standards.
5. Camp Sanitation
Inspections of camps and proposed camp sites for various camp organizations; sanitation of recreational camps, including state and federal developments; inspections and issuing permits for tourist camps under State Board of Health regulations and collaborating with Agricultural and Industrial Board in relation to tourist camps.
6. Public Health Mapping
Making field surveys and preparation of maps for sanitation and other general purposes for state, county and municipalities, planimetric maps developed from aerial photographs, especially for malaria control and environmental sanitation and for general state health work.
7. Visual Public Health Educution and Cartography
Coordination of surveying and mapping facilities with Division of Public Health Education, photographing, reproducing, preparation of charts, graphs, illustrations, and developing picture reels and slides.
8. Hospital A 1chitecture and Planning
Working with architects in consultative capacity in planning hospitals and with state hospital consultant; examination and approval of plans and specifications for hospitals and maternity homes.
9. Milk ancl Food
Milk sanitation for counties and municipalities, particularly those operating under approved milk ordinances; regular field inspections of milksheds, dairies, pasteurization and other milk plants, rendering advisory service to the milk industry, assistance in design and construction of such plants; operation of mobile laboratory on local milksheds. Food sanitation for public eating and drinking establishments, school lunchrooms, including inspections and grading; certification of both food and milk supplies for interstate carriers; promotion of adoption, interpretation and enforcement of local ordinances and general assistance to local health departments.
10. Shellfish Sanitation
Surveys, investigations and maps determining sanitary and insanitary areas for shellfish production, collection and analysis of shellfish water areas, and certification to U. S.
Public Health Engineering
73
Public Health Service for interstate shipment and collaboration with Department of Game and Fish in oyster production and sanitation.
11. Mattress Sanitation
Sanitation program conforming to Georgia Laws of 1937; issuing licenses, stamps, and labeling new and used material; sterilization of used material for mattress renovation and assistance to the mattress industry.
12. Recruiting and Training Personnel
Development of a source for recruiting and training sanitarians and public health engineers and nominating trainees to the Division of Local Health Organizations and for general state and local assignments.
WATER SUPPLY AND SEWERAGE
An unprecedented public demand for adequate water and sewerage facilities exists in Georgia. The toleration of improvised and inadequate facilities is a thing of the past. It has gone the way of all outgrown and outmoded things. Providing public water and sewerage service is now big business in Georgia involving many millions of dollars for capital improvements and large annual operating expenses. It is a major factor in both the governmental and industrial progress of the state. The Georgia Department of Public Health is an integral part of the entire protective fabric which now surrounds those citizens who daily rely without question upon their safe public water and sewerage systems.
No lengthy explanation of difficulties at this time facing those who deal in physical construction is necessary. Shortage of materials, ever increasing costs and scarcity of technical skills beset the path of progress in water supply and sewerage in 1947 as they have done in all other production enterprises. The problems imposed by these facts called for mental adjustments and new solutions to cope with changed conditions. After an immediate post-war period of wishful hoping for a return to "the good old days" and detecting no signs to indicate such a return, Georgia municipalities are proceeding to meet the situation with new resourcefulness and revised methods. Construction of public water and sewerage facilities on a large scale is now under way. Neces,sity has brought about many changes in financing and construction methods. The development of new methods does not mean that they are immediately applied everywhere. The newly developd procedures require some time to penetrate to all the points of need. However, there is ample evidence that the water supply and sewerage services of the state are rapidly getting out in the clear where they can travel forward in the fast company
74
Georgie~ Depa1tment of Public H ecdth
Yu,blic H ecdth Engineering
75
which they must keep with bulging municipalities and rapidly expanding industrial establishments in Georgia.
Results of Previous Planning Progmm
The extensive planning program of the last few years, while construction was at a low ebb, is now bearing fruit in the construction of many long deferred projects. Completely new water and sewage systems together with water purification and sewage treatment plants are being built to serve communities previously without protection. Obsolete and hazardous old facilities are being replaced with modern ones. Water and sewerage service to rapidly growing suburban areas is being extended at a rapid rate. Even rural waterfication is well on its way in several counties.
Essential Services Provided
To make all these things possible and to keep them in operation, the state provides certain essential public health services. The services take many and varied forms as general or specific requirements demand. The services must be ready before they are needed and available for immediate delivery. Constant advance planning and adequate familiarity with local problems, present and potential, constitute the basis for having the service where and when it is needed. Engineering procedures supplemented by laboratory results make this possible. A continuous consultation service to municipal and industrial officials is one means of attaining the objectives. The training of local personnel for operating and controlling technical processes has been a continuing activity without which physical construction of facilities would be ineffective in providing public health protection.
Streamz, Polhdion Studies
Increased usage of surface stream water for domestic and industrial purposes is intensifying stream pollution control measures. Investigation and studies of stream pollution have been accelerated and the basic facts on the condition of some of the major streams are now recorded. Very satisfactory progress in securing these basic data has been made and much useful information was added during 1947. The general nature of conditions in the streams studied thus far is now much clearer. However, a great amount of investigatory work remains to be done in filling in important details upon which specific construction projects can be economically designed. Similar studies must be applied to other stream systems. Stream pollution information in quantitative form is now available for the following large river systems and important smaller streams:
Chattahoochee River Chattooga River
Oostanaula River Etowah River
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Geo1gic~ Department of Public Health
Ocmulgee River Altamaha River Flint River
Chattanooga Creek Sweetwater Creek Coosa River Oconee River
Stream pollution or sanitary quality investigations consist of closely coordinated and accurately timed field and laboratory activities. By the nature of the studies, part of the investigatory procedures must be carried out at or very near the point of sample collection on the stream. Other laboratory work must be accomplished in the central laboratory where suitable equipment is available. The whole program is coordinated and controlled from the central headquarters. The laboratory procedures are in the field of quantitative chemistry, biochemistry and bacteriology. The following types of analyses and examinations illustrate the range of determinations, except where unusual conditions are encountered which require additional ones :
Dissolved Oxygen Biochemical Oxygen Demand (20C.) Alkalinity Hardness Hydrogen Ion Concentration Carbon Dioxide Iron Fluoride Coliform Organism Concentration (37C.) Total Bacteria Count (37C.)
Results of Stream Pollution Studies
The stream pollution studies provide basic information upon which the industrial plant location program functions. The industrial sites involved are those to be occupied by manufacturers whose liquid wastes present a problem in stream pollution. The industrial plant location service provides site data to those prospective industries which inherently have offensive wastes or are seeking water of good quality to serve both drinking and process purposes. The establishment and maintenance of the industrial plant location pattern is preventing costly public health burdens upon those streams which are and must remain natural public health resources of the first order of importance. The industrial promotion agencies of public utility companies and railway systems operating in Georgia are cooperating very effectively in this program. Its application is being more fully understood by local boards of trade and similar commercial promotion bodies. The stream pollution or stream quality data are used by already established industries and communities in effecting great economies in capital expenditures for industrial waste and domestic sewage treatment.
Public Health Enginee1ing
77
S ewage tre atment plant.
Review of Plans and Sp ecifications for Water and Sewage P1ojects
The review and approval of plans and specifications for all proposed public water and sewerage projects before construction is begun continues as a primary function of the broad control program. Through this activity is applied the full force of the public health control of public water supplies and sewerage. It is the assurance to the citizens who are the stockholders in municipalities that these public health facilities have been properly planned. All public health aspects are given careful attention before approval for construction is granted. Water purification and sewage treatment projects are process plants each designed to meet specific needs and situations. Processes of water purification and sewage treatment vary over wide ranges of technological fields. Review of plans and specifications includes close scrutiny of all process features to accomplish the required degree of treatment. The review also includes all necessary studies of sources of water and streams for sewage treatment.
Continuous Training of Local Personnel
The continuous training program for personnel responsible for the operation of water purification and sewage treatment process plants throughout the state occupies a place of high importance. A large share of the total time of the small staff available for the water and sewage protection program is budgeted for train-
78
Georgia Departrnent of Public Health
ing municipal and industrial water, sewage and industrial wastes treatment process operating personnel. The training activities are carried on by staff engineers with local personnel within their own plants where the daily operations are performed. This enables a very practical type of training to be given. Where necessary, arrangements are made for personnel of cities and towns to visit other installations to observe good practice and gain wider experience than local facilities permit. The principle of adjusting skills and aptitudes of highly varying degrees is applied in proper position placement for effective results and stability. The progress being made by individuals and the application of their knowledge is checked upon through monthly plant and control laboratory reports submitted to the central office of the Department.
The Georgin Water and Sewage School
The Georgia Water and Sewage School is a part of the continuous local personnel training program. The School is an intensive group instruction course, conducted without charge for attendance, held in Atlanta each year. The School is sponsored and conducted jointly by the Georgia Water and Sewage Association, the Georgia School of Technology and the Georgia Department of Public Health. The sixteenth annual session of the School in September 1947 was attended by over two hundred men from cities and industries over the entire state. In addition to presenting opportunity for acquiring practical knowledge directly derived from the theoretical, the annual School sessions maintain an esprit de corps essential to the raising of standards of performance in any collective enterprise. A direct result of the School is a voluntary system of graded certification of water and sewage operators maintained by the Georgia Water and Sewage Association. Certification is now recognized as a measure of ability in placing responsibility on local personnel for water purification and sewage treatment safety. The Georgia Water and Sewage School annually attracts observers from outside the state. It has been the model for similar schools in several other states.
The Engineering Laboratory
The Engineering Laboratory is the tool-kit and yardstick of public water and sewage engineering in Georgia. The engineering laboratory services are being extended into new phases of the statewide control program without any reduction in the longer established and better known fields of usefulness. This is being accomplished in spite of the increasing difficulty of retaining qualified technical employees. To enlarge services under the existing personnel situation it has been necessary to rearrange laboratory practices within the laboratory and also by those who collaborate with the program in the local communities.
Public Health Engineering
79
The revised procedures are being received and adhered to through a generous response from those receiving the service after explanations of the necessity for revision are understood. The bacteriological examination of samples from public, semi-public and private water supplies continues to be a major function of the laboratory.
New laboratory techniques are under study and exploratory application. The results of these investigations will be made available to local water purification control laboratories, modified where necessary to meet specific conditions. The extended services cover sanitary and chemical analyses for basic engineering purposes as well as the solving of operating problems continually occurring in public water and sewage treatment plants which are beyond the scope of facilities of local control laboratories. The statewide fluoride survey of public water sources has been continued because of the increasing scientific and popular interest in the direct relationship of the fluoride content of drinking water and dental caries (tooth decay). A map showing the fluoride content of public water supplies in Georgia has been prepared. The prel)aration of another map showing the hardness of public water supplies in Georgia has been completed.
The categories and volume of analyses and examinations performed in the Engineering Laboratory in 1947 were as follows:
Bacteriological Samples-Water
Public and semi-public -------------------------------------------------- 13,316
Dairy ------------------------------------------------------------------------------
38
School ------------------------------------------------------------------------------ 353
Tou.rist Camp ------------------------------------------------------------------
34
Private ---------------------------------------------------------------------------- 864
Swimming Pool -------------------------------------------------------------- 285
Shellfish --------------------------------------------------------------------------
1
Miscellaneous ------------------------------------------------------------------ 73
Chemical Samples-Water---------------------------------------------------- 6L13
Sewage and Stream Pollution Samples
Bacteriological ---------------------------------------------------------------- 285 Biochemical -------------------------------------------------------------------' 542 Chemical -------------------------------------------------------------------------- 156
TOTAL ------------------------------------------------------------------------------------ 16,590
Swimming Pool Sanitation
The promotion of swimming pool sanitation throughout the state is carried on in conjunction with the public water control
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Georgia Department of P~tblic Health
program. The elements of the program are review and approval of plans and specifications, extensive training of operators in a field where seasonable personnel turnover is high, and consultation with sponsoring organizations to maintain sanitary safety
for swimming as a very desirable and popular form of public recreation. Briefly, the swimming sanitation program parallels that of water supply which it technically resembles.
Evaluations, Results and Objective
The services rendered are kept under constant review and scrutiny to discover obsolete trends and promptly eliminate unprofitable activities. Modern research and technological developments are followed through published material, personal contacts wherever possible and participation in technical associations and committee memberships. The products of rapid scientific development are translated and applied to the practical problems as found in Georgia. It is a basic principle of this service to remain as many steps as possible in advance of the problems to be met so that the margin already attained in the safety of public water supply and sewerage in Georgia may be maintained and enlarged. The greatest compensation for the effort expended is that another year can be added to the now long series in which no death or disease has occurred from public water borne causes in Georgia. The objective of the program is to continue the essential statewide public health protection and to further extend its services wherever needs occur or changing situations demand.
Plans and Specifications Approved 1947-WatM
AcworthA delAileyAlamoAuburnAugustaAugustaAveraBaldwinBlairsvilleBlakelyBlue RidgeChattooga County
Clarke Thread Company. Water works improvements. New well and water main extensions. New water works system. Water works improvements. New water supply .and distTibution system. WateT works improvements. Flocculation and settling basin extensions. New water system, provisionally approved. Water main extensions. New water works system. Water wo1ks extensions. Water main extensions.
New water system.
---------------..,
Public IIealth Engineering
81
Columbus-
Water main extensions.
Covington-
New purification plant and distribution system extensions. (Contract let; construction not begun).
Darien-
Water works improvements.
Eastman-
Water works improvements.
East Point- Filtration plant additions.
Gordon-
Water main extenswns.
Greensboro- New raw water supply with storage reservoir.
Hiawassee- New water works system.
Jackson-
Purification plant-approved and contract let.
Jasper-
Water main extensions.
Jefferson-
New purification plant and additions to distribution system.
Kennesaw-
New water system provisionally approved.
IGngsland- Water works improvements.
Lawrenceville- Water main extensions.
Logansville- Water works improvements.
Luthersville- New water system, provisionally approved.
lVIetter-
Water works improvements including chlorination.
lVIolena-
New water system, provisionally approved.
lVIoreland-
New water system, provisionally approved.
lVIoultrie-
New well, ground and elevated storage and water works extensions.
Nashville-
Water main extensions.
Nelson-
New water system, provisionally approved.
Norcross-
Water main extensions.
Pelham.:.._
Water main extensions.
Pepllerton- New water system and treatment plant.
Roberta-
Purification plant plans approved.
Royston-
Purification plant, provisionally approved.
Savannah-
Revised plans for clear water storage reservoir.
Springfield-
Improvements to water works system purchased by city from private owner.
Stapleton-
New water system, provisionally approved.
Statesboro- Water works extensions.
Toccoa-
Purification plant additions.
Vidalia-
New deep well and elevated storage.
Villa Rica- Repairs to rese1voir.
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Georgia Department of Public Health
Washington- Water main extensions.
Waycross-
water main extensions.
Plans and Specifications Approved 1947-::ieweraae
Adel-
Sewage treatment.
Alma-
New collection system and sewage treatment.
Adairsville- New collection system and sewage treatment.
Augusta-
Collection system extensions.
Baldwin-
New collection system and sewage treatment.
Barnesville- Collection system extensions.
Blairsville- New collection system and sewage treatment.
Blakely-
Collection system extensions and sewage treatment
Blue Ridge- Collection system extensions.
Camilla-
Collection system extensions, pumping station and sewage treatment.
Coolidge-
New collection system and sewage treatment.
College Pad>- Collection system extensions and pumping station.
Davisboro-
New collection system and sewage treatment.
Douglas-
Sewage treatment.
Eastman-
Collection system extensions.
Edison-
New collection system and sewage treatment.
Ellaville-
New collection system and sewage treatment.
Gordon-
New collection system and sewage treatment.
Greensboro- Collection system extensions.
Hogansville- Collection system extensions.
Jackson
Pepperton
New collection system and sewage treatment.
Cotton Mills
Jasper-
Collection system extensions and sewage treatment.
Kennesaw-
New collection system extensions and sewage treatment.
Kingsland-
New collection system.
Metter-
Collection system extensions pumping station and sewage treatment.
Monroe-
Collection system extensions.
Nashville-
Collection system extensions.
Nelson-
New collection system and sewage treatment.
Ocilla-
Collection system extensions.
Public Health Engineering
83
Pelham-
Collection system extensions and sewage treatment.
Riverside
Moultrie-
New collection system.
( Cotton Mills)
Roswell-
Collection system extensions and sewage treatment.
Smyrna-
Collection system extensions and sewage treatment.
Stapleton-
New collection system and sewage treatment.
Statesboro- Collection system extensions and pumping station.
Tallapoosa- Collection system extension and sewage treatment.
Toccoa-
Collection system extensions.
Thomson-
Collection system extensions, pumping station and sewage treatment.
Thomasville- Sewer extensions and pumping station.
vVaycross-
Collection system extensions and sewage treatment.
Plans and Specifications App'rovecl-1947-Swimming Pools
Cave Springs----< School for Deaf-Swimming pool with recirculating equip-
ment including chemical coagulation, filtration and chlorination.
Donalsonville- Swimming pool, with recirculating equipment, including chemical coagulation, filtration, and chlorination.
Hapeville-
Reconstruction of existing pool to p1ovide adequate purification equipment.
Macon-
Swimming pool, with recirculating equipment, including chemical coagulation, filtration and chlorination.
Statesboro
Swimming pool, with recirculating equipment including chemical coagulation, filtration and chlorination.
Water Supply PTojects UncleT Construction 01 Completecl-1947
Adrian-
Deep well completed and placed in service with hypochlorinator installed.
Alamo-
New hypochlorinator installed on deep well supply.
Americus-
Two new chlorinators installed replacing old equipment.
Atlanta-
Water main extensions program in progress during year.
Blairsville- Well drilled for new water system.
Butler-
New elevated tank under construction.
Calhoun
(Echota Mill)-Two new hypochlorinators on well supply.
Camilla-
New chlorinating equipment installed replacing obsolete equipment.
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Georgia Depcwtment of Public Health
Canton-
New chlorinator and chemical feeding equipment installed to replace obsolete machines.
Catoosa County-Distribution system and booster station completed.
Cartersville- Filtration plant addition under construction.
Chatsworth- Construction of purification plant including coagulation, filtration and chlorination completed.
Chickamauga- Plant to reduce mineral constituents in water (soften), including filtration, chlorination, distribution system and elevated storage tank completed.
Clarkesville- Water main extensions to Vocational Trade School.
Clayton-
Filtration plant with coagulation and chlorination treatment and distribution system extensions completed.
Cleveland-
Deep wells with hypochlorinating units, distribution system and elevated storage completed.
Colquitt-
New chlorinator installed replacing obsolete equipment.
Columbus-
Construction projects doubling capacity of filtration units and distribution system extensions completed.
Comer-
Improvements and extensions to old privately owned water supply recently acquired by city.
Danielsville- New water distribution system in process of contract letting. New well completed 1946.
Douglasville- Water purification plant including coagulation, filtration and chlorination under construction.
DeKalb County-Extensive progress has continued on the long term pro-
gram to extend the water service to industries and homes on a county-wide basis.
Duluth-
Two new deep wells with hypochlorinating units, distribution system and elevated storage completed.
East Point- Additions to filtration plant under construction.
Eatonton-
Prechlorinating equipment added to purification plant to improve treatment.
Gainesville-
Two new chlorinators and three new chemical feeders installed in purification plant.
Greensboro--
New raw water pump station, main and storage reservoir under construction.
Griffin-
New clear water storage reservoir.
Jefferson-
New purification plant under construction.
LaGrange-
New iaw water development and new purification plant.
Lawrenceville- New well drilled, pump and chlorinator being installed.
Manchester- ConstnlCtion completed on additional filtration capacity and finished water reservoir.
Montezuma- Reconditioned chlorinator placed in service.
Monticello- Filtration plant project to replace obsolete plant completed.
Public Health Engineering
85
Norman Park- New hypochlorinator installed on deep well.
Pepperton-
New deep well with alkali treatment, chlorinator, reservoir and distribution extensions completed.
Perry-
Iron removal plant to include gravity filtration unit with aeration and chlorination under construction.
Pooler-
New well and elevated tank completed.
Rhine-
New hypochlorinator installed on deep well.
Savannah--
Construction in progress on new water supply of 35 million gallons per day for process and drinking water for industrial area. Source will be Savannah river; treatment will include coagulation, sedimentation, filtration and chlorination with completely equipped chemical and bacteriological control laboratory.
Talbotton-
New deep well and pump completed.
Tallapoosa- New chlorinator installed to replace obsolete equipment.
Toccoa-
New chlorinator installed for prechlorination treatment.
Trenton-
New hypochlorinator installed on spring supply.
Major Sewer Extension Projects Under Construction-1947
Albany Barnesville Baxley
Cairo College Park Decatur
DeKalb County Griffin
Doraville
Moultrie
Dublin
Tifton
Sewerage and Sewage Treatment Projects UndeT ConstTuction OT Completed 1947
Aldora MillsAlma-
New sewer system for industrial village and sewage treatment plant consisting of Imhoff tank, trickling filter, secondary clarifier and sludge drying beds completed.
Collection system and sewage treatment under construction.
Clayton-
Clarkesville North Georgia
Collection system and sewage treatment under construction. Collection system and sewage treatment completed.
Vocational School
Doraville-
New sewer system under construction.
Indian Springs- Camp Ground, new sewer system completed.
Pepper tonSmyrna-
Tallapoosa-
Sewer system and sewage treatment under construction.
Major sewer extensions, lift station and sewage trea~ment under construction.
Sewer system and sewage treatment under construction.
MALARIA CONTROL
A continued drop in malaria morbidity is indicated by the reporting by physicians of 67 cases of malaria during 1947. Among
86
Georgia Depar-tment of Public Health
the cases reported are 19 cases reported by one physician from one county, none of which was confirmed by a blood smear. The mortality rate is approximately the same for 1947 as for 1946. With the exception of the one county mentioned, not more than four cases have been reported from any one county.
Impounded Waters
The control of A.quadrimaculatus breeding on the hydroelectric reservoirs throughout the state continues as a function of the operating agency under the surveillance and guidance of the Division.
Companies and agencies so operating during 1947 were:
Georgia Power Co. (3 reservoirs) Georgia Light and Power Co. (1 reservoir) Tennessee Valley Authority (3 reservoirs) Crisp County Power Commission (1 reservoir) U.S. Army Engineers (3 reservoirs under construction)
The Georgia Power Co. continues to use paris green for larviciding on two of the projects, and an oil-water mixture on the third. Control on the Flint River Project at Albany should probably be designated as suppression of anopheline breeding, as the continued thickening of surface vegetation make control less effective.
The Georgia Light and Power project on Spring Creek in Southwest Georgia will be entirely inundated by the new lake being constructed by the U. S. Engineers and responsibilities for control will be transferred to the U. S. Government.
The Tennessee Valley Authority reservoirs have all been well conditioned before impounding and standard water level management has replaced much of the need for larviciding. Maintenance is good and no apprehension is had regarding effectiveness of control measures.
Control of mosquito breeding in Lake Blackshear, the impoundment of the Crisp County Power Commission on the Flint River, continues to be a great problem. Some progress was made during the year in removal of growth in some specific areas where control has been especially ineffective. Convict labor was assigned to clearing operations during the low water period in the summer. This work is to be continued in succeeding years. The adulticidal operations conducted during the latter part of 19L!6 entirely replaced larvicidal operations during 1947. In this, all adult mosquito resting places within one and one-quarter miles of the lake perimeter were sprayed with DDT emulsion twice during the season. Though the results were highly satisfactory, this method of control should still be considered largely experi-
Public Health Engineering
87
mental. The development of a Veterans' Memorial Park by the State Parks Department along the banks of Lake Blackshear will necessitate more efficient control in succeeding years.
The Allatoona clam on the Etowah River near Cartersville and the Jim Woodruff dam below the confluence of the Chattahoochee and Flint Rivers near Chattahoochee, Florida, by the district office of the U. S. Engineers at Mobile, are under construction. Assurance of the engineers has been received that these reservoir sites will be properly conditioned before being flooded and preventive measures will be adopted as necessary. The Clark Hill dam, 22 miles north of Augusta on the Savannah River, is being constructed by the U.S. Engineer District Office at Savannah. Since it was first initiated, there has been an engineer assigned on the project to follow-up on all public health aspects of construction and future maintenance. This will be the largest hydro-electric development in the state.
The Production and Marketing Agency (AAA) of the U. S. Department of Agriculture has continued the farm pond practice started in 1946, under which farmers were given assistance up to $300 on the construction of dam and spillway for ponds built for the purpose of furnishing water for livestock. This practice has stimulated pond construction so that field and office personnel have been taxed to the limit in the inspections of pond sites, office review and issuance of impounded water permits. Six hundred seven (607) maintenance permits have been issued on approved impoundments. Many additional preliminary permits in the form of letters of authorization to begin construction have been issued to farmers who have planned to build ponds under the AAA program. Many of these have completed the dams and spillways but have not cleared the pond site in accordance with the impounded water regulations, and consequently receive no permit. Some of these can still qualify for AAA assistance by compliance with the rules of the State Board of Health to secure a maintenance permit. The Soil Conservation Service of the Federal government is to be especially commended for their wholehearted cooperation with health officials and farmers, and their assistance in obtaining pond construction without major health hazards.
DDT Spray Program
For the past three years the Division has directed a program of extended malaria control in which the U. S. Public Health Service and county governments are cooperating. The program was directed against the insect vector in houses and consisted of two seasonal sprayings of walls and ceilings of homes and of privies with DDT (dichloro-diphenyl-trichloroethane) emulsion. The application rate was sufficient to leave 100 milligrams of DDT crystals per square foot on the surface, this being effective against
88
Georgia Department of Public Health
mosquitoes alighting thereon for a period of ten to fourteen weeks.
The anticipation of eventual eradication of the disease through this type of program is given credence by the present low incidence of malaria.
Fifty-one counties responded to the proposal for the 1947 season. The counties furnished office and warehouse space and all labor (with transportation) for applying the spray. In multiplecrew counties, contact personnel was also furnished. The state and USPHS continued to furnish supervision, chemicals, spraying equipment, mapping and record form requirements and such incidentals as were needed.
All cities under 4000 were included, and in the larger cities, the expense of spraying over 1000 houses was borne by the municipality. In actual practice sprayings in only one instance exceeded this maximum as it was confined to the outlying unscreened sections of the city. In practically all counties, funds used for participation were derived from tax and paid from the general fund. Where additional money was obtained through subscription or donation, this was used by the county in the same manner as tax funds, and in no instance was a homeowner refused the spray because he had not contributed.
Several very ingenious improvements were made in spraying equipment and in techniques resulting in higher efficiency and saving of considerable local labor. Special mention should be made of the substitution of the commercial type of sprayers requiring hand pumping to a type developed by the program in this state of a pressure regulated sprayer for which compressed air is obtained from a reserve tank carried on the crew truck. This sprayer will deliver its entire contents at a uniform pressure and the spray can be applied very uniformly. Improved emulsion mixing methods have made it possible to bring the cost of this material much lower. Close supervision from the State Office to the last laborer has paid high dividends.
In the 51 counties operating an average of 261 gallons of emulsion was applied in 218,245 unit sprayings, each unit being one house, including privy, mattresses and porches where such were indicated. Total expenditures on the program amounted to $528,753 of which $194,546 was by state and counties and $334,207 by the U. S. Public Health Service. Unit costs averaged $2.42, $0.89 for state and county and $1.53 for the USPHS. The USPHS costs include the off-season activities of key personnel which have been used in tourist camp and public rest room sanitation activities which are mentioned later in this report.
Public Health EngineeTing
89
COUNTIES PARTICIPATING IN EXTENDED MALARIA CONTROL
Co~mty
Unit Sprayings Total Local Cost Local Cost/Unit Spraying
Bacon --------------------------------- 2,758
$1,800.00
$0.65
Baker --------------------------------- Ben Hill --------------------------- Bleckley ----------------------'------ Brantley --------------------------- Bryan -------------------------------
Bulloch ----------------------------- Burke --------------------------------- Calhoun ----------------------------- Camden ----------------------------- Candler -----------------------------
Clay----------------------------------- Colquitt ----------------------------Crawford -------------------------
2,509 3,885 2,735 2,400 2,375 7,879 9,843 3,354 1,982 2,334 2,603 8,971
2,315
1,583.00
.63
2,515.00
.65
2,417.00
.88
1,755.00
.73
1,458.00
.61
7,852.00
1.00
7,746.00
.79
1,952.00
.58
1,700.00
.86
1,819.00
.78
1,680.00
.65
7,524.00
.84
2,140.00
.92
Crisp--------------------------------- 5,713
3,759.00
.66
Decatur ----------------------------- 7,555
5,965.00
.79
Dougherty -------------------------- 4,553
2,497.00
.55
Early --------------------------------- 7,172
5,017.00
.70
Echols ------------------------------- 1,031
770.00
.75
Effingham -------------------------- 3,787
2,675.00
.71
Emanuel --------------------------- 7,265
6,180.00
.85
Evans ------------------------------- 2,346
2,068.00
.88
Jeff Davis------------------------- Jefferson --------------------------- Jenkins -----------------------------Johnson ----------------------------- Laurens -----------------------------
Lee-------------------------------------Liberty ----------------------------Long (one round only) _
2,949
6,700 4,496 4,046
11,720 2,796
3,039 787
2,188.00
.74
5,179.00
.77
4,235.00
.94
2,810.00
.69
10,888.00
.93
1,850.00
.66
1,519.00
.50
718.00
.91
Mcintosh _________________________ 2,050
1,638.00
.80
Macon (one round only) 2,828
Miller --------------------------------
~~~J~o~-~~:~--------~~~----~--~--~~--~--~~--~
3,765 2,880 3,544
2,164.00
.77
2,182.00
.58
1,728.00
.60
3,143.00
.89
I
Pulaski ----------------------------- Quitman --------------------------- Screven ----------------------------- Seminole ___________________________
2,738 1,340 7,059
2,769
2,536.00
.93
1,157.00
.86
6,754.00
.96
1,838.00
.66
Sumter -----------------------------
Tattnall --------------------------- Terrell ------------------------------- Tift ----------------------------------- Toombs ----------------------------- Treutlen --------------------------- Turner _ W ashingt~-;:;-::::::::::::::::::::::
7,045
4,732 5,576 5,125 4,335 2,356 3,805
7,788
5,148.00
.73
4,92Ll,QQ
1.04
4,786.00
.86
4,911.00
.96
3,415.00
.79
1,529.00
.65
1,999.00
.53
6,059.00
.78
Wayne -------------------------------
;W~elb:islitxer::::::::::::::::::::::::::::::::
4,454 1,734 3,736 6,688
4,400.00
.99
908.00
.52
2,220.00
.59
5,348.00
.80
Totals --------------------------- 218,245
$171,046.00 average-.78
90
Georgia Department of Public Health
SCHOOL SANITATION
The principal objectives in the school sanitation program continue to be (a) safe drinking water, (b) approved plumbing, (c) satisfactory sanitary disposal of sewage, (d) a safe milk supply and (e) sanitary serving of school lunches.
The school lunch room program has been discussed under Food Sanitation. The insistence on maintenance of sanitary standards of Grade B or better in school lunch rooms is a tremendous influence in obtaining compliance with all of the objectives mentioned above. Notwithstanding the high costs of building materials and labor, there has been an awakening of interest in sanitation on the part of school officials and a corresponding increase in development of sanitary facilities.
The review and approval of plans and specifications covering sanitary features of construction continues to be a major activity in the Division. Close cooperation is maintained with the State Department of Education and private architects.
Further advancement in needed sanitary improvements is believed feasible through a closer tie between the Department of Public Health and the Accrediting Boards of the Elementary and of the High Schools of the state. This is an objective of the coming year.
Improved excreta disposal facilities have been provided by the construction of 139 approved privies and 40 septic tanks, with auxiliary tile absorption fields. Samples of water for bacteriological examination have been collected and sent to the Division Water Laboratory, principally for confirmation of findings of physical inspections of the supplies.
HOUSING SANITATION
The shortage of homes has resulted in a tremendous increase in the housing activity despite material and labor costs. The extensive rural electrification program has assisted in developing a movement away from the densely populated areas in the cities and more people are moving to the outskirts of cities. Usually the development of such areas is within reach of municipal water distribution systems, but often they are proposed in sections where sewerage is not available. In such instances the advisability of private sewage-disposal systems on each lot must be investigated. Community sewerage systems, except those which are tax supported and maintenance of which is the responsibility of a public agency, are seldom satisfactory.
The Division continues the custom of reviewing plans for new and existing subdivisions where approved public water supply and sewerage systems are not available. This review is to de-
Public Health Engineering
91
termine whether the development of such subdivisions without such public facilities is desirable. In general, where individual sewage-disposal systems are required, private water supplies are not approved because of the impossibility of eventual contamination of ground water strata with this system.
All homes built under loans insured with the Federal Housing Administration, having or proposing to have private water and;or sewerage systems, are required to have approval of the State Department of Public Health. In addition to the investigation and approval of subdivisions, the individual systems are inspected and approved by local or state sanitation personnel and reviewed and approved by the Division before F.H.A. acceptance is obtained.
One residual benefit of the Extended Malaria Control Program has been the secural of sanitation data at 130,000 homes in the 51 counties. This information included the house number, name of each householder, number of occupants, number of rooms, type of water supply and sewage disposal, screening, and electricity. An alphabetical director of householders and sanitation cards with the names of householders and the house numbers, together with copies of the sanitation data for each county has been turned over to local health departments for their use. As an example of the data obtained, there are 100,000 homes in the 51 counties which are in need of sanitary pit privies.
Further residual benefits from the Extended Malaria Control Program have been the inspections of Public Rest Rooms by key personnel during the off-season period. Working through region and county health offices, nearly 6,000 public rest rooms in service stations, stores, court houses, restaurants, railway and bus stations, etc., have been carefully checked once and will be checked again during early 1948 for violations of sanitation items. These surveys are made only along the principal highway arteries through the state. The results of the survey will be analyzed and tabulated. Wherever possible, they will be followed up and a program will be developed which will, insofar as is possible, make necessary the least amount of routine inspection by the health department. A genuine spirit of cooperation was evidenced on the part of the majority of operators and by nearly all of the major oil companies.
The following tabular summary shows the distribution by counties of the 1,314 privies and 5,783 septic tanks built, and the 1,575 privies repaired, under supervision of sanitation personnel. No attempt has been made to report the large number of private water supplies made safe, the connections to public sewers, extension of water and sewer mains and many other sanitation activities difficult to tabulate.
92
Geor-gia Depar-tment of Public Health
PRIVIES AND SEPTIC TANKS CONSTRUCTED BY COUNTIES
.
PRIVIES
SEPTIC TANJ<S
County
Home
Appling ------------------------------------------
Bacon --------------------------------------------
Banks --------------------------------------------
Barrow -----------------------------------------
Bartow ----------------------------------------
Berrien ----------------------------------------
Bibb ---------------------------------------------- 16
Brantley ----------------------------------------
Brooks --------------------------------------------
Bryan ------------------------------------------
Bulloch ------------------------------------------
1
Burke ---------------------------------------------- 34 Butts ----------------------------------- ________
Camden ----------------------------------------
Candler -------------------------------------------
Carroll ------------------------------------------
2
Chatham ---------------------------------------- 112
Chattooga ------------------------------------
Cherokee ----------------------------------------
Clarke ------------------------------------------ 48
Clayton -----------------------------------------
2
Clinch -----------------------------------------
Cobb ---------------------------------------------
Coffee ---------------------------------------------
Colquitt ---------------------------------------
Columbia ---------------------------------------
9
Cook --------------- ------------------------------
Coweta ------------------------------------------- 61
Crawford --------------------------------------
2
Crisp --------------------------------- ----------- 66
Decatur ---------------------------- ------------ 46
DeKalb ------------------------------------------
Dougherty ----------------------------------- 39
Douglas ------------------------------------------
Early ----------------------------------------------
Elbert -------------------------------------------
2
E1nanuel ----------------------------------------
Fannin ------------------------------------------
Fayette ------------------------------------------
Floyd ----------------------------------------------
Forsyth -----------------------------------------
Franklin -------------------------------------
1
Fulton ------------------------------------------- 36
Glynn -------------------------------------------
1
Gordon ------------------------------------------
Grady -----------------------------------'----------
Greene --------------------------------------------
4
Gwinnett --------------------------------------
5
Habersham -----------------------------------
2
Haralson ----------------------------------- ___
1
Hart------------------------------------------------
J
Heard ------------------------------------------
Henry --------------------------------------------
Houston ----------------------------------------
3
Jackson -----------------------------------------
9
Jasper .. ------------------------------------------
2
Jeff Davis --------------------------------------
.T enldns --------------------------------------- 2S
Lamar ----------------------------------------- 67
Lanier --------------------------------------------
Laurens ----------------------------------------- 32
Liberty -----------------------------------------Lowndes -----------------------------~---------
Lumpkin ----------------------------------------
Macon --------------------------------------------
Madison ----------------------------------------
8
Marion --------------------------------------------
McDuffie --------------------------------- ______
2
Mcintosh ---------------------------------------
Mitchell ---------------------------------------- 48
Monroe ------------------------------------------ 17
Morgan ----------------------------------------
Murray ------------------------------------------
Public Places Total Repair
3
3
3
19
3b
68
2
2
2
34
57
5
2
4
112
146
18
781
2
1
5
9
2
6
61
2
3
66
24
H
60
10
18
77
2
37
4
1
3
3
23
31
5
1
5
2
1
1
1
3
7
3
9
2
3
31
17
31
98
2
2
2
14
46
8
8
2
48
15
17
3
Home
4 1 7 5
815 3 1 5
99 16 36
2 1 1 201 V1
116 288
89 1
39 15
4 18 31 60
6 604 H9
91 1 1 12 1 5 15 1 2 1103 40
45 1
11 12
7
82 31
4 1 12 8 50 1 118
2 2 11 3
55 2 1
42 7
Public Places
1 6 3 2 1 2
2 19
6 1 11 3 3 1
12
7 2 2 2 3
55 2
11 6 4
2 7
2
Total
5 1 1 7 6 6
818 3 6 6
101 16 37 2 1 3 223 H 1
116 291
1 100
1 12 18
5
18
g.j
62 6
604 161
9 1 4 12 1 5 16 1 2
1110 lO 2 47 1 11 H 3 7
83 32
4 1 12 8 105 3 132 6 6 2 12 3
2 55
9 1 42 7 2
Public Health Engineering
93
PRIVIES AND SEPTIC TANKS CONSTRUCTED BY COUNTIES
(continued)
County
Home
Muscogee -------------------------------------- 45
Newton ~-----------------------------------------
5
Oconee --------------------------------------------
6
Oglethorpe ------------------------------------
Peach ----------------------------------------------
3
Pickens ------------------------------------------
Pierce --------------------------------------------
Pike ------------------------------------------------ 32
Polk ------------------------------------------------
Putnam ------------------------..---------------
Richmond -------------------------------------- 10
Rockdale ----------------------------------------
'1
Schley --------------------------------------------
2
Screven ------------------------------------------ 33
Spalding ----------------------------------------
2
Stephens --------------------------------------
1
Sumter ------------------------------------------ 72
Talbot --------------------------------------------
4
Taliaferro ________________ ---------------------
2
Taylor --------------------------------------------
7
Thomas ----------------------------------------
3
Toombs ------------------------------------------
To\vns --------------------------------------------
Troup ------------------------------------------ 128
Union ------------------------------------------
Upson --------------------------------------------
3
Walker --------------------------------------------
Walton ------------------------------------------
Ware ---------------------------------------------- 38
Warren ------------------------------------------
Washington ----------------------------------
Wayne --------------------------------------------
White----------------------------------------------
Whitfield ----------------------------------------
Wilkes --------------------------------------------
Worth ------------ ------------------------------
1122
PRIVIES
Public Places Total
3
48
5
7
3
He11air 15 3
27
59
5
10
39
4
5
2
4
37
63
2
70
1
72
39
4
2
7
11
14
131
3
2
4
1
38
37
2
10
192
13H
1575
SEPTIC TANI<S
Public Home Places Total
108 33 1 2 27
9 22
2 394
4 21
8 H 11 93
9 1 12 65 3
77
44 84 17 58 2 4 10 2 8 3 18
550,1
108 33 2
2 27
1
1
9
17
39
2
2
2
1
395
,j
21
8
3
17
2
13
7
100
7
16
1
12
2
67
3
2
2
30
107
1
1
44 g,j
17
58
2 4
2
12
1
3
3
11
3 18
279
5783
Division personnel attended a housing seminar at Louisiana State University, Baton Rouge, and seeing the very beneficial public health benefits which may be obtained from an extension of such activities into other organizations, have been active in promoting a Southeastern Housing Seminar which will be held early in 1948 at the Georgia School of Technology, Atlanta.
CAMP SANITATION
Sanitation, particularly with reference to water supply, sewage disposal, screening, garbage disposal, milk and food sanitation, and unpolluted swimming areas at recreational and public works camps has always been an activity of the division. Assistance in any or all of these phases of sanitation is given on request.
The factual survey of tourist courts begun in 1946 was completed early in 1947 and has been a continuing function through the year. Nearly six hundred camps were inspected on this
94
Geor-gia Depar-tment of Public Health
survey. The data secured was carefully reviewed by county and state health authorities and the owner of each establishment was given verbal and written instructions regarding necessary improvements. Upon completion of these improvements and favorable recommendation by the health authority having jurisdiction permits to maintain a tourist camp during 1947 were issued in the Division Office. Such permits are countersigned and delivered by the local health authority having jurisdiction.
Permits were issued in 1947 to 415 tourist camps which had complied with minimum sanitation requirements. Permits were withheld from 89 others at which major improvements had not been made. Many of the smaller camps and trailer parks preferred to discontinue soliciting transient business and removed their signs accordingly.
Little was done regarding sanitization of eating establishments at tourist camps during the year. Permits were issued to establishments without a careful check of their food handling methods. This phase will be tightened up and only provisional permits will be issued to those camps having eating places which do not have a rating of Grate B or better. In all other particulars, the camp will be required to meet minimum requirements. This "provisional" permit will be replaceable with a full permit when the food establishment regulations are complied with.
PUBLIC HEALTH MAPPING
The demand for public health mapping services and the concentration of all division mapping in Atlanta required additional space. This was met by the addition to the small building at 245 Capitol Place, the third floor of which is occupied by the Mapping and Photographing Laboratory. The space provides ample drafting room space, fire-proof storage of original drawings and tracings, an Ozalid black and white printer, a map projection room, small clark room and a large clark room. In the large clark room is mounted a Salzman Projector with 8' x 8' vacuum frames for the enlargement, reduction or reproduction of maps, drawings, aerial photographs, etc. as may be required.
The division is now prepared to render all mapping and photographic service to local health departments and other divisions of the:'State Health Department, limited only by the capacities of the personnel employed. In addition to Engineering needs, service has been rendered to the Industrial Hygiene, Maternal and Child Health, Dental Health Education, Preventable Diseases, Administration and Health Education Divisions.
City and County Maps
Basic, sanitary and malaria survey maps are prepared from basic data from the field or from aerial photograps. Basic maps
Public Health Engineering
95
show all roads, streets, houses, public buildings, railroads, and principal drainage channels, with house numbers and identifying names on other features. Sanitary survey maps include all basic map data and shown in addition are water mains, valves, fire hydrants, storage tanks; sewer mains, manholes and treatment plants; and symbols showing the type and condition of water and sewage-disposal facilities at each inhabited place. Malaria survey mays, in addition to basic information, show drainage channels, ponds and lakes which may prove breeding grounds for anopheline mosquitoes.
Sixty-six (66) maps of cities and towns, scale 1" equals 400' were prepared for the Extended Malaria Control Program.
Four maps of counties, scale 1-20,000, were prepared for the same program; one county map is in progress.
Nine maps of cities are in progress, scale 1" equals 200', for eventual development as sanitary survey maps.
Eleven county maps have been revised from material sent in from the field, and all county and community maps used in the 51 extended malaria control counties have been revised and corrected in minor details from checked field copies of the originals.
Lithographed prints of Burke County were received from the Government Printing Office and copies were distributed to public health workers as well as other State and Federal Departments. This map was prepared by the Soil Conservation Service from basic data obtained from actual field surveys.
Blueprinting-1021 Ozalid prints were made of maps, charts, graphs, and schedules for health department uses. Prints were also made for engineers, ::;urveyors, utility companies, etc. for which a charge of eight (0.08) cents per square foot is made.
Photography-125 color transparencies and 300 black and white photographs were made for display and educational materials. Negatives were made of aerial photographs for enlargement and mapping purposes. Prints of X-ray negatives were made for medical lectures. Lantern slides were prepared from pictures, maps, charts and graphs for use in lectures and talks before public health meetings. Five hundred sixty prints were made of marine charts for use on shellfish sanitation work of the department. Large displays, numerous photographs and charts were made for development of the Hospital Program. Thirty-six aerial pictures were taken of water and sewage disposal plants throughout the state and photographs and slides were prepared from them. Aerial photographs were also made of a number of municipalities. These will be used as base information for preparation of municipal maps.
96
Georgia Department of Public Health
GENERAL ARCHITECTURAL AND ENGINEERING SERVICE
During the last six months, consultant architectural services have been furnished to the Hospital Division on the State Hospital and Health Center Program.
Assistance was rendered in the preparation of the state plan submitted to the Surgeon General, USPHS.
Preliminary plans for 20 proposed hospitals and 4 health centers were reviewed, and the sites under consideration for 8 projects were visited. Suggestions for location changes were made where water and sewerage facilities were not available or the cost of extending existing facilities was prohibitive.
The division architect met with Hospital Authorities in numerous cities throughout the state, together with their architects, to discuss programming, building planning, site selection, fundraising, submission of applications for funds, submission of plans for formal review, etc.
Talks were made to groups of architects and allied professions, explaining the Georgia Hospital Plan and the rules and regulations for construction standards as set forth under the HillBurton Act.
Inspections were also made of a number of existing hospitals for compliance with safety requirements, room sizes, etc., necessary to qualify for Federal Funds.
MILK SANITATION
There is an increasing responsibility placed upon state and local health departments for clean and safe milk. Milk sanitation must necessarily be under the local administration of the city andjor county supported by legal power and authority inherent in state and local governments to enact and enforce laws and ordinances within constitutional limitations to protect and promote the public health. That such authority includes regulations of milk and milk products is now a well established principle of law. The same may be said of foods other than milk.
Milk sanitation activities are being constantly expanded by local health departments with assistance from this Division. Notable improvements are being made by dairy farms, milk receiving stations and pasteurization plants throughout the state, particularly through local adoption of the standard milk orclinance and code.
Milk sanitation on the local level is provided for by establishment of local health departments and augmented by engineers andjor sanitarians assigned to such local health departments.
Public Health Engineering
97
On the state level it is provi'ded for by specialized milk sanitarians assigned to the State Department of Health for the purpose of assistance to the local health departments.
The facilities at the present time on the state level comprise three milk sanitarians and one mobile milk laboratory with service almost exclusively confined to local health departments and where such departments have legal authority established by adoption of the ordinance.
The mobile milk laboratory service in general conforms to the following conditions:
(a) In collaboration with local health department operations.
(b) Local adoption of standard milk ordinance and code. (c) Service rendered upon request of local authorities. (d) Qualified sanitation personnel with city andjor county. (e) Adequate legal support from local administrative and legal
authorities.
The chief purpose in operations is to locate and remain on an individual milkshed until the entire milk supply in all phases of production, handling, and distribution completely meets the requirements of the ordinance. Sanitation and bacterial requirements are the prime factors. The principal tests are for temperature, sediment, bacteria count, and the phosphatase tests for pasteurization, together with rigid requirements for sanitation.
Full advantage is taken of the opportunity to use this mobile service as an instrument for public health education, especial emphasis being given to milk-borne diseases and the obligation on the part of milk producers and distributors to provide safe
milk to the public. Those in the milk industry are encouraged to visit the mobile laboratory and become familiar with all sanitary aspects of safe milk production.
The demand for this service is increasing to the extent that one mobile laboratory is inadequate. At the present, plans are in progress for expansion of the service.
The legal aspects of milk sanitation in this state are quite complex. It is obvious that this factor contributes to difficulties of operations. However, recently there have been several important legal decisions which have proved to be of definite advantage.
Standard milk ordinances in effect December 31, 1947:
Americus Athens Atlanta Augusta
Carrollton Cartersville Columbus Cordele
Hogansville LaFayette LaGrange Macon
Statesboro Thomasville Tifton Toccoa
98
Georgie( Department of Public Health
Bainbridge Barnesville Bremen Brunswick Cairo Calhoun
Dalton Decatur Douglas Gainesville Griffin Hinesville
Marietta Millen Moultrie Quitman Rome Savannah
Villa Rica Waycross Waynesboro West Point
Milksheds designated by name of the city operating under the standard ordinance and detail of the work accomplished. It will be noted that six milksheds were covered during the year, an average of two months per station for the mobile laboratory.
City
Bacteria Samples Inspections Phosnhate Tests Sediment Tests
Thomasville
128
Macon
226
Eatonton
-- ------------------------------- -- 3,22<!
Waynesboro
50
Americus ____________ -----------..-
63
Augusta
------------------ 555
Totals ______ ------------- ------------- 4,2<!6
52
14
51
33
51
Receiving Station
3<!
8
22
16
98
39
308
110
25 74 518 30 32 602 1,281
In addition to the above there were 286 tests made to determine the addition of water to milk. Inspection service initiated for the University of Georgia milk supply. The local health departments invested $600 in sediment testing equipment so that this work can be continued by local health service.
Other services rendered :
School milk supplies investigated____________________________________________ 11 Health departments rendered advisory service________________________ 22 Pasteurization plants investigated.. __________________________________________ 25 Raw milk producer plants visited______________________________________________ 308
New pasteurization plants have been constructed as follows:
Atlanta Americus Augusta Bainbridge Calhoun
Carrollton Cartersville Cordele Cobb County Dalton
Fulton County Moultrie
LaGrange
Newnan
Macon
Spalding Co.
Milledgeville Waynesboro
Monroe
FOOD SANITATION
The epidemiological and sanitary aspects of public food service become an increasing public health problem. There are few, if any, problems so clearly correlated with the subject of communicable diseases. Rigid food sanitation is the solution
As in the case of milk sanitation, municipal corporations, being political subdivisions of the state, have the police power to exercise jurisdiction over all matters affecting the health of the people.
Public Health Engineering
99
It seems evident that the proper approach is through local adoption and enforcement of ordinances in order to protect the health of the public by rigid control of food production and distribution. This course is generally followed in this state.
Service for food sanitation is established on both state and local levels. Local provisions are most effective by organized local health departments with qualified engineers and sanitarians. Assistance is rendered to municipal corporations and counties from the state by specialized food sanitarians. At present there are two qualified members of this Division rendering this service.
Included in the above is a service in collaboration with the State Department of Education in a school lunch program. This service originated several years ago with the Agricultural Marketing Administration of the U. S. Department of Agriculture. Under this administration there were established certain sponsors and co-sponsors. Generally such sponsoring agency was the authority responsible for the operation of a state public school system. In Georgia, the State Department of Education was designated as the sponsor. This collaborative service between the State Departments of Health and Education has developed into a very extensive sanitation program for school lunchrooms.
Working relations with the Civil Aeronautical Administration have been establishedwhereby all building plans developed under the Federal Airport Act, and, in particular, plans for the larger terminals from which food and drink will be transported by air carriers in interstate commerce require approval jointly by the U. S. Public Health Service and the State Department of Public Health. In this routine, the approval by the State Department of Health is tantamount to approval by the U. S. Public Health Service.
During the year there were seven schools conducted for training food handlers and operators of eating establishments. These schools were held at the following cities: Americus, Athens, Carrollton, Cartersville, Cordele, Dalton, and Milledgeville.
The following counties adopted the standard ordinance regulating eating and drinking establishments: Bartow, Cobb, Carroll, Coffee, Dougherty, Fulton, Gordon, Harris, Sumter, Tift, and Worth. Those revising their ordinances to meet new standards were Crisp, Decatur, and Grady.
There are approximately 2,178 public eating and drinking establishments in the state under a grading system. These establishments serve approximately 376,503 persons daily.
There were 1,660 school lunch rooms in operation under a grading system. The total average daily lunches served was 282,390. This does not include the faculty which would probably increase this figure to over 300,000.
100
Georgia Department of Public H ecdth
Therefore, it is evident that approximately two-thirds of a million persons are daily protected in public eating places by an organized food sanitation program.
SHELLFISH SANITATION
The General Assembly of 1943 enacted two laws regarding shellfish, regulation of oysters and oyster beds. In 1945 two additional laws were enacted, oyster gathering permits and oyster shipping regulations.
These laws place the oyster industry under regulation of two
state departments, the Game and Fish and the Public Health. Under these laws the Department of Public Health through the State Board of Health, is authorized to establish sanitary rules and regulations regarding shellfish.
Effective sanitary control requires the following essential provisions:
1. Oysters shall come from beds which are as nearly as possible fre~ from pollution and disease producing organisms.
2. Conditions of storage, handling and distribution shall protect from contamination with pathogenic organisms and deterioration or adulteration.
3. Careful epidemiological studies of disease outbreaks which incriminate shellfish.
Pursuant to these laws the State Board of Health adopted sanitary rules and regulations consistent with the requirements
of these laws and also to conform with Federal requirements for interstate shipments. In this latter, the Department of Public Health collaborates with the U. S. Public Health Service in control of interstate shipments.
In effecting the purpose of these laws and regulations, this
Division has made studies of all oyster producing areas in regard to the bacteriological conditions of all water within the producing areas. Surveys have been made and maps prepared showing which areas may be permitted and which should be
prohibited.
Accomplishments for the year:
Furnished all oyster gatherers a certificate to which was at-
tached a chart showing the area from which oysters may be
legally gathered. This chart shows the legal area as well as
the condemned portions within and adjacent to Shucking house inspections____________________________________________________ 785
Drinking and wash water samples taken for examination
22
Approximate acres of water, over oyster growing areas,
investigated ----------------------------------------------------------------------- 2,000
Public l-1ealth Engineering
101
Shucking houses certified to U. S. Public Health Service____ 17 Shucking houses improved______________________________________________________ 22 No additional areas were condemned.
MATTRESS SANITATION
The General Assembly of 1937 enacted a law entitled Mattress Sanitary Regulations. This is an Act to improve the sanitary conditions regarding the manufacturing and renovation of mattresses. Provision is also made for collection of a license fee and sale of revenue stamps to provide for the cost of operating the law.
After several years effort, a uniform label and registry number has been adopted by all states enforcing sanitary beclcling laws. This label as well as the license number is essentially the same as first suggested by this Department through its representative in 1939.
Due to added personnel, it was possible to resume full-time inspection in May of this year.
Licenses renewecL ___________________________________________________________________ _ 75
New licenses issued___________________________________________________________________ _ 21 Inspections made, approximate _____________________________________________ _ 1,200
Complaints investigated, approximate_________________________________ _ 175
RECRUITING AND TRAINING PERSONNEL
This Division has established a program of finding, recruiting, training, and assigning engineers and sanitarians for state and local service. This is conducted by maintenance of an application file and by correspondence and by personal contact with prospective applicants.
Training facilities are provided at Vanderbilt University, University of North Carolina and the U. S. Public Health Service School at Columbus, Georgia. This has included both short and long term training. Long term training has also included University of Michigan and Harvard University. Generally the short term training at Columbus for sanitarians is the major portion of the training program.
Since this has been in operation there has been provided training for 11 long term trainees and 97 short term trainees. During this year, short term training was provided for 24 applicants, chiefly for local assignments.
CERTIFYING HOMES FOR ORPHANS AND ADOPTED CHILDREN
In collaboration with the State Department of Public Welfare a plan has been perfected for certification by this Division of
102
P1tblic Health Engineering
homes from which applications are received by the Welfare Department for placing children. Certification is contingent upon
conditions determined by a sanitary inspection. Extensive im-
provements are frequently necessary before such homes are acceptable for this purpose.
Division of Dentali-Iealth Education
J. G. WILLIAMS, D.D.S. ______________________________________Part-time DiTector ANNIE TAYLOR. _____________________ __________________________ .Educational Director VIRGINIA LITTLE. _____________________________ Associate Educational DirectoT ADRIANNE LUNSFORD ________________Educational Mater-ials Consultant
Division of Dental Health Education
Pe1sonnel and Polic1J Changes
The division has continued its program as outlined in previous reports with no changes in operating policies and with the following changes in personnel : Employment of Mrs. Adrianne Lunsford as Educational Materials Consultant February 3; resignation of Miss Virginia Little as Associate Education Director, September 12.
In addition to the routine activities involved in the promotion of its program of PLANNING, EDUCATION and CORRECTIVE SERVICE for Dental Health, the special emphases for 1947 have been:
1. Study and dissemination of information concerning topical application of sodium fluoride as a dental carrier preventive.
2. Workshop in dental health planning for the dentists of Georgia.
3. Preparation of educational aids. 4. Surveys to determine dental needs in Colquitt, Thomas and
Grady Counties. 5. Dental health project for 4-H Clubs of Georgia.
The staff has continued to counsel and to work with all agencies -both official and voluntary at State and local levels-interested in the promotion of dental health, as :
Georgia Dental Association State Department of Education Georgia Education Association Georgia Congress of Parents and Teachers Agricultural Extension Service Instructional Supervisors and Visiting Teachers Womens Clubs Civic Clubs.
The increased interest in dental health on the part of these and many other organizations in our State contributes greatly to the success of our efforts to improve the dental health of the people of Georgia. It has been our objective to direct the interest and use the assistance of these groups toward :
(1) Studying dental needs and facilities (2) Working toward solutions of the problems involved (3) Providing dental care for all children (4) Promoting dental health education so that all people may
understand the need for and ways by which dental health can be attained and maintained.
106
Georgia Department of Public Health
W orkshop in Dental Health Planning
On June 16, eighty-nine dentists registered for a three-day Workshop in Dental Health Planning, which was a cooperative project of the Georgia Department of Public Health and the Georgia Dental Association. There were twelve consultants for public health and education fields, eight out-of-State visitors. The seriousness with which the factual information and special problems were studied indicates the genuine interest of the dentists of Georgia in a dental health program and also their willingness to participate in solving dental health problems.
Prepamtion of Educational Aids
The Division of Dental Health was allowed to take advantage of a special allocation of funds from the Children's Bureau for the purpose of preparing educational materials. Those prepared include:
(1) An Exhibit, depicting the four phases of a dental health program: Planning, Education, Prevention and Service.
(2) A Primary Grade Reader, "Frank Visits the Dentist", twenty pages of four color illustrations and text.
(3) "For Dental Health"-Twelve pages photograph illustrations made in Georgia which suggest the responsibilities of the members of a community in planning and carrying out a functional dental health program.
(4) Bookmarks-Five different bookmarks in different colors to be used by school and public libraries in the State.
The Photographic Laboratory has been most efficient and helpful in assisting the Division in securing appropriate illustrations for these materials, which have received national recognition and enthusiastic acceptance from schools, health departments, dentists and community leaders. Permission has been granted the American Dental Associatioi to distribute the primary reader, "Frank Visits the Dentist", with the Georgia copyright line retained.
Topical Application of Sodium Fluoride
From a public health viewpoint, the approval and endorsement of topical application of sodium fluoride as a dental .caries preventive by the U. S. Public Health Service, American Dental Association and Georgia Dental Association is the most significant event of the year. The possibility of reducing the dental caries attack rate by forty to fifty percent offers great hope for public dental health. Dr. John Knutson, U. S. Public Health Service, presented the facts and results of studies on topical sodium fluoride at the Workshop in Dental Health Planning. Dr. J. F. Volker, Tufts College Dental School, an authority on the use of sodium fluoride, was brought to Georgia in November for
Dental Health Education
107
two District Dental Society meetings at Albany and Columbus attended by approximately 250 dentists and public health workers. Many dentists are using this treatment routinely in their practice. The Georgia Dental Association, at its annual meeting in October, approved the use of topical application of sodium fluoride and also recommended a project to demonstrate methods and techniques involved in its use. Approval of a recommended dental health program for communities of 50,000 and over was also given by the Georgia Dental Association. This recommendation plan includes dental health education, corrective service, the application of preventive techniques and evaluation based on a public health approach and conducted as a part of the general health activities of a local health department.
Plans are under way to conduct a demonstration dental health program in Columbus-Muscogee County as a training center for dentists and public health workers. Two hygienists for the project are being trained at Temple University by the State Health Department.
Dental Surveys
In cooperation with the TB-VD Case Finding Surveys, studies of dental needs were continued in Moultrie and Colquitt County; Thomasville and Thomas County; Cairo and Grady County. The Public Health Reports, December 19, 19L17, includes a report of Caries Prevalence and Tooth Mortality in Georgia. The report will be available to all dentists, public health personnel and others interested in the study.
Dental Health Program For 4-H Clubs
In February, the Staff of the Georgia Agricultural Extension Service asked the assistance of the Division of Dental Health in the planning and initiation of a special dental health project for 4-H Clubs of the State. Approval was given to the project by the Public Health and Welfare Committee of the Georgia Dental Association. Rewards were offered by the Agricultural Extension Service to the counties in North and South Georgia securing the largest percentage of dental corrections among Club members. The State Health Department furnishes a booklet, "Facts About Teeth and Their Care" with a test, "Dental Health Quiz", for promotion of the educational phase of the plan.
Schools, Colleges, Teacher Eclucc(tion
Advantage has been taken of every opportunity to work with in-service teachers in their schools; in county, district and State organizations; through their leaders and supervisors and in their workshops. Contacts with college instructors and students give opportunity for pre-service guidance of teachers. A decreasing amount of effort by our staff is directed toward work
108
Ge01gia Departrnent of Public Health
with children in public schools, since the teacher can do a more effective job. Therefore, our objective is to reach the teacher.
For the second year, the Director has conducted a Public Health Course for senior dental students at Emory University School of Dentistry with the assistance of the Health Department Staff Members.
Coopenttion of the Georgia Dental Association
Appreciation is expressed to the Georgia Dental Association, its Public Health and Welfare Committee and individual members throughout the State for their active support and participation in making possible the dental health program described in this report. The Public Health and Welfare Committee has held sixteen meetings with the staff of the Dental Division. Seven District Dental Society Committees have been set up to function with the State Committee. An excellent working relationship exists between the Georgia Dental Association and the Department of Public Health.
Appreciation is expressed to Dr. T. L. Hagan, Senior Dental Surgeon, U. S. Public Health Service, for the assistance he has given the Division of Dental Health. Since the Division does not have a full-time director, his guidance and assistance has been sought and used in planning and conducting all phases of the dental program.
Dental Corrective Services
There are many indications that an increasing number of children and adults are receiving dental corrective services through dental offices. Accurate evaluation is impossible.
Dental service programs not reported to the State Health Department are operated in several counties.
Dental Clinics
Activities in dental clinics in 1947, operating according to Regulations for Paying Honoraria to Clinicians Conducting Dental Clinics may be summarized as follows:
There were twenty-one clinics in twenty-one counties with forty-six white dentists and one Negro dentist, working- 4,382 hours, admitting 3,087 white children and 394 Negro children. There were 15,793 operations, or approximately four operations per child, including fillings, extractions and prophylaxes. Local dentists were paid $10,460.00 in honoraria for these services.
The clinics have been visited and supervised during the year 1947 by the Dental Director.
Counties operating clinics during the year 1947 are as follows:
Dental Health Education
109
Cmmty
Months Operating
in 1946
T1Jpe of Clinic
1. Bibb -------------------------------------- 11 2. Charlton -------------------------------- 5 3. Chatham -------------------------------- 11 L1. Clarke ------------------------------------ 8 5. Clinch ------------------------------------ 8 6. Cobb -------------------------------------- 6 7. Coweta ---------------------------------- 8 8. Decatur ---------------------------------- 8 9. DeKalb ---------------------------------- 12 10. Floyd-------------------------------------- 8 11. Fulton-Atlanta City__________ 6 12. Fulton-Bass Clinic ____________ 10
13. Jenkins ---------------------------------- 2 14. Jones -------------------------------------- 8 15. Liberty ---------------------------------- 9 16. Muscogee ------------------------------ 10 17. Rabun ------------------------------------ 12
18 Screven ---------------------------------- 8 19. Spalding -------------------------------- 12 20. Upson ------------------------------------ 7 21. Ware-------------------------------------- 7
Negro Children
White Children
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
White Children
White Prenatal Cases
White Children
"
"
"
"
"
"
The new clinics were : 1. Floyd (reactivated) 2. Cobb 3. Coweta
Clinics Approved But Not Yet Operating: (To begin operation in near future)
1. Sumter 2. Harris.
Meetings and Associations Attended:
Mee-ting
Attended By:
Conference .of Visiting Teachers, Atlanta ____________ Miss Taylor, Miss Little Nutrition Conference, Atlanta __________________________________ Miss Taylor
National Congress of Parents and Teachers, Memorial Exercises, Marietta ____________________________ Miss Taylor
New Orleans Dental Health Workshop _______________ Miss Taylor, Dr. Williams Southern District American Association Health,
Physical Education and Recreation,_J'!Iemphis ____ Miss- Taylor, Miss Little District Georgia Education Assoc:iatipp,- Rome ______ Miss Taylor
110
Geo1gia Depa1tment of Public Health
Georgia Education Association, Savannah __________Miss Taylor, Miss Little
Georgia Congress of Parents and Teachers,
Macon -------------------------------------------Miss Taylor, Miss Little Georgia Home Economics Council, Atlanta ______ Miss Taylor
Northeastern Conference of Public Health and Public School Officials, Athens ____________________ Miss Taylor, Miss Little
Georgia Public Health Association ___________________ Miss Taylor, Miss Little
Dr. Williams Parent-Teacher Institute, Athens ___________________ Miss Taylor, Miss Little
Dental Health Workshop, Atlanta -----------------Dr. Williams Miss Little
American Dental Association, Chicago -------------- Dr. Williams Hinman Midwinter Dental Clinic, Atlanta --------Dr. Williams, Miss Taylor Georgia Dental Association, Atlanta ------------ Dr. Williams, Miss Taylor Conference of Instructional Supervisors, Atlanta _Miss Taylor In-service Training Course for the Evaluation
of Dental Caries Control Technics, Michigan __ Miss Taylor American Public Health Association,
Atlantic City -----------------------------------------Miss Taylor Di strict Georgia Education Association, Macon ---Miss Taylor District Georgia Education Association, Athens __Miss Taylor Western District Dental Society, Columbus ____Miss Taylor, Dr. Williams Southwestern District Dental Society, Albany ___Miss Taylor, Dr. Williams South eastern Waterworks Association, Atlanta ____ Miss Taylor, Dr. Williams Conference of Georgia Librarians, Atlanta ______ Miss Taylor National T eachers Conference, Atlanta _______________Miss Taylor Citizens Health Council, Macon ____________________ Miss Taylor
With prope1 guidance, pupils unde1stand the impo1tance of early dental corrections.
Dental Health Education
111
112
Georgie~ Department of Public Health
DENTAL CLINIC STATISTICS
January Through December, 1947
NUMBER COUNTIES OPERATING CLINICS.________________________
NUMBER CLINICS -----------------------------------------------------------------NUMBER CLINIC SESSIONS-------------------------------------------------------NUMBER CLINIC HOURS (TOTAL) _________________________________________
NUMBER DENTISTS WORKING-----------------------------------------------
White
20"~
20 2,092 4,184
46
HONORARIA PAID DENTISTS---------------------------------------------------- $10,460.00
TOTAL ADMISSIONS -----------------------------------------------------------------------
6-8 Years --------------------------------------------------------------------------------------9-ll Years ----------------- ----------------------------------------------------------------12-1'1 Years ------------------------------------------------------ -----------------------------% 6-8 Years ------------------------------------------------- ------------------------------% 9-11 Years --------------------------------------------------------------------------------% 12-1,1 Years ------------------------------------------------------------------------------TOTAL VISITS ----------------------------------------------------------------------------------
3,087
1,382 983 722 45% 32% 23%
7,000
TOTAL PATIENTS DISMISSED______________ ---- --------------------------------
Completed ------------------------------------------------------------------------------------ Others --------------------------------------------------------------------------------------------% Completed -----------------------------------------------------------------------------------
2,380
2,170 210 70%
PROPHYLAXIS -----------------------------------------------------------------------------------
% of Admissions -----------------------------------------------------------------------------NUMBER TEETH EXTRACTED__________________________________________________ _
Decid. -------------------------------------------------------------------------------------------ls t Perm. Molars ------------- -------------------------------------------------------------Othel" Perm. Teeth ------------------------------------------------------------------------NUMBER TEETH FILLED..--------------------------------------------------------
Decid. ----------------------------------------------------------------------------------------------1st Pe1m. Molars------------------------------------------------------------------------Other Perm. Teeth-----------------------------------------------------------------------NUMBER FILLINGS ----------------------------------------------------------------------Cement --------------------------------------------------------------------------------------------Alloy -----------------------------------------------------------------------------------------------S Hieate ------------------------ _-------------------------------------------------------- ___________
1,495
48% 3,156
2,556 509 91
8,184
2,638 3,865 1,681 10,267 1,188 8,517
562
Negro
99 198
$495.00
394
150 176
68 38% 45% 17%
572
136
136 0 35%
48
12% 684
438 205
'n
H2
30 98 H 1,13 39 10,1
0
Division of Hospital Services
JOHN E. RANSOM __________________________________________________________________ Director
Division of llospital Services
Per-sonnel
Mr. John E. Ransom, who served as Hospital Consultant and Program Director, was with the Department the entire year.
In April, an arrangement was worked out with the Division of Public Health Engineering whereby the services of Mr. T. D. Adkins, an architect, were made available to the program.
To assist in making the field survey of hospital facilities, three graduate medical students were employed from April through June. These field representatives were Doctors Charles E. Todd, Jr., Carol G. Pryor, and Joseph R. Carver.
In the fall, Mr. James M. Sitton and Mr. James F. Gunter were added to the staff to assist in the overall administration of the program.
Function
The Division of Hospital Services has the responsibility for the administration of the Federal Hospital Construction Act in Georgia and the Georgia Hospital Regulations Law. The Division has encouraged local communities throughout the State to create hospital authorities under the provisions of the Georgia Hospital Authorities Act, or to organize hospital boards to carry forward the respective Community's desires to develop hospital facilities.
Federal Hospital Constr-uction Act
Public Law 725, popularly known as the Federal Hospital Construction Act or the Hill-Burton Law, authorizes the appropriation of Federal funds to assist in the construction of hospital facilities and public health centers, and provides for one-third Federal participation of the total allowable construction cost for each approved project. The Act, also, authorizes the Surgeon-General to prescribe regulations for the administration of Public Law 725.
Geor-gia H ospitc~l Reg1tlations Act
The Georgia Hospital Regulations Act (Georgia Laws, 1946-Part I-Title III-No. 623) authorizes "the State Board of Health to make and promulgate reasonable rules and regulations for the protection of the health and lives of inmates and patients of hospitals and to prescribe the kind of hospital facilities which hospitals shall have to properly care for patients."
Geor-gia Hospital Authorities Act
The Georgia Hospital Authorities Act authorizes each county or municipality to formulate a local hospital authority
116
Georgia Department of Public Health
for the purpose of constructing andjor operating hospitals, and to provide medical care and hospitalization for the indigent sick of such sub-divisions.
The activities of the Division for 1947 included (1) a field survey of existing hospital facilities, (2) a study of the socioeconomic conditions of the State relative to hospital planning, and the correlation of these factors with field data, (3) the preparation of a State Hospital Plan, (Ll) the preliminary formulation of rules and regulations for the operation of hospitals and related institutions, (5) establishing the foundation for the administration of Public Law 725 (Hill-Burton Act) in Georgia and (6) work conferences on various phases of the hospital program with the U. S. Public Health Service; State Hospital, medical and related associations; and interested individuals and groups.
Hospital Survey
One of the requirements of the Surgeon-General of the U. S. Public Health Service was that each State make a complete inventory of existing hospital facilities. In April through July, 1947, the Georgia Survey of Hospitals was made utilizing the survey form designed and approved by the American Hospital Association.
The survey involved one or more visits to approximately 220 hospitals, and the interviewing of the officials of these institutions regarding the facilities, management, and organization of their respective institutions. Specific items included were area served, physical plant, patient service data, organization of medical staff, administration of hospital, financial data, and educational and research activities.
Many hospitals had neither adequate records nor sufficient personnel to prepare the data requested, and in those cases it was necessary for our field representatives to devote much time to helping develop the data required for the inventory.
This survey revealed and measured the acute need for all types of hospital facilities within our State. A summary of the number of existing acceptable beds by category is as follows:
Existing Acceptable
Category
Beds
General ---- 6,906
Tuberculosis ---- 2,338
Mental ------ 9,351 Chronic ------------- 1,085
The survey also disclosed that 60 counties had no hospital fa-
Hospital Seruices
117
cilities whatever, and that 23 more counties had no acceptable facility within their borders.
Socio-Economic Data
In conjunction with the Division of Vital Statistics, a study of the socio-economic conditions relative to hospital planning was made during the summer of 1947. This summary included studies of population, population characteristics, population trends, effective buying income, average standard of living, distribution of physicians and nurses, and many tabulations of health or vital statistics data.
The above study, after being tabulated and analyzed, was correlated with field data obtained through the survey of hospital facilities. The conclusions thus formulated served as a guide in preparing the State Hospital Plan.
State Hospital Plan
The State Hospital Plan is based on a statewide survey of need for hospital facilities of various types and an inventory of existing facilities. It follows a general pattern set out in the Federal Law and the Regulations which the Law empowered the SurgeonGeneral of the U. S. Public Health Service to prescribe.
This plan was prepared by the Division in September, 1947, and included such major items as the geographic division of the State into hospital areas, determination of relative need for facilities, development of a system of priorities, and formulation of basic principles of administration of the program.
On October 9, 1947, the State Advisory Council reviewed the Plan and recommended its approval to the State Board of Health. The State Board of Health, at the regular meeting on October 16, 1947, officially adopted the Plan.
The Public Hearing on the State Hospital Plan was held in Atlanta, Georgia on October 30, 1947. Prior to that date, general information regarding the State Plan and the public hearing was publicized through statewide releases to newspapers. In addition to news releases, 694 individual announcements of the public hearing were mailed by the Office of the Governor. These announcements were sent to the secretaries of the Chambers of Commerce, Chairmen of County Boards of Roads and Revenues, Mayors of all municipalities in the State, County Commissioners of Health, and various other individuals interested in the Hospital Construction Act. The public hearing was attended by 233 persons from various sections of the State.
The primary objective, the attainment of which the Plan was devised to secure, is the development of such additional hospital facilities as may be needed to provide adequately for the people of Georgia.
118
Georgin Department of Public Health
Hospital LicensU'i'e
During 1947, the Division did a considerable amount of Work in assisting the State Board of Health in establishing certain basic principles which are requisite in a licensure program. This, of course, involved, in addition to individual study of specific items and the review of tentative rules and regulations for other States, conferences and informal discussions with the Hospital Advisory Committee on Rules and Regulations, the State Advisory Council, the Hospital Committee of the State Board of Health, representatives of various hospital, medical and civic groups, and the staff of other Divisions of the Georgia Department of Public Health. Also, many hospital administrators and owners were asked to express their opinions regarding what they thought should be required or desirable in such a program.
As of the date of this report, Rules and Regulations for hospitals and related institutions have been formulated which could become operative in the Spring, 1948. It is believed, however, that it would be desirable to make certain amendments to these rules and regulations before the program is actually activated. In carrying out the provisions of this State Law, it is the aim of the Division to encourage higher standards for hospitals through educational and mutual assistance conferences. It is hoped that the various institutions throughout the State may be visited during 1948 for the purpose of issuing operating permits.
Conferences
During the early part of 1947, Mr. Ransom visited and addressed the medical, hospital and civic groups of twenty-seven communities for the purpose of explaining the philosophy of the Federal Hospital Construction Act.
Many conferences were held by the Division during the year, both in the office in Atlanta and in various communities, with members of hospital authorities, county commissioners and hospital administrators regarding specific hospital projects.
Mr. Ransom also gave counsel and advice to several hospitals regarding the administration and management of these institutions.
Hospital Services
119
TUBERCULOSIS HOSPITAL
NEED
SASEO ON 2.!i TIMES THE AIIERAGE ANNUAL DEATHS FROM TUBERCULOSIS IN THE STATE OVER THE 6-YEAR PERIOD fROM 1940 TQ 1944
GENERAL HOSPITAL NEED
CHRONIC HOSPITAL NEED
BASED ON 2 BEDS PER THOUSAND POPULATION
NERVOUS AND MENTAL HOSPITAL NEED
82.4%
DEFICIENCY
5,091 BEDS
Division of Industrial IIygiene
LESTER M. PETRIE, M.D, ________________________________________________________Director H. L. PARKER_____________________________________________________ ]ndustrial Hygienist GWEN DEKLE, R.N. ______________fnci~tstrial Hygiene Consultant Nurse
Division of Industrial Hygiene
The Industrial Hygiene Service was organized in 1941 in the Division of Preventable Diseases and attained full divisional status in July 1946. From this beginning through December 1947 recorded services have been rendered to 508 plants in 65 counties with a total employee population of 202,051, a number equivalent to about one-third of the present estimate of non-agricultural employment in this State of 608,000. Reference to Table Number 4 will summarize on a year to year basis the number of plants visited, type of service rendered, the employee population and the number of counties in which plants were located. The nature of the services rendered can be divided into two main groups:
1. The evaluation and control of disease hazards in the industrial working environment.
2. Arranging for the examination and control of the individuals exposed not only to these risks, but also to the preventable disease hazards common to the community as a whole.
Activities of the Division of Industrial Hygiene during 1947 have been to a considerable extent influenced by the continued general expansion which currently exists in the industries in Georgia. There has been a considerable increase in the demand for the services of the Division due to this expansion of industry and also clue to the fact that the older industries of the State have become increasingly aware of the necessity for this type of service. More freedom has been exercised in the type of plants contacted due to the fact that it is now possible to 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 current emphasis during this period which has been placed on the mass TB-VD surveys applied to industry.
PERSONNEL
The staff including medical, nursing, engineering, and chemical personnel was as follows: one medical director, two consultant nurses, one chemical engineer, one mechanical engineer, four chemists, three stenographers and one clerk. In rendering services to industry they act as consultants to the local health authorities. They also help industry to make use of the related health services of other divisions in the State Health Department and other agencies. When Mr. N. V. Hendricks, who was acting as assistant director, resigned in May, the services of another trained industrial chemical engineer were secured; however, this
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Industrial Hygiene
125
engineer, Mr. James W. Hammond, resigned in September. Subsequently, the engineering and chemical phases of the Industrial Hygiene program were slpervised by the Chief Industrial Hygienist, Mr. Hugh L. Parker.
The Division was to a certain degree unable to comply with all the requests for services during the year clue to several factors:
1. Completion of the new laboratory necessitated the stoppage of all analytical work during May and the first part of June.
2. During June, July, and August the new laboratory was used for training students in the cooperative graduate summer course in industrial hygiene offered by Georgia Tech.
3. Resignations of the chemical engineers.
4. The increasing demands for the services of the Division by industry.
MEDICAL AND NURSING PROGRAMS
Medical and nursing activities include the investigation of occupational diseases, or other diseases affecting industrial populations, the promotion and establishment of medical and nursing services, and the establishment of proper and accurate record keeping. Also included are the promotion of public health measures in industrial establishments and correlation of industrial health activities with community health services. Programs dealing with tuberculosis, venereal diseases, immunizations, nutrition, sanitation, dental hygiene and health education are especially emphasized.
ENGINEERING AND CHEMICAL PROGRAM
Industrial Hygienists (chemists and engineers) promote and carry out plant services in order to study processing methods and materials and their relationship to the working environment. This is done by means of an impartial study including accurate chemical determinations where indicated. Observed data are assembled and 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 plants and in training individuals concerned with industrial hygiene and safety programs.
Industrial Hygiene Labomtor?J: Laboratory activities are important factors in the engineering investigation of the industrial environment and evaluation of observed hazards. A labora-
126
Georgia Department of P~tblic Health
tory is provided for the qua:ntitation of air contaminants such as dust, fumes, gases, vapors, mists, smokes, and the like. In addition to the study of processing materials and their byproducts which are toxic, a certain amount of bio-chemical work is done on blood, urine, and other biological samples. These data are correlated with the engineering and medical data so that actual hazards may be properly evaluated and that a more intelligent and comprehensive report may be submitted to the industry concerned. In connection with the laboratory activities it should be pointed out that the Industrial Hygiene Division was fortunate enough to secure new quarters of a more adequate and spacious :nature.
On June 15th, the Division laboratory moved into its :new quarters, built to accommodate the laboratory and space for offices for the chemical personnel. The :new laboratory planned by Mr. N. V. Hendricks, before his resignation, occupies one :floor of the new laboratory building adjacent to the New State Office Building, where the administrative industrial hygiene offices are located. The laboratory is reached through an entrance lobby which will be used as a display room for educational posters, field equipment, and other items of general interest to the public and visitors.
There are two offices for the personnel which will accommodate seven or eight desks with space for passage ways and file cabinets. Adjacent to the offices is the field equipment store room and calibration room whicli is used as a general workroom for the engineering staff. Through the calibration room one can enter either the chemical stockroom or the central laboratory which leads back to another large laboratory room across the rear of the building. From the back laboratory the balance room opens. This room is also used for making dust counts, since it is easy to darken and otherwise is well adapted for this purpose. Besides these eight rooms, there are also two complete washrooms and toilet facilities for both men and women. The overall dimensions of the laboratory are 25 x 86 feet.
The services rendered by this laboratory during the past twelve months include: 118 field samples, totaling 13'12 analyses. As mentioned elsewhere, the laboratory was used during June, July, and August for teaching industrial hygiene students.
PUBLIC RELATIONS
Georgin Section of American Industrial Hygiene Association:
The Industrial Hygiene Division continues to cooperate with the Georgia Section of the American Industrial Hygiene Association on matters pertaining to the promotion of industrial hygiene in Georgia. This cooperation and functioning of the Georgia Section of the American Industrial Hygiene Association has done
Industrial Hygiene
127
much to promote the program of the Industrial Hygiene Division of the Georgia Department of Public Health. In October, the Director of the Division, Dr. L. M. Petrie, was elected as President of the Georgia Section and Hugh L. Parker was elected to the office of Secretary-Treasurer of this organization.
Medical Association of Georgict: The Medical Director continues to serve as Secretary of the Committee on Industrial Health of the Medical Association of Georgia. This connection has been helpful in securing the cooperation of the organized medical profession.
Orientation Course fo1 Engineers and Sanitarians: U. S. Public Health Service: The Industrial Hygiene Division has cooperated with the U. S. Public Health Service in its orientation course for engineers and sanitarians. In this connection, Mr. Juan Alberto Gonzalez, of Puerto Rica, spent six weeks with the personnel of the Industrial Hygiene Division, observing techniques as applied to occupational hygiene.
The Division visited the Public Health Service Training Center for Sanitary Engineers at Columbus, Georgia. Arrangements were made to conduct the trainees through industrial plants. Our Division also presented lectures on industrial hygiene to the students. Eighteen graduate sanitary engineers were enrolled in the 3-months course.
Recruitment of Per-sonnel: Upon the invitation of the Division of Industrial Hygiene and the Georgia School of Technology, Dr. Clyde M. Berry, U. S. Public Health Service, addressed the engineering graduates of Georgia Tech on careers in industrial hygiene. Dr. Berry spoke to a group of approximately 75 on the opportunities open in the field of industrial hygiene.
Exhibits: Exhibits consisting of: 1) a model health program for small industries, and 2) various types of field sampling equipment were shown. These were displayed at: 1) Medical Association of Georgia Convention at Augusta, Georgia; 2) Southern Machinery & Metals Exposition in Atlanta; 3) Georgia Public Health Association in Atlanta; 4) Atlanta Health Week Exhibit at Belle Isle Building; 5) "Made iri Georgia Exhibit" at the Atlanta Auditorium, and 6) American Mutual Liability Insurance Company, Industrial Medical Seminar.
Visitors to the Division: 102 visitors to the Division have been recorded in the Guest Book during the year. This includes visitors from New York, New Jersey, Mississippi, Maryland, South Carolina, Washington, D. C., Alabama, New Orleans, Tennessee, Pennsylvania, California, and Illinois. Visitors from the following foreign countries were also recorded: India, England, China, and Puerto Rica.
The Atlantct Tubeuulosis Associcdion: The Medical Director
128
Georgia Department of Pt~blic Health
has been elected a director of the Atlanta Tuberculosis Association and has been appointed to serve as Chairman of the Industrial Health Steering Committee of that organization. This Committee holds meetings about once a month. The Chamber of Commerce and management representatives gather around the conference table with union leaders to discuss various industrial health problems under the guidance of health councelors assembled by the Committee. The work appears to be instrumental in maintaining good labor relations within industries of this area.
Georgia Worker's Education Service invited the Medical Director to talk at their mid-summer meeting in Clayton, Georgia. This was a significant meeting which focused attention on the efforts of organized labor to force industrial management to provide more adequate health controls.
Out of State lJ!Jeetings:
1) The Industrial Nurse Confe,rence of Southeastern States in Nashville, Tennessee in January was attended by Miss Dekle. This conference was sponsored by the Division of Industrial Hygiene of the U. S. Public Health Service.
2) American Conference of Governmental Industrial Hygienists in Buffalo, New York This joint industrial health meeting of the American Conference of Governmental Industrial Hygienists, The American Association of Physicians and Surgeons, The American Association of Industrial Dentists and The American Industrial Hygiene Association was attended by the Medical Director, Engineer, Chemist, and Nurse. The Medical Director served on the Committee on Codes, the Committee on Recruitment and Training, and was appointed Chairman of the Committee on Plant Records and Reports. The Engineer and Chemist represented the Georgia Section of the American Industrial Hygiene Association in their executive meetings.
3) The National Tuberculosis Association Annual Meeting in San Francisco in June. At the invitation of the Association, the Medical Director prepared a paper, "What Do We Expect From Community X-ray Programs," which was read at this meeting. The paper was a review of the first twelve months of Georgia's Community-wide X-ray and blood test surveys. This was national recognition of the Georgia program.
4) The Eye Sight Conservcdion in Industry Institute at Oak Ridge, Tennessee in September was attended by the Medical Director. This meeting was sponsored jointly by the Atomic Energy Committee, The National Committee for the Conservation of Eye Sight, and the Oak Ridge Lions Club.
5) The Sotdheastern Regional Conference of the Council on Industrial Health of the American Medical Association in New Orleans, Louisiana was attended by the Medical Director.
Industrinl Hygiene
129
Field trip during Georgia Tech Short Course in Industrial Hygiene. Occupational disease hazards and their control, 'Which have just been observed in an industrial plant, are being discussed by Dr. Petrie and the students
as they return by bus from the plant to the school.
SPECIAL PROJECTS AND PLANT SURVEYS
The work described in this report includes services rendered to 182 plants with 85,474 employees in 37 counties. Tables at the end of this report will give further figures.
Indust?-ial Hygiene Short Course: On June 16th, a ten-weeks program began which was offered to graduate students in need of orientation in the environmental phases of industrial hygiene. This was a project of the Georgia School of Technology in collaboration with the Communicable Disease Center of the U. S. Public Health Service, the Division of Industrial Hygiene of the U. S. Public Health Service, and the Georgia Department of Public Health. Students who successfully completed the course received graduate credit from Georgia Tech.
Dr. W. E. Doyle, Industrial Hygiene Consultant, U. S. Public Health Service, gave the introductory lecture. The services of Dr. F. H. Goldman, Chief, Analytical Unit, Chemical Section, U. S. Public Health Service, were obtained for the entire period to teach laboratory procedures for industrial analysis. Mr. Clyde Fehn, (SA) Engineer (R) of the Communicable Disease Training Center, had the responsibility of integrating the services of the U. S. Public Health Service with the training program of the
130
Georgia Department of Public Health
Georgia Department of Public Health and the Georgia School of Technology.
The new laboratory of the Industrial Hygiene Division and the laboratory personnel were used in training the students in analytical procedures for the evaluation of industrial exposures.
The services rendered to industry in the past by the Industrial Hygiene Division provided the contacts that enabled the Division to arrange an adequate field training program for the students. The Georgia Department of Public Health also provided lecturers for specialized subjects and mimeographing facilities for the dissemination of literature. Three industrial hygienists from this Division attended the course. A total of 17 students from 6 states completed the course.
The course and its fundamental framework were conceived by the former Assistant Director of the Division of Industrial Hygiene, Mr. N. V. Hendricks, and most of the promotion and planning prior to his resignation were done by him.
Industrial Health Calendar: The consultant nurses and medical director have been developing a plan for systematic health education in industrial plants by means of a Health Calendar. This calendar consists of a listing-month by month-of health subjects for major emphasis. It includes subjects which are receiving national emphasis. Known sources of suitable health education material such as posters, literature, films, and the like are also listed. It is recommended that at the close of each drive any special exhibit material which is worth saving should be put away for use the next year when the subject is again presented. Intensive work along this line at the Gainesville Cotton Mill was nationally recognized. The Mill nurse read a paper on the project at the Industrial Health ConfereHce in Buffalo, which was illustrated by lantern slides prepared by this Division. The Atlanta Tuberculosis Association has agreed to serve as clearing house for industries in this area in securing material which may be available from various sources for free distribution. By the end of the year thirteen establishments employing over 8,000 in the Atlanta area were cooperating in the program.
Cooperative Industrial Health Centers:
1. The Winder Manufacturers Health Clinic continues to operate satisfactorily. As previously reported this cooperative industrial health center was organized in 1942 under the direction of Dr. W. L. Matthews in cooperation with the Division of Industrial Hygiene. The exhibit which was prepared by this Division was originally shown in Chicago at the Industrial Health Conference and is being maintained. It is very useful for teaching purposes for visitors to the Division, and for showing from time to time at conventions and public gatherings as described elsewhere in
Indust1'ictl Hygiene
131
this report (see exhibits). The successful operation of the Winder Plan has served as a guide for promotion of other cooperatives.
2. The P1'oposed Atlanta lndust1'ial Health Center: This project is being promoted jointly by the Division of Industrial Hygiene and the Atlanta Chamber of Commerce. It is planned as an independent self-sufficient cooperative venture owned and operated by a board of directors representing:
A. The cooperating industries
B. Emory University Medical School
C. Georgia School of Technology
The plan has the support of the deans of both schools and lacks only the financial backing of the sufficient number of industries. It is designed to serve two major functions.
A. To provide industrial health service.
B. To be a training center for graduate and under graduate students of the engineering and medical colleges.
The plan has been endorsed by the Board of Trustees of the Fulton County Medical Society, The House of Delegates of the Medical Association of Georgia, the Council on Industrial Health of The American Medical Association, the Division of Industrial Hygiene of the U.S. Public Health Service and the U.S. Chamber of Commerce, and other interested individuals and agencies. The plan has r.eceived two setbacks which it is hoped are only temporary. In January there was a meeting at the Atlanta Chamber of Commerce attended by the Deans of both schools and representatives of eighteen different employers in the Marietta Street area. A financial commitment could be attained, however, from only three employers representing six or seven hundred employees. This was insufiicient to support the project and it was decided to select a new area. During Atlanta Health Week in September there was a meeting at the Atlanta Chamber of Commerce attended by representatives from eight plants in the East Point area, and also by the Secretary of the newly organized East Point Chamber of Commerce. No commitments, however, were obtained ~i:; this meeting. It appears that a great deal of additional personal contact and promotion will have to be done on an individual basis with management. Small industries will have to be convinced that the scheme will more than pay for itself.
3. Indust1'ictl Health Coopenttives in Other' A1'ects of the State: In Griffin and Spalding County a different pattern for industrial health is beginning to appear through active cooperation between the health department and local industries. Dispensaries have been established in some of the mills with the County Health Department nurses under direction of the County Health Officer.
132
Georgia Department of Public Health
Hence a preventive program in industry is developing under direct guidance of the County Health Department. Individuals discovered who need medical treatment are referred to the practicing medical profession. In Thomasville and Thomas County an industrial council has been organized which is interested in developing a cooperative. In Dalton and Whitfield County the County Health Officer and industries have expressed interest along similar lines.
InteTstate Silicosis Study-Tennessee CoppeT Company: Supposed cases of silicosis among Georgia citizens residing in Fannin County who were employed by the Tennessee Copper Company of Copperhill, Tennessee have been reported to this Division by Dr. Hix, practicing physician in McCaysville. A joint study of the plant was made by industrial hygiene representatives from the Georgia Department of Public Health and the Tennessee Department of Public Health. Although silicosis has developed among employees of this plant in the past, it became evident that the Tennessee Copper Company is now doing an outstanding job in silica dust control. Physicians in Georgia who are interested in silicosis control might do well to give more attention to the warning as expressed by L. E. Hamlin, M.D., a nationally recognized authority on dust diseases of the lungs as follows: "Physicians, industrial and otherwise, still make the diagnosis of occupational fibrosis because of the chest X-ray pattern and of a history of employment in a supposedly dusty industry.. No consideration is given to the fact that dependable examinations of respirable size particles of dangerous dust and safe atmospheric concentrations have been established. The physician is frequently unaware that such standards exist . . . . Industrial Compensation Commissions need to be reminded that consideration of these factors is essential before awards for disability based on vague roentgenographic shadows and uncertain exposures should be granted or upheld."
Community-wide TB and VD SuTveys: The medical director and nursing consultants have continued to assist in the countywide surveys which have been conducted during the year in the following counties: Colquitt County, March; Thomas County, May; Grady County, June; Floyd County, July-August; Polk County, September; and Lowndes County, November. The medical director had to limit the amount of time he spent on the later surveys because of the pressure of other responsibilities. Nevertheless, the Industrial Hygiene Division has taken the responsibility for industrial organization and has assigned one consultant nurse to full-time activity with the survey team during the organization and conduction of the surveys. In addition to her industrial responsibility this nurse has been made the overall nursing supervisor and is responsible for the scheduling of all the survey teams. The relationship established with industries in
Industrial Hygiene
133
these community surveys is of great value to this Division, particularly with regard to the promotion of overall industrial health programs and follow-up studies of occupational diseases. An example of the latter is the discovery in the Floyd County survey of forty-eight individuals with abnormal lung shadows which were interpreted as probably being due to dust exposure. Thirtyfive of these gave a history of working in Rome's foundry or stove works. (Fourteen of them in one particular plant, nine in another) . These men were believed to have silicosis. A preliminary survey of these plants was made which revealed probably serious silica dust exposures. Further intensive studies have been offered to the industries involved.
X-my Surveys of Individual Industries often combined with blood testing or other procedures have also been arranged during intervals between the larger county-wide case finding programs. An example is the x-ray examination and immunization project for 3,326 civilian employees at the two Army Depots at Conley. Typhoid and smallpox immunizations were offered in addition to chest x-rays.
Granite Sheds: The termination of priority restrictions has permitted allocation of critical material to all types of plants. In this connection, the granite sheds in the area of Elberton are installing ventilating equipment for the control of dust from plant operations. A large percentage of plants have completed the installation of this equipment during the past year. The Division of Industrial Hygiene has cooperated with these sheds in advising as to the type of controls indicated and in reviewing plant specifications covering proposed installations. Contacts have been made with the various plants and fifteen of the plants, with a total employee population of approximately 900 have been studied. These studies included atmospheric dust samples in the breathing zone of the workers, and the inspection of the ventilating equipment including a check on the efficiency of equipment after installation. As soon as the remaining plants have installed ventilating equipment they will also be studied.
UTinary Lead Studies: During the year the urinary lead study of all the fifty-one employees of the Globe-Union Battery Company was completed. An atmospheric lead study was also done at this time. An attempt is now being made to correlate the values obtained in these studies. It is hoped that by the use of this method a:t the Globe Union and various other lead processing companies, a better evaluation of the environmental lead hazard and a more reliable method for the early diagnosis of lead intoxication will be obtained. Considerably more work needs to be done along this line.
Development of J1/Jethods: For the past few months the laboratory of this Division has been engaged in the development of a new and simplified method for the determination of arsenic-
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Industrial Hygiene
135
containing field samples. The development of this new method should save much time and effort in evaluating arsenic exposures in insecticide plants throughout the State.
During the year the Division accepted the responsibility of acting as referee for the development of a better method for the determination of formaldehyde in atmospheric samples. Much research work has been done in an attempt to develop a satisfactory method. Copies of three methods have been mailed to the eight collaborators and standard samples will be mailed to the various laboratories cooperating in this undertaking shortly after the first of 1948.
Dust Studies, Georgia Marble Compcmy: In February, both labor and management asked this Division to re-evaluate the dust exposure at the Georgia Marble Company at its Canton, Nelson and Tate Plants. Acting upon this request, the Division made dust studies at the above mentioned plants, and a solution agreeable to both labor and management was offered.
Reported Occupational Diseases : Since the occupational disease compensation amendment to the Workmen's Compensation Law which went into effect in 1946 there has been a moderate increase in reporting of occupational diseases. This increase is primarily due to the legal requirement that the Industrial Board report all cases to the State Board of Health. Also there have been sporadic reports from other sources. For example, silicosis and bysinnosis cases were reported by the chest x-ray and blood test mass surveys.
The following cases have been reported, although not all are specified as of occupational origin :
Cases
Bysinnosis ------------------------------------------------------------ 2 Carbon monoxide ------------------------------------------------ 6 Dermatitis ------------------------------------------------------------ 2 Lead poisoning ---------------------------------------------------- 4 Other poisonous gases ---------------------------------------- 3
Ringworm ------------------------------------------------------------ 1 Silicosis ---------------------------------------------------------------- 63 Sulfa poisoning ---------------------------------------------------- 1 Tuberculosis (occupational) ------------------------------ 1 Utility gas ------------------------------------------------------------ 6
Deaths 3
3 1 1 6
TOTAL ---------------------------------------------------------- 89
14
In addition, 139 cases of undulant fever have been reported, over half of which are believed to have beeri due to occupation,
136
Georgia Department of Public Health
although undulant fever is not compensable as an occupational disease.
Carbon M onoxicle Investigations: In October the Division was called upon to investigate an exposure to carbon monoxide in a large quick freeze plant. After careful study of the plant processes it was discovered that the carbon monoxide in the large storage locker was coming from the operation of a gasolinepowered lift truck. It was recommended that this gasolene-powered lift truck be replaced by one operated by electricity. This alleviated the problem and no further trouble was experienced by the plant.
In November, three people were overcome by carbon monoxide
fumes in a private residence in the town of Manchester. The
Division of Industrial Hygiene was called in to investigate this
incident by the City Physician. It was discovered that a floor
furnace in the hall of the residence had been improperly installed.
The furnace was constructed to operate with a vent to the out-
side atmosphere. However, the company that installed the furnace
had failed to equip it with a vent. After the vent had been
installed, the Division checked the atmosphere in the house
again and the atmospheric samples were negative for carbon
monoxide. Since several other incidents were reported through-
out the State at approximately the same time, a brochure on
the dangers and methods of eliminating the exposures to this
deadly gas was prepared by the Division Director. These bro-
chures were mailed to all of the health officers. Arrangements
have also been made with the Secretary of the Georgia Liqui:fied
Petroleum Gas Producers Association for the cooperation of that
organization in preparation of health department regulations for
control of the CO hazard due to inadequate venting of devices
which burn carbonaceous fuels.
Chlorinatecl Hydrocar-bons: In September of this year, the Industrial Hygiene Division was called upon to investigate an interesting exposure to chlorinated hydrocarbons. A clutch replacement company in the City of Atlanta had recently installed large overhead gas-fired protective blower type heating units. After only six weeks of operation, these heating units had corroded to the point where it was impossible to operate them any longer. Consequently, the Division was called in to investigate the problem. After study and analysis of the problem it was discovered that the company was operating a trichloroethylene de- greaser beneath and not too far away from these unit heaters. This degreaser had no thermostatic control nor was it equipped with local exhaust ventilation. Therefore, it was possible for the fumes all coming from this degreaser to rise into the atmosphere around the heating units and contact with the hot metal of the heaters caused the trichloroethylene to break down into hydrochloric acid and phosgene. The hydrochloric acid corroded the
IndustTial Hygiene
137
metal of the heaters and it was possible for the workers in the area to be exposed to phosgene. Isolation of the degreaser and the installation of an axial flow fan in one wall of the room eliminated the excess trichloroethylene fumes.
Peanut IndustTies: At the request of the Mayor of Blakeley, Georgia the Division investigated the excessive discharge of dust from the peanut unloading equipment in the City of Blakeley. In harvesting the peanut crop in the State of Georgia most peanut companies use a pneumatic unloader. In the usual type of installation the pneumatic system passes through a cyclone. These cyclones were not constructed to handle finely divided dust. Consequently, clouds of dust are discharged at the exhaust end of these cyclones. In the City of Blakeley this causes the town to be covered by a haze of dust during the peanut harvesting season. A sample of the settled dust showed a silica content of approximately 52%. Consequently, a large number of people were being exposed to a high silica dust. It was recommended that the cyclones be replaced by cloth filter type dust samples.
138
Georgia Department of Public Health
TABLE I
GEORGIA SUMMARY OF INDUSTRIAL HYGIENE ACTIVITIES
January through December 1947
Tbc and Vd Surveys
Number of establishments given se1vice ----------------------------------------------------- 51 Number of wo1kers in these establishments---------------------------------------------- 26,597 Number of plant visits made----------------------------------------------------------------------- 116 Number of services requested by management and health departments Number of services self-initiated ..--------------------------------------------------------------------
T o t a l .... ------------------------------------------------------------------------------------------------------
Other Services
133 58,008
181 144 198
342
No. Plants Given Service
Type of Service Given:
Promotional ----------------------------------------------------------------------------------------- 80 Surveys of working environment----------------------------------------------------------- 47 Technical studies ------------------------------------------------------------------------------------ 21 Nuisance complaint ------------------------------------------------------------------------- ~1 Appraisal of medical department---------------------------------------------------------- 5 Investigation of occ. diseases.----------------------------------------------------------- 6 Examination of plans -------------------------------------------------------------------------- 2 Consultations regarding problems of work, environments--------------- 10 Medical services ------------------------------------------------------------------------------------- 22 Nursing services --------------------------------------------------------------------------------- 54 Other ------------------------------------------------------------------------------------------------ 10 Tuberculosis and venereal disease surveys --------------------------------------------- 51 Follow-up on recommendations ---------------------------------------------------------- 23
No. of Services
Given
82 49 24
4 5 6 2 10 22 62 10 51 24
No. of Plants
Improvements Recommended Regarding: Working environment ------------------------------------------------------- 19 Health and welfare services.-------------------------------------------- 10
Improvements Carried Out: Working Environment -------------------------------------------------------- 16 Health and welfare serviceS--------------------------------------------- 52
Specific Services: Number ehest xrays made of workers in cooperation with health departments---------------------------------------Number blood tests made of workers in cooperation Sampwlietsh fhoeralltahbodreaptoarrytmaennatlsys..i.s-.--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_
Field determinations made ------------------------------------------------Occupational diseases investigated-------------------------------Small pox vaccinations.-----------------------------------------------------
No. Recom mendations
300 59 86 42
No. Workers Affected
3,639 22,775
1,674 9,950
24,021
18,997 276 187 88
2,900
Industrial Hygiene
TABLE II
CLASSIFICATION OF LABORATORY ANALYSES
Samples from Industrial Plants
Contaminants:
Arsenic ----------------------------------------------------------------------------------------------- 0 Benzene-------------------------------------------------------------------------------------------------- 15 Brine ---------------------------------------------------------------------------------------....:------ 1 Carbon Monoxide ---------------------------------------------------------------------- 22 Chlorides ____ ------------- -------------------------------------------------------------- 6 Chlorinated Hydrocarbons ------------------------------------------------------------ 4 Chlorine ----------------------------------------------------------------------------------------- 4 Chromic Acid ------------------------------------------------------------------------ ______ Dust-Asbestos -------------------------------------------------------------------------------- 45 Dust-Silica ----------------------------------------------------------------------- 149 Dust-Other Inorganic ---------------------------------------------------------- 29 Flourine -------------------------------------------------------------------------------- 4 Formaldehyde ------------------------------------------------------------------- 0 Hydrogen Sulfide ----------------------------------------------- ---------------- 6 Lead-Atmospheric ---------------------------------------------------------------- 73
Lead-Urinary ---------------------------------------------------------------------------------- 61 Mercury -------------------------------------------------------------------------------------------- 18 Meta-di-ni tro benzene --------------- -------------------------------------------- 0 Molecular Wt. --------------------------------------------------------------------------------- 0 Nitrogen Oxides -------------------------------------------------------------------------------- 18 Para-di-chlor benzene -------------------------------------------------------------------- 0 Phosgene ------------------------------------------------------------------------------ 1 Silica-free ------------------------------------------------------------------------ 5 Solvent ---------------------------------------------------------------------------------------- 3 Sulfur dioxide ----------------------------------------------------------------------------------- 3 Zinc oxide ----------------------------------------------------------------------------------- 2 1080 ------------------------------------------------------------------------------------------------ 0
Totals------------------------------------------------------------------------------- 469
Research on
Methods
244 12
6 29
0 0 0 12 122 10 0 0 20 18 21 16 15 0 10 0 0 8 182 725
139
Totals
244 27
1 22
6 4 10 29 45 1<19
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122 16 73 61 38 18 21 34 15 1 15 3 3 10
182 1,194
TABLE III
MONTHLY ACTIVITIES REPORT OF
DIVISION OF INDUSTRIAL HYGIENE
Reported To Date
I. FIELD ACTIVITIES: A. Promotional ---------------------------- ------------------------------------------------------- ------------ 257 B. Survey ------------------------------------------------------------------------------------------------------------------------ 550 C. Study ------------------------------------------------------------------------------------------------------------- 112 D. Other Activity ----------------------------------------------------------------------------------------------------- 252 E. 0 ccupa tional diseases investigated ---------------------------------------------------------------------------- 32 F. Samples Collected ------------------------------------ ---------------------------------------------------------- 383 G. Field Determinations --------------------------------------------------------------------- 118
JJ. PUBLIC RELATIONS: A. Conference -------------------------------------------------------------------------------------------------------------- 1,001 B. Meetings Attended ----------------------------------------------------------------------------------------------------- 116 C. Lectures, 'falks, etc. ------------------------------------------------------------------------------------------------------- 110 D. Persons Addressed ----------------------------------------------------------------------------------------------- 2,871 E. Occupational Diseases Reported----------------------------------------------------------------------------- 82
Ill. LABORATORY ANALYSES: A. Samples in Industrial Plants ....-------------------------------------------------------------------------- 469 B. Research on Methods------------------------------------------------------------------.. .... .. 700
t-L 11::. 0
TABLE IV
NUMBER OF PLANTS SERVED BY THE DIVISION Ol!" INDUSTRIAL HYGIENE AND TYPES OF SERVICE RENDERED
1941
Total number plants contacted----------------------------------------- 20
Number new plants (initial service during current period) --------------------------------------------------------------------- 20
Number old plants (service initiated in previous years) -------------------------------------------------------------------- 0
Number plants received medical service------------------------ 17 Number plants received nursing service -------------------- 11 Nun1ber plants l'eceived engineering service.___________________ 17 Number plants received laboratory service ----------------------- 4 Number plants received feeding service--------------------------- 0
Number plant days that plants were visited .................. 48
Total employee population of plants----------------------------- --------
Nun1ber counties in which plants were located --------------- 14
1942
1943
1944
96
113
84
87
48
33
9
65
60
76
43
64
30
33
12
19
0
8
309
396
163,798
31
31
51
64 17 45 23 20
250
186,800
21
1945
153
96
55 86 84 6:3 12 13 262 124,389
31
1946
147
95
52 107
89 40
5 1 237 120,213
23
1947
182
102
80 31 99 101 47
0 295 85,474
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65
Division of Maternal and Child 1-Iealth
GUY V. RICE, M.D.--------------------------------------- _ _____________________ Director MYRA REAGAN ___________________________________________ ._____ Nutrition Consultant HANNAH MITCHELL ------------------------------ ______________ Consultant NU'rse FRANCES SANCHEZ __________ ____ ._______________________________ Consultant Nurse NELL SMITH ________________________________________ Health Education Executive
Division of Maternal and Child Health
All phases of maternal and child health work increased during 1947, with the exception of the Emergency Maternity and Infant Care Program. There were only 1,632 maternity and infant cases authorized in 1947 as compared with 4,170 cases authorized in 1946. This decrease is due to the return of servicemen to civilian life and to the liquidation of the program. The Children's Bureau has requested that the Emergency Maternal and Child Health program for wives and infants of servicemen be brought to a close. No further authorizations will be made except for cases in which conception occurred prior to July 1, 1947. Work with this program, however, will, of necessity, continue for many months in order to process delinquent applications and close cases authorized prior to June 30.
Since September 15, 1943, the date the Emergency Maternity and Infant Care program went into effect in Georgia, 24,310 applications for mothers and infants were authorized at a cost of $1,605,534.38.
EMIC ACTIVITIES MATERNITY CASES
Number
1. Maternity cases completed _________ ---------------------------------------- _________________ 2,497
2. Cases completed after delivery ------------------------------ --------- ----'-------------- 2,210
a. Person in attendance ____ 2,210
b. Place of delivery ________ 2,210
(1) Doctors of medicine 2,207
(1) In hospitals ____________ 2,051
(2) Osteopaths ____________ 0
(3) Others ___
3
(2) At home _______
159
3. Cases completed before delivery ________ ------------------------------------------------- 287
Number of cases
1eceiving
care
Amount of money
approved for
payment
4. Total __
____ ----------------------------------------- _____ 2,497
5. Both services of attending physicians and hospital care paid for, but paid separately______ 1,522
a. Physicians' services -------------------------------b. Hospital care -------------------------- _____________
(Days of hospital care ______ 9,352)
6. Both physicians' services and hospital care
paid for in single payment to hospitals ____ 118
(Days of hospital care ______ 511)
7. Attending physicians' service paid for but
not hospital care --------------------------- _____________ ---- 268
8. Hospital care paid for but not attending phy-
sicians' services _______
_____________ _____________ 468
(Days of hospital care _______.4,304)
9. Consultation service -------------------------------------------- 123
$156,614.67 112,110.73 54,166.24 57,944.49
2,764.65
10,878.94 27,404.99
2,794.46
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Georgia Department of Public Health
Number of cases receiving
cme
Amount of money approved
for
payment
10. Bedside nursing _______________ ------------------------------------ 7 11. Prenatal and postpartum care provided in
clinics but not included in items 5, 6, or 8____ 1 12. Drugs, ambulance, blood for transfusions,
travel of consultants, and all other services
not included above --------------------------------------------
187.00 328.03
INFANT CASES
Numbe? of cases nceiving
care
Amount of money approved
for payment
13. Total __ ------------------------------------------------------------------ 403
14. Both services of attending physicians and
hospital care for sick infants paid for, but
paid separately _________ _______________________________
153
(a) Physicians' services _______ ____________________ 29
(b) Hospital care ____ _____ __ ___ __ ___ _ _______
(Days of hospital care ________ 1,871)
15. Both physicians' services and hospital care for
sick infants paid for in single payment to
hospitals _______________ ------------------------------------------ 23
(Days of hospital care ______ 320)
16. Attending physicians' services for care of sick
infants paid for, but not hospital care________ 176
17. Hospital care for sick infants paid for, but not attending physicians' services ________________ 41
(Days of hospital care ____________1,021)
18. Consultation service ------------------------------- ___ ______ 36
19. Bedside nursing for care of sick infants
paid for ___ ------------------------------------------------- ___
1
20. Medical care for sick infants provided in clinics
but not included in items 14, 15, or 17 __________ 1
21. Drugs, ambulance, blood for transfusions,
travel of consultants, and all other services
for sick infants not included above ____
0
22. Immunizations of well infants ------------------------ 0
$29,013.21
16,979.13 3,858.28
13,120.85
1,604.15
2,185.58 6,067.07 1,184.00
532.50 22.00
Personnel
One of the greatest handicaps of the Division of Maternal and Child Health at the present time is the lack of medical personnel. The failure to recruit doctors has greatly handicapped the program. Not only do local health department personnel need supervision and guidance, but the medical service in our maternal and well child conferences is greatly in need of improvement. To improve the clinic services without additional medical assistance is impossible although we have endeavored to see that new conferences have some guidance when begun.
It is felt that the two greatest handicaps, at the present time,
Maternal and Child Health
145
in the development of a full scale maternal and child health program, are the shortage of local commissioners of health and the lack of sufficient number of consultant physicians in the central and regional offices to give proper technical supervision and aid in the development of the program, and to set up suitable programs of in-service training for commissioners of health and clinicians. A good program of in-service training is being developed for nurses, but we feel that unless this training is extended to all public health workers, the job will not be complete and the program will develop in a distorted manner.
Maternal ctnd Infant Care
During the year many doctors who were in Service, returned to resume work as clinicians in the maternal and child health conferences. Many new centers have been organized and many old centers reopened during 1947. During the year there were 67 maternal, 73 infant and 90 combined (maternal and infant) centers in operation in 92 counties of the State, and there has been an increase of 1941 maternal admissions and 3978 infant admissions, or an increase of 13o/a lind 27o/a respectively, over the same period last year. Also, there has been an increase of 23% in the number of prenatal visits and 45% in the number of infant visits to these centers.
MATERNAL HEALTH CENTER ACTIVITIES
Prenatal Admissions Admissions, total ------------------------------------
White -----------------------------------------------------Negro -----------------------------------------------------Period gestation, total ---------------------------Under 16 weeks -----------------------------------16-27 weeks --------------------------------------------
28-36 weeks -------------------------------------------Over 36 weeks ----------------------------------------
Prenatal Syphilis Reports, total -------------------------------------------White -----------------------------------------------------Negro ----------------------------------------------------- Number positive, total ---------------------------White --------------------------Negro ------------------------------------------------------
Prenatal Ac-tivities Visits, total -----------------------------------------------
White ----------------------------------------------------- Negro ----------------------------------------------------Transferred, total ------------------------------------
Postnatal Activities Admissions, total -------------------------------------White -----------------------------------------------------Negro -----------------------------------------------------Visits, total ---------------------------------------------White -----------------------------------------------------Negro ------------------------------------------------------
1946
14,776 1,248 13,528 14,776 4,052 7,201 3,052
471
10,744 895
9,849 1,027
37 990
44,711 3,824
40,887 465
3,225 229
2,896 3,873
426 3,447
%plus 1947 or minus
16,717 1,612 15,105 16,717 4,307 8,247 3,591
572
+ 13
++
29 12
+ 13
+6
+ 15
+ 18
+ 21
11,155
969 10,186
1,298 43
1,255
+4
+8
++
3 26
+ 16
+ 27
55,113 6,114
48,999 418
+ 23 + 60 + 20
10
3,461 479
2,982 4,393
689 3,704
+7
+109
+3
++
13 62
+7
146
Georgia Depa1tment of Public Health
"See your do ctor ear ly" is basic maternal and child health t eaching.
MATERNAL AND CHILD HEALTH CENTERS REPORTING TO THIS OFFICE, 1947
Nursing Connties Sponsoring MCH Centers
Maternal Centers
Infant Cente1s
Combined Cente r s
34
16
6
34
Organized Counties Sponsoring MCH Centers
58
Total
92
51
67
56
67
73
90
MateTnal and Child Health
147
INFANT HEALTH CENTER ACTIVITIES
Admissions-Infant and Preschool
Admissions, total _ White ____________________________________________________ Negro _______________________________
Age Groups, total ____________________________________
Under 4 months -----------------------------------4-12 months _________________________________ 1-5 years __________________________
Visits and Activities
Visits, total _ White _________________ Negro _______________ ________________________________
Referred Cases _______________________________________
1946
o/o plus 1947 o1 minus
14,822 5,142 9,680 14,822 5,566 3,985 5,271
18,800 7,493
11,779 18,800
6,869 5,276 6,955
+ 27 + 46 + 22 + 27 + 23 + 32 + 32
38,003 13,387 24,616
1,286
55,179 19,826 35,353
1,384
+ 45 + 48 + 44 +8
Much new equipment has been sent to the maternal and child health centers. The availability of these supplies since the war has made it possible to replace the broken and worn equipment in these centers. Audiometers, slide projectors and vision and hearing testing machines have been placed in the six regional health offices for use in the schools. Local health organizations in each region have access to these machines.
The laboratory of the Georgia Department of Public Health has been equipped to do Rh factor testing and blood group determinations on prenatals. Since this service began, February 1, 1947, 29,744 specimens have been examined. Of this number there were 4,668 negative specimens.
With careful planning of the maternal and child health program there has been a gradual reduction in premature deaths in the past few years. In 1946 premature deaths per 1,000 live births were 12.1 as compared with 15.2 for 1942.
The table below shows infant mortality and deaths in children from one to four years of age for 1937 and 1946. There has been 1t marked decrease in the past ten years in the death rate of children in this age group from all causes except deaths from measles and congenital malformations. We may account for deaths from congenital malformations by the fact that recently greater emphasis has been placed upon the reporting of deaths from this cause than in the past. The increase in number of tleaths from measles may be explained by the fact that 1946 was an epidemic year for this disease.
148
Georgict De1Jartment of Public Health
Maternal and Child Health
149
NUMBER OF DEATHS AND RATES PER 100,000 OF THE AGE GROUP 1-4 YEARS BY CAUSE OF DEATH FOR 1937 AND 1946
Cause of Death
1937 Deaths Rates
1946 Deaths Rates
All Causes -----------------------------------------Measles -----------------------------------------------WDihpohotphienrgiaC__o_u_g_h__--_--_--_--_--_-_--_--_--_--_--_--_--_-_--_---_-
Influenza ---------------------------------------------Dysentery -------------------------------------------Poliomyelitis -------------------------------------Men. Meningitis---------------------------------Tuberculosis ---------------------------------------Pneumonia _ --------------------------------------Diarrhea & Enteritis -----------------------Scarlet Fever -------------------------------------Tetanus -----------------------------------------------Syphilis -----------------------------------------------Congenital Malformations ______________
1122 3
L!7
70 71 26
8 10 25 217 195
6
2 4
9
414.35 1.10
17.35
25.85 26.22
9.60 2.95
3.69 9.23
80.13 72.01
2.21
.73 1.47
3.32
559 220.84
18
7.11
19
7.50
31
12.24
27
10.66
2
.79
5
1.97
8
3.16
14
5.53
82
32.39
23
9.08
1
.39
2
.79
2
.79
19
7.50
INFANT MORTALITY WITH RATES PER 1,000 LIVE BIRTHS IN 1937 AND 1946
Infant Mortality --------------------------------
1937 Deaths Rates
3968
62.00
1946 Deaths Rates
3068
35.80
Medical
As in the past, scholarships were offered health officers and clinicians who served in the maternal and child health centers in 1947. There were 12 physicians who attended the Southern Pediatric Seminar at Saluda, N. C. Fifteen physicians attended the Obstetric Seminar at the University of Georgia School of Medicine, Augusta, Georgia. This Seminar was held in Georgia for the first time. It was sponsored by the University School of Medicine in cooperation with the Georgia Department of Public Health and the South Carolina Department of Health. A great deal of interest was shown by the physicians attending. It is hoped that next year the Seminar may be enlarged to include Florida physicians in the participation. The tuition for one week's study was $25.00.
Some of the more important health educational activities participated in by the director of the Division were as follows:
150
Georgia Department of Public Health
Conferences:
Academy of Pediatrics Survey Nutrition Unit, U. S. Public Health Service U. S. Children's Bureau
Disr.ecct.or of Maternal and Child Health Division, Columbia,
Joint Health Education meeting, twice a month Departments of Education and Crippled Children's Division Professor of Obstetrics of the University of Georgia School
of Medicine Chairman of the Committee on maternal mortality and in-
fant deaths Dr. Arney Chappell, Contraceptive Clinic, Grady Hospital,
Atlanta
Meetings Attended:
Convention of the Medical Association of Georgia Obstetric Seminar, University of Ga. School of Medicine,
Augusta, Ga. State and Territorial Health Officers Meeting Meeting of Maternal and Child Health Association American Public Health Association State Nutrition Committee Refresher course on Infantile Paralysis at the Knicker-
bocker Hospital in New York
Meetings Addressed :
Public Health course at University of Ga. School of Medicine Lyons Club, LaGrange, Georgia Ben Hill School, Ben Hill, Georgia Dental Students Inman Park Methodist Church, Atlanta, Georgia Radio Congress of Parents and Teachers, Mansfield, Georgia University of Georgia School of Medicine Emory University School of Dentistry
Fellowship Grant:
Six weeks traveling fellowship granted by Rockefeller Foundation to observe maternal and child health activities in hospitals, health centers and health departments at the following places:
1. South Carolina, to observe maternal and child health program.
2. Maryland, medical care program for indigent. 3. Johns Hopkins, premature training program. 4. Harvard School of Public Health, to confer with Dr. Harold
Stuart in regard to some proposed work in Georgia on toxemia of pregnancy.
Maternal and Child Health
151
5. Chicago Maternity Center.
6. Minnesota Health Department, premature program.
7. New Mexico Health Department, especially, to see the nursemidwife program.
8. Texas State Department of Public Health, to observe the maternal and child health program.
Midwives:
The number of midwives continues to decline, as it has for the past several years. There were only 1634 midwives certified in 1947 as against 3171 ten years ago. Midwives delivered only
21 o/a babies in 1947 as against 37.9% in 1937.
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 with better opportunities extended the colored individual, and with increased educational facilities, midwifery does not have the appeal to the individual that it formerly did. Patients 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 the 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 take 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.
Nurse-Midwife Program
Georgia at present has two Nurse-Midwife demonstrations. One is a hospital delivery service connected with a county hospital, the other is a home delivery service.
The Nurse-Midwife Service in Walton County was begun January 7, 1947. The two nurse-midwives have rendered the following services to that county during the year:
1. Assisted the doctors with the labor and delivery of 303 private cases.
2. Delivered 64 cases on the Nurse-Midwife Program. 3. Made a total of 86 hospital prenatal visits. 4. Made a total of 958 hospital postpartum visits. 5. The nurse-midwives have spent a total of 2855 hours on
duty at the hospital. 6. Made a total of 166 home visits to prenatal cases.
152
Georgia Department of Public Health
7. Made a total of 275 home visits to postpartum cases.
8. Assisted with 36 prenatal clinics with a total attendance of 595 prenatals.
The local midwife deliveries in this county have decreased from 165 in 1946 to 98 this year. The number of deliveries in the hospital has increased and the number of visits per patient has increased both in the clinic and the home.
The Nurse-Midwife Service in Thomas County was begun June 19, 1947 with two Nurse-Midwives. This is a home delivery service. From July to January 1st, they delivered 15 cases on the Nurse-Midwife Program. The other services are quite different from that in Walton County. Instead of assisting with only one prenatal conference in the county per week, they have from 14 to 16 per month. These clinics increased from a monthly attendance of 125 to 196. In the supervision of the local midwife, they made 135 home visits to postpartum cases. They made 82 visits to prenatals and 81 postpartum visits to nurse-midwife cases.
Each service has done obstetrical summaries on the patients attending prenatal clinics. This total is approximately 2500 and enables the obstetrical history of the patient to be reviewed at a glance without searching through many records.
It is anticipated that this Nurse-Midwife Service will be established in 1948 in connection with a maternity home demonstration. Equipment has been purchased to be used in this home.
The major activities, January through June, of the MCH Consultant, Miss Mitchell, were relative to the Nurse-Midwife Program beginning in Georgia. Her time was largely given over to being on the ground floor for organization and development of these services in Walton and Thomas Counties.
1. Standing orders and policies written and approved.
2. A standard nurse-midwife general bag and delivery bag was set up.
3. Conferences were held with hospital board, medical societies.
4. Speeches regarding nurse-midwife program: Rotary Club, Kiwanis Clubs, Junior Service Leagues and Women's Medical Club.
5. Discussions with individual physicians, county officials, etc.
6. Personnel: If the nurse-midwives have not been trained in Georgia, they receive a month's orientation to the State before they are assigned to the position. Three nurse-midwives had this orientation which included visits to Rapid Treatment Center (Alto), T. B. Center (Battey), the State Hospital for Mental Patients at Milledgeville for the study of Psychosis associated with pregnancy, state office statistical department, three county health departments,
Muternul und Child H eulth
153
and conferences with laboratory and other divisional heads. Each nurse-midwife has expressed great appreciation for this orientation in adopting her previous experiences to Georgia.
Report of Consultant Nurses
In-service education on maternal and child health has received considerable emphasis. A two weeks maternity and child health work conference will be held at Emory University early in 1948 and will be sponsored by the Georgia League of Nursing Education, State Health Department and Emory University. Supervisors in schools of nursing and supervisory public health personnel will be invited.
Enrichment of midwife instruction has been encouraged through demonstration and instruction of the staff nurse in regional staff conferences.
A monthly news letter about pertinent maternal or child health problems has been sent to each public health nurse.
The number of hospitals visited for the purpose of inspection for EMIC approval has decidedly decreased.
A number of visits to larger hospitals for teaching and demonstrating the use of the incubator in the care of the premature was the entree for surveys of obstetrical and pediatric depart- . ments. A coordinated type of service between hospital and local health departments was stressed. An extensive patientinstruction service is being started in the maternity department at Emory.
One of the MCH Consultants has been on educational leave taking post-graduate work in Pediatrics at Columbia University in New York City since September.
Nutrition Consultant
The place of nutrition in a public health program is only now beginning to be recognized. It is a basic part of almost every phase of public health work.
The extent of malnutrition in Georgia can only be estimated for there are few accurate figures on the nutritional status of the population. It is well known that gross, easily recognized deficiency states such as pallagra, beri-beri and scurvy are not common. It is also well known that the subclinical states of malnutrition are much too prevalent.
The hemoglobin level is generally considered a fair index of the nutritional status of' the individual. If this is conceded to be true we can say that the majority of the people studied in the state are not well nourished.
154
Georgia Department of Public Health
In 1945 hemoglobin readings were made on over 3,500 school children in Georgia. Of this number 8 '?/a had readings of 14.5 gms. or more. At the same time similar readings were made in other states. In one of these states 31 '?/a of the children had hemoglobin levels of 14.5 gms. or over, in another state 36'?/a of the children studied had readings that high.
In 1946 hemoglobin readings were made on the population of an entire village in Georgia. The median for males was 12.7 gms. and for females 11.7 gms.
In 1947 in one county in Georgia hemoglobin readings were made on 141 pregnant women. These readings were as follows:
Hb. in gms. per 100 cc blood
No. of Women
13 or over ------------------------------------------------------------ 5 10.1 - 12.9 -------------------------------------------------------------- 38 10 or under ---------------------------------------------------------- 98
The lowest reading was 5 gms. and the highest 14 gms.
In September, 1947, hemoglobin readings were made on several hundred volunteers in Atlanta. Most of these were white people and the ages ranged from under 10 years to over 70 years of age. These readings follow:
Hb. Readings
No. Males No. Females
~~f~r1g:-~~:__:::::::::::::::::::::::::::::::::::::::::::: ~
10.1- 11 ------------------------------------------------------ 7 11.1 - 12 ------------------------------------------------------ 48 12.1 - 13 ------------------------------------------------------ 59 13.1 - 14 ------------------------------------------------------ 125 14.1 - 15 ------------------------------------------------------ 67 15.1- 16 ------------------------------------------------------ 13
16+ -------------------------------------------------------------- 7
-
These studies are typical of others made in the state.
10 13
5.9 167 104
38
6 3 7
A study of food consumption is another method of judging the nutritional status of people. Carefully checked studies on the food eaten by school children in various sections of the state show very poor food habits.
In one county dietary studies were made on 1,367 school chil-
dren. Of this number only 16o/a scored as having adequate or good diets. In one school in another county out of 97 pupils only one had a score of adequate or good. In another county in one school of 98 pupils none rated adequ,ate or good.
There are morbidity and mortality rates in other conditions in which nutrition may be either a major or minor factor. In 1946
~ R.,....
~
~.,....
R ...(J
{::!"
.,....
R..
::t::
~
R ~ {::!"
f-l Ol Ol
Teachers lea1n to conduct animal feeding experiments to show the effect on growth of good and poor lunches.
156
Georgia Department of Public Health
there were 93 deaths from pellagra in Georgia. Dr. W. H. Sebrell of the U. S. Public Health Service estimates that pellagra deaths
are 3 o/o of the total number of clearly recognizable pellagra cases.
If we use this figure that means we had 3,100 definitely defined pellagra cases in the state that year.
Many authorities consider tuberculosis very largely a nutritional disease. To what extent this is true is certainly questionable but undoubtedly nutrition does play a part in the prevention and treatment of tuberculosis. In 1946 there were 1,048 deaths from tuberculosis reported.
More and more studies are showing the relationship between nutrition and maternal deaths, infant deaths, stillbirths and congenital defects. No one can say the exact number of such deaths and defects attributable to diet but they must be large. In 1946 in Georgia there were 229 maternal deaths, 3,068 infant deaths and 2,241 stillbirths. Also reported were 557 infants born with various deformities.
Poor diets are due to a number of factors, the major ones of which are lack of knowledge, lack of interest and inadequate income. The greatest handicap is lack of interest or poor eating habits. Many people who can afford to buy adequate food and who know what they should eat have poor diets through lack of interest. The nutritionists in the Health Department have to work on these factors. They try to teach the foods that make an adequate diet and to stimulate an interest so people will want to eat right foods. They also give advice on food buying so families may have the needed food on limited budgets.
Recognizing these facts during the year 1947, the nutrition staff was increased from one to eight workers. Nutrition consultants were placed in five of the regional offices. One, who is in school completing her graduate work in community nutrition, will be placed in the other regional office in 1948. One nutritionist was employed to work with a nutrition survey team and another to work with industries and institutions. The nutrition consultant in the state office supervises the technical phases of the program carried on by the other nutrition workers.
The work of the regional nutrition consultants is carried on through the local health departments. Staff training in nutrition is one of the most important phases of this work. This staff training is conducted by the nutritionists participating in staff conferences, by consultation with individual staff members and by working with patients along with health department personnel. The work with patients is done either in clinics or in home visits. The nutritionists work in prenatal clinics, child health conferences, tuberculosis clinics, and clinics for crippled children. Work in schools is one part of the nutrition services rendered. The nutritionists attend county and district educational meetings to stimulate interest in nutrition education as a part of the regu-
JI!IateTnal and Child Health
157
lar school program. Intensive nutrition-health education programs have been carried on in a limited number of schools. In one county this was done on a county wide basis. In this county the work was started in 1946 and is to be continued as a regular part of the school work in that county. The nutritionists have participated in state and county workshops in nutrition-health education and in workshops for school lunch managers. They have met with a limited number of college groups. These groups consisted of medical students, student nurses, student dietitians, and student teachers.
The nutritionists are working with mid-wife groups to teach them the fundamentals of prenatal diets. The midwives have much to do with the health of the women they serve and they can play an important part in teaching these women to eat correctly during the prenatal and nursing periods. The information given is very simple and is adapted to the needs of this group.
It is realized that demonstration teaching is the most effective method with most groups. For this reason simple, practical food demonstrations have been outlined for use with mothers' groups. These demonstrations are given as part of the mothers' classes in connection with prenatal clinics and in well baby conferences. The demonstrations being used are on green leafy vegetables, potatoes, other vegetables, fruits and fruit juices, eggs, lean meats, dried skim milk, fish and cereals. In one region nine counties are now conducting these demonstrations. The other regions have a lesser number.
The nutritionists help to coordinate the nutrition teaching of the health department with that done by other agencies. They also help other agencies with the nutrition phases of their respective programs. They have helped to stimulate the activities of local nutrition committees.
The industrial nutritionist came on the staff December 19, 1947. This does not allow sufficient time to have much to report in the way of accomplishments in this phase of the program. This worker is available to help plan and improve feeding facilities in industries and in institutions.
The work of the nutrition survey team is a cooperative project with the United States Public Health Service and Georgia Department of Public Health. The purposes of this work are to learn more of the actual nutritive conditions of population groups, to test methods of improving conditions when this is indicated and to use this information as a basis for educational work on nutrition. It has been found that the mere taking of a nutrition survey acts as a stimulus to improve dietary habits.
The survey team is made up of a medical officer especially trained in nutrition, a biochemist, a technician, a nutritionist, a nurse and a clerk. The nutritionist with the survey team will
158
Georgia Department of Public Health
take dietary histories and give recommendations on diets to the individuals who are being studied in the group selected.
Health Education
Most of the educational materials are prepared in the state office. During 1947 these consisted of a growth graph for use in schools, a mimeographed pamphlet "Getting the Most for Your Food Dollar," two radio broadcasts, a mimeographed leaflet, "Food Helps for Anemia," additional food demonstration outlines and recipes for distribution at the demonstrations, regular monthly articles for Geo-rgia's Health and seven sets of five slides each on prenatal diets. Help was given in preparing exhibits for a Seminar in Obstetrics, a Chamber of Commerce Health Week exhibit, one for the Restaurant and Hotel Association, several fairs and club meetings. Sets of food value sticks were prepared for each regional office and two for loan. Copies of "Nutrition for You" were purchased for distribution. A search was made for good nutrition films and four new ones were purchased. A light weight movie projector was secured and slide projectors were purchased for the state and each regional office.
The work has been focused upon the preparation of educational materials which would motivate mothers to put protective health habits into practice for themselves and their children. The work has been presented through channels by which lay persons might best be reached according to their educational levels.
VISUAL EDUCATIONAL MATERIALS
National Public Health Nursing Week, April 20-26, 1947: As a part of the observance of the week, a window emphasizing the high incidence of prematurity in Georgia, and the cooperative work being carried on by the Maternal and Child Health Division and Public Health Nurses to lower this death rate, was set up in the window loaned by the Atlanta Gas Light Company.
Junior Chamber of Commerce Health Week, September 14-20, 1947: A nutrition exhibit was prepared for the annual Health Week for the Atlanta Junior Chamber of Commerce, held at the Belle Isle Building. To further point out the relation between nutrition and health, a U. S. Public Health Service bio-chemist made free hemoglobin readings. Volunteers from the Fulton County Medical Auxiliary acted as his aids. The nutrition consultant prepared a leaflet on the right foods to prevent anemia, to be given to persons along with their hemoglobin readings. Readings made on 959 persons, whose ages ranged from 5 to 70 years, showed generally low levels.
Georgia Restaurant Association: The nutrition exhibit used for the Junior Chamber of Commerce Health Week was loaned
Maternal and Child Health
159
to the Georgia Restaurant Association for their 2-day convention at the Atlanta Municipal Auditorium. A regional nutritionist was in charge of the booth to answer questions.
Dade County Fair: The nutrition exhibit, prepared for the Junior Chamber of Commerce Health Week, was loaned for the annual Dade County Fair.
Made in Georgia Exposition, October 8-9-10-11-12, 1947, Atlanta Municipal Auditorium: An exhibit dramatizing some of the programs of the State Department of Health to better the health of the people of Georgia, was prepared for Taft Hall
which had been set aside for various departments of the state:
Henry County Fair: An exhibit, stressing the economic value of good health, was prepared for the Tri-County Kiwanis Club, sponsors of passage of the Ellis Health Law, to use at the Henry
County Fair. The Ellis Health Law was voted upon and passed subsequently.
Exhibit Case for State Capitol: An exhibit of twelve color pictures, made in Health Centers over the State, showing various
phases of the Maternal and Child Health Program to better the health of mothers and children, was prepared for the State Capitol.
Peters: Posters which may be suitable for Maternal and Child Health use have been ordered for reviewing. Some have
arrived. Some of the suitable ones have been given to health centers. The approved posters will be ordered in quantity. Where needed, health slogans which apply to Georgia problems will be
added before the posters are sent to the health centers. Help has been given in planning and preparing numerous posters for staff members.
Mother and Baby Book: Pictures for the revised Georgia Baby and Maternal Care Pamphlets which are to be combined and published as the "Georgia Mother and Baby Book" have been
made. Each picture, except the cover, tells the reader how to handle a specific phase of prenatal or child care. The book has been edited and is being made ready for the printer.
Writing, Editing: Help has been given staff members on speeches, radio talks and news releases.
This Is the Fig bush Family: A lay booklet on immunization,
written and published by the Division.
Films: Because of the wartime film shortage and the lack of personnel for reviewing, many Maternal and Child Health films had been kept on the active list long past their usefulness. These have been reviewed and a number, no longer useful as teaching devices, have been recommended for discard.
Cooperation with other Agencies: Work Conferences have been held with staff, other agencies, and lay persons.
160
Gemgia Depar-tment of Public Health
Cmwfor-d Long Pr-ematur-e Tmining Pr-ogmm
One of the most promising programs begun in 1947 was the planning for a training center for nurses in the care of the premature infant at Crawford Long Hospital. An advisory committee composed of two representatives from Crawford Long, two from the Health Department, one from the City Health Department, and one pediatrician from the medical staff. This meets monthly. Three supervisors have been sent away for training on scholarships from the Health Department. When the school is begun, it will answer a great need in our state.
Mater-nity Home, Rabun County
The Maternity Home in Rabun County, which was begun in 1943, has continued to enjoy its community popularity. Three hundred and seventy-three patients were admitted to the antipartum service, and 379 deliveries were done.
There is not a graduate nurse at the maternity home at the present time but the local health department and the ordinary for the county have indicated they desire to have a graduate nurse there. Supervision is still being given by the public health nurse in the local health department.
Division of Public Health Education
C. D. BOWDOIN, M. D. _____________ ________________________________ Acting Director
MAYOLA S. CENTER----------------------------------------- ______ Assistant Director LYN KEYES ________________________________________________________________ Field Exec~dive GEORGE M. STENHOUSE ________________________ Public Relations Consultant DOROTHY I. URY ________________________________________ Negro Health Educator KATHLEEN M. BARRON ________________________________________________________ Librarian IRENE J. SLAUGHTER _______________________________________________________________ Artist FRANCES S. RIDGWAY ______________________________________________ Editorial Writer
Division of Public llealth Education
The Division of Public Health Education has long felt the need for expansion. Public Health activities during the war focused attention on this valuable phase of living. In order that this interest may be maintained and public understanding improved, the Division has increased its services and added to its personnel during the past annual period. In keeping with a basic precept of the State Department of Public Health, the Division has endeavored to carry on its continuing and added services as much as possible through the regional and local health organizations, rather than rendering direct services to the public.
Health Education is a continuing and well balanced education program, which has for its goal the improvement of human living. Its functions are to instruct the people of the community -men, women, and children-in matters of personal hygiene, to keep them informed about specific health problems, to create an understanding public support for the community health program, and to so stimulate individuals that they will translate recognized health practices into terms of action.
No one individual or division can satisfy the educational needs for such a program. In the State Department of Health, these needs are met by staffs from the various divisions with activities coordinated by the Division of Public Health Education.
To the ends indicated above, the progress of the Division during the past year may be traced along three broad lines : (1) The provision 'of informational services through the preparation, purchase, and distribution of educational materials for lay and professional consumption in cooperation with other Divisions. (2) Addition and training of health education personnel. (3) Furtherance and expansion of the school-community health project for the promotion of positive health through health education.
lnjoTmational Services
I. VISUAL EDUCATION SERVICES
ATt SeTvices-Increasing requests from the various Divisions for art services made it advisable to employ a full time artist in addition to the continued services of a part-time artist. These services consisted largely of poster designing, sketching and lay-out work for pamphlets and bulletins, worldng out suggested ideas for exhibits and displays, cartoons, and related media.
Film SeTvices-During the past annual period, the film library was augmented by the purchase of six new films.
164
Georgia Department of Public Health
TABLE NO. I NEW FILMS ADDED DURING 1947
Subject
Title
Type of Film
Nutrition Two Little Rats and How they GrewLay
Nutrition Modern Nutrition
Professional
Nutrition Magic Food
Lay
Nutrition Making Good Food Better
Lay
Sanitation A Dishwasher Named Red
Lay
Communicable
Disease Hookworm (three prints)
Lay
Because of damage to some of the more popular and more frequently used films, three duplicate prints were purchased and fourteen usable prints were repaired. At the close of the year, the Division's motion picture library contained 151 sixteen milliameter motion pictures on popular and technical health topics. One hundred and seventeen were sound, thirty-five were in color, and sixteen were animated. For each health subject treated in motion pictures, there were from one to six duplicate prints on hand. With this supply, it was not always possible to comply with all requests.
TABLE NO. II
REPORTED MONTHLY USE OF FILMS FOR 1947
Month
No. Different No. Times Estimated Films Shown Shown Attendance
January ---------------------------------------- 50 February -------------------------------------- 42 March-------------------------------------------- 42 April --------------------------- ________________ 61
May ---------------------------------------------- 49 June ---------------------------------------------- 41 July ---------------------------------------------- 44 August ------------------------------------------ 26 September ------------------------------------ 14 October ---------------------------------------- 34 November ------------------------------------ 24 December ------------------------------------ 24
Totals ---------------------------------------- 451
143 102 119 110 121 122 235 47 30 88 101
78
1,296
22,817 11,163 18,276 16,256 11,203 11,249
5,569 2,075 3,402 5,834 5,061 5,071
117,976
Public Health Education
165
TABLE NO. III A COMPARISON OF FILM USAGE FOR 1946 AND 1947
Yea1
No. Different No. Times Films Estimated Films Shown Were Shown Attendance
1946 -------------------------------------- 402 1947 -------------------------------------- 451
1,114 1,296
102,637 117,976
The Division has a small library of twenty-five filmstrips consisting of a limited number of health subjects. Because of the increased number of requests during the year, plans were made to expand this service. All Divisions were asked to submit subject recommendations and numerous agencies producing and distributing filmstrips were contacted and their films previewed.
II. PUBLICATIONS
Free Materials Bu1eau-During the past year 247,730 health education circulars were distributed free of charge by the Division in answer to requests for information from individuals, professional, and lay groups. During the previous year, the distribution totaled 226,414. The increased demand probably resulted from greater development of community health education activities, by local education and health departments. The following table shows the monthly distribution of materials.
TABLE NO. IV
MONTHLY DISTRIBUTION OF PUBLICATIONS FoR 1947
Month
N~tmber
Distributed
January ---------------------------------------------------------------------------------- 34,297 February -------------------------------------------------------------------- ___________ 18,092
March ------------------------------------------------------------------------------------ 21,781 April __________________________ ---------------- -------------------------------------------- 15,50L!
JMuany-e---_-_-_-_-_-_-_-__-_-_-_--_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__--_-_-__-_-_--_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_--_-_-_-__-_-_-_-_-_-_-_---_-_-_-_-_-_-_-_
15,152 23,095
July ---------------------------------------------------------------------------------------- 12,533 August ------------------------------------ ______ --------------------------------------- 12,351
S.eptember ------------------------------------------------------------------------------ 27,851
October ---------------------------------------------------------------------------------- 28,833 November __ --------------------------------- ---------------------------------------- 22,495
December ------------------------------------------------------------------------------ 15,746
Total
247,730
166
Georgia DepaTbnent of Public Health
Production of MateTials-An unprecedented demand for the publications distributed by the Division forced many subjects out of print. The need arose for preparation of new materials and the revision of old publications. Due to the lack of sufficient properly trained personnel, this work did not progress as rapidly as desired. Despite these difficulties, twelve new titles were added and two publications were revised.
SUMMARY OF PUBLICATIONS ADDED AND REVISED IN
1947
Publications produced by the State Department of Public Health:
1. The Management of Syphilis in General Practice-A summary of current methods of treatment and diagnosis for physicians and health officers. The material is presented in a multi-colored index type folder and the information is based on a nation-wide research program conducted by the U. S. Public Health Service.
2. Listen-A brightly colored, four page leaflet depicting in a few simple words and sketches some of the pertinent facts about syphilis.
3. This is The Figbush Family-Mr., Mrs .. Donald and Nancy, and Their House-A small attractive bulletin of six pages, which tells in a direct manner some of the general health precautions which should be taken by parents of infants and young children.
4. Report of the Health-Nutrition Education Workshop-A 76page report of the organization and services of the third Health Education Workshop conducted by the College of Education, University of Georgia, Athens, Georgia, June 16 to August 1, 1947.
5. Frank Visits the Dentist-A twenty page beautifully illustrated booklet prepared by the Division of Dental Health Education as a reader for primary school children.
6. A series of five Book Marks in five different colors reminding children to care for their teeth and visit their dentist periodically.
Publications of Other Agencies:
1. Wilkins, Walter; French Boyd, Nutrition For You-A forty-eight page bulletin which gives the reasons for good eating habits in terms the layman can understand.
2. Gonorr-hea-Its Causes, Spread and Cure-Federal Security Agency, V. D. Folder No. 5. A five page leaflet released in June 1947.
Public Health Education
167
3. A series of Social Hygiene pamphlets distributed by the American Medical Association: Sex Education for the Preschool Chilcl, by Harold E. Jones, Ph.D., and Katherine Read, Sex Education jo1 the 10 Year Old, by M. Marjorie Bolles, Ph.D., Sex Education j01 the Adolescent, by George W. Corner and Carney Landis, and Sex Edncation j01 the Woman at Menopause, by Carl G. Hartman, Ph.D.
Publications Revised:
The catalog of available health publications for free distribution and the list of free films loaned by the State Department of Public Health were revised and enlarged.
Ill. PUBLIC HEALTH LIBRARY
Expanded activities in the Department of Public Health as a whole have been reflected in a correspondingly greater demand for library service. Public health workers in the field are becoming increasingly aware of the service which the library can render. Physicians, dentists, nurses, students and teachers, professional workers in related fields, and others interested in promoting the health and welfare of the people, are available themselves in greater numbers of library materials and reference aid.
Users of the library in 1947, other than official public health workers in the state, include personnel from the following institutions or organizations; other State Departments, the Georgia State Nurses' Association, Grady Hospital, Crawford Long Hospital, Emory University, Georgia School of Technology, the University of Georgia, Atlanta University, the Communicable Disease Center, Lawson Veterans' Administration Hospital, the Atlanta Junior Chamber of Commerce, and many of the public schools in Atlanta and in Fulton and DeKalb Counties.
Resources of the library have been limited by lack of shelving space, and service has been curtailed in many instances by the fact that it is necessary to use the library as a conference room. The addition, during the year, of a double row of stack shelves has greatly relieved crowded shelving conditions, and it is hoped that the problem of additional space for the library may be worked out in 1948.
Through reciprocal agreements State Department of Public Health Library resources have been supplemented, when the need arose, by interlibrary loans made from the Atlanta Carnegie Library, the A. W. Calhoun Medical Library, the Communicable Disease Center Library, the University of Georgia Library and Emory University Library. Requested material, otherwise unavailable, is obtained through the microfilm service of the Army Medical Library.
The library staff consists of a librarian and an assistant. Miss Pearl Motley, who organized the library in 1940 and had admin-
168
Geo1gia Department of Public Health
istered it since that time, resigned her position as librarian in August, 1946, and Mrs. Kathleen M. Barron was appointed as librarian. Miss Mary Henderson is library assistant.
The book collection is decentralized to the extent that many of the Divisional Officers keep a number of books conveniently at hand on their shelves, and each of the Regional Offices and the Branch Laboratories has a small permanent deposit of books. These collections are added to from time to time and are supplemented by loans from the central library. All library books are cataloged in, and distributed from, the central library, and a union card catalog shows the location of each book. Lists of recently cataloged material are distributed periodically to all offices of the Department. In order to give the broadest possible service the mail is utilized freely in extending loans. Long-term loans of books and pamphlets are arranged as needed if the items concerned are not otherwise in demand. It has been found that elastic loan periods in an organization such as this are conductive to better use of materials, and losses resulting from this policy remain at a minimum.
The circulation total for books, 892 during the year, is, for reasons given above, not a true indication of their use. An instance of this is a loan of 50 books, made to the College of Education, University of Georgia, in June. These books were used for six weeks in a Health-Nutrition Education Workshop. In September a similar loan of books and journals was made to the Public Health Nursing Division for a workshop held at Warm Springs.
The periodicals continue to be the backbone of the collection in a library such as this where the need so often is for current information. The journals were used extensively during the past year, the circulation figure being 3,036. The number currently received is 254, 100 of them being received through paid subscription and 154 through gift or exchange. In return for the receipt of "Georgia's Health," this Department is placed on the mailing list of numerous state and regional bulletins. Through generous contributions of journals by Department personnel the library is able to accumulate a backlog of duplicate copies of some of the basic journals. These are loaned very freely while their usefulness is at its height, and, when storage of these duplicates becomes a problem, they are given to other libraries to fill gaps in their files. Over 100 such journals were given to Lawson Veterans' Administration Hospital Library and to the Communicable Disease Center Library in 1947.
It is, perhaps, somewhat surprising that 850 of the 2,548 requests for reference aid during the year (approximately 1/3) came from outside the Department. Every effort is made to supply the desired information when the inquiry appears to spring from a legitimate need. Bibliographies are prepared upon re-
Public Health Education
169
quest. The library periodically receives such reference aids as the Quarterly Cumulative Index Medicus, the Current List of Medical Literature, Health Articles of the Week, and the Social Legislation Information Service bulletin. Useful additions to the reference collection recently have been a Microfilm Reader and the 1946 edition of the Encyclopedia Americana.
Accessions for the year 1947 numbered 450, bringing the total number of accessioned items to 8,612. Some out-of-date and useless material has been discarded, but there is a need for further weeding out of deadwood. Major projects for 1948, and succeeding years, include working toward a well-rounded, live, and more functional book collection, and better coordination of the central library and its branches.
STATISTICAL REPORT 1947 INVENTORY
No. Vols.
1. BooIkns,mCalianssilfiiberdar--y--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_---1--,-8--7--3-
In divisional offices ------------------------------------ 785 In regional offices -------------------------------------- 398 In branch laboratories ------------------------------ 75 2. Books, Law-------------------------------------------------------------------3. Journals, Bound (56 titles) ----------------------------------------
3,131
240 767
Total
4. Pamphlets and Ephemeral Materials,approximately
5. Periodicals Currently Received -------------------------------By subscription ------------------------------------------ 100 By gift or exchange ------------------------------------ 154
5,250 254
ACTIVITIES
Total
1. Books and Pamphlets Cataloged ___:_________ _ 450 2. Circulation -------------------------------------------------- 4,254
Books ---------------------------------------- 892 Journals ------------------------------------ 3,036 Pamphlets -------------------------------- 326 3. Reference Calls Answered ------------------------ 2,548 Inside Department __________________ 1,698 Outside Department ________________ 850 4. Attendance-------------------------------------------------- 4,645
Mo. Average
38 355
212
387
Personnel Additions and Training Additions to the Division Staff-In an effort to increase con-
170
Georgia Department of Public Health
sultant services in the field, to coordinate the Health Education activities of the various Divisions in the Health Department, as well as to establish liason services with the State Department of Education, a Public Health Educator was added to the staff in June. A Negro Health Educator was also added to the staff at this time to work under the direction of the Georgia Joint Committee for Health Education for the promotion and coordination of Negro Health Education in school-community projects. The services of a full-time artist were added to the Division in November.
Training of Personnel-Two Health Educators were added to the staff of the Northwestern and Southwestern Regional Health Departments in December. Orientation and terminal training was given these two workers through consultive field visits and regularly planned conferences at the Division's office in Atlanta. It is felt that this procedure has worked to the mutual benfit of both the Division and the individual.
Various conferences attended by the members of the Division staff included the Annual Meeting of the Georgia Public Health Association, the Southern States Work Conference on Educational Problems, the Annual Meeting of the American Public Health Association, the Annual Meeting of the American Association for Health, Physical Education and Recreation, the annual Georgia Teachers Education Conference, District and Annual Meetings of the Georgia Education Association and the State and National Annual Convention of the National Congress of Parents and Teachers.
The Division of Public Health Education also cooperated with the University of Georgia in arranging for personnel of the State Department of Public Health to serve as part of the staff for the summer Health Education Workshop in Athens, June 16 through August 1, 1947.
School Comm~mity Health Program
The program for the promotion of school-community health education in Georgia continued to be one of the major activities of the Division of Public Health Education. Since its inception, through a grant-in-aid from the Kellogg Foundation in June 1945, the Georgia Joint Committee for Health Education has guided numerous activities designed to bring about increased understanding and a closer working relationship between the State Department of Public Health, the State Department of Education and the University System on problems of schoolcommunity health. This committee, composed of representatives from these three agencies, continued to direct the health education activities in the four experimental counties. The election of the Director of the Division to the Chairmanship of the Joint Committee in August brought many of its problems, needs and
Public Health E clucation
171
activities into sharper focus for the entire personnel of the Division.
Because the grant-in-aid was almost terminated and believing that such a demonstrated, worthwhile program should be maintained in Georgia, the State Departments of Education and Health pooled their resources in order that the Committee might continue its activities. As a result of a constant demand from workers in all parts of the State who are anxious to expand their school-community health education activities, the Joint Committee decided in July to work with the entire State. Realizing that such an expansion would require additional personnel and services, the Division of Public Health Education immediately added a Negro Health Educator to its staff and assigned her to work full time under the direction of the Committee. The parttime services of the Division's Field Executive were also made available to the Committee.
Health Education Workshops-As an added means of expanding the experimental school-community health program, scholarships to the third health education workshop were made available to selected and recommended school personnel from the entire State. This workshop was sponsored by the Joint Committee for Health Education and the Nutrition Education Advisory Committee and was conducted by the College of Education, University of Georgia, Athens, June 16 through August 1. Personnel from the Division of Public Health Education and other Divisions of the State Department of Public Health served as staff and consultants for this workshop. A report of the workshop was published by the Division of Public Health Education, under the direction of the Joint Committee for Health Education.
Personnel from the Division rendered consultant services to a Health Education Workshop for Negro teachers held concurrently at Atlanta University. Staff members of the Division also worked in close harmony with the many summer sessions in colleges and universities throughout the State and with the numerous generalized off-campus workshops.
Progress of the Joint Committee for Health Education-With the election of a new Chairman, the Director of the Division of Health Education, the Joint Committee also named a new Coordinator to replace the former, who resigned in June. In addition to working closer with participants of the 1947 workshops, the Joint Committee suggested that the Coordinator, the Negro Health Educator and the Division's Field Executive help whereever possible with requests from school and community groups interested in finding and working on their health problems. The Coordinator was also urged to discover people in the State who were qualified and available for field work in health education and to utilize their services in areas where they were employed.
Handicapped by the lack of trained leaders in health education
172
Georgia Department of Public Health
throughout the State, the Joint Committee was faced with the persistent problem of extending help to areas which the Coordinator and the consultants were unable, through lack of time, to reach. In an effort to alleviate this problem, the Joint Committee searched for some practical means of transmitting the understandings and techniques learned from the work in the experimental counties during the last two and one-half years to school people in other parts of the State.
A check list covering the various aspects of a functional health program was devised and distributed to selected schools in the State. This instrument was received with a considerable amount .of approval. The Committee plans its revision and subsequent publication. As another means of helping teachers with their school health problems, the Joint Committee has volunteered to sponsor the writing and publication of a teachers guide in Health Education.
Vision and Hearing Conservation Progrc~m
Plans for the establishment of a vision and hearing conservation program in the public schools are being worked out by the State Department of Education in cooperation with the Division of Public Health Education. As the first step toward the inauguration of this program, the Division of Maternal and Child Health was responsible for the placement of screening equipment in the six regional offices during the past year. Each Regional Office was supplied with two Massachusetts Vision Screening Kits, two Fading Number Group Phonographic Audiometers, and one Discreet Frequency Audiometer. This equipment was loaned free of charge to schools through local Health Departments or directly from the Regional Office to counties which had no public health organization.
Each Regional Office was responsible for scheduling the use of this screening equipment. The following policies regarding the use of these instruments were adapted:
1. The equipment will be used as a part of a local general health appraisal program and not as a special screening program per se.
2. Programs will be developed in cooperation with all health facilities of the community. It is recommended that county and local school health councils be developed to guide the program and aid in establishing'follow-up procedures.
3. Equipment should not be loaned unless plans have been made for adequate follow-up.
4. Vision and hearing screening will not normally be done by the nurse but by someone on the school faculty or a lay person whom the Regional or local Health Department is satisfied is properly trained in its us~.
~
a-
"~ ~"
~
(I>
..,,.......
t?:j
.~ ::
~
>=>
;0"N:;":o
.......
-:] ~
A school faculty tests one of the two audiometers supplied each of the six regional offices during the yenr.
Division of Preventable Diseases
C. D. BOWDOIN, M.D. __________________________Director and Epidemiologist WILLIAM J. MURPHY, M.D. ______ _________________________________ Cancer Control MAYOLA S. CENTER, CONSULTANT ____________________________Social Hygiene RoY J. BOSTON, M.S. ENG'R. --------------- __________ Typhus Fever Control C. D. BowDOIN, M.D. ____________________________ Venereal Disease Control
Division of Preventable Diseases
CANCER CONTROL SERVICE
The activities of the Georgia Cancer Control program continued to expand during the year. The number of state-aid patients receiving diagnostic and treatment services increased materially, two new clinics were approved and additional emphasis was given to physician and lay education.
The two new clinics which were approved during the year are located at St. Joseph's Infirmary, Atlanta and at the Little-Griffin Hospital, Valdosta. Both clinics had been operating for some time before making application for recognition as state-aid treatment centers. Both are well equipped and have excellent staffs. Approval of these clinics, effective as of January 1, 1948, brings to 15 the number of state-aid treatment centers.
Applications were received from 2,786 persons during the year, an increase of 496 (21.7 per cent) over the previous year. The increased number of applicants together with the crowded conclitions of the hospitals placed an added burden on the resources of the clinics. Nevertheless, it was possible to provide medical and hospital care for all patients who reported to the clinics although some delay was experienced in obtaining hospitalization in many instances. With very few exceptions, all emergency cases were hospitalized promptly.
Financial Aid
Financial aid was given to 2,893 patients during the year as compared with 2,360 during 1946, an increase of 533 (22.6 per cent). The sum of $161,442.03 was expended for diagnosis and treatment as compared with $116,321.32 in 1946.
The major portion (over 50 per cent) of the increase in the cost of the program in 19Ll7 may be explained on the basis of the increased patient load. The remainder was clue to an increase in the average cost per case. For malignant cases the average cost increased from $53.80 in 1946 to $61.92 in 1947 while in nonmalignant cases the cost increased from $36.36 to $40.18.
Most of the increase in the average cost per patient was clue to the change in the per diem rate for hospital board which went into effect on October 1, 1946. The new rate increased the cost of hospitalization by about one dollar per hospital clay. However, a slight increase in the average period of hospitalization (less than one-half clay per patient) also contributed to the increased cost per patient.
In table I is shown a break-clown of the expenditures in 1947 by clinics according to the type of service rendered. Approximately two-thirds of the total cost of the program is accounted
~
--=! 00
TABLE I
c;':)
(1:>
0
EXPENDITURES ACCORDING TO TYPE OF SERVICE RENDERED BY CLINICS
""'~
:'-::":,'
1947
Americus
Athens -------- ------------- ------
Augusta
-----
Canton
Columbus Dalton
-
........
LaGrange
MSaavcoannn~h
-------
Sheffield
Thomasville Waycross
...........
Winship ------------
Totals ........ ..........
Hospital Cost
4044.00 12216.00 20064.00
3834.00 3492.00
684.00 4890.00 154 78.00 3558.00 14786.00 12912.00 1098.00 10386.00
107,442.00
Board Outside Chg. I Hosp. Hospital Day-Out-Patients Biopsies
856.00
458.30 30.00 56.00
1028.50 110.00 446.50
28.00 3,013.30
102.00 12.00 24.00 27.00
12.00 117.00
18.00 36.00
348.00
378.00 270.00 990.00
81.00 111.00
18.00 189.00 951.00 390.00 408.00 129.00
84.00 174.00
4.173.00
Diagnostic X-Rays
438.50 250.35 1376.50 163.50 126.00
21.00 156.00 944.50 227.00 1204.00 459.00
31.00 210.12
5.607.47
Radium
358.52 293.55 2081.40 205.50 259.20 185.85 566.93 2958.64 980.75 724.50 402.01 524.50
9,541.35
l;:j
X-Ray Therapy
Other
(1:>
'<::::3:,
--.;>
No
Total ;:1
1837.23 2163.22 2532.13 2549.63 2009.09 1481.95 1872.00 3467.90 1165.90 3476.75 4196.02 1762.50 2501.74
31,016.06
5.00
260.85 35.00
300.85
(1:>
8014.25
;:::5
<:--;-
15205.12
27531.33 6890.63
6053.29 2390.80
--0
"ti
7673.93 ~
25101.39 0'
6548.65 ''-"""''
21098.75
(-:,
18134.03 3500.00
~
13299.86
(1:>
161.442.03 .,.._.
~
Clinics
Americus Athens Augusta Canton Columbus Dalton ... LaGrange Macon ... Savannah Sheffield Thomasville Waycross Winship
Total
TABLE II
SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID WITH COST FOR CALENDAR YEAR
1947
.'.U;;
Malignant
Non-Malignant
Malignant and Non-Malignant
"""~"""
No. Cases
Amount
Average
No. Cases
Amount
Average
No. Cases
Amount
Average
"~"""
Cost
Cost
Cost
0" ~
135 105 313 118
59 49 109 381 116 212 218 106 !58
2079
6330.75 13655.44 20744.33 5358.13 5319.39 2354.80 5797.68
19588.10 5033.03
16435.50 13752.00 3336.50 11026.36
128,731.01
46.89 130.05
66.28 45.41 90.16 48.06 53.19 51.41 43.39 77.53 63.08 31.48 69.79
61.92
69 52 127 39 18
2 34 155 69 116 53 19 61
814
1683.50 1549.68 6787.00 1532.50
733.90 36.00
1876.25 5513.29 1515.62 4663.25 4382.03
163.50 2273.50
32.710.02
24.40 29.80 53.44 39.29 40.77 18.00 55.18 35.57 21.97 40.20 82.68
8.61 37.27
40.18
204 !57 440 !57
77 51 143 536 185 328 271 125 219
2893
8014.25 15205.12 27521.33
6890.63 6053.29 2390.80 7673.93 25101.39 6548.65 21098.75 18134.03 3500.00 13299.86
161,442.03
39.29 96.85 62.55
43.89 78.61
46.88
53.66 46.83
b
"">":"""1 """"""
35.40
64.33
66.92
28.00
60.73
55.80
I-' ....:]
CD
180
Georgia Department of Public Health
for by hospital charges. The next largest item of expenditure is for X-ray therapy which accounts for approximately 20 per cent of the cost of the program. All other expenditures combined account for less than 15 per cent of the total cost.
In table II is shown the total expenditures by clinics for malignant and non-malignant cases as well as the average cost per case. It will be noted that the average cost varies greatly between the different clinics. In a few of the larger clinics the higher cost is chiefly due to the fact that they accept certain types of difficult cases which are not treated in the smaller clinics. In a few clinics, however, the higher average cost is due to extended periods of hospitalization in many cases. To some extent, at least, this could be improved.
In table IV is shown the expenditures by counties.
Physicinn Educntion
Increased emphasis was given during the year to the question of physician education. The Georgia Cancer Bulletin was mailed once each month to all physicians in the state. This publication is an adaptation from the I1linois Bulletin. It is being distributed by the Department of Public Health but all of the expense involved is being borne by the Georgia Division, American Cancer Society.
In order to reach more directly the physicians in rural areas, a program of cancer symposia was planned for all of the cities in the state where state-aid clinics are being conducted. It was thought appropriate to have four physicians on each program to discuss different types of cancer. For each meeting the physicians in the surrounding counties who normally refer patients to that clinic are being invited to attend. A free supper is given to all attending physicians, the cost of which is borne by the American Cancer Society. The first symposium was held in LaGrange on December 18.
Other Activities
The follow-up of patients reporting to the clinics 5 or more years previously was continued as in the past. This aspect of the program has been slowed up somewhat due to a shortage of personnel.
The transfer of information from the clinic reports to punch cards was continued. However, this work has also been delayed somewhat due to a shortage of personnel.
Assistance was given to the University of Georgia School of Medicine in securing a special grant of $25,000.00 from the National Cancer Institute for the teaching of cancer in the Medical School. However, an application for another grant from the Institute for a special study of the prevalence of cancer in Rich-
Preventable Diseases
181
mond County was rejected. Emory University Medical School also received a teaching grant of $25,000.00 from the National Cancer Institute.
In table III is shown a summary of the activities for 1947 as compared with those for the preceding year.
TABLE III
SUMMARY OF ACTIVITIES
1946-1947
APPLICATION
1946
1947
Total received_______________________________ _ Number approved _______________________ _ Number disapproved ____________________ Counties represented ___________________ _
2291 2286
5 156
2786 2775
11 158
CASES GIVEN FINANCIAL AID
Total number -------------------------------Malignant -------------------------------------Non-malignant ------------------------------
2360 1749
611
2893 2079
814
AMOUNT OF FINANCIAL AID
Total amount given___________________...$116,321.32
Average amount per malignant
case --------------------------------------------
53.80
Average amount per non-malig-
nant case ------------------------------------
36.36
OTHER ACTIVITIES
Addresses made ---------------------------Other meetings attended ___________ _ Clinic visits and consultations ____ Articles written ---------------------------Literature distributed _________________ _
5 10 33
6 3723
$161,442.03
61.92
40.18
25 12 56 6 3106
182
Ge01gia Department of Public Health
TABLE IV
SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINICS WITH CosT FOR CALENDAR
YEAR-1947
Counties
"~ '
u"
]
0
1-
Appling -------- 10 4 H
Atkinson ------ 9 1 10
Bacon
21
3
Baker -------------- 3 2
5
Baldwin
8 5 13
Banks -------------- 7 2
9
Barrow ---------- 10 5 15
Bartow ---------Ben Hill ________
76
'1
6 11
Berrien __________ 4 1
5
Bibb
98 30 128
Bleckley ---------- 8 3 11
Brantley -------- 8
8
Brooks ---------- 11 5 16
Bryan -----------Bulloch _________ 8 '1 12
Burke ------------ 21 3 2,1
Butts
63
9
Calhoun -------- 2 6
8
Camden ---------- t!
t!
Candler ---------- 9 5 14
Carroll ---------- 28 Q 37
Catoosa ---------- 1
1
Charlton -------- 4 1
5
Chatham
72 ,13 115
Chattahoochee 1
1
Chatooga
5
5
Che1okee _______ 38 '1 ,12
Clarl<e ------------ 31 6 37
Clay
42
6
Clayton ---------- 6 1
7
Clinch ------------ 6 1
7
Cobb
19 10 29
Coffee ------------- 12
12
Colquitt
24 3 27
Columbia -------- 7 3 10
Cook ---------------- 10 5 15
Coweta
22 12 3,1
Crawford ______ 6 3
9
Crisp
19 3 22
Dade---------------Dawson ---------- 10 1 11 Decatur ________ 16 1 17
DeKalb
23 10 33
Dodge -------------- 23 9 32
Dooly
18 10 28
Dougherty ______ H 9 23
Douglas __________ 13 6 19
Early ______________ 29 10 39
Echols
5
5
Effingham ------ 5
5
Elbert
52
7
Emanuel -------- 44 H 58
Evans ------------ 4 3
7
Fannin ---------- 22 8 30
Fayette ---------- 8 5 13
Floyd
71
8
Forsyth ---------- 9 'I 13
...
u"0'
369.75 226.00
4'1.00 274.00 565.38 9,18.91 1094.75 386.25 340.13 414.00 7623.53 325.31 521.00 1639.55
266.88 1565.13
303.75 172.50 707.63 532.87 2538.52
15.00 135.00 4827.8'1 139.00 562.50 1370.00 3681.81 358.22 ,184.75 312.00 1907.00 338.64 1079.05 671.00 1092.12 1821.50 386.87 795.63
595.50 1504.98 2250.00
9,17.82 1544.31 H39.16
705.50 2609.80 171.50
80.00 672.75 1993.75 158.00 1549.25 816.25 931.50 871.00
Counties
Franklin ______ 9 3 12
Fulton ----------- 1
1
Gilmer ------------ 11
11
Glascock -------- 2
3
Glynn ------------ 7
8
Gordon ---------- 14
14
Grady ------------- 8 2 10 Greene ----------- 8 6 14
Gwinnett ------ 29 10 39 Habersham _-- 9 4 13
Hall ---------------- 12 13 25
Hancock -------- 13 1 14 Haralson ______ 17 18 35
Harris ------------ 7 1
8
Hart -------------- 5
5
Heard ------------ 5 1
6
Henry ------------ 7 5 12
Houston ---------- 7 7 14
Irwin
61
7
Jackson ---------- 21 7 28
Jasper ------------ 6 1
7
Jeff Davis ____ 5 6 11
Jefferson ______ 23 5 28
Jenkins
18 5 23
Johnson ---------- 9 7 16
.Tones -------------- 6 3
9
Lamar ------------ 21 8 29
Lanier
63
9
Laurens ---------- 38 5 '13
Lee ------------------ 6 1
7
Libel'ty ---------- 5 8 13
Lincoln ---------- 5 3
8
Long
1
1
Lowndes
22 7 29
Lumpkin -------- 2 2
'1
McDuffie -------- 11 8 19
Mcintosh ______ 1
1
Macon ------------ 17 5 22
Madison ---------- 14 4 18
Marion ---------- 6
6
Meriwether ____ 23 8 31
Miller -------------- 16 2 18
Mitchell -------- 25
25
Monroe
7 3 10
Montgomery__ 11 8 19
Morgan ---------- 10 1 11
Murray
5
5
Muscogee ------ 30 6 36
Newton ---------- 11 3 14 Oconee ---------- 5 6 11 Oglethorpe ____ 11 1 12
Paulding ------ 13 14 27
Peach ------------ 12 9 21
Pickens ---------- 9 6 15
Pierce ------------ 8 2 10
Pike ------------- 4 '1
8
Polk ---------------- 9 18 27
Pulaski ---------- 5 2
7
~
u"0'
708.00 102.00 882.50 123.00 401.00 528.00 910.52 794.00 1541.00 1021.75 1920.63 858.56 2810.00 467.61 462.45 237.90 ,194.50 505.94 301.75 881.43 240.00 171.00 1281.95 1035.75 629.25 651.00 1220.65 298.00 2282.90 226.50 634.29 ,163.50 39.00 2218.20 169.00 1868.25
4.00 933.50 1426.35 470.54 2013.00 687.00 1595.12 517.15 462.75 ,162.00
172.00 3380.67
590.75 1631.35 1185.48
991.50 880.85 949.13 217.75 567.37 1869.00 347.00
Preventable Disectses
183
TABLE IV (continued)
SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINICS WITH COST FOR CALENDAR
YEAR-1947
Counties
....
.. . -""""-.'"~,
:"s"o
--""".~.
:s..,,
z= 0o~ "
Putnam ----------
4
Quitn1an --------
Rabun ------------ 7 3 10
Randolph ------ 10 3 13
Richmond ____ 95 30 125
Rockdale ______ 2 5
7
Schley
5
5
Screven __________ 20 28 48
Seminole -------- 15 1 16
Spalding -------- 44 21 65
Stephens ------- 9 3 12 Stewart ---------- 9 7 16 Sumter _________ 26 16 42
Talbot ------------ 2
2
Taliaferro ____ 7
7
Tattnall ---------- 9 4 13
Taylor ---------- 7 4 11 Telfair __________ 11 3 14
Terrell ---------- 16 6 22
Thomas -------- 14 3 17
Tift -------------- 14 3 17 Toombs ________ 18 7 25
Towns ----------- 12 12 24
..
"0 '
0
397.50
247.16 844.81 7481.20 254.00
76.00 4254.50
724.45 4032.00
612.50 1006.37 1218.32
147.00 263.25 918.00 721.63 614.75 908.69 1594.48 1121.01 1205.93 1004.50
Counties
-c
. ....
c
-co"->.<"," :"s"o
c" --.~.
:s..,, co.,, zo
~"
0"
:e
0
1-
Treutlen -------- 17 8 25 TTruorunper-----_-_-_-__-_-_-_-_-_- 386 29 478
Twiggs ---------- 10 8 18
Union ----------- 14 5 19 Upson ------------ 22 11 33
Walker __________ 19 1 20 Walton __________ 17 10 27
Wa1e
14 3 17
Warren __________ 7 4 11
Washington
14 13 27
Wayne ------------ 10 2 12
Webster--------- 6 2
8
Wheeler --------- 12 7 19
White ------------- 2 2
4
Whitfield ______ 16 1 17
Wilcox ---------- 17 8 25
Wilkes
12 6 18
Willdnson _____ 8 3 11
Worth ----------- 17 7 24
1407.50 2481.38
351.38 675.13 584.00 2141.'10
1132.50 2001.87
961.75 444.00 1331.88 500.50 348.00 502.00 189.50
853.80 1535.58 1222.18
60!.50 2110.25
Total ... 2079 814 2893 $161,442.03
EPIDEMIOLOGIC SERVICE
Personnel
The personnel of the central office consisted of the State Epidemiologist and one stenographer. Personnel assigned to the biological activities at the end of 1947 consists of the Senior Biologist who acts as executive assistant for the Service under the supervision of the Director of the Division of Preventable Diseases, a permanent field biologist, two part-time biologists, a field nurse, and a secretary. In September 1947, the field biologist was granted educational leave for study at the University of North Carolina. He will return to duty in the spring of 1948. During the summer of 1947, six temporary biologists were employed. One of these is a former permanent employee with whom there exists a special arrangement for summer work. One other temporary biologist was re-employed for the ninth successive summer, and another was employed for the second successive summer. The former Assistant Director of the Division of Mala1ia and Hookworm Investigation continued to act as an un-
184
Georgia Department of Public Health
paid consultant during the year, but was unable to return to Georgia for active work during that period.
The general plan of Service activities requires the temporary employment of consultant biologists and biological aides during the summer period in which entomological activities reach a peak. In this way it is possible to employ the required number of trained technical workers.
Activities
The office of the State Epidemiologist is the center of all activities related to reporting of 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 his medical and scientific aides whenever such assistance is requested. As an aid to communication 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 and type of work is mimeographed and circulated to health officials and others interested. This directory is kept up-to-date by forwarding supplements and corrections as changes occur.
Major activities during the year consisted of helminthological investigations and control activities primarily aimed at hookworm control, and entomological investigations designed to provide data for the evaluation of control activities carried on by other state and county agencies, and to work out simpler, more economical methods of controlling medically important insects. To these ends, several investigations on worm diseases were made as described briefly under the general heading of Hookworm Control, and four major entomological studies were carried on; one in Dougherty and Worth Counties on anopheline mosquito control; one in DeKalb, Fulton and Union Counties on tick control; one in Muscogee County on fly and mosquito control; and one in Jenkins, Bulloch and adjacent counties on a study of anopheline mosquito populations in known breeding areas and the effect on these populations of the standard Extended Malaria Control Program.
Field Visits
The total number of field visits made in unorganized counties by regional medical directors and public health nurses amounted to 3,623 in 1946 and 4,407 in 1947. This was a 21.6o/a increase over the previous year. The following table shows the summary broken down by diseases and personnel :
Preventable Diseases
185
Type of Activity
Eoidemiologists and Regional
Medical Directors
1946
1947
Consultations with physicians.--------------------- 70 Admissions to medical service-------------------- 704 Admissions to nursing service------------------- -------Admissions to medical and/or nursing
service ----------------------------------------------------- -------Field Visits:
Diphtheria -------------------------------------------- 8 Malaria --------------------------------------------------- I Measles -------------------------------------------------- -------Scarlet Fever -------------------------------------- 2 Smallpox ------------------------------------------------ 1 Typhoid and Paratyphoid-------------------- 26 Typhus ------------------------------------------------------- 2 Whooping Cough ----------------------------------- -------Ifook\vorm ------------------------------------------ ________ Treated for Hookworm__________________________ 952
Othem ------------------------------------------------------- 35
Total Field Visits -------------------------------- 1027
61 608
19 6
11 1225
31 1293
Public Health Nurses
1946
1947
1179
1820
119 888
14 73
2 38
3 15 1209
205
2596
172 88 5 88 5 37 16 65
1550
750
3076
Total
1946
70 704 1179
1217
127 889
44 75
3 64
5 15 1209 952 240
3623
1947
61 608 1820
1824
473 88 45 88 5 56 22 75
1550 1225
780
4407
The following tabulations show the number of field visits made by public health workers in the state by counties for specified preventable diseases :
DIPHTHERIA:
Appling ---------------------------- 1 Bacon -------------------------------- 1 Baldwin ---------------------------- 28 Banks -------------------------------- 4 Barrow ---------------------------- 4 Berrien ---------------------------- 1 Bibb ---------------------------------- 37
BBlreocolkdsey__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ no1
Bryan -------------------------------- 1 Burke -------------------------------- 1 Butts -------------------------------- 5 Camden ---------------------------- 3 Candler ---------------------------- 1 Catoosa ---------------------------- 5 Chatham -------------------------- 59 Clarke ------------------------------ 14 CCol abybt o__n_____-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- 2 1 53
Coffee -------------------------------- 2 Colquitt ---------------------------- 90
Cook ---------------------------------- 2 Coweta ------------------------------ 9
Decatur ---------------------------- 16 DeKalb ---------------------------- 8 Early -------------------------------- 2 Emanuel -------------------------- 3 Evans -------------------------------- 26 Fannin ------------------------------ 5 Floyd -------------------------------- 6 Forsyth ---------------------------- 1 Franklin ------------------------ 40 Fulton ------------------------------ 99
Gwinnett -------------------------- 4 Habersham ______________________ 91
Hall ----------------------------------152 Hancock ---------------------------- 1
Harris ------------------------------ 2 Hart ---------------------------------- 17 Jackson ---------------------------- 43 Jefferson -------------------------- 24 Jenkins ------------------------------ 2 Johnson ---------------------------- 37 Lamar ------------------------------ 2 LLoawninedres---_-_-_-_-__-_-_-_-_-_-_-_-_-_--_-._-_-_-_-_-_-_-_-_-_-_-_ 115
186
Georgia Depar-tment of P~tblic Health
Mitchell ---------------------------- 11 Montgomery ____________________ 7
Muscogee -------------------------- 11 Oconee ------------------------------ 2 Oglethorpe ---------------------- 26 Peach -------------------------------- 28 Pierce -------------------------------- 4 Pike ---------------------------------- 21 RP oalbku n-----_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- 1973
Richmond ------------------------ 53 Screven ---------------------------- 5 SSpteaplhdeinngs -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 2834
Sumter ------------------------------ 13
Talbot ------------------------------ 3 Tattnall ---------------------------- 33 Terrell ------------------------------ 2 Thomas ---------------------------- 31 Toombs ---------------------------- 35 Treutlen ---------------------------- 5 Troup ------------------------------ 1 Upson -------------------------------- 98 Walton ------------------------------ 6 Washington---------------------- 40 Wayne ------------------------------ 5 Whitfield -------------------------- 28 Wilcox ------------------------------ 4 Worth -------------------------------- 2
Total ------------------------ 1975
HOOKWORM:
Appling ___________________________.448 Atkinson _, ________________________ 99
Bacon -------------------------------- 27 Baldwin ---------------------------- 26 Berrien ____________________________ 360 Bleckley ____________________________ 75 Brantley __________________________ 83
Brooks ------------------------------ 1 Bryan -------------------------------- 47 Calhoun ---------------------------- 5 Camden ---------------------------- 8 CCahnadrllteorn ---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_14348 Chatham __________________________280
CColifnfeceh __-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_26862 Colquitt ____________________________ Ll7
CDoeockat-u--r----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-___ 2424
JLoanneiser ---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_2523 Laurens ____________________________ 341 Long __________________________________ 140 Lowndes __________________________ 537
MM iclilnetro_s__h____-_-_-_-_-_-_-_--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 22367 Montgomery ____________________ 21
Muscogee -------------------------- 35 Pierce -------------------------------- 74 Pike ---------------------------------- 8 Richmond ________________________ 7
Seminole -------------------------- 9 STua tmt nt earl l ---_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_- 1 3 86
Telfair ------------------------------ 34 Thomas ---------------------------- 12 TTiofto--m---b--s----_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_ 1340
Dodge ----------------------------- __ 953 Dougherty ________________________ 31 Effingham ________________________ 39
Emanuel -------------------------- 38 GGlryandny -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-1585
Hancock ---------------------------- 1 Irwin -------------------------------- 2 J e:fferson -------------------------- 47 Johnson ---------------------------- 5
Troup -------------------------------- 2 Twiggs ------------------------------ 7 Upson -------------------------------- 2L! Wheeler ---------------------------- 22 Whitfield -------------------------- 1 Wilcox ------------------------------ 28 Worth ------------------------------ 17
Total -------------------------- 5496
Preventable Diseases
187
MALARIA:
Baker ------------------------------ 85 Bryan ---------------------------- 1 Chatham ------------------------ 31
Coffee ------------------------------ 1 Crisp ------------------------------ 1
LDoewKnadlbes ---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 13 Total __________________________ 123
MEASLES:
Atkinson ------------------------ 3 Baldwin -------------------------- 8 Bibb -----~-------------------------- 301 Calhoun -------------------------- 7 Chatham ------------------------ 384 Clarke ---------------------------- 7 , Clinch ------------------------------. 1 Cobb -------------------------------- 4 Coffee ------------------------------ 1 Crisp ------------------------------ 5 DeKalb -------------------------- 24 Dodge ------------------------------ 11 Dougherty ---------------------- 8 Early ------------------------------ 1 Floyd ------------------------------ 5 Fulton ---------------------------- 77 Glynn ------------------------------ 41 Johnson -------------------------- 13 JLoonnegs __-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_--:_-_--_-_-_-_-_-_-_-_-_ 163
Lowndes ------------------------ 32
MMcoinnttgoosmhe-r-y-----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 25
Morgan -------------------------- 2 Muscogee ------------------------ 2 Oconee ---------------------------- 4 Pulaski ---------------------------- 53 Richmond ---------------------- 1 Spalding ------------------------ 3 Terrell ---------------------------- 1 Thomas -------------------------- 23 Troup ------------------------------ 29 Twiggs ---------------------------- 3 Upson ---------------------------- 1 WWaalrteon___-_--:_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_-_ 272
WWhhietefileelrd--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- 21
Wilcox ---------------------------- 2
Total __________________________ 1115
SCARLET FEVER:
Bibb -------------------------------- 62 Bleckley ------------------------ 12 Brooks ---------------------------- 15 Butts ------------------------------ 3 CCahtaotohsaam ---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 1785
Clarke ---------------------------- 79 Clinch ------------------------------ 3 Cobb -------------------------------- 144 Colquitt -------------------------- 4 Columbia ------------------------ 2 DeKalb ---------------------------- 61 EEfafrilnygh-a--m------_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 24
Floyd ------------------------------ 3
Franklin ________________________ 2 Fulton __________.__________________ 359
JHaaclkl so--n-----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 2443
JJeafsfpeersron-----_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_- 16 Meriwether ____________________ 22
Monroe ---------------------------- 4 Muscogee ------------------------ 19 Pike -------------------------------- 4 Pulaski ---------------------------- 5 Rabun ---------------------------- 17 Richmond ---------------------- 53 Spalding ------------------------ 26 Stephens ------------------------ 16
188
Georgia Department of Public Health
Tattnall -------------------------- 2 Terrell ---------------------------- 10 Treutlen -------------------------- 1
Troup ------------------------------ 48 Upson------------------------------ 15 Ware-------------------------------- 2
Whitfield ________________________ 51 Wilcox ---------------------------- 1 Worth ---------------------------- 1
Total __________________________ 1309
SMALLPOX:
Berrien -------------------------- 1 JFeuflfteornson-----_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_- 111
LMowernidwese-t-h--e--r---_-_-_-_-__-_-_-_-_-_-_-__-_-_-_-_-_-_ 18
Newton -------------------------- 2 Twiggs ---------------------------- 1
Total -------------------------- 25
TYPHOID FEVER:
Bacon ------------------------------ 1 Baldwin -------------------------- 1 Barrow -------------------------- 1 Berrien -------------------------- 3 Bibb -------------------------------- 7 Brooks ---------------------------- 2 Carroll ---------------------------- 4 Chatham ________________________ 4 Cherokee ________________________ 3
Clinch ------------------------------ 9 Cobb -------------------------------- 5 Colquitt -------------------------- 23 Crisp ------------------------------ 17 Decatur -------------------------- 3 DeKalb ---------------------------- 12 DDooduggehe--r--t-y----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 21
EDmouagnluaesl ---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 28
Fannin ---------------------------- 10 Fayette -------------------------- 2
Floyd ------------------------------ 4 Franklin ------------------------ 6 Fulton ---------------------------- 106 Glynn ------------------------------ 1 Jones ------------------------------ 2 LLuammpakr in-----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 15
MMoernirwoeeth_e__r____-_-_-_-_-_-_-_-_--_-_-_-_-_-_-_-_-_-_-_ 12 Montgomery __________________ 2 Muscogee ________________________ 1
Newton -------------------------- 3 Pickens -------------------------- 1 Sumter -------------------------- 9 Thomas -------------------------- 14 Tift ---------------------------------- 4 Troup ------------------------------ 1 Whitfield ________________________ 4
Total -------------------------- 287
TYPHUS FEVER:
Atkinson ------------------------ 4 Candler -------------------------- 1 CCahrartohlalm-----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 14
Coffee ------------------------------ 6 Colquitt -------------------------- 14 DDeoKugahlbert-y----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 21
Douglas -------------------------- 1
Lanier ---------------------------- 9 Mitchell -------------------------- 67 PRuiclahsmkoi n--d-----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 16
Sumter ---------------------------- 2 Toombs -------------------------- 1 Worth ---------------------------- 1
Total -------------------------- 121
Preventable Diseases
189
WHOOPING COUGH:
Atkinson ------------------------ 12
Baker ------------------------------ 1 Barrow -------------------------- 1 Bibb -------------------------------- 179 Brooks ---------------------------- 4 Butts ------------------------------ 19 Calhoun -------------------------- 3
CCahmatdheanm---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 2663
Clarke ---------------------------- 117
Cobb -------------------------------- 9
Coffee ------------------------------ 213
Columbia ------------------------ 17
DDoecuagthuerrt-y----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_
2 43
Floyd ------------------------------ 3 Fulton ---------------------------- 129 Glynn ------------------------------ 8 Johnson -------------------------- 2
Jones ------------------------"----- 16
Lamar ---------------------------- 1
Lanier ---------------------------- 18
Lowndes ------------------------ 221
MMceirniwtoesthhe-r----_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_--_
9 2
Muscogee ------------------------ 5
RNiecwhtmoonnd-----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_
2 23
Sumter ---------------------------- 5
~~i~~~-::::::::::::::::::::::::::::
26 2
Upson ------------------------------ 1
Wheeler -------------------------- 6
Wilcox ---------------------------- 6
Worth ---------------------------- 2
Total -------------------------- 1375
OTHERS:
AAptkpilninsogn---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 47148
Bacon ------------------------------ 38 Baker ------------------------------ 8 Baldwin -------------------------- 35 Bartow ---------------------------- 1 Berrien -------------------------- 113 Bibb -------------------------------- 15 Bleckley -------------------------- 21 Brantley -------------------------- 17 Brooks ---------------------------- 3 Butts ------------------------------ 3 Camden -------------------------- 4 Candler -------------------------- 8 CChataoroltsoan -_-_-_-_-_-_-__-_-_-_-_-_-_-_-_--:_-_-_-_-_-_--_-_-_ 843 Chatham ________________________ 319
Clarke ---------------------------- 65 Clinch ---------------------------- 86 Cobb -------------------------------- 120 Coffee ------------------------------ 2 CCoolluqmuibttia---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 16674
Cook -------------------------------- 40 Crisp ------------------------------ 10 Dade ---------------------,---------- 1
DeKalb -------------------------- 62
Dodge ------------------------------ 5 Dooly --------------------,--------- 1 Dougherty ---------------------- 67
Early ------------------------------ 3 Emanuel ------------------------ 5 Fannin ---------------------------- 3 Fayette ---------------------------- 8 Floyd ------------------------------ 2 Fulton ---------------------------- 393 Glynn ------------------------------ 91 Greene ---------------------------- 3 Gwinnett ------------------------ 33
Hall -------------------------------- 45 Harris -----------~---------------- 4 Hart -------------------------------- 16 Jefferson ------------------------ 17
Johnson -------------------------- 7 Jones ------------------------------ 5
Lamar ---------------------------- 4
Lanier ---------------------------- 290 Long -------------------------------- 97 Lowndes -------------------------- 400 Mcintosh ------------------------ 1 Madison -------------------------- 5 Meriwether -------------------- 5
190
Georgia Department of Public Health
Mitchell -------------------------- 106 MMoonnrtogeom-e--r--y----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 12 Muscogee ________________________ 21
Peach ------------------------------ 1 Pulaski ---------------------------- 2 RRiacbhumnon--d-----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 305 Spalding ________________________ 4 Stephens ________________________ 4
STuatmtntearll---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 216
Terrell ---------------------------- 1 Thomas -------------------------- 4 Toombs -------------------------- 12 Troup ------------------------------ 22 Twiggs ---------------------------- 7 Walton ---------------------------- 7 WWhairtefie-l-d-----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 33
Wilcox ---------------------------- 3 Worth ---------------------------- 72
Total __________________________ 3628
Outbreaks Investigated:
Gastro-intestinal-Five gastro-intestinal outbreaks were investigated during the year, four of which were caused by food poisoning and two occurring at the same place but about three weeks apart. They were as follows:
1. The first two investigations involved a statistical analysis of an atypical food borne outbreak at Emory College, Oxford, Georgia. This episode is interesting and informative chiefly because it occurred a second time, after a two-week interval, in almost exactly the same way. Both outbreaks, the first one tentatively and presumptively, the second one more clearly, were traceable to frozen turkey which was allowed to thaw at room temperature and, more pertinently, to remain out of the refrigerator for approximately twenty-hours between cooking and serving. Samples from one turkey showed abundant growth of an alpha streptococcus, a type of organism shown separately by Dach and Colman to be capable of producing food infection. Moreover, epidemiologic evidence already assembled before the results of laboratory work became known had effectively ruled out any possibility of staphylococcic food poisoning. The average incubation period was twelve hours, the predominant symptom was a violent and painful cramping, there was little nausea, very little vomiting, and a profuse and continued diarrhea lasting approximately eight hours. No recorded elevation of temperature occurred and prostration did not develop even in the most serious cases. Recovery was rapid. The second episode indicated that no appreciable immunity had developed, and the severity of symptoms appeared to be conditioned largely by the amount of the peccant food eaten.
Modification of the cooking schedule and the refrigeration of all prepared meats was adopted and the difficulty has not again occurred; this despite the fact that the two major episodes described above were by no means isolated incidE!nces, but instead were a spectacular climax to a long series of minor outbreaks. Apparently then, the problem arose from unsound practices in
Preventable Diseases
191
handling cooked meats and the employment of a rational procedure has been sufficient to obviate further mishap. The fact that the offending food was purchased frozen is probably not a factor of importance.
2. Food poisoning of probably staphylococcus origin affected 26 persons in Habersham County in April as a result of eating meringue pies from a single source.
Epidemiologic investigation of the outbreak implicated the pies when it was found that all patients had eaten them at the meal preceding the onset of symptoms, and in no case did gastroenteritis occur where no pie was eaten. Sixteen cases occurred on April 4 with onset of symptoms within 2-3 hours from the time ;,. the pie was consumed. Unfortunately material for laboratory examination was not available. In the succeeding 3 days the remaining 10 cases occurred, but in these the pies had not been eaten until quite a while after delivery, and the illness produced differed in many respects from the first outbreak. The bakery producing the affected pies ceased operation for a time and all pies which had been delivered were returned, terminating the outbreak.
3. Gracewood Home for Mental Defectives was the site of a small outbreak of bacillary dysentery, the last cases of which occurred in September. The institution houses 564 inmates and 51 employees, and experienced 9 cases of typical dysentery between October and September. Bacteriologic examination of the stools of the patients revealed Flexnor Z to be the agent in 5 cases, and Flexnor W and Schmitz to be the agent in 2 cases each. During the last outbreak in September mild diarrhea was experienced by a number of children in the institution of whom a small number also showed Flexnor Z as did a patient who had previously had Flexnor W. Inspection of the institution showed almost unimpeachable cleanliness and little chance for fly transmission. There was practically no chance for transmission from one cottage to the other, because of the lack of intermingling of the inmates except on special occasions. Because of the mental level of some inmates, personal cleanliness was difficult to maintain, and afforded slight possibility of personal transmission through the personnel caring for this type inmate. However, no "carrier" could be implicated as the one who initiated the outbreak.
The water and sewage systems were investigated in detail with the help of engineers from the Engineering Division and the supply was found to be inadequate in quantity and substandard at times in quality. This was due to the nipidity with which the institution has expanded and the practical problems involved in procuring a good water supply. In the absence of epidemiological evidence to sustain a personal contact theory as the basis of the outbreak, and with evidence that the water has been known to be contaminated on occasions, it was recommended that steps
192
Georgia Department of Public Health
be taken to rectify the situation with regard to the water. No cases have occurred subsequent to that time.
4. On March 7, 10 and 11 an investigation was made of an unusual number of cases of diarrhea reported in Lawrenceville, Gwinnett County. Three of the four physicians were contacted, two reported no unusual diarrhea but one stated that he had had 50 cases of mild diarrhea in the last 2-3 months lasting from 1-3 days. There had been recurrences. Only one person was reported to be very ill which resulted in a loss of one week's work. Fifteen persons reported to have been ill were seen and all stated their diarrhea had lasted but a day or two, five days at most. Water, milk, and food did not appear to be implicated.
Infectious Hepatitis-A small outbreak of infectious hepatitis, involving 4 cases, occurred in and near Lithonia, DeKalb County. One of these cases became ill in April and the other three had onsets in June. All but one recovered. Investigation of all cases revealed no mode of transmission by food or water.
"Pretibial" or "BTushy Creek FeveT"-An outbreak of disease of unknown origin occurred in Grady County during July and August which involved 15 persons. The disease followed the following pattern: After a variable period of prodromal malaise lasting up to two days, the patients experienced prostration of 4 to 12 days with anorexia, nausea and vomiting, some abdominal cramps and diarrhea. Headache was severe in most cases and lasted about one week, being frontal mainly in location and associated with photophobia. There were chills or chilly sensations experienced and four cases had fever which recurred after a remission of 1 to 3 days. Five cases experienced delirium for 2 to 4 days and all had weaknesses for about one week following illness. One had an erythematous maculo-papular rash on legs on the 5th clay of illness.
Laboratory tests were used exhaustively but yielded no hint as to the nature of the etiological agent and gave no confirmation to the diagnosis of known disease processes resembling this outbreak clinically. Epidemiologic investigation revealed that all who ran the above clinical course and three others who were not ill had but one feature in common. This was found to be the fact that they had all been swimming in "Mash Creek" on July 20 about 10 days before the onset of illness.
It was felt that this was an outbreak of "Pretibial" or "Brushy Creek" fever previously experienced in small outbreaks during the past few years, but in which no infectious agent has been isolated.
Typhoid CarTiers-During the year investigations and laboratory tests found 13 new typhoid carriers.
Preventable Diseases
193
Notifiable Diseases Reported
Diphtheria
Cases Median (1943-1947) __ 462 Reported in 1947 ________ 437 Percentage increase
since 1946 ______________ 17.8
Deaths Median (1943-1947) __ 4fi Reported in 1947 ________ 42
Percentage decrease since 1946 ________________ 6.7
Diphtheria cases in 1947 reversed the downward fluctuation shown in 1946 and rose toward the median for the five year period just past. Deaths decreased slightly, falling a little below the median experience. The fatality rate (9.6o/o) also dropped slightly, being exceeded by the fatality rates for 1945 and 1946 and exceeding the rates for 1943 and 1944. The median fatality rate for the years 1938-1942 was 8.5;7a.
Dysentery
Cases Median (1943-1947) __ 304 Reported in 1947 ________ 154 Percentage decrease
since 1946 ________________ 28.0
Deaths Median (1943-1947) __ 60 Reported in 1947 ________ 19
Percentage decrease since 1946 ________________ 47.2
The all time low of last year has been replaced by this year's record with a remarkable reduction in deaths due to the disease. As mentioned in the last report, the widespread use of insecticide residuals probably has been a factor in this decrease. Also the fact that economic conditions and general sanitation have improved, has no doubt contributed to the present low figure. In this connection, the improvement of restaurant sanitation accomplished through the efforts of public health agencies should be pointed out.
GonorThea
Cases Median (1943-1947) 12338 Reported in 1947 ______ 12338
Percentage decrease since 1946 ________________ 19.3
Deaths Median (1943-1947) __ 5 Reported in 1947 ________ 5
Percentage increase since 1946 ________________ 150.0
The number of cases of gonorrhea recorded in 1947 continues to show the influence of an active case finding and rapid treatment program. The decrease in cases found reflects the locale of survey programs rather than lessened activity by control agencies. The years 1945 and 1946 show higher totals primarily
because urban areas were surveyed. As surveys reach into rural communities a lower rate of infection is found. It is interesting to note that the fatality rate is very near to that recorded for 1945 when almost the same number of cases was reported.
194
Georgia Department of Public Health
Hookworm
Cases Median (1943-1947) __ 3799 Reported in 1947 _______.4321
Percentage decrease since 1946 ________________ 12.3
Deaths Median (1943-1947) __ 0 Reported in 1947 ________ 0 Percentage increase or
decrease since 1946 0
Methods of reporting materially affect the case totals shown for hookworm. During the period1936-1940, the median number of cases reportec117,307, a figure which derives from the inclusion of all cases positive by salt flotation. The median shown above for 1943-1947 is influenced very largely by the limitation of reporting to infections showing an egg count of 2000 or more eggs per cc (fsb) by the Stoll dilution method, and also by wartime limitations on case finding and treatment. The decrease in cases from 1946 to 1947 reflects primarily the emphasis placed by control authorities on treatment of each case to the point of eliminating all worms rather than on single treatments of numbers
of individuals.
Influenza
Cases Median (1943-19L17) 6073 Reported in 1947 _____ _ 6073 Percentage increase
since 1946 _____________ _ 166.5
Deaths Median (1943-1947) __ 473 Reported in 1947 ________ 367
Percentage decrease since 1946 ________________ 13.2
Influenza cases went up and influenza deaths decreased in 1947, the death total being the smallest reported in recent years. The fatality rate for 1947, 6.04%, is the median rate for 1943-1947. Normally, influenza deaths increase somewhat as cases increase despite the fact that case fatality rates in epidemic years are notably less than in non-epidemic years. A decrease in deaths by 13.2% as cases increased 166.5'/"a is therefore worthy of note. As shown above, 1947 is the median year of the period1943-1947 in number of cases reported and the increase in cases, while sharp, is merely typical of the wide fluctuations expected of in-
fluenza.
Malaria
Cases Median (1943-1947) Reported in 1947 ______ Percentage decrease
since 1946 ______________
416 67 41.7
Deaths Median (1943-1947) __ 26 Reported in 1947 ________ 13
Percentage increase since 1946 ________________ 8.3
Malaria continued to recede in 1947 as it has steadily clone for the past ten years with the exception of a slight rise in 1945 which was attributed to the reporting of recurrent cases in veterans. Continued efforts to find endemic foci in Georgia by thick
Preventable Disectses
195
smear examinations have yielded no positive cases. The percentage increase in deaths shown above is due to an increase from 12 deaths in 1946 to 13 deaths in 1947. This is in sharp contrast to the 235 deaths reported in 1937.
Mectsles
Cases Median (1943-1947) 4184 Reported in 1947 ______ 3406
Percentage decrease since 1946 ______________ 18.6
Deaths Median (1943-1947) __ 27 Reported in 1947 ________ 17
Percentage decrease since 1946 ________________ 61.4
Measles decreased in cases and deaths in 1947 after a sharp rise in 1946. The decrease did not, however, approach the low point reached in 1945 which is the record low of the period 1938-1947. The number of cases falls below both the five-year and ten-year medians and the number of deaths is also markedly below the median for either period. The fatality rate is the
lowest of record.
Meningitis
Cases Median (1943-1947) __ 117 Reported in 1947 ________ 53 Percentage decrease
since 1946 ________________ 24.3
Deaths Median (1943-1947) __ 31 Reported in 1947 ________ 20
Percentage decrease since 1946 ________________ 35.5
The figures on meningitis indicate a subsidence toward the low level of the 1938-1942 period (median cases 35, median deaths 17). The 1943-1947 period began with two years of unusual incidence. This influences the averages for the entire five years and makes it appear that the moderate recession of meningitis in 1946 and 1947 represents a great decrease in the disease whereas the present downward trend represents a return to more nearly normal conditions. The fatality rate is almost in perfect inverse relationship to the number of cases reported for each year of the decade just past.
Pellagra
Cases Median (1943-1947) __ 112 Reported in 1947 ________ 112 Percentage increase
since 1946 ________________ 4.7
Dectths Median (1943-1947) __ 106 Reported in 1947 ________ 102
Percentage increase since 1946 ________________ 9.7
Pellagra cases and deaths rose slightly from the ten year low recorded in 1946, thus interrupting a trend downward which began in 1938. The fatality rate continued to trend upward. This would seem to indicate that a tendency exists to report as pellagra only advanced cases, a large portion of which terminate fatally.
196
Georgia Department of Public Health
Pne~tmonia
Cases Median (1943-1947) __1947 Reported in 19L!7 ________1897
Percentage decrease
since 1946 ---------------- 2.6
Deaths Median (1943-1947) __1500 Reported in 1947 ________1294
Percentage decrease
since 1946 ---------------- 3.5
After a slight upswing in 1946, pneumonia fell to a new low in cases and deaths. The fatality rate remained at the level recorded for 1946. Improved therapy is apparently indirectly responsible for the higher fatality rates of the past 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 is undoubtedly due to virus pneumonias.
Polio Cases.
Median (1943-1947) __ 104 Reported in 1947 ________ 89
Percentage decrease since 1946 ________________ 46.1
Deaths Median (1943-1947) __ 8 Reported in 1947 ________ 4
Percentage decrease since 1946 ________________ 50.0
Poliomyelitis cases in Georgia reversed the upswing begun in 1944 and decreased sharply in 1947. In keeping with the general decline in the disease throughout the Southeast, cases stood at a moderately low level and deaths approached the all-time low (3) recorded in1943. The fatality rate in 19L17 decreased slightly from 1946 and was the lowest since the epidemic year of 1941 (790 cases).
Scarlet Fever Cas..,es
Median (1943-1947) __ 964 Reported in 1947 ________ 621
Percentage increase since 1946 ________________ 23.5
Deaths Median (1943-1947) __ 2 Reported in 1947 ________ 1
Percentage increase or decrease since 1946__ 0
Scarlet fever cases increased in 1947 over 1946 but remained well below the. level of previous years. Comparison of the 1947 case total with the five year median shown above and the tenyear median (1,000) indicates the current situation. However, no ready explanation of the lowered case totals in 1946 and1947 after a ten-year period in which scarlet fever remained nearly static at approximately 1,000 cases can be offered. Three possibilities deserve recognition: (1) a larger than usual percentage of streptococcic infections were not attended by the characteristic sign of scarlet fever, (2) the increased use of penicillin and sulfonamides might account for a number of aborted cases, and (3) a tendency exists to consider scarlet fever simply as a streptococcic infection.
P1eventable Diseases
197
Smallpox
Cases Median (1943-1947) __ 7 Reported in 1947 ________ 3
Percentage increase or decrease since 1946__ 0
Deaths Median (1943-1947) __ 0 Reported in 1947 ________ 0
Percentage increase or decrease since 1946__ 0
Smallpox remained unchanged from 1946. Comparison of the case median for 1938-1942 (11) with the figure for 1943-1947 shown above is the best indication of the present trend.
Syphilis Cases
Median (1943-1947) 12,224 Reported in 1947 ______11,103
Percentage decrease since 1946 ____________ 3.3
Deaths Median (1943-1947) __ 358 Reported in 1947 ________ 322
Percentage increase since 1946 ________________ 4.2
Syphilis cases declined in 1947 despite continued emphasis on
case finding. The 1943-1947 median shown above is about onehalf as large as the median case number for 1938-1942. It would appear that steady pressure on syphilis is producing the type of decline shown by tuberculosis. Progress is not dramatic as viewed from year to year but the change made for the better in a five-year period is revealing and encouraging. The slight
increase in deaths is not considered significant.
Tuberculosis
Cases Median (1943-1947) __2534 Reported in 1947 ________3324 Percentage increase
since 1946 ________________ 31.2
Deaths Median (1943-19L17) __ 1107 Reported in 1947 ________1074
Percentage increase since 1946 ________________ 2.5
Tuberculosis cases increased sharply in 1947 while deaths rose
very slightly. The increase in both cases is attributable to a vigorous case finding survey campaign and not to an actual increase in tuberculosis. More early and curable cases have been found and th'e control of tuberculosis has received further impetus. The total number of deaths is not significantly higher than the figure for 1946. The median number of deaths in 1938-
1943 is 38;7'o higher than the 1943-1947 median.
Typhoid Fever
Cases Median (1943-1947) __ 168 Reported in 1947 ________ 74
Percentage dE:crease since 1946 ________________ 8.6
Decdhs Median (1943-1947) __ 23 Reported in 1947 ________ 9
Percentage decrease since 1946 __ :_____________ 18.1
Typhoid fever cases continued the decline begun in 1934 which
198
Georgia Depctrtment of Public Health
is broken only by the high case total of 1938 (829). The rate of decline is indicated by fact that the 1943-1947 median shown above equals approximately one-third of the 1939-1942 median.
Deaths also declined in number. It is interesting to note that the fatality rate has changed very little during the past ten years.
Typhus Fever
Cases Median (1943-1947) ..1111 Reported in 1947 ........ 441 Percentage decrease
since 1946 ................ 27.2
Dectths
Median (1943-1947) .. 57 Reported in 1947 ........ 31 Percentage decrease
since 1946 ................ 6.1
Endemic typhus cases decreased sharply in 1946 and decreased again in 1947, the decrease from 1945 (1111 cases) being 60o/o. A slight reduction has been noted from year to year since typhus control measures were undertaken and the 1946 and 1947 declines very probably represent the increasing effectiveness of this program. Before the control program was instituted, typhus was on the increase in Georgia. Deaths declined slightly in 1947 but the fatality rate rose to the highest level recorded within 10
years.
Unclulcmt Fever
Cases Median (1943-1947) .. 151 Reported in 1947 ........ 136 Percentage decrease
since 1946 ................ 19.5
Deaths Median (1943-1947) .. 3 Reported in 1947 ........ 1 Percentage decrease
since 1946 ................ 66.6
Undulant fever decreased slightly in 1947, interrupting an upward trend which, except for a slight decline in 1942, has inclicated a steady increase in undulant fever. Deaths decreased by
2 but the total number involved is so small as to give a misleading percentage value.
Whooping Cough
Cases Median (1943-1947) .. 921 Reported in 1947 ........1384 Percentage increase
since 1946 ................ 125.0
Deaths Median (1943-1947) .. 65 Reported in 1947 ........ 95
Percentage increase since 1946 ................ 58.3
Whooping cough cases more than doubled the 1946 total and exceeded the median for 1943-1947 by 50%. However, the case total is slightly below the median for the previous five-year period. Deaths also increased and surpassed the five-year median but also fell short of the 1938-1942 median figure. With the increase in cases, the fatality rate fell.
The tables which follow show the number of notifiable diseases
PTeventable Diseases
199
reported during the year by months and a comparison of the numbers reported for the years 1946 and 1947.
It will be noted that there was an increase in the number of cases for the following diseases: Acute infective conjunctivitis, chickenpox, diphtheria, influenza, pneumonia, rheumatic fever, scarlet fever, tetanus, tuberculosis, tularemia, and whooping cough.
The disease which showed a decrease in the number of cases are as follows: Dengue, Amebic dysentery, bacillary dysentery, gonorrhea, hookworm, lethargic encephalitis, malaria, measles, meningococcus meningitis, mumps, paratyphoid fever, pellagra, poliomyelitis, Rocky Mountain spotted fever, septic sore throat, syphilis, typhoid fever, typhus fever, undulant fever, and Vincent's infection.
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE
DISEASES REPORTED IN GEORGIA, 1938-1947, WITH RATES PER 100,000 POPULATION AND PER CENT FATALITY
Diseases Diphtheria:
Dysentery:
Gonorrhea:
Year
Case Rate Per I00,000
Cases Population
Death Rate
Per I00,000 Fatality Rate Deaths Population (Per Cent)
1938
1232
39.7
106
1939
1112
35.3
95
1940
5<13
17A
59
19<11
758
24.1
63
1942
660
21.1
55
1943
520
16.6
47
19<1<1
462
H.8
40
1945
695
22.2
71
19<16
371
11.9
<15
19<17
<137
13.5
<12
1938
679
21.9
192
1939
585
18.6
127
1940
582
18.6
126
19<11
516
16A
109
1942
584
18.7
86
1943
459
H.7
79
19H
30<1
9.7
fi3
1945
313
10.0
60
1946
214
6.9
36
1947
15,1
4.8
19
1938
<1686
151.2
21
1939
<1583
H5.7
2,1
19<10
5282
169.1
22
19<11
7229
22\1.8
24
1942
16786
537.4
6
1943
10028
321.0
12
19H
8557
273.9
8
1945
123,10
395.0
5
19,16
15282
489.2
2
19<17
12338
381.6
5
3A
8.6
3.0
8.5
1.9
10.9
2.0
8.3
1.8
8.3
1.5
9.0
1.3
8.7
2.3
10.2
1.4
12.1
1.3
9.6
6.2
28.3
<1.1
21.7
<J.O
21.6
3.5
21.1
2.8
H.7
2.5
17.2
2.0
20.7
2.0
19.2
1.2
16.8
0.6
12.3
0.7
OA
0.8
0.5
0.7
OA
0.8
0.3
0.2
0.03
OA
0.1
0.3
0.1
0.2
0.0'1
0.1
0.01
0.2
0.04
200
Georgia Department of Public Health
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE
DISEASES REPORTED IN GEORGIA, 1938-1947, WITH RATES PER 100,000 POPULATION AND PER CENT FATALITY (continued)
Diseases
Year
Hookworm:
1938 1939 19,10 1941 1942 19<!3 1944 1945 1946 19,17
Influenza:
1938 1939 19,10 1941 1942 1943 19,14 1945 1946 1947
Malaria:
1938
193~
1940 1941 1942 1943 19<14 19,15 19,16 1947
Measles:
1938 1939 1940 1941 1942 1943 19,11 1945 1946 1947
Meningitis: (Meningococcus)
1938 1939 1940 1941 19,12 1943 194<1 1915 1946 1947
Case Rate Per I 00,000 Cases Population
Death Rate
Per I 00,000 Fatality Rate Deaths Pcpulatlon (Per Cent)
17711 2038,1
17306 71<13 4617 3409 3372 3799 ,1928 4321
571.4
647.9 551.0 227.1
147.8 109.1 107.9 121.6
157.8 133.7
2
0.1
0.01
8
0.3
0.04
1
0.03
0.01
2
0.1
0.04
1
0.03
0.02
3782
122.0
802
25.9
21.2
11592
368.5
950
30.'1
8.2
13420
429.6
92,1
29.6
6.9
36021
1145.3
994
31.6
2.8
2900
92.8
482
15.4
16.6
13238
423.8
62,1
20.0
'1.7
8118
259.9
742
23.8
9.1
3780
121.0
,173
15.1
12.5
2279
73.0
423
13.5
18.6
6073
187.8
367
11.'1
6.0
3816
123.1
146
2996
95.2
101
2502
80.1
89
1122
35.7
75
981
31.'1
76
525
16.8
37
416
13.3
34
460
14.7
26
115
3.7
12
67
2.1
13
4.7
3.8
3.2
3.4
2.8
3.6
2.4
6.7
2.4
7.7
1.2
7.0
1.1
8.2
0.8
6.0
OA
lOA
0.4
19.'1
1051<1
339.2
157
5.1
1.5
3423
10H.8
51
1.6
1.5
3282
105.1
23
0.7
0.7
11009
250.0
157
5.0
1.4
5921
189.5
60
1.9
1.0
4413
141.3
27
0.9
0.6
6239
199.7
68
2.2
1.1
653
20.9
7
0.2
1.1
418,1
133.9
44
1.4
1.1
3406
105.4
17
0.5
0.5
40
1.3
20
0.6
50.0
35
1.1
15
0.5
42.9
27
0.9
9
0.3
33.3
35
1.1
17
0.5
'18.6
53
1.7
18
0.6
34.0
211
6.8
31
1.0
14.7
215
6.9
56
1.8
26.0
117
3.7
38
1.2
32.5
70
2.2
31
1.0
44.3
53
1.6
20
0.6
37.7
Preventable Diseases
201
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE
DISEASES REPORTED IN GEORGIA, 1938-1947, WITH RATES PER 100,000 POPULATION AND PER CENT FATALITY (continued)
Diseases Pellagra: Pneumonia: Poliomyelitis: Scarlet Fever:
Smallpox:
Year
Case Rate Per 100,000 Cases Population
Death Rate Per 100,000 Fatality Rate Deaths Population (Per Cent)
1938 1939 19,!0 1941 1942 1943 19'1'1 19,15 1946 19,17
1938 1939 1940 1941 19,12 19,13 19,14 19,15 19,16 1917
1938 1939 1940 19<11 1942 19<!3 1944 1945 1946 19,17
1938 1939 19,10 19<11 19,12 19,13 194,1 19,15 1916 19,17
1938 1939 19,10 19,11 19,12 19,13 1944 19,15 1946 1947
1209 745 429 33-1 257 208 159 110 107 112
5165 ,1765 ,1,180 3623 <1172 3797 252,1 1911 19,17 1897
76 101
30 790
19 28 104 128 165 89
782 1055 1000 1079 11<18
964 997 1187 503 621
33 ,17 11 11
7 12
7 10
3 3
39.0 23.7 13.7 10.6
8.2 6.7 5.1 3.5 3A 3.5
166.6 151.5 143.4 115.2 133.6 121.6
80.8 61.2 62.3 58.7
2.5 3.2 1.0 25.1 1.6 0.9 3.3 4.1 5.3 2.8
25.2 33.5 32.0 3<1.3 36.8 30.9 31.9 38.0 16.1 19.2
1.1 1.5 0.4 0.3 0.2 0.4 0.2 0.3 0.1 0.1
365 271 235 20,1 181 175 131 106
93 102
2731 2299 2055 171,1 1612 1734 1581 1500 13<11 129,1
18 12
7 33 10
3 9 10 8 4
13 19 16
9 2 6 2 5 1 1
11.8 8.7 7.5 6.5 5.8 5.6 '1.2 3.4 3.0 3.2
88.1 73.6 65.8 5'1.5 51.6 55.5 50.6 48.0 '12.9 40.0
0.6 0.4 0.2 1.1 0.3 0.1 0.3 0.3 0.3 0.1
0.4 0.6 0.5 0.3 0.1 0.2 0.1 0.2 0.03 0.03
0.03
30.2 36A 51.8 61.1 70.4 8'1.1 82A 96.4 86.9 91.1
52.9 48.2 '15.9 47.3 38.6 '15.7 62.6 78.5 68.9 68.2
23.7 11.9 23.3
4.2 20.4 10.7
8.7 8.0 '1.8 '1.5
1.6 1.8 1.6 0.8 0.2 0.6 0.2
OA
0.2 0.2
10.0
202
GeoTgia DepaTtment of Public Health
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE
DISEASES REPORTED IN GEORGIA, 1938-1947, WITH RATES PER 100,000 POPULATION AND PER CENT FATALITY (continued)
Diseases Syphilis:
Tuberculosis:
Typhoid Fever:
Typhus Fever:
Year
Case Rate Per IOO,OOU
Cases Population
Death Rate Per I00,000 Fatality Rate Deaths Population (Per Cent)
1938 1939 1940 1941 1942 1943 1914 1945 1946 1947
18013
20183 21259 19510 21544 21548
13954 12221 11477 11103
1938 1939
1940 1941 1942 1943
1941 1945 1946
1947
3011
2996 2805 2635 3067 2891
2608 2112 2534
3324
1938
829
19.39
564
1940
487
1941
397
1942
384
1943
208
1944
177
1945
168
1946
81
1947
74
1938 1939 1940
1941 1942
1913 1944 1945 1946 1947
1017 1131
589 944 1153
1256 1182 1111
606
441
582.1 641.7 680.6 621.3 689.7 689.8 446.7 391.3 367.4 343.4
97.1
~5.2
89.3 83.8 98.2 92.5 83.5 67.6 81.1 102.8
26.7 17.9 15.6 12.6 12.3
6.7 5.7 5.4 2.6 2.3
32.8 35.9 18.9 30.2 36.9 40.2 37.8 35.6 19.4 13.6
178 473 587 503 462 435 372 358 309 322
1612 1533 1533 1385 1265 1304 1107 1108 1048 1074
121 83 68 55 24 23 24 23 11 9
47 44 26 36 52 57 63 59 33 31
15A 15.1 18.8 16.0 14.8 13.9 11.9 11.5
9.9 10.0
52.0 49.1 19.1 44.0 10.5 11.7 35.4 35.5 33.5 33.2
3.9 2.7 2.2 1.7 0.8 0.7 0.8 0.7 0.4 0.3
1.5 1.4 0.8 1.1 1.7 1.8 2.0 1.9 1.1 1.0
2.6 2.3 2.8 2.6 2.1 2.0 2.7 2.9 2.7 2.9
53.5 51.2 54.7 52.6 41.2 43.7 42.4 52.5 41.4 32.3
H.6 14.7 14.0 13.9
6.3 11.1 13.6 13.7 13.6 12.2
4.6 3.9 4.4 3.8 1.6 4.5 5.3 5.3 5.4 7.0
Preventable Diseases
203
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE
DISEASES REPORTED IN GEORGIA, 1938-1947, WITH RATES PER 100,000 POPULATION AND PER CENT FATILITY (continued)
Diseases Undulant Fover:
Whooping Cough:
Year
Case Rate Per I00,000 Cases Population
Death Rate Per I00,000 Fatality Rate Deaths Population (Per Cent)
1938
83
2.7
1939
121
3.8
1910
123
3.9
1941
117
3.5
1942
129
4.1
1913
98
3.1
1944
159
5.1
1945
151
4.8
1946
169
5A
1947
1S6
1.2
3
0.1
3.6
2
0.1
1.7
3
0.1
2.4
2
0.1
1.7
3
0.1
3.1
3
0.1
1.9
3
0.1
2.0
3
0.1
1.8
1
0.03
0.7
1938
2329
75.1
225
1939
1614
51.3
134
1940
1020
32.7
108
1941
H06
4!.7
140
1942
1369
43.8
101
1943
1749
56.0
170
194<1
792
25A
65
1945
921
29.5
65
1946
615
19.7
60
1947
1384
12.8
95
7.3
9.7
4.3
8.3
3.5
10.6
1.5
10.0
3.2
7A
5A
9.7
2.1
8.2
2.1
7.1
1.9
9.8
2.9
6.9
NUMBER OF CASES OF NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY MoNTHS, 1947
Total
Actinomycosis ----------------------------Acute Infectious Conjunctivitis____ AChincktehn-rpaoxx::::::::::::::::.::::::~-::::::::::::::: Cholera -------------------------------------------Dengue Fever Diphtheria ........:::::::::::::::::::::::::::::::
1 67 1965
437
Dysentery, Amebic ------------------------- 22 Dysentery, Bacillary ...................... 121
Dysentery, Unspec. ------------------------ 11
Gonorrhea -----------------.............. 12338
Hookworm ---------------------- ---------------- 4321
Influenza
6073
Leprosy ____::::::::::::::::::::::::::::::::::::::::::__________
Lethargic Encephalitis -----------------Malaria -------------------------------------------Measles .-------------------------------------------Meningococcus Meningitis ____________
Mumps -----------------------------------------------Paratyphoid Fever -------------------------Pellagra --------------------------------------------Pneumonia ---------------------------------------PPouleiropmetyeallitiSsep~-i~---~~:::~::~:::~~~:::::~::::~~: RRaabt ieBsite(iFnevmera__n__)__________________________________________________________
3 67 3406
53 311
43 112
1897 89 1
2 2
Rheumatic Fever ---------------------------- 85
Rocky Mountain Spotted Fever.... 23
Scarlet Fever --------------------------------- 621
Septic Sore Throat--------------------------- 208
Smallpox
3
Syphilis __ .::::::::::::::::::::::::::::::::::::::::: 11103
Tetanus ------------------------------ -------------Trachoma ------------ ----------------------------Trichinosis ________ ------------------------------Tuberculosis _______ Tularemia _____________ ----~:~~:~~~::~~~~~~~~-:~~
Typhoid Fever -------------------------------Typhus Fever ---------------------------------Undulant Fever --------------------------Vincent's Infection------------------------Whooping Cough ---------------------------Cancer ---------------------------------------------
33
3324 104 74 441 136 61
1384 117
Total
49059
Jan.
2
194
27 1 4
1283 264 108
1 405
8 13
1 5 200 1
------
5
74 12
1 871
1
200 19 2 65 7 15 39
3828
Feb.
\)
232
March
-------457
20 3
11
1023 34B 551
1 5S8
6 32
4 1:-l 237
1
16 4 9 2
1164 723
3826
1 5 1063 5 36 2 10 297
-----
8
11
79
79
38
17
1
924
1217
4
2
210 11 3 44 5 5
108
4519
286 21
24 9 6
65
H357
April
------
418
13 1 8
842 564 1189
6 600
4 54
5 13 233
2
4
39 7
1085 1
281 18 2 24 10 6 94 8
5531
May
1
411
9 2 8
1141 481 63
1 7 458 6 51 2 8 126 2
1 10
16 11
1 1219
4
288 7 6
17 13
8 232
8 4618
June
-------45
July 1 1
14
8
7 1 1055 225 25
8 1 10 1 1013
218 15
5
17
102
52
4
7
22
28
7
3
13
8
100
63
12
7
1 5 6 9 14
838 2
301 5 7
46 25
4 219
24
3137
7 4 18 10
847 3
--------
305 6
13 58 26
3 103
14
2884
Aug.
9
13
14 2 7 3
1357 295 25
11 24
1 15
6 9 65 16
4 5 23 18
991 8
437 5
10 64 12
4 258
17 3728
Sept.
38
1
48 2
21 2
1026 231 16
5 2 1 7 2 6 74 22
6 6 31 24
828 5
295 2
14 39
9
99 10 2872
Oct.
4
10
95 4
16
958 292
70
6 35
4 6 6 9 124 11
10 1
72 17
873 1
270 2 6
29 11
4 54 13 3013
Nov.
2
36 -----
125 1
12 2
831 241
65
36 2
12 4 7
142 14
7 1 101 20
834 1
240 7 7
20 3 1
55 14 2843
l\:) 0 ~
Dec.
134 qJ
..,~
54
0
1 <:c:;,
8 "~"
645 439
b
120
~
..,'1:3
1
~
3 .,....
41
5 35
1
~ .;~ ,:.s...
11
236 3
..0......
1 'lj
::::
8 0"
""~
80
~
20
~
576
~
1 .~,....
:;:.-
211 1 4
11
6 5 5S 9
2729
Preventable Diseases
205
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
CouNTIES, 1947
Area
Diphtheria
Estimated Population Cases Rate
Gonorrhea
Cases
Rate
Influenza
Malaria
Cases Rate Cases Rate
State Total
3,233,000 437 13.5 12338 381.6 6073 187.8 67 2.1
Rmal --------------------- 1,878,800 310 16.5
2033 108.2 39,!4 209.9 55 2.9
Cities 2,500-5,000.... 115,600
22 19.0
230 199.0
355 307.1
5 4.3
Cities 5,000 and
Above ______________ 1,238,600 105
8.5
9197 742.5 1770 H2.9
7 0.6
Military
Not
Reservations _________________ available
878
,j
Appling --------------- 13,300
7.5
Atkinson ----------------
6,900
Bacon ----------------------
7,700
13.0
Baker ---------------------Baldwin -------------
**
6,200 17,021
11 64.6
Banks --------------------Barrow ---------------Bartow ----------------Ben Hill ----------------Berrien --------------------
6,400 13,000 26,300 14,000 lt!,200
9 140.6 2 15A 6 22.8 2 14.3 2 H.1
Bibb ------------------------ 110,100
Bleckley ----------------
9,100
9
8.2
1 11.0
Brantley ---------------Brooks -------------------Bryan ----------------------
6,700 18,900
6,100
8 42.3 1 16.4
Bulloch -------------------- 24,000
8 33.3
Burke ------------------- 24,500
3 12.2
Butts -------------------
8, 700
Calhoun -----------------
9,900
Camden -----------------
6,500
15A
Candler -------------------
7,200
Carroll --------------------
31,000
9.7
Catoosa -------------------- 11,000
9.1
Charlton ---------------
4,700
Chatham
155,200
3
1.9
Chattahoochee ------
1,800
1 55.6
Chattooga ------------ 20,000
Cherokee ----------------Clarke -------------------
19,200 30,000
2 10.4 6 20.0
Clay ------------------------
6,400
Clayton -------------------- 12,500
8.0
Clinch ---------------------
Cobb ----------------------Coffee -------------------Colquitt ------------------
5,100
52,000 22,000 33,100
11 21.2 l 18.2 8 24.2
Columbia --------------Cook ---------------------
8,300 11,100
2 18.0
Coweta -----------------Crawford .--------------Crisp ------------------------
26,000 6,200
16,000
1 16.1 2 12.5
Dade -----------------------Dawson -------------------Decatur ----------------DeKalb --------------------
6,000 4,000 23,300 88,200
1 25.0
3 12.9
5
5.7
Dodge ---------------------- 17,600
Dooly ---------------------- 15,200
Dougherty ------------- 36,300
Douglas -------------
9,500
10.5
Early -------------------- 18,000
Echols ----------------------
2,500
Effingham ------------Elbert --------------------Emanuel -------------Evans ------------------
9,100 16,800 19,500
6,600
2 11.9
3 15A 6 90.9
Fannin -------------------- 13,500
Fayette -------------------Floyd ----------------------
7,100 58,200
1 14.1 12 20.6
Forsyth ----------------Franklin
10,100 15,000
13 86.7
Fulton -------------------- 463,800
25
5.4
Exclusive of State Milledgeville Hospital.
8 115.9
15
88.1
1
15.6
9
69.2
5
19.0
2
14.3
18 126.8
90
81.7
35 38,1.6
9
47.6
1
16.4
13
5'1.2
179' 730.6
1
11.5
1
10.1
4
61.5
19
61.3
2
18.2
351 226.2
2 111.1
3
15.0
68
226.7
1
15.6
,j
32.0
1
19.6
48
92.3
299 1359.1
214 1;46.5
12 108.1
1
3.8
166 1037.5
4 100.0
14
49.9
18 102.3
5
32.9
327 900.8
7
73.7
4
22.2
2
22.0
1
6.0
10 2
129 2 4
6630
74.1 28.2
221.6 19.8 26.7
1429.5
5
37.6
4
58.0
1
13.0
1
16.1
2
31.3
31 238.5
l
15.2
10
70.4
9
8.2
22 211.8
1
14.9
94 1541.0
41 170.8
l
16.3
4
'!6.0
3
41.7
5
16.1
11 234.0 177 lH.O
2
10.0
79 411.5
4
13.3
3
24.0
1 19.6
508 976.9
9
40.9
2
6.0
2
7.7
2
32.3
3
18.8
1
16.7
5
21.5
667 756.2
3
17.0
3
19.7
7
19.4
6
63.2
7
38.9
10 109.9
33 196.4
1
5.1
1
15.2
14>1 1066.7
3
42.3
216 371.1
1
9.9
51 340.0
804 173.4
5.9 11.0 10.1 13.9
1.9 4.5 2 18.0
3 17.0
14.1 3 0.6
206
Georgie~ Department of Public Health
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
COUNTIES, 1947 (continued)
Area
Diphtheria Estimated Population Cases Rate
Gonorrhea Cases Rate
Influenza
Malaria
Cases Rate Cases Rate
Gilmer--------------------- Glascock ------- Glynn-----------------------Gordon --Grady ....... ---Greene ---------------------Gwinnett --------------Habersham .............. Hall ..........................
Hancock -----------------Hara]son ----------------
Harris ---------------------Hart --------- Heard --------Henry ---- Houston -----------------1rwin --------------------Jackson -----------------,}asper -------------------Jeff Davis
Jefferson -----------------Jenkins -----------------Johnson ---------
Jones ----------------------Lamar ---------------------Lanier ---------------------Laurens -----------------Lee---------- Liberty ----------~------- Lincoln ----~---------------
Long ----- Lowndes -------~------~~ Lumpkin ------- Tvlacon -----~---------~---- Madison --- Marion --------~--------- McDufliie -----Mcln tosh ----- Meriwether ~-------~--~ Miller ...................... Mitchell ..................
Monroe -----~---~----~----~ Montgomery ~-------
Morgan -----------------Murray -------------------Muscogee ---------------Newton ..................
Oconee -------------------Oglethorpe ..............
Paulding ---- Peach ...................... Pickens ....................
Pierce --------------------Pike---- Polk -------- Pulaski -------
Putnam ----------------Quitman .................. Rabun ....................
Randolph --------- Richmond --------Rockdale ----Schley ......................
Screven ---------------- Seminole ----------------Spalding ................
Stephens ---------Stewart ---- Sumter ------- Talbot -------
9,100 3,700 45,800
16,500 18,500 13,200 27,100 14,300 35,000
12,000 12,000 11,000 12,100
7,100 15,000
17,600 12,100 18,200
7,900 7,400 18,800
10,500 10,400
7,200 9,600
5,200 33,000 7,200 11,000
6,000 3,600 34,000 5,600 15,200
11,800 6,900
10,500
6,000 20,300 10,100 22,600
10,200
7,600 12,100 10,600 100,000 18,300
6,500
11,000 11,400 11,000
7,800 11,600
9,100 28,'100
9,100 7,700 3,100
7,000 14,800 94,400
7,400
4,400 17,000
7,900 28,600
14,100 9,800
24,700
7,700
36A
1
7.6
19 70.1
5 35.0
22 62.9
1
8.3
1
8.3
1
9.1
5 '11.3
1
6.7
2 llA
1
8.3
'1 22.0
3 16.0 3 28.8
1 19.2
2
6.1
2
5.9
3 53.6
16.9 1<1.5
4 17.7
-2 18.9
4
4.0
8 43,7
1 15A
1
9.1
6 5'1.5
3 38.5
2 17.2
1 11.0
2
7.0
25 357.1
1
6.8
11 11.7
1 22.7
5 29.4
2 25.3
2
7.0
7 49.6
2
8.1
19 115.2
23 124.3
11
83.3
10
36.9
6
42.0
208 594.3
2
16.7
20 181.8
6
49.6
2
28.2
2
13.3
26 1<17.7
1
8.3
8
4<1.0
18 227.8
12
63.8
5,1
514.3
11
105.8
10.4
205 621.2 11 152.8
50.0
5
14.7
5
89.3
3
19.7
30 254.2
20
98.5
11
'18.7
1
9.8
4
33.1
8
75.5
51
51.0
22 120.2
1
15.4
1
().1
1
8.8
86 781.8
7
89.7
7
60.3
'1
44.0
37 130.3
8
87.9
8 103.9
3
42.9
25,1 269,]
3
40.5
216 1270.6
11 139.2
,15 157.3
6
42.6
13 132.7
70 283.4
1
27.0
4
8.7
9
54.5
6
32.4
50'1 3818.2
8
29.5
2
14.0
36 102.9
2
16.7
3
27.3
3
2<1.8
1
1<1.1
1
5.5
106 1341.8
4,1 234.0
17 161.9
51 490.4
1
13.9
1
10.4
,15 136.4
1
13.9
5
45.5
9 150.0
36 105.9 100 1785.7
459 3889.8
2
29.0
60 571A
6
29.6
1
9.9
1
13.2
25 206.6
2
18.9
1
1.0
2
10.9
2
30.8
52 '172.7
5
43.9
11 100.0
600 7692.3
21 181.0
.3
33.0
3,19 1228.9
2
26.0
2
64.5
1
14.3
2
13.5
137 145.1
20 270.3
8
'17.1
83 1050.6
16
55.9
22 156.0
2
20.4
6
24.3
1
13.0
'1 24.2
2 18.2
9.6 6 18.2
2.9 3 14.8
1 9.1 1 12.8
3.5 1.1 25 316.5
Preventable Diseases
207
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
COUNTIES, 1947 (continued)
Area
Diphtheria Estimated Population Cases Rate
Gonorrhea Cases Rate
Influenza
Malaria
Cases Rate Cases Rate
1.,aliaferro
4.900
Tatnall -Taylor ____
15,000
10.0
9,300
Telfair
12,600
1
7.9
Terl'ell ---------------------
17,100
2 11.7
Thomas -------------------
36,400
10 27.5
Tift --------------------------
20,500
1
4.9
Toombs ------------
16,000
2 12.5
'Tfore,vuntlsen --_-_-_-----------_-_-_-_-_
1,300 6,000
50.0
Troup ---------------------
16,400
Turner --------------------
~';;f~:fs --~~~~~~~~~~~~~~~~~~~~
8,500 9,000 7,000
2 22.2 1 57.1
Upson ---------------------
24,000
6 25.0
Walker --------------------
31,700
4 12.6
Walton -------------------
20,500
2
9.8
Ware -------
29,400
Warren ------------------
9,400
Washington ------------
22,000
9 40.9
Wayne---------------------
13,100
2 15.3
Webster ----------------
4,000
Wheeler ------------------
6,500
3 46.2
White ----------------------
6,000
5 83.3
Whitfield
30,000
4 13.3
Wilcox--------------------
10,100
2 19.8
Wilkes ------------------- 13,000
Wilkinson -------------
9,600
1 10.4
Worth -------------------- 19,900
10 50.3
Military
Reservations .Not Available
1
7.9
9
52.6
198 514.0
23 112.2
2
33.3
136 293.1
3
35.3
4
4<1.4
4
16.7
21
66-2
133 618.8
111 377.6
47 213.6
13
99.2
21
350.0
261
870.0
2
19.8
16 123.1
2
20.8
82 !12.1
878
20.4
6.7
6.7
7.9
11
30.2
2
9.8
6
37.5
1
23.3
12
25.9
1
11.8
1
11.1
17 242.9
12
50.0
2
6.3
21 102.'! ----
1
13.6
16.7 3.2
18.2 7.6
350.0 15.1
3
10.0
35 316.5
4
30.8
5
52.1
3
15.1
1 9.9 10.4
4
NOTE: Rates are based on the estimated population as of July 1, 1917.
208
Geo1gia Department of Public Health
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
CouNTIES, 1947
Area
Measles Cases Rate
Meningococcus Pneumonia Meningitis
Cases Rate Cases Rate
Poliomyelitis Scarlet Fever Cases Rate Cases Rate
State Total ---------- 3<106 105.'1
53
1.6 1897
58.7
89
2.8 621 19.2
Rural
... 1322
70A
26
lA 1006
53.5
l13
2.2 226 12.0
Cities 2500-5000 ~ 239 206.7
3
2.6
62
53.6
10
8.7
Cities 5000 and
Above ~~~~~~~~---~
1834 148.1
22
1.8 742
59.9
<17
3.8 378 30.5
Military
Reservations
11
2
87
Appling
6
Atkinson
4
Bacon ____
Baker __
Baldwin
30
Banks
Barrow
Bartow -- ~
Ben Hill ----------
Berrien -------------
Bibb ------------------
673
Blecldey ---------
23
Brantley -----
Brooks
Bryan --------------
7
Bulloch.
19
Burke --------Butts -----------------Calhoun
Camden -----------
Candler -------
2<1
Carroll --------
Catoosa --------------
Charlton
12
Chatham
809
Chattahoochee
Chattooga ---------
Cherokee ----------
112
Clarke --------
5
Clay
Clayton -----Clinch
Cobb ------------
;)1
Coffee
1
Colquitt ----------
Columbia
Cook
Coweta
Crawford ----Crisp -----------Dade
Dawson -----------------
Decatur -----------
DeKalb _
217
Dodge -------~--~~
4
Dooly
Dougherty
Douglas ----------------Early ---Echols
Effingham ------
H
Elbert
1
Emanuel Evans ________
Fannin ______
Fayette --
Floyd
61
Forsyth --
Franklin
Fulton
287
45.1 58.0
176.3 23.1 19.0 1<1.3
611.3 252.7
11<1.8 79.2
8.2 10.1 333.3
255.3 521.3
583.3 16.7
98.1 4.5
16.1
246.0 22.7 22.0
153.8 6.0
44.'1 10<1.8
61.9
6
<15.1
7 lOlA
2
26.0
1
16.1
23 135.1
2
31.3
7.7
8
61.5
9
3<1.2
11
78.6
1
7.0
11
77.5
5
<1.5
52
47.2
12 131.9
4
59.7
8
42.3
4.2
9
37.5
17
69.<1
4
46.0
'I
40.4
15.4
3
46.2
3
<11.7
3.2
17
5<1.8
'I
36.'1
1
21.:;
1.9 122
78.6
1
55.6
3
15.0
H
72.9
11
36.7
5
78.1
4
32.0
1
19.6
1.9
20
38.5
20
90.9
12
36.3
2 24.1
I
48.2
4
36.0
11
<12.3
8 129.0
4
25.0
12
51.5
2.3
35
39.7
8
15.1
10
65.8
9
24.8
5
52.6
5.6
8
<l<IA
1
40.0
5
54.9
2 11.9
6
35.7
1
5.1
8
41.0
2
30.3
3 22.2
15 111.1
3
42.3
48
82.5
9.9
5
49.5
9
60.0
1.3 253
54.5
3.8 1.8
2
8.3
3 12.2
5.9
3 23.1 7 26.6 3 21.'1
28 25.<1 6 65.9
26.5
4.2
27.8
11
7.1
6 333.3
1
5.0
6.7
1.9
12.0 3.8
3.2 46 29.6
36 120.0
8.0
25 48.1
2
6.0
3 36.1
6.3
1.1
37 12.0
1
5.7
1
6.6
5.6
6.0 5.1
7.4 H.1
8 13.7
3 20.0
22
4.7 203 43.8
Preventable Diseases
209
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
COUNTIES, 1947 (continued)
Area
Measles Cases Rate
Meningococcus Pneumonia Meningitis
Poliomyelitis Scarlet Fever
Cases Rate Cases Ra:e Cases Rate Cases Rate
Gilmer
Glascock
Glynn
2t1
--~--
Gordon ------------
1
Grady
Greene
15
Gwinnett
7
Habershmn ------------ 2
Hall
3<1
Hancock
Haralson
Harris ---Hart ...
Heard --------------Henry ..
Houston
76
Irwin
Jackson ------------------ 51 Jasper
Jeff Davis ..
Jefferson -------
Jenkins --------------
3
Johnson --------------
21
Jones -------------------- 17
Lamar
Lanier
Laurens
16
Lee -------------------Liberty .............
Lincoln ----------Long
Lowndes ------------------
Lumpkin
1
Macon
2
Madison -----------Marion
McDuffie ...........
31
Mcintosh ........
17
Meriwether _______
Miller
Mitchell ------------------ ----Monroe
Montgomery -------
Morgan ------------------
Murray ------------------
Muscogee
3
Newton ------ ------Oconee ---------------Oglethorpe ---------Paulding
Peach -----------------
53
Pickens ----------------- 11
Pierce
8
Pike ----------------
1
Polk -----------------
'1
Pulaski --------- ------- 222
Putnam ----------
Quitman
Rabun ..................
Randolph ~
20
Richmond ------------ H
Rockdale
Schley ..................... 12
Screven ------------------ 36 Stewart ---------------- ------Sumter --------------Talbot ------------------Taliaferro ---------Tattnall --------------
52 A 6.1
113.6 25.8 14.0 97.1
<131.8 280.2
28.6 201.9 236.1
48.5 9.1
17.9 13.2
295.2 283.3
8.3 3.0 15.4
'181.8 141.0
69.0 11.0 H.l 2,139.6
135.1 1<1.8
272.7 211.8
12.1
5A 2.9
2 16.9
9.8
2.0 5.5 15.4
1
6.8
2
2.1
4.0 6.7
,j
44.0
12
26.2
9
5'1.5
4
21.6
,17
356.1
15
55 A
5
35.0
9
25.7
6
50.0
5
41.7
6
5'!.5
'1
33.1
1
14.1
9
60.0
12
68.2
6
'19.6
10
5'!.9
7
88.6
9 121.6
14
7<!.5
12 114.3
7
67.3
5
69A
6
62.5
1
19.2
28
8'!.8
5
69A
1
9.1
3
50.0
8
23.5
'1
71.'1
11
72..!
20 169.5
8 115.9
5
47.6
3
50.0
13
64.0
3
29.7
11
'18.7
5
49.0
'1
52.6
9
HA
2
18.9
6<1
64.0
9
<!9.2
2
30.8
5
45.5
8
70.2
23
209.1
5
64.1
12 103.4
5
5<!.9
23
81.0
6
65.9
2
26.0
1
32.3
1
14.3
10
67.6
75
79A
5
67.6
1
22.7
11
64.7
2
20A
18
72.9
<1
51.9
3
61.2
5
33.3
2 12.1
7.6
3.7
7A
17.1
16.7 9.1
6.7 15 85.2
19 10,1A 2 25.3
5.3
2 10.6
9.5
8.5 14.5
3'!.5
9
9.0
23 23.0
2 10.9
12.8
5.3 5.9 'l.O 2 13.3
10 128.2
3.5 11.0
5 71.4 24 25.4
1 13.5
210
Georgia Department of Public Health
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
COUNTIES, 1947 (continued)
Measles
Meningoccccus Pneumonia Meningitis
Poliomyelitis Scarlet Fever
Area
Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
Seminole
6
Spalding
11
Stephens ---------------- --------
Taylor ------------------- 32
Telfair -------------------- 1
Terrell -------------------- 1
Thon1as ------------------ 4
Tift -------------------------- 1
Toombs ------------------ --------
Towns -------------------- --------
Treutlen ----------------
Troup ------------------- 41.
Turner -------------------- -------,.fwiggs ------------------ --------
Union --------------------
Upson -------------------- 14
Walker --------------------
Walton ------------------ 29
Ware ---------------------- 106
Warren ----------------Wtt.shington ---------- 5
Wayne ------------------- 5
Webster ------------------
Wheeler ----------------- 1
White ----------------------
Whitfield ---------------- 7
Wilcox -------------------- 3
Wilkes --------------------
Wilkinson -------------- 24
Worth -------------------- 5
Military
Reservations ------ 11
75.9 38.5
3<14.1 7.9 5.8
11.0 1.9
94.8
58.3
141.5 360.5
22.7 38.2
15.4
23.3 29.7
250.0 25.1
6
75.~
16
55.9
6
<12.6
7
75.3
8
63.5
5.8
6
35.1
18
19.5
3
14.6
9
56.3
1 16.7
2.2
40
86.2
4
47.1
2
22.2
4
57.1
4.2
15
62.5
3.2
5
15.8
1.9
H
68.~
12
10.8
10 106A
8
36.4
1
30.5
5 125.0
2
30.8
H
16.7
4
39.6
5
38.5
6
62.5
4
20.1
2
87
3.5 35.5
5.8
35.1
1 16.7 22 47.4
11.1
4 16.7 3.2
3.4
1 13.6
4.5 7.6
3.3
18 60.0
5.0 7
NOTE: Rates are based on the estimated population as of July 1, 1947.
Preventable Disecwes
211
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
COUNTIES, 1947 (continued)
Are:~
Syphilis Cases Rate
Tuberculosis Typhoid Fever Typhus Fever Whooping Cough Cases Rate Cases Rate Cases Rate Cases Rate
State Total -------- 11103 Rural ------------------- 2676 Cities 2500-5000 -- 267
343.4 142.'1 231.0
3324
1336 142
102.8
71.1 122.8
74 52
3
Cities 5000 and
Above ---------------- 7912 638.8 1824 H7.3
19
Milita17
Reservations ___ 218
22
2.3 4H 13.6 138,1 '12.8
2.8 320 17.0 584 31.1
2.6
21 18.2
8,1 72.7
1.5 100
8.1 716 57.8
Appling ----------------
2
Atkinson ------------
Bacon -----------------Baker -------------------Baldwin ----------------
1 1 89
Banks -------------------Barrow ----------------
1
Bartow
1
Ben Hill ---------------
3
Berl'ien ---------------- 22
Bibb ---------------------Bleckley ----------------
468 13
Brantley -------------
Brooks ---------------- 75 Bryan-------------------- 10
Bulloch -------------- - 65
Burke -------------------- 213
Butts --------------------
Calhoun ---------------- 28
Camden ----------------
2
Candler ---------------Carroll ------------------- 14 Catoosa ------------------ 3
Charlton ------------
Chatham
2361
15.0
13.0 16.1 522.9
7.7 3.8 21A 154.9 425.1 142.9
396.8 163.9 270.8 869.'1
282.8 30.8
45.2 27.3
1521.3
5 37.6 3 43.5 '1 51.9 2 32.3 25 H6.9
3 46.9 9 69.2 18 68A 8 57.1 4 28.2
138 125.3 4 ,1,1.0 2 29.9
9 '17.6 4 65.6
13 54.2 28 114.3
5 57.5
6 60.6
6 92.3 5 69A 15 48A
16 H5.5
3 63.8
255 164.3
13.0
2
11.8
6 '15.1 1 14.5 3 39.0
2 15.0 22 318.8
2 32.3
15 115.4
llA
1
3.8
6 42.9
1
7.1
15 105.6
3.6
'1
3.6 177 '160.8
6 65.9
6 65.9
5.3
12.5
21 87.5
35 145.8
20 81.6
6 69.0
2 20.2
3 30.3
4 55.6
13.9
2
6.5
2
6.5
2
6.5
1 21.3
9
5.8 301 193.9
Chattahoochee ____ 1 55.6
2 111.1
Chattooga ------------
3 15.0
34 170.0
1
5.0
2 10.0
4 20.0
Cherokee -------------Clarke --------------------
--252
8'10.0
19 99.0 23 76.7
1
Clay -.-------------------Clayton ---------------Clinch ------------------
Cobb ------------------Coffee -----------------Colquitt ------------- __ Columbia ------------
1
8.0
1 19.6
97 186.5
84 381.8
549 1658.6
1 48.2
8 6'1.0 5 98.0 39 75.0 12 5'1.5 66 199A 2 24.1
5.2
5.2
1
5.2
67 223.3
3 46.9
19 36.5
12 5<1.5
97 4'10.9
9.1
H '12.3
1
3.0
1 12.0
Cook ---------------------Coweta ----------------
2 18.0
2
7.7
3 27.0 18 69.2
6 54.1
1
9.0
3.8
1
3.8
Crawford -------------- 1 16.1
2 32.3
Crisp --------------------
Dade ------------------Dawson ----------------
67 H8.8
17 106.3 15 250.0
2 50.0
2 12.5 25.0
Decatur ----------------
3 12.9
13 55.8
6 25.8
DeKalb ----------------- 107 23,!.7
65 73.7
5
5.7
2
2.3
10 11.3
Dodge ----------------- 27 153A
12 68.2
1
5.7
17 96.6
Dooly ------------------- 11 72.4 Dougherty ---------- 259 713.5
5 32.9 39 107.4
2
13.2
15 98.7
1
6.6
4 11.0
33 90.9
Douglas ----------------
10 105.3
10.5
1 10.5
Early --------------------
5 27.8
15 83.3
3 16.7
34 188.9
Echols ------------------
1 40.0
Effingham ------------
7 76.9
9 98.9
5 54.9
Elbert ------------------
6 35.7
17 101.2
Emanuel --------------
'1 20.5
8 41.0
2
10.3
6 30.8
Evans--------------------
1 15.2
4 60.6
8 121.2
1 15.2
Fannin ----------------
1
7.4
23 170.4
1
7A
3 22.2
Fayette ----------------
5 70.4
1 H.1
Floyd ------------------- 214 367.7 278 '177.7
2
3A
2
2,1 41.2
Forsyth ----------------
1
9.9
'1 39.6
3
29.7
2 19.8
Franklin --------------
2 13.3
3 20.0
1
6.7
Fulton ------------- -- 2762 595.5 490 105.6
14
3.0
13
2.8
93 20.1
Gilmer -------------- .._
6 65.9
212
Georgia Department of Public Health
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
COUNTIES, 1947 (continued)
Area
Syphilis Cases Rate
Tuberculosis Typhoid Fever Typhus Fever Whooping Cough cases Rate Cases Rate Cases Rate Cases Rate
Glascock
Glynn----------------Gordon ------------- __ Grady ------------------Greene -----------------Gwinnett -----------HH aa bne_r__s_h___a__m______________ _
Hancock ---------------Haralson ------- ---Harris ----------------Hart---------------------Heard -- --------------Henry -----------------Houston ---------------Irwin ------------------Jackson ---------------JJaelsfpeDr av--i--s-----_-_-_-__-_-_-_-_--_
2 54.1 7 15.3 3 18.2 3'1 200.0
9 68.2 19 70.1
66 188.6 3 25.0
38 345.5
1
8.3
8 45.5 6 49.6
38.0 2 27.0
31 67.7 9 54.5
23 124.3 4 30.3
29 107.0 6 42.0
23 65.7 9 75.0
11 91.7 9 81.8 5 41.3 1 14.1
12 80.0 9 51.1 6 49.6 6 33.0
2 27.0
1
27.0
1
2.2
6.6
21 45.9
2 12.1
16 86.5
1
5.4
12 44.3
5 14.3
1
8.3
1
8.3
2 18.2
14.1
1
6.7
2 11.4
17 96.6
12 99.2
3 24.8
12.7 3 40.5
Jefferson
167 888.3
Jenkins ---------------- 100 952.4
Johnson ----------------
1
9.6
Jones --------------------
1 13.9
Lamar ------------------
2 20.8
Lanier ------------------
Laurens ---------------- 90 272.7
Lee ---------------------Liberty
,j
55.6
15 136A
6 31.9 10 95.2
5 48.1 8 111.1 7 72.9 1 19.2
24 72.7
5 69.4
7 63.6
3 16.0
9.6
13.9
10.4
1 10.4
1 19.2
13 39A
9.1
6 31.9 7 66.7
6 83.3 2 20.8
7 21.2
Lincoln--------------Long
Lowndes --------------Lumpkin -------------
Macon -----------------Madison ---------------Marion ----------------
1 16.7 1 27.8
8 23.5
1 17.9
5 32.9 6 50.8 1 14.5
2 33.3 1 27.8 34 100.0 5 89.3 15 98.7 9 76.3 3 43.5
1
2.9
2
35.7
1
6.6
6 17.6 2 35.7
14.5
2
5.9
5 89.3
1
6.6
,j 33.9
McDuffie --------------
Mcintosh ------------Meriwether ---------
1
9.5
9 150.0
85 418.7
6 57.1 1 16.7
18 88.7
5 47.6 6 100.0 62 305.4
Miller-------------------Mitchell ----------------
2 19.8 83 367.3
1
9.9
7 31.0
3 29.7
13 57.5
4.4
Monoe -----------------Montgomery --------
Morgan ---------------
3 29.4
1 13.2
1
8.3
13 127.5 ,j 52.6
10 82.6
2 19.6
4 52.6
1
8.3
1 13.2 2 16.5
Murray
4 37.7
16 150.9
Muscogee ------------ 288 288.0 244 244.0
14 14.0
Newton ---------------Oconee -----------------
2 10.9 7 107.7
16 87.4 ,j 61.5
Oglethorpe -----------Paulding ---------- ___
6 54.5
1
8.8
8 72.7
1
8.8
9.1
1
8.8
8.8
Peach -------------------- 95 863.6
6 54.5
3 27.3
9.1
Pickens
1 12.8
8 102.6
12.8
1 12.8
-Pierce----------------
2 17.2
7 60.3
6 51.7
10 86.2
Pike ----------------------
1 11.0
10 109.9
2 22.0
2 22.0
Polk ---------------------Pulaski ------------------
22 77.5 15 164.8
36 126.8 5 54.9
2
7.0
3 33.0
23 81.0
Putnam
2 26.0
Quitman ----------------
3 96.8
32.3
Rabun -----------------
4 57.1
RRiacnhdmolopnhd ---_-_-_-_-_-_-_-_-_-_-_-_
3 43
20.3 45.6
14 94.6 115 121.8
4 27.0
4
4.2
24 25.4
Rocl,dale --------------
7 94.6
2 27.0
Schley ----------------
7 159.1
1 22.7
Screven ---------------- 116 682.4
15 88.2
5.9
29A
22 129.4
Seminole
20 253.2
4 50.6
12.7
31 392.4
Spalding ---------------- 133 465.0 36 125.9
4 14.0
Stephens -------------
3 21.3
21 148.9
1
7.1
SSutemwtearrt _-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_
2 20.4 333 1348.2
8 81.6 20 81.0
2 20.4
4.0
6 24.3
20.2
TTaallbiaofterr--o-----_-_-_-_-_-_-_-_-_-_-_-_
4 51.9
20.4
6 122.4
20.4
Prwventable Diseases
213
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF
SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY
COUNTIES, 1947 (continued)
Area
Syphilis Cases Rate
Tuberculosis Typhoid Fever Typhus Fever Whooping Cough Cases Rate c.:tses Rate Cases Rate Cases Rate
Tattnall ----------------
4 26.7
Taylor -----------------
1 10.8
Telfair ----------------
7 55.6
Terrell ---------------- 94 549.7
Thomas ---------------- 12 33.0
Tift ---------------------- 203 990.2
'l'oombs ----------------
5 31.3
Towns ------------------
Treutlen ---------------
T1oup ------------------ 239 515.1
Turner ------------------
2 23.5
Twiggs --------------- 28 311.1
Union ----------------Upson ---------------Walker
3 12.5
2
6.3
Walton ----------------- 33
Ware---------------------- 46
Warren ---------------
2
Washington ------ _ 117
161.0 156.5
21.3 531.8
Wayne --------------Webster --------------Wheeler
52 396.9 4 100.0
White-------------------Whitfield ------------Wilcox ----------------Wilkes
59 196.7
1
9.9
4 30.8
Wilkinson -----------Worth ----------------Military
12 125.0 82 412.1
Reservations __ 248
8 5.3.3 1 10.8 5 39.7 9 52.6 58 159.3 24 117.1 9 56.3 2 46.5 2 33.3 54 116.4 3 35.3 5 55.6 3 42.9 19 79.2 47 148.3 14 68.3 19 64.6 6 63.8 11 50.0 8 6i.1 4 100.0 3 46.2 1 16.7 77 256.7 8 79.2 8 61.5 5 52.1 8 40.2
22
8 53.3
7 75.3
8 63.5
1
7.9
1
5.8
2 11.7
3
8.2
4 11.0
2
9.8
34 165.9
3 18.8
18.8
2 33.3
2.2
30 64.7
58.8
11.1
11.1
3.2
3.2
5 17.0
21 71.4
1 10.6
3 13.6
1
4.5
6 45.8
1
7.6
25.0
2 50.0
7 107.7
3.3
3.3
9.9
1 10.4 11 55.3
5 25.1
214
Geor-gia Depar-tment of Public Health
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN CITIES OF 5,000
POPULATION AND ABOVE IN GEORGIA, 1947
Area
Estimated Population
Total .................. 1,238,600
Albany ................ Americus ............ Athens ................ Atlanta
(DeKalb) .. Atlanta
(Fulton) .... Augusta .............. Bainbridge Brunswick __________
Cairo ----------------Carrollton .......... Cartersville
Cedartown --------College Park ........ Columbus .......... Cordele .............. Cuthbert ............ Dalton ..................
Decatur -------------Douglas .............. Dublin ..................
East Point -------Elberton ............ Fitzgerald .......... Fort Valley ........
Gainesville --------Griffin .................. Hapeville ............ LaFayette .......... LaGrange
Macon -----------------Marietta Milledgeville
Monroe ---------------Moultrie ............
Newnan -------------Quitman ..............
Rome ------------------Sandersville ........
Savannah -----------Statesboro Thomaston ---------Thomasville ........ Tifton ................ Toccoa Valdosta .............. Vidalia Waycross -----------Waynesboro _______
30,000 11.600 21,400
29,100
320,300 81,000 9,700 28,500 5,500 7,700 7,600 9,600 11.'100 65,000 9,200 5,,100 1<!,800 21,100 8,'100 11,500 17,600 6,500 g,500 7,000 14,000 16,500 7,500 5,500 25,000 77,800 22,500 8,600 5,000 13,100 8,400 7,500 35,000 5,100 134,500 6,400 13,000 16,200 7,,100
7,200 20,100
5,200 21,600
5,100
Diphtheria Case Rate
105
8.5
2 17.2 5 20.5
16
5.0
11 13.6
2 20.8
3
'1.6
2 21.7
3 20.3
11.9 8.7
5 71.4
5 35.7
1
6.1
5 66.7
8 10.3
1
4.4
8 93.0
1 20.0
3 22.9
4 53.3
2
5.7
2
1.5
1 15.6
6 46.2
1
6.2
1 13.5
3 <11. 7
2 10.0
Gonorrhea Cases Rate
Influenza Cases Rate
Malaria Cases Rate
9197 285
61 62
13
6209 253
742.5 950.0 525.9 254.1
44.7 1938.5
312.3
18 327.3
13 168.8
2
26.3
23 239.6
62 5'13.9
17
26.2
118 1282.6
217 1466.2
17
84.6
208 2476.2
71 617.4
63 358.0
1
15A
1
11.8
59 842.9
105 750.0
30 181.8
5
66.7
8 H5.5
95 380.0
62
79.7
38 168.9
15 174.4
58 1160.0
137 1045.8
1
11.9
2
26.7
107 305.7
16 313.7
331 246.1
3
'16.9
2
15.4
136 839.5
12 162.2
3
41.7
3
14.9
111 513.9 H4 2823.5
1770
2 795 136
2 3 2
H2.9 20.0
12.3 6.9
248.2
167.9 20.6 10.5 36.'1
H'l 1500.0
1
8.8
1
1.5
3
32.6
2
37.0
2
13.5
115 572.1
7
83.3
25 217A
1
5.7
9 128.6
28 200.0
2
12.1
9
36.0
7
9.0
2
8.9
4
80.0
11.9
212 605.7
1
19.6
161 119.7
20 312.5
10
76.9
6
37.0
1
13.5
22 305.6
20
99.5
2
38.5
2
9.3
1
19.6
0.6 0.6 10.4 11.9 18.2 4.1
5.0
Preventctble Diseases
215
NUMBER OF CASES AND CASE RATE PER 10o',000 POPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN CITIES OF 5,000 AND
ABOVE IN GEORGIA, 1947
Area
Measles Cases Rate
Meningococcus Meningitis Pneumonia
Cases Rate Cases Rate
Poliomyelitis
Scarlet Fever
Cases Rate Cases Rate
rota! - 1834
Albany................... 6
Americus ------------- 2
Athens -- 5 Atlanta (DeKalb) 6 Atlanta (Fulton) 279 Augusta ................ 9 Bainbridge ............ Brunswick ............ 17
Cairo ---------------------- --------
Carrollton
........
Cartersville ------------
Cedartown
4
College Park ..........
Columbus .............. 3
Cordele .................. - Cuthbert ................ Dalton .................... 7 Decatur .................. 116 Douglas ..................
Dublin - 12
East Point ............ 2
Elberton
l
Fitzgerald
2
Fort Valley .......... 39
Gainesville ............ 1
Griffin .................... l
Hapeville ........................
LaFayette ............
LaGange ................ 35
Macon - 402
Marietta
51
Milledgeville .......... 15
Monroe .................. 24
Moultrie ..........................
Newnan ----------------- -------Quitman - Rome ...................... 39
Sandersville --------Ravannah ------------- 620 Statesboro ............ 11
Thomaston ............ 11
Thomasville - 2
Tifton - 1 Toccoa -------------------- -------Valdosta ........................
Vidalia ..................
Waycross .............. 106
Waynesboro ---------- 2
148.1 20.0 17.2 20.5 20.6 92.3 11.1
59.6
<11.7
4.6
47.3 577.1
101.3 11.4 15.4 23.5
557.1 7.1 24.2
140.0 516.7 226.7 174.4 480.0
111.4
461.0 171.9
84.6 12.3 13.5
490.7 39.2
22
1.8 742
59.5
6
20.0
1
34.5
8
32.8
1
3.4
13
44.7
4
1.3 195
60.9
2
2.5
63
77.8
7
72.2
10
35.1
18.2
2
36A
13.0
1
51.9
2
26.3
13 135.4
6
52.6
1.5
51
78.5
2
21.7
1
18.5
7
47.3
5
24.9
5
59.5
8
69.6
13
73.9
3
16.2
4
17.1
15 211.3
7.1
3
21.4
7
42A
1
13.3
1
18.2
27 108.0
5
6A
13
55.3
1
4A
8
35.6
10 116.3
2
10.0
8
61.1
1
11.9
1
13.3
30
85.7
5
98.0
3
2.2 102
75.8
1 15.6
3
46.9
1
7.7
4
30.8
13
80.2
3
41.7
4
19.9
4
76.9
8
37.0
7 137.3
47
3.8 378 30.5
1
8.6
2
8.2
32 131.1
1
3A
15 51.5
16
5.0 H4 15.0
5
6.2
20 21.7
13.2 8 12.3
6.8
17.0
13.2
1
8.8
18 27.7
11 7
M.l
2
2.6
6
4.5
1 15.6
5 35.7
1
6.1
7 93.3
19 76.0 26 33.4 15 66.7
1 11.6
7.6
1 13.3 5 14.3
33 24.5
3 23.1
H.7
13.9
216
Georgia Department of Public Health
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN CITIES OF 5,000 AND
ABOVE IN GEORGIA, 1947
Area
Syphilis Tuberculosis Typhoid Fever Typhus Fever Whooping Cough Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
Total --------------------- 7912 638.8 1824 1<17.3
19
1.5 100
8.1 716 57.8
Albany ------------------- 239 706.7
31 103.3
2
6.7
19 63.3
Americus ---------------- 230 1982.8 Athens ~---------------- 222 909.8
H 120.7 22 90.2
1
8.6
5 '13.1
66 270.5
Atlanta (DeKalb) 4 13.7
23 79.0
1
3A
1
3A
Atlanta (Fulton) 2750 858.6 386 120.5
11
Augusta ---------------- 35 '13.2 103 127.2
Bainbridge --------- 3 30.9
3 30.9
Brunswick ------------ 5 17.5
23 80.7
Cairo --------------------- 35 636.4
18 327.3
3.4
11
3.'1
80 25.0
3
3.7
19 23.5
'1 41.2
3.5
3 10.5
15 52.6
10 181.8
Carrollton
11 1<12.9
8 103.9
2 26.0
13.0
Cartersville ------------ --------
6 78.9
13.2
Cedartown
17 177.1
13 135.4
2 20.8
18 187.5
College Park -------- 2
Columbus ------------- 242 Cordele ---------------- 47
Cuthbert --------------- 1 Dalton -------------------- 52 Decatur ------------------ 129
17.5 372.3 510.9
18.5 351.4
6<11.8
12 105.6 20,1 313.8 12 130.4
8 1<18.1 44 297.3 20 99.5
1 10.9 1 18.5
9 13.8
1
6.8
4 19.9
Douglas ---------------- 58 690.5
3 35.7
2 23.8
Dublin -------------------- 38 330.4
East Point ----------- 3 17.0
Elberton
1 15.4
9 78.3 7 39.8 12 184.6
7 60.9
26.1
Fitzgerald -------------Fort Valley -----------Gainesville ------------
2 23.5 78 111<1.3 50 357.1
5. 58.8 3 '12.9 15 107.1
47.1 28.6
7.1
Griffin ------------------- 86 521.2
27 163.6
6.1
Hapeville -------------- -------
LaFayett -------------- 2
LaGrange -------------- 123
Macon -------------------- 401
Marietta
70
36.4 492.0 515.4
311.1
6 80.0 9 163.6 32 128.0 118 151.7 22 97.8
7 28.0
1.3
4
5.1
87 111.8
H '16,1.3
lVlilledge;ille --------- 7,1 860.5
20 232.6
Monroe ----------------- 1<1 280.0
7 HO.O
Moultrie ---------------- 369 2816.8
Newnan ---------------- 1 11.9
Quitman ---------------- 25 333.3
Rome ---------------------- 15,1 '140.0
Sandersville
22 431.4
34 259.5 10 119.0
'1 53.3 156 4<15.7
4 78A
7 53.4 11.9
1 19.6
22 62.9
Savannah ------------- 2003
Statesboro ------------- 21
Thomaston ------------ 2
Thomasville ---------- 8
Tifton ------------------- 102
Toccoa ------------------- 3
Valdosta
6
1489.2 328.1
15.4 49.4 1378.4 <11.7 29.9
231 171.7
'1 62.5 13 100.0 ,11 253.1 15 202.7 15 208.3 2,1 119.'1
7
5.2 265 197.0
8 125.0
6 93.3
3
18.5
1
6.2
10 135.1
24.9
2 10.0
Vidalia -------------------- 2 38.5 Waycross ---------------- 40 213.0
2 38.5 16 74.1
19.2
1 19.2
21 97.2
Waynesboro ---------- 12,1 2431A
10 196.1
10 196.1
Preventable Diseases
217
NUMBER OF CASES OF SPECIFIED NOTIFIABLE DISEASES REPORTED
IN GEORGIA BY COLOR, SEX AND AGE, 1947
Typhoid Fever Typhus Fever
Age Level by Years
~
"3":
"~"
~
0"'
~
"'"~'-"<""=''
'-'::J
~
"3":
"~"
~
'-<"='
"0 ~o""C'
0
<J::J
Under 1 year M
F
1-2 yea-rs
M
F
2-3 years
M
1
F.
1
1
3-4 years
M
2
1
F
1
4-5 years
M
2
F
2
5-6 years
M
F
1
6-7 years
M
2
F
5
7-8 yea1s
M1
4
F5
1
8-9 yea;s
M2
7
F
2
1
9-10 yeurs
M
F
3
10-14 years M 4
1
20
2
F1
2
14
1
15-19 Y<ars M 2
1
23
3
F3
17
3
20-24 years M 2
1 -----
6
3
F3
12
25-29 years M 1
1
14
6
F3
1
15
1
30-3J YC!al'S
M
2
1
16
'1
F1
1
16
1
35-39 years M 1
2
30
'1
F
1
9
1
4 0-4 .J Y\.~ars
M
1
17
5
F
1
14
2
45-49 years M
1
22
5
F
1
15
1
50-54 y,,ars M
13
3
F1
11
1
55-64 y<>ars M 1
19
'1
F1
9
'1
65-74 years M
17
1
F1
8
75 yrs a.nd over M _
2
F
Unknown age M _______
3
F1
6
1
Total
M 20 16
219 41
F 25 12
161 17
Unknown sex
and age
1 -----
State Total
45 28
1 380 61
Undulant Fever Whooping Cough
c
.~
3"":
"~"
~
0"
'l:
"''-<=
.0:-'< o<= O::J
~
"3":
51 82 27
32 22 33 29 31
35 19 16 29 31
27 26 18 15 23 13 15
6 13
2
8
1
a2
2 2
2
11
6
2
3
23
2
3
1
10
2
2
5
2
5
~
6
5
2
3
3
-------- --------
1
2
1
7
2
85 17
278
26
8
327
111 25
605
"~"
~ 0
"'l: "''-<=
~o"<"='
'-' <J::J
,18 5,1
19 20 21 15 12 12 19 12
7 11
7 9
'1 '1 2 7 2 2 1 7 1 1
1
2 143 159
,177 302 ,177
218
Georgia Department of P~tblic Health
NUMBER OF CASES OF SPECIFIED NOTIFIABLE DISEASES REPORTED
IN GEORGIA BY CoLOR, SEX AND AGE, 1947 (continued)
DIPHTHERIA
AMEBIC DYSENTERY
Age Level by Years
c
c
~"
..c
3:
"~ '
0
Q
"''-c0
.o2"c'
Q:J
";::
..c
3:
".~:':
0 Q
"'0
'o-_C,. 'Oc
Q::J
Under 1 year M 7
1
F
5
2
1-2 years
M 19
8
F 17
l
2-3 years
M 21
6
F 21
3
3-4 yeacs
M 28
6
.t!-5 yea.:-s
F 23
5
M 15 11
5-6 yea.~_s
F 21
l
M 12
4
6-7 years
F 15
2
M 18
3
F 13
4
7-8 years
M 10
3
F9
3
8-9 years
M8
2
F 10
4
9-10 years M 3
2
F
9
2
10-14 years M 12
2
F 12
6
15-19 y-ears M 2
4
F5
2
20-24 years M 1
F1
25-29 yo,ars M 2
F3
30-34 years M J
F l
35-39 years M 1
F3
..:10-14 years M 1
F
~15-49 years
M
F
50-54 years M
F
55-64 years M
F
65-74 y:ars l\<1
F 75 yrs and over M ........
F
Unknown Age M 1
F3
Total
M 166 54
F 174 42
Unknown Sex
and Age
State Total
310 96
1 2
l 1
2
14
2
3
2
17
4
**These figures include Unspecified Dysentery.
BACILLARY DYSENTERY
c
:~c
3:
"~' .::
0 Q
"'0
'o- C . , 'Oc:
Q::J
8
l
4
2
4
1
3
1
l
1
7
3
3
2
1
2
5 2 l
MALARIA
c
~
..c
3:
"~ '
0
0 Q
"'0
'o- C . , 'Oc:
Q::J
1
l
2
5
1
3
1
l
l
;j
3
1 3
3 1 1
1
2
1
3
1
1
3
3
57 16 45 11
102 27
7
3 1
l
4
2
5
1
1
3
3
2
2
3
2
2
1
2
1
2
3
1
1
5
I
35
5
22
5
3 3 57 10
Preventable Diseases
219
NUMBER OF CASES OF SPECIFIED NOTIFIABLE DISEASES REPORTED
IN GEORGIA BY COJ,.OR, SEX AND AGE, 1947 (continued)
MEASLES
MENINGOCOCCUS MENINGITIS
Age Level by Years
~ .= 3:
."~"
..2
(J
c ':1:
.......'-C
'Qc
(J;;}
:.ce
3:
"~"
..2
0 (J
c ':1:
.......<-C
-c
c3::J
Under 1 yea1 M 30
1
4
F 32
3
5
1-2 years
M 43
8
1
F 38
1
1
2-3 years
M 65
4
1
F 42
3
3-4 years
M 68
1
2
F 80
'1
1
1
'1-5 yeals
M 70
3
1
F 78
6
5-6 years
M 70
3
F 62
1
6-7 years
M 132
2
F 127
5
7-8 years
M 83
5
F 92
6
8-9 years
M 76
4
2
F 71
3
9-10 years
M 26
5
F 40
5
3
10-14 years M 38 10
1
1
F 44 13
3
2
15-19 years M 10
2
1
1
F6
8
1
20-24 years M 8
2
1
F7
6
25-29 years M 5
2
F
0
3
1
30-34 years M 7
1
1
F7
1
35-39 years M 4
F3
40-44 years M 3
F
2
2
45-49 years M
F2
50-54 years M 1
F
55-64 years M
F
65-74 years M
F
75 yrs and over M ........
F
Unknown Age M 13
F 11
Total
M 752 52
17 12
F 752 71
16
7
Unknown Sex
and Age
1779
State Total 150,! 123 1779 33 19
PNEUMONIA POLIOMYELITIS
-g
.c
':1:
.~ .= 3:
~
("J'
' " "O..:<
'Qc
(J::J
:.ce
3:
."~"
..2
..c
':1:
<-C
'0Q-c"
(J
(J::l
87 HO
65 11,1
15 17
16 14
13
'1
7
9
10
6
5
2
8
3
6
'1
6
4
5
3
3
4
r;
3
5
2
6
2
3
1
3
1
5
2
4
1
16
6
18
3
8 10
7 17
H 15
6
8
23 21
7 11
14 12
12 17
10 12
4 16
22 24
6 15
9 3,1
9 19
25 32
4 28
46 ,12
33 <14
79 33
63 28
96 32
112 24
84
1
3
1
601 457
407 384
6
2
6
3
6
1
3
2
1
4
3
3
2
2
3
1 -----
2
6
4
2
5
1
1
5
3
1
1
2
3
45
8
31
5
48 1008 841 48 76 13
220
Georgia Depctrtment of Public Health
NUMBER OF CASES OF SPECIFIED NOTIFIABLE DISEASES REPORTED
IN GEORGIA BY COLOR, SEX AND AGE, 1947 (continued)
SEPTIC SORE
SCAR,LET FEVER
THROAT
Age Level by Years
.~
.c
3:
Under 1 yea1 M 'I F2
1-2 ye2rs
M
'I
F 11
2-3 ye"rs
M 2!
F 18
3-4 years
M 27
F 23
4-5 yeh.ra
M 35
5-6 years
F 29 M ,15 F ,16
6-7 years
M 41 F 36
7-8 years
M 31 F 36
8-9 years
M 17 F 31
9-10 years
M 19 F 25
10-14 years M 29
F 35
15-19 years M 2 F3
20-24 y<!ars M I F3
25-29 years M
1
F2
30-3,1 years M 1
F --------
35-39 years M
F
4 0-14 y ~a rs M
F
45-,19 years M
F
50-54 years M
F
55-6<! years M
F
65-74 years l\1
F
75 Yl'S and over M
F --------
Unknown Age M 9
F4
Total
M 293
F 306
Unknown Sex
and Age
State Total
599
.,
c 3:
~
.,;
0"
Q
<..C
-8":'"c:"~'
1 1 1 1 1 2 2 2
1 2
------ --------
6 13
3
19
3
c
.~
.c
3:
.~;
0
._3o:
.,c --"'
OC 0;:)
1 1 2 2
3 1 1 2
2 5
'I 2 2 3
3 3 1
2
5
'I
3
10
2
6
3
H
1
7
2
6
2
7
1
H
2
7
2
5
'I 3
4
2
4 4
'I 5
'I 2
R9 12 71 19
17 160 31 17
SMALLPOX
TUBERCULOSIS
.,
~
.c
3:
~
.,;
r3
2
c 3:
.,
c 3:
Q
'-C
-"o'""c'
O::l
:2c
3:
~
.,;
8
Q
'-C
-"o'-c" O::l
6 3 7 1
'I
1 4 6 6 6 3 11 10 6 8 8
'I 2 7 2,1
26 21 ,16
71 98 99 93 96 84 128 81 96 69 109 ,14
140 58
181 103
97 61 33 21 29 10 1181 843
3 3 3 1 2 1 2 1
'I 3 3 3 5
'I 3 7
3 5 12 24 23 56 61 ----100 63 77 72 85 71 73 75 ,18
58 5'1 56 29 58 26 ,13
23 5 4
10 7
6,13 626
31 2024 1269 31
Preventable Diseases
221
Hookworm Control
A summary of data on hookworm control activities herewith included shows a comparison of figures for 1945, 1946 and 1947. In addition, there is included a statement of sanitation data and hookworm incidence in forty-nine Southern and Central Georgia counties which was prepared for inclusion in a special privy bulletin. Table I.
There has been an apparent increase in the number of hookworm examinations made in the number of positives found. This reflects renewed field activities in hookworm control and the general effect of the removal of limitations on the use of tetrachlorethylene for hookworm treatment. During the war years travel was severely hampered by gasoline and tire rationing and areas seriously affected by hookworm, being usually the least accessible, were necessarily neglected. The resumption of a more general activity will continue to reflect itself in the increasing number of cases found and persons treated.
The basic plan of hookworm activities carried on in 1947 was essentially that adopted in 1946. Selective school surveys were not encouraged except in Health Officer counties or in counties with experienced nurses. Where facilities for surveys based on hemoglobin determinations did not exist a modified method was employed. Here, selection of persons for examination was made on the basis of a history of ground itch in an individual or in his family on the basis of the absence of a toilet of any type at the home, and on general apparent physical well-being as judged by the school teacher and nurse. It continued to be urged that nurses not attell!pt to find more cases than they could treat and follow up.
Two communities in Appling County were surveyed completely with the assistance of the local Farm Burea1.1 organizations. This pilot experiment was undertaken in order to determine the feasibility of a combined community-wide hookworm treatment and sanitation campaign to be made in connection with the introduction of a new prefabricated aluminum privy. The Farm Bureau provided voluntary workers who did all the field work required for the program, including writing out la,boratory examination forms, handing out specimen containers, and examining the type of privy in use at the homes. These workers undertook to elicit a promise from the householder to construct an adequate pit privy_or better toilet facilities within a definitely agreed upon period. Approximately 90 o/o of the individuals found positive for helminth diseases in these two communities were treated at the County Health Department, and a large number of sanitary toilets were installed despite the fact that the prefabricated privy did not become available in time for use in this project. (Note: The prefabricated privy mentioned is described under another heading).
1.\:l
TABLE I
1.\:l 1.\:l
HOME SANITATION AND HOOKWORM INFECTION IN 49 GEORGIA COUNTIES
SANITATION DATA FROM 1947 EXTENDED MALARIA CONTROL REPORTS. HOOKWORM DATA, AVERAGE OF 1945, 1946, 1947 PREVENTABLE DISEASES REPORTS OR FROM SOURCE INDICATED IN FOOTNOTE.
County
Homes with No Toilet
Homes with Open-back
Toilets
Total Number of Homes and Percentage of Homes
with No Toilet or an Open-back Toilet
Totals
~
(I>
Percentage of Persons Found to Have Hookworm
c
"<:.C)
"~"
Bac011 --------------------------------- ------------ ------------------------------
Baker ---------------------Bleckley --- ____________________ :::::::::::::::::::: :::::::::::: __ _____
Brantley ------------------------- ----------------------------- --------------- __
Bryan -------------------------------------------------------------------------------Bulloch -----------------------------------------------------------------------------Burke -------------------------- _____________ ---------------------------------------
Calhoun ----------------------------------------------------------------------------
Camden ---------------------------------------------------------------------------
Candler ---------------------------------------------- ------------- ---
Clay -------------------------------------------------------------------------------
Colquitt ----------------------------------------------------------------------
Crawford ----------------------------------------------------------------
Crisp ------------------------------------------------------- -- -----------------
Decatur ----------------------------------------------------------------------------
Dougherty --------------------- ------- --------------------------------
Early -----------------------------------------------------------------------------
Echols --------------------
---------------------------------------------
Effingl1am -------------------- .... ------- .... ____ ---------------------
Emanuel ----------------------------------- --- -------------------- --------
Evans ________ ----------------------- ---- ------------------------------
Jeff Davis ____ ------------------ ---------------------------------
Jefferson ------------------- _...... -----------------------------
Jenkins ----------------------------------------------------------------------
Johnson -------------------------- ------ __ ---------------------------------
Laurens ---------------------- -------------- ------------------------------- .
Lee ------------------------------------------- ----------------------------
Liberty ---------------------- ----------- ---------------------------------
Long ---------------------------------------------------------------------
Mcintosh ------ ----------------------- -- --------------------------------
Macon ------------------------------ ---- ----------- ------------------- ----
84 553
57 196 28'7
72 870
522 433
12
750 V!O 261
63
lOS~
264 301
28 100
344
277
73 7:1 154
82 221
677 44
118
142 851
1501 867
1375 1025
370 2783 2904 1157
757 1246
711 4907
1190 2437 1907
702 3381
604
1658 3410
905 1254
2194 1116 1835 4861 1004
391 703
848 1327
Number
1585 1420
1432 1221
657 2855 3774 1679 1190 1258 1461 5047 1451 2500
2989
966 3682 632
1758 3754 1182
1327 2267 1270 1917 5082 1681
435 821
990 2178
Percent
75.6 78.1
84.6 76.3 41.3 53.2 66.2
82.5 70.3 70.7
X1.8 63.6 88.7 li9.3
49.6 31.2 70.0
90.4 76.1 78.8
68.6 G0.8
54.6 49.6 83.8 72.0 76.7
21.1 83.5 73.4 66.1
2097 1817 1692 1600 1592
5369 5704
2035 1693 1780 1786
7938 1636
3607 6032
3098 5257
699 2309
4765 1722 2182 4150 2561
2288 7057 2191 2060
9S:l 1348
3297
b
36.4 30.0
(I>
'1:3
18.21
67.6 26.4 36.6 21.8 21.1"
~
"<:-1-
~
(I>
;::l
<:-1-
49.6 2
40.7 20.5
45.8" 20.0
--c
'\:j
17.2 1 30.0 16.0 1 61.82
-"&"
<":"">
38.5 36.8
~
21.0
(I>
23.4 39.6
.,....
19.1"
;;s-
31.5 2
35.0 37.4 1
20.0 22.7 1
34.1
35.0 1
30.0 1
TABLE I
HOME SANITATION AND HOOKWORM INFECTION IN 49 GEORGIA COUNTIES (continued) SANITATION DATA FROM 1947 EXTENDED MALARIA CONTROL REPORTS. HOOKWORM DATA, AVERAGE OF
1945, 1946, 1947 PREVENTABLE DISEASES REPORTS OR FROM SOURCE INDICATED IN FOOTNOTE.
County
Homes with No Toilet
Miller
391
Montgomery
590
Pulaski
99
Quitlnan
302
Screven
88
Seminole
7l
Sumter -- ------- _
2lu
Tattnall
616
'ferrell
45
Tift -----------------------
59
Toombs -------------
211
Treutlen ----------------- ----- -----------------------------
108
Turner ------ --------------- ---------------------------- _____________________ None
Washington
167
Wayne
69
Webster
157
Wilcox
None
Worth -------- ------------------------
374
Totals _____________
-------------- ------------------------12,694
' Georgia Hookworm Infection Rates. 1930-39. 2 Georgia Laboratory Reports to Private Physicians 1947.
Homes with Open-back
Toilets
1411 1078 1280
422 3308 1325 1164 2529 1982 3181 2662 1059 1722 2745 2158
687 1957 3802
--
85,802
Total Number of Homes and Percentage of Homes
with No Toilet or an
011en-back Tcilet
]\Tu'fnber
1802 1668 1379
7~4
3396 1396 1380 3145 2027 3240 2873 1167 1722 2912 2227 844 1957
- - - 4176 ~8.496
Percent
83.3 76.6 72.9 90.2 81.0 67.6 35.8 81.6 68.7 (;5.9
70.3 ':'3.9 66.8 60.5 73.9 92.7 90.0 79.9
---
(i7.65
Totals
Percentage of Persons Found to
Have Hookworm
~
('>
2163
51.0
"'('>
;,:.S...
2176
35.2 2
!;::,
1892 803
18.7 20.0
:0s-'
4191
34.6 1
2065 3857 3854
2951 4917
68.3
b
24.1
40.4 13.5 30.5 2
"c.";,
('>
!;::, c.;,
4084 1578
38.4 38.8
('>
c.;,
2577
25.0
4815
15.0 2
3014
46.9 2
910
18.9
2173
36.9 2
- - - 5225
-2-6.5
145,590
t--:l l\J
C;:i
224
Georgia Department of Public Health
During 1947 a special project for the continued study of a new method for counting hookworm eggs, devised in 1946 by the consultant biologist, was continued in the Branch Laboratory at Waycross, Ga. An experienced biologic aide was employed to supplement the regular laboratory staff. With the assistance of the Field Nurse and the Senior Biologist, this worker made parallel examinations by both the Beaver and Stoll methods of counting hookworm eggs on a series of stools from the same individuals. This work was interrupted in September by the return of the biologic aide to school, but was resumed shortly thereafter under an arrangement with the institution which he attends by which his work for the Department of Public Health will be accepted in partial satisfaction of the requirements for a graduate degree. Work is now in progress and will be continued through the winter and resumed on a full-time scale in 1948. Present indications are that the Beaver method can be adapted to the needs of routine laboratory work and will provide a means by which a limited staff can examine a larger number of specimens than is possible when the Stoll method is used.
Considerable work was done in collaboration with the Technical Development Division of the Communicable Disease Center, USPHS, at Oatland Island, Savannah, in an effort to develop a means for destroying hookworm larvae in the soil without concomitant destruction of vegetation or danger to human life. This project was materially aided by the Laboratory Division which provided positive hookworm stools obtained from roptfne examinations. At the end of the year, results were inconclusive and somewhat discouraging, but the collaborating agencies will continue until definite results can be obtained.
A new mailing 'container for hookwor~ specimens developed during 1946 has been used with general success during 1947. The Laboratory Division is at present giving serious consideration to the possibility of adopting this container for all stool specimens forwarded for helminthological examinations.
At the end of 1947, no specific indication of the introduction into Georgia of Ancylostoma cluoclenale, the old world hookworm, had been noted. Attention is being given to all resistant cases of hookworm infection in order to locate any such infection at the earliest possible moment. The soil decontamination project described above was entered into partially because of the inherent danger of the establishment of Ancylostoma presented by the presence in Georgia of numerous returned servicemen who without doubt harbor this parasite.
Prefabricated Aluminum Privy Project
Early in 1947 an attempt was made to interest a private manufacturing company in the construction of a prefabricated aluminum privy for use with a curbed pit. Interest on the company's
PTeventable Diseases
225
part having been aroused, the question of appropriate design was referred to the Engineering Division, and serious efforts were made to plan and prepare for the manufacture and sale of a satisfactory and economical sanitary unit.
At the end of 1947, it appeared that the major problems interfering with the achievement of this purpose had been resolved and that a satisfactory design had been developed. Essentially, the privy consists of a basic assembly which includes an aluminum template to whichthe riser and seat is bolted, and which serves as a form into which reinforcing materials can be placed and concrete poured. An aluminum framed house completes the unit. The basic assembly has the very real advantage of eliminating the necessity for cumbersome and expensive wooden forms. Aluminum parts of the base can be assembled on a level place and concrete poured without further ado. When the concrete hardens, the base is moved over a previously dug and curbed pit and the aluminum framing, sides, and roof are then bolted in place.
As shown il.l the appended table of costs (Table II), the expense of materials for the prefabricated privy and the expense of erection of this structure total considerably less than the cost of materials alone for a standard plan privy with a concrete slab and riser. It is realized that the average householder cannot construct a wooden privy house without the assistance of a carpenter and that this item will add an additional $16.00 charge to the cost of a wooden privy, the real difference in the cost of the two structures is apparent. In addition, the prefabricated aluminum privy is easily moved to a new pit or even to an entirely different location, while the wooden house of a standard plan privy is heavy, cumbersome, and extremely difficult to move without mechanical equipment.
Plans for marketing and distributing the prefabricated privy have not been entirely perfected, but it is hoped that a cooperative system can be worked out. If this can be done under the sponsorship of the Department of Health, the manufacturing company will undertake to supply privies at the cost shown in Table III. If not, the regular retail price of the privy, $49.50, will prevail.
The basic assembly, i.e., the aluminum template, riser, seat and lid, will be sold separately and can be used to modify an existing open-back privy, or to adapt any suitable structure for use as a privy shelter. It is hoped by this means to reach a number of low income families for whom satisfactory sanitary installations are otherwise out of the question.
Dougherty County PToject
In 1946 an area in Dougherty and Worth Counties was employed for the study of a newly devised method for destruction
226
Geo1gia Depwtment of Public Health
of anopheline mosquito populations. This method involved the spraying- of all good resting places for anopheline mosquitoes found outside of human habitations. The interiors and porches of all houses in the area had previously been sprayed with DDT as a part of the Extended Malaria Control Program. Additional spraying of outside resting places was attempted in an effort to reduce anopheline populations to an entirely innocuous level. The resting places sprayed included the eaves and undersides of houses, privies, barns, animal shelters, hollow trees within fifty yards of anopheline breeding ponds, the undersides of bridg-es
TABLE II
BILL OF MATERIALS FOR EVERWEAR ALUMINUM PRIVY
Basic Assembly (a) Slab template _____ -------------------------------------------------- $ 5.67 (b) Seat and riser___________ ---------------------------------------- ___ _ 4.33 (c) Sand, gravel and cement_____________ -------------------------- 2.13
Total cost if used without aluminum superstructuJ'e to modify an old p1'ivy ___________ _________________ --------------------------- $12.13
Superstructure ------------------------------------------------------- _______________ _ 25.00 Freig-ht (estimated) ____________________________________________________________ _ 1.50
Total for complete structure....... -------------------------- $38.63
BILL OF MATERIALS AND NECESSARY LABOR FOR WOODEN PIT PRIVY WITH CONCRETE SLAB AND RISER
(Georgia Bulletin Form A.P. 10,614)
House: Lumber ---------------------------------------------------------------------------- $19.60 1-Iardware ------------------------------------------------------------------------ 5.60 Nails ____________ ------------------------ _____ .. ____________________________________ _ 1.10
$26.30 Materials for Slab Form _______________________________________________________ _ 3.87 Mud Sill Form _______________________ ----------------------------------------------- 1.9L! Riser Core ------------------------------------------------------------------------------ 2.05 Riser Sides ------------------------------------------------------------------------------ 2.30 Riser Ends ------------------------------------------------------------------------------ 1.14 Seat and Riser _________________________________________________________________________ _ 2.06 Materials for Slab, Riser and SilL______________________________________ _ 5.22
$44.90 Skilled labor necessary__________________________________________________________ 16.00
Total expense ------------------------------------------------------------------ $60.90
Preventable Diseases
227
and culverts, and all similar harboring places for mosquitoes. The results obtained at the end of the year indicated that the method had great promise, and it was planned to repeat the work, including a slightly larger area, in 1947.
In the spring of 1947 it became apparent that the mosquito population in the control area, as well as in the experimental area, was unusually low. This was true of surrounding counties as well as the area under study. Some adjacent areas which previously had to be controlled by routine oiling and larviciding did not require treatment. Under these circumstances it appeared wise to refrain from additional spraying and to concentrate all efforts on the determination of the effect of spray residues left over from 1946 spraying. The biologist in charge of this work was compelled to leave to attend school before the end of the mosquito breeding season; however, his work was carried on for several months by one of the biological aides. An apparent clifferential in mosquito populations between the sprayed and unsprayed areas continued to exist until the end of the season.
While it is considered unwise to draw definite conclusions on these data, a renewed attempt to duplicate the results obtained is thought to be entirely justifiable. Work will therefore be resumed and ouside spraying again attempted, as soon in the spring as the services of the permanent :field biologist become available.
Muscogee County Project
In 1946 anc11947 a study of the effectiveness of DDT sprays in controlling flies and mosquitoes under urban conditions was carried on in Columbus and Muscogee County. The 1947 work on this project was considerably influenced by the results obtained in Dougherty County, and greater emphasis was placed on spraying of resting places of insects than on the spraying of the interiors of houses. At the end of the year, the applicability of both methods of insect control was still somewhat in question. The data appeared to indicate that urban mosquito control and urban fly control cannot be successful in the absence of routine, systematic, weekly inspections of all premises capable of breeding mosquitoes or flies. The production rate of a few breeding places, it was shown, can be high enough to flood a neighborhood with insects for short periods despite house or resting place spraying. The project has therefore developed into an attempt to determine what combination of residual spraying and houseto-house inspection methods is desirable and economical. Plans for continuation of this work have been made.
Tick Project
The occurrence of seven cases of Rocky Mt. Spotted fever during 1945 within one small area in DeKalb County resulted in the institution in 1946 of a control program directed toward a reduc-
228
Georgie& Department of Public Health
tion of the tick population. In 1946, this area was dusted with 21;2 lbs. of DDT per acre with results which were reported by publication in the Journal of the Medical Association of Georgia, in June 1947. It was concluded from this study that DDT and possibly other insecticides could be used effectively in tick control in limited areas. In 19L!7, the same area was treated with DDT, although by a modified method. The results obtained are not yet complete inasmuch as evaluation of the experiment is partially dependent upon winter trapping of the rat hosts of immature stages of the tick but appear to be equally encouraging. In addition, a roadside area in Fulton County was sprayed with wettable DDT powder, and an adjacent area was sprayed with wettable chlordane powder. In this area, control appeared to be good with both insecticides, and the slight difference between the two areas appeared to indicate that chlordane was the more effective of the two chemicals for short periods. Trapping is being carried on in the described areas during the winter by a part-time worker.
A third area in Union County, Georgia, was chosen because of an extreme abundance of ticks. Parts of this area were sprayed in mid-summer with DDT or chlordane for the purpose of determining the immediate effect on adult tick populations and on the winter survival of tick nymphs and larvae. Here again both methods appeared to give good immediate control. Data on the winter residual effects are not yet available.
Results so far obtained from these experiments appear to indicate that chlordane may have a more immediate effect on ticks than DDT, but that DDT has a longer residual effectiveness. It is therefore thought that a combination of these acaricicles might be considerably more effective than either compound when used separately. There is a further possibility that benzene hexachloride is more toxic for ticks over short period than either DDT or chlordane. A study of these differential effects, particularly of the effectiveness of combinations of these chemicals, is now underway.
J enkins-Bulloch Project
The Magnolia Springs area of Jenkins County continues to be used as an index of Anopheles quadrimaculatus populations in the Southeastern section of the state. For the sixth successive year the population of Anopheles quadrimaculatus showed a decrease, having decreased 91.74% during the period. However, the rate of decrease in 1947 was the lowest shown in this series of years. The decrease is not associated with a reduction in breeding or with an apparent reduction of the mosquito potential of the area, nor can it be directly associated with DDT house spraying or other control methods. In contrast, a study of 17 anopheline ponds in Bulloch County showed a definite increase in anopheline breeding over that found in the same pond in 1942
Preventable Diseases
229
and 1943. In addition, a reinvestigation was made of 90 ponds studied in Bulloch County in 1942, and a survey was made to determine the number of new ponds which had been constructed. It was found that all the old ponds were in existence, and that 54 additional ponds had been constructed. Twenty-one of the original ponds were known to be Anopheles quadrimaculatus breeders whereas 56 of the present total were found to be breeding Anopheles quadrimaculatus in 1947. Close study of ponds adjacent to sprayed houses did not reveal any effect of spraying on the larval anopheline population.
It is a major purpose of this continuing study to determine the mosquito potentialities of new farm ponds which, as the figures above indicate, are being built in increasing numbers, and which, despite all efforts at the procurement of proper building methods, are very likely to become mosquito breeders. New ponds are being taken under observation as soon as water is impounded, and data on the development of conditions favorable to anopheline mosquito breeding is being collected. The technique applied in the Dougherty project appears at the moment to offer the best hope of achieving economical mosquito control around farm ponds.
Malaria
No outbreaks were experienced during the year and the malarial illnesses reported on the basis of laboratory examinations continued to be recurrent cases of war veterans. Table III shows the cases reported as distributed by county. No major smear surveys in school children were made during the year inasmuch as no areas are known which can legitimately be suspected of being malarious. Some malaria in individuals other than veterans continues to be reported. On occasions these cases have apparently been confirmed by private laboratory examination, but duplicate slides examined in the state laboratories have yielded no positives.
Baldwin ---------------------------- 1 Candler ---------------------------- 1 Cobb ---------------------------------- 2 Coffee -------------------------------- 1 Cook ---------------------------------- 2 Decatur ---------------------------- 4 Dodge -------------------------------- 1 Fayette ---------------------------- 1 Franklin -------------------------- 1 Fulton ------------------------------ 3 Gordon ------------------------------ 4 Harris ------------------------------ 2
Johnson ---------------------------- 1
Laurens ---------------------------- 5
Meriwether ---------------------- 3
Peach -------------------------------- 1
Pickens ---------------------------- 1
Polk ---------------------------------- 2
Seminole -------------------------- 19
Tattnall ---------------------------- 1
Wilcox ------------------------------ 1
Wilkinson
2
Total ---------------------------- 59
230
Georgia Department of Public Health
EPIDEMIOLOGIC SERVICE 1947
I. BY DIRECTOR AND ASSISTANT EPIDEMIOLOGIST
1946
1947
1. Educational and Promotional (a) Meetings attended (not addressed) 7 (b) Meetings addressed ------------------------ 11 (c) Approximate number addressed ____ 1015 (d) Literature distributed ____________________34077
2. Field Conferences ---------------------------------- 76
II. BY FIELD PERSONNEL
1. Mala1ia and Hookworm C_ontrol
A. Educational and Promotional
1. Meetings attended -------------------------- 12
2. Addresses made ------------------------------ 8 3. Exhibits and movies -------------------- 3
4. Conferences ------------------------------------ 810
B. Epidemiologic Services
1. Physical examinations or inspec-
tions -------------------------------------------------- 416 2. Hemoglobins ------------------------------------ 790 3. Hookworm treatments
(a) Anthelmintic -------------------------- 282 (b) Persons treated with iron ______ 17
4. Home visits ----------------------------- ______ 168
5. Malaria smears ------------------------------ 1494 6. Spleen palpations ----------------------------
7. Containers
(a) Distributed ------------------------------ 2532
(b) Collected ---------------------------------- 423
8. Soil samples ------------------------------------
9. Cultures taken -------------------------------10. Specimens examined ______________________
___*_
C. Entomological Services 1. Ponds investigated ________________________ 908
2. Ponds dipped ------------------------------------ 580 3. Adult searches (mosquitoes) ________ 1671 4. Light traps run (overnight pe-
riods) ------------------------------------------------ 867 5. Areas investigated -------------------------- 3985 6. Areas trapped (ticks) ____________________ 223 7. Sanitary surveys (premises) ________ 257
8. Mapping hours -------------------------------- 71 9. Days in office or laboratory ____________ 582
* Specimens not examined in 1946.
3 15 1011 49609 63
27 18
8 835
2 232
460 12
246 70
2402 885
3669
1949 1007 1816
303 719 675
16 77:Y2 567
Preventable Diseases
231
SOCIAL HYGIENE
Educational Program
Community interest has been growing in social hygiene education. People have been more concerned with how this education can be made a part of everyday education and everyday living for individuals.
Many groups, such as teacher groups, civic groups, and church groups have sponsored meetings where the subj ect has been discussed. The Social Hygiene Consultant has been available for study and discussion groups, as well as lectures on the problem of venereal disease in the state, which includes the need for social hygiene education. Films have also been shown upon request.
Consultation service has been offered upon request to students, teachers, nurses, and any other groups and individuals concerning health and human relations.
During the last session of the Legislature, a 12th grade was added to our public school system in Georgia, thereby making it necessary to plan curriculum for an extra grade. The State Superintendent of Schools is requiring in the new curriculum a broad health education course which will include health and human relations and sex education. In a broad program of health
Consultation service is available upon 1equest to any gr oup interested in social hygiene p1oblems.
232
Georgia Depa1t1nent of Public Health
education, which includes human relations, family life education and so on, a great deal more can be done for better social living and will be accepted by parents, communities, teachers, and all concerned. We realize, of course, that some faculty members are not qualified to do this type of teaching, some communities are not ready for schools to undertake it, some Boards of Education are still bound down by tradition, but we are overcoming many of these handicaps and in many of the schools in the state social hygiene education is a part of the total health education program beginning in the primary grades and going on through high school. We have encouraged teacher education colleges to give to the preservice teachers the help necessary to make them feel adequate in teaching social hygiene. Some colleges have done more than others along this line; however, we feel that there is need for improvement everywhere.
We had a very fine experiment going in the girls' high school in Augusta which proved to be interesting and helpful. This was a full credit course, which began the second semester of school in February, 1947. The Social Hygiene Consultant assisted in planning this program. The teachers and some of the students asked the Georgia Department of Public Health to assist them with a course on sex education. The Richmond County Health Department furnished the services of a nurse, who had a degree in public health education, to conduct the class. After the girls came together to begin their work, they gave the course the title, "Orientation to Life."
TB-VD Surveys
During the year, the Georgia Department of Public Health assisted local health departments in eight counties in the state in conducting a TB-VD survey. The purpose of these surveys was to find every case of infectious syphilis and tuberculosis and refer them to a private physician or public treatment.
Preceding each survey, the Social Hygiene Consultant conferred with local agencies, organizations and individuals in the county concerned, requesting their support and cooperation in this project. Assistance was given the local commissioner of health in sending out letters to the citizens in the county, informing them of the survey and urging them to avail themselves of these tests. Representatives from organizations, agencies, churches, and individuals were called together for a meeting to discuss plans for the survey and to organize a Citizens Advisory Committee. This committee worked with the survey team in carrying forward the plans locally. Separate meetings were held for whites and negroes. The Social Hygiene Consultant assisted in setting up procedures for testing stations in order that they might function properly; scheduled various groups for tests; and assisted the survey team with all types of public relations.
Preventable Diseases
233
We would like to emphasize the fact that we have received splendid cooperation from the Negroes in each county where a survey has been held. A Negro Citizens Advisory Committee has been organized to confer with the local commissioner of health and the survey team. They have been very willing to work with
their own groups after we met with them to plan with them about the survey. They have organized various committees and have set up their own procedures to visit the Negro citizens and urge them to come to the testing stations; they have been instrumental in getting school children to the testing stations; their publicity committee has worked in connection with our regularly established publicity committee for the survey. They are due much credit for making the surveys successful.
The eig{lt counties (and number of persons tested) in which surveys were held during the year are as follows:
Colquitt --------------------------------------
Thomas -------------------------------------Grady ---------------------------------------Floyd -----------------------------------------Polk -------------------------------------------Lowndes -----------------------------------Lanier ---------------------------------------Echols ----------------------------------------
16,904 persons tested
17,899 "
"
8,757 "
"
31,925 "
"
14,873 "
"
18,913 "
"
2,408 "
"
508 "
"
TOTAL ------------------------------ 112,187 "
"
Health Education Workshops
During the summer of 1947, the Social Hygiene Consultant worked in the Health Education Workshops in the capacity of Consultant at the University of Georgia, Georgia State College for Women, and Emory University. At these workshops, teachers were given assistance in planning better instructional programs; particularly, were they assisted in planning outlines for courses in family life education, which included social hygiene or sex education.
Books and Publications
Books on social hygiene were loaned to individuals, parentteacher associations, clubs, and other interested groups.
During the year, there were 33,843 publications on venereal disease and social hygiene distributed upon request to people in the state.
Cooperation With V arious Organizations
Organizations which have contributed to the work in social hygiene education are as follows: Georgia Social Hygiene Council ; Georgia Congress of Parents and Teachers ; Georgia Department of Education; civic clubs; womens' clubs; and many churches. Their service has been very valuable.
I Conferences
January --~-
14
February ___
16
March ------------
20
April ------------
21
May ------------
11
June ------
6
July ----------
18
August --
7
September
7
October ____
10
November
14
December
7
Total
151
Meetings Attended Other Than Addressed
3 2 2
2 q 1
1 6
4 27
ACTIVITY REPORT January-December, 1947
Lectures
No.
Au d.
5
365
7
684
3
431
5
854
7
722
2
240
8
420
3
115
6
390
7
955
9
1,942
4
197
66
7,315
Films
No.
Au d.
1
72
1
72
t-:l CJ:i H:::.
Contacts
4 1 4 13 1
2
25
Exhibits Displayed
1 1
0
(1:)
0
Publications
'"tQ":"":l'
Distributed
b
(1:)
2,615 ~
5,655
.~,..,..
5,328
~
(1:)
1,118 .;,:.5.,..
3,230 ..0..... 829
1,805
~
1,785
.0,.."..
"~"
1,894
3,431
~
(1:)
1,555
~
;~ _:,.
4,238
33,483
---
P1eventable Diseases
235
GET THAT FLE.
WITHjJ,J},f
---- --
EVENT
YPHUS FEVER
TYPHUS CONTROL SERVICE
The activities of the Typhus Control Service consisted of promoting, organizing, and supervising local control programs on the city and county-wide levels. These activities were directed from the Atlanta Central Office. Field operations were under the supervision of the Macon Field Office personnel and Regional Supervisors attached to the East Central, West Central, South-
236
Georgia Depwrtment of Public Health
eastern and Southwestern Regional Health Departments. Field operations in the Northeastern and Northwestern Regions were supervised by personnel of the Atlanta Central Office under the general supervision of the Regional Medical Directors of each region, and county health departments in which control programs were conducted.
Control measures applied were: DDT dusting of rat runs and harborages, rat eradication, and ratproofing of buildings. As an aid toward the effective application of control measures, investigations consisting of epidemiologic and rodent surveys were made in most of the counties conducting typhus control programs.
Through the :financial participation of the U. S. Public Health Service, Communicable Disease Center, in the state-wide program, it was possible to assist cities and counties in establishing and expanding control programs to more adequately cope with the disease problem. Participation by the U. S. Public Health
Service amounted to about 60 7o of the total cost of operations.
The remaining 40% of the cost of operations was borne by the State, local county and municipal governments, and individual citizens participating in the programs. The principal federal expenditures were in the form of salaries and travel expenses for supervisory personnel; motor vehicles, including operating cost; DDT dust and dusting equipment; rodenticides, such as sodium fluoroacetate and arsenic trioxide; entomologic and biologic :field equipment and supplies; laboratory service, and miscellaneous equipment and supplies. State participation included salaries and travel expenses of the Director, one Sanitarian, and one clerk; office space, equipment and supplies for the Central Office in Atlanta, Field Office in Macon, and Regional Offices in Albany and Waycross; and certain miscellaneous operating expenses. Local participation included salaries for labor personnel; rodenticides and bait not supplied by the U. S. Public Health Service; and office space and equipment. Ratproofing projects were :financed through revolving funds established by local governments and reimbursed through charges made to building owners or tenants for work performed on their buildings.
Personnel
At the end of 1947, personnel engaged in typhus control activities throughout the State consisted of a Director, Sanitarian, and Clerk employed by the State; Three (3) U. S. Public Health Service Commissioned Officers assigned to the Thomasville Typhus Investigative Project; Seventy-one (71) U. S. Civil Service employees, and approximately Sixty-one (61) local city or county paid employees. The total number of employees actually engaged in typhus control activities was One-hundred-thirty-seven (137). Compared with the year 1946, the total number of em-
Preventable Diseases
237
ployees engaged in this activity during 1947 was about Nineteen (19) more than employed in 1946. During 1947, personnel engaged in this activity expended approximately 279,860 manhours of work in protecting approximately two million people in Seventy-six (76) counties from typhus fever.
Educational
This activity was performed on the city and county level principally by regional and county health department personnel. The educational program was directed toward adult groups for the immediate promotion of city and county typhus control programs. Education material and information on the control and prevention of typhus fever was disseminated through the media of posters, booklets, pamphlets, newspaper articles, film strips, and motion pictures. Group meetings were held with civic organizations, city and county officials, farm and other groups. A long range educational program has been continuously conducted for many years through supplying elementary and high school teachers and students booklets and pamphlets as prepared by the Typhus Control Service, U. S. Public Health Service, and U. S. Fish and Wild Life Service.
The U. S. Public Health Service, Communicable Disease Center, was of great assistance to the State program during 1947 by making available to the Typhus Control Service, educational and training material and facilities. In this connection, the loan of strip and motion picture films and projective equipment was of tremendous help as well as their cooperation in training new personnel for the State program.
DDT Dusting and Rat Eradication
DDT dusting and rat eradication activities were conducted in Seventy-six (76) counties. Thirty-six (36) of these counties participated on a county-wide fulltime basis. The remaining Forty (40) counties participated on a part-time basis with operations confined principally to cities and towns requesting this activity. The counties participating on fulltime basis were as follows:
Appling Atkinson Ben Hill Berrien Bibb Bulloch Burke Chatham Coffee
Colquitt Cook Crisp DeKalb Dooly Dougherty Evans Fulton Glynn
Jenkins Lanier Laurens Lee Macon Mitchell Randolph Richmond Schley
Screven Seminole Sumter Telfair Terrell Tift Toombs Turner Worth
238
Georgia Department of Public Health
The need for proper placing of DDT dust in rat burrows, harborages, shelters, runs, etc., to control the vector or vectors, such as rat :fleas and possibly other ectoparasites, is of great importance. The basic principles which proved so encouraging during 1946, were studied in detail during 1947, both as to amount and application of DDT dust. These studies and observations were in turn capitalized upon to the extent that time, material, and labor were economized and produced more effective rat ectoparasite control. In areas where the rat :flea index (principally X. cheopis) was reduced, there was an observed reduction in the human morbidity case rate of typhus fever.
DDT dust is not permanent control, and the holding time of the effectiveness of this dust is influenced by climatic conditions, together with the extent and manner in which it is applied. The dust to be utilized to the greatest effectiveness must be properly placed and applied just prior to the seasonal rise of the ectoparasite population. Further studies have indicated, that in order to maintain effective control of rat ectoparasites, DDT dust should be applied at intervals of not greater than four months.
With an apparent increase in the incidence of typhus fever in rural areas arid farm communities during 1946, and a decrease in urban DDT dusted areas, this control activity was extended in 1947 to cover larger areas and include, to a greater extent, farm residences and out buildings. As a result of this expansion in DDT dusting activities, there was an increase of 34,850 premises dusted during 1947 than for 1946. This increase in the number of premises dusted during 19Ll7 was accomplished with about the same number of personnel for 1946. This may be attributed principally to: (1) Regional decentralization and more adequate DDT dust storage facilities for each region; (2) More experience in applying DDT dust, and, consequently, a more efficient organization; (3) A greater understanding of local problems and working relationships with civic officials and the general public.
In the fall of 1945, approximately five pounds of DDT dust per premise was first used as a standard for rat ectoparasite control. In 1946, effective rat ectoparasite control was obtained with an average of 3.9 pounds of DDT dust per premise, and in 1947, an average of 2.42 pounds per premise was used for effective rat ectoparasite control. From these results, effective rat ectoparasite control may be accomplished by applying from two to three pounds of 10 o/a DDT per premise. This is a substantial savings in cost of material as compared with the original standard of five pounds of 10o/a DDT dust per premise.
The Mobile Unit, operating from the Macon Field Office, organized and supervised DDT dusting and rat eradication programs in the part-time participating counties. This unit well served its purpose in meeting the requests for DDT dusting and rat eradication programs in counties not participating on full-
Prwventable Diseases
239
time basis. During the year, this unit treated 3,410 premises with DDT dust and 5,106 premises with poison bait.
The principal rodenticides used were as follows: Liquid red squill, 1080 (Sodium Fluoroacetate), ANTU (Alphanapthylthiourea), and cyanogas-A-Dust (Cyanide Gas).
Since rat eradication activities were conducted over large areas, red squill poison bait was the principal rodenticide used. While red squill is not as effective as other rodenticides, it is the safest of all rodenticides for safe-guarding human lives and pet animals. Red squill is toxic primarily only to rats, and for this reason, is generally accepted as the most desirable rodenticide for mass rat eradication activities over large areas. In preparing red squill bait, the kind of bait material used varied according to the areas and habits of the rodent. For example, in some areas of the State peanut meal was found to be most effective; whereas, in other areas, scrap meat, fish meal, fruits, etc., were used as the most effective bait material.
Other rodenticides used, such as 1080, ANTU, and CyanogasA-Dust have limited usage due to their toxicity to humans and pet animals. These rodenticides are highly effective in rat eradication activities when used under certain restrictions. They have been used to a great advantage for rat eradication activities in business establishments.
During the year, 55,826 pounds of red squill bait; 511 gallons of 1080 poisoned water; 565 pounds of ANTU baits; and 296.5 pounds of Cyanogas-A-Dust was used in the rat eradication program.
Ratproofing
Making buildings rat resistive or rat proofed is considered a permanent type of rat and typhus control measure, together with the rat eradication which follows this operation.
The supervision of these projects was handled by a State Ratproofing Supervisor operating out of the Macon Field Office. He in turn, was ably assisted by three trained and experienced ratproofing supervisors who exercised immediate supervision over local projects. The mobile construction equipment was furnished by the Typhus Control Service, and local labor was paid from the revolving fund.
Ratproofing projects were operated in the following cities: Nashville, Douglas, and Cordele during the year of 1947. Atlanta and Macon also had projects which were operated under local supervision.
In the City of Nashville, construction was started in January and terminated in May. With the completion of eradication, the project was closed at the end of June. The local health department and the city officials were very cooperative throughout the
240
Georgia Depa1tment of Public Health
entire project operation, and extended very able assistance to the typhus control project supervisor.
In the City of Cordele, the project was started in 1946 and continued through 1947. A great deal of difficulty was encountered due to the inability of the original ordinance to uphold its enforcement measures. The ordinance was amended to include the "fi-fa" clause. It has been found that without this clause the ordinance is not practical to enforce against an owner of property who lives in another city.
In the City of Douglas, the project was completed in December of 1947. Eradication measures will be completed early in 1948. The same difficulty was encountered here with the ordinance which occurred in Cordele. The ordinance was so amended as was necessary to be able to carry out the work.
Surveys were made in Augusta and Tifton with the intention of starting projects in these cities during 1948.
Arrangements were completed to survey three other cities with the intention of instituting ratproofing projects during 1948. These additional cities have expressed the desire for ratproofing projects and have made temporary arrangements for the projects.
The difficulties incurred with the interpretation and enforcement of the ratproofing ordinances that were in operation during 1947 caused delay in operation of projects in two cities. After extensive study and evaluating standard ordinances, collected from many cities and towns, the Georgia Program was able to adopt a standard ordinance which is felt will overcome former difficulties in operation and enforcement. These difficulties could not be foreseen, but were incurred after the projects were in operation.
Organizing ratproofing projets involves promotional work, meetings with city councils, project cost surveys, and adoption of ordinances. This involves a great amount of time and effort on the part of the ratproofing personnel. For this reason, these projects necessitate more time for activation than for DDT dusting and rat eradication projects.
During 1947, cost estimates for ratproofing were made of 976 business establishments and ratproofing was completed on 717 business establishments. The average cost of ratproofing was 9-bout $100.00 per business establishment.
Sanitary Refuse Collection and Disposal
This phase of the Typhus Control Program may more adequately be considered a program of "municipal housekeeping." It is directed toward the elimination of the food supply and harborage of rats.
During 1947, this control measure was applied through con-
Preventable Diseases
sultation services to cities and towns. These consultation services were provided by the Director and Field Supervisor of the Typhus Control Service.
With the increasing availability of refuse collection and disposal equipment, many cities and towns made improvements to their refuse collection systems. In addition, sanitary land-fills were operated in Muscogee County and in the cities of Macon, Valdosta, Waycross, and possibly others. Other cities and towns have shown interest in this activity and plan to improve their collection system and provide sanitary disposal of refuse when the necessary equipment becomes available.
Investigations
A. Epidemiologic
Epidemiologic investigations were conducted by field supervisory personnel of the Typhus Control s'ervice under the general supervision of the Regional Medical Directors and county health officers.
These investigations were confined strictly to obtaining nonmedical information. The basic reason for these investigations was to supply the field supervisory personnel with pertinent information as to the location of typhus fever cases and their contacts so that immediate control measures could be instigated.
Information from these investigations was transcribed onto maps as an aid in determining the foci of infection and effectiveness of control measures applied.
With few exceptions, practically all of the typhus fever cases that were reported from participating counties were investigated and control measures applied.
During the early part of the year, a new phase of typhus investigations was established in connection with the VD-TB Control Surveys. After VD serology laboratory tests were made of the blood specimens collected from these surveys, the remaining blood sera was used for typhus fever serology tests. The typhus fever laboratory test, complement fixation test, was made by the Virus Research Laboratory of the U.S. Public Health Service, Communicable Disease Center, Montgomery, Alabama. The purpose of these blood surveys was to determine the prevalence of the disease during past year, to obtain information as to the geographic distribution of typhus fever cases, and for purposes of obtaining additional information that might lead to the increase in our knowledge of the disease.
During the year, 53,549 blood specimens were examined by the laboratory. These blood specimens were taken from the VD-TB Surveys that were conducted in Colquitt, Thomas, Grady, Lowndes, and Floyd counties. Positive laboratory results were
242
GeoTgia DepaTtment of Public Health
correlated with case histories by the Epidemiologic Service.
B. Rodent Investigations:
The basic purpose of the rodent investigations can be divided into two phases:
1. To obtain an index of the ectoparasite infestation of rats as a means of determining the extent of the effectiveness of DDT dusting.
2. To collect rat blood specimens for serologic (complement fixation) tests to determine the prevalence of murine typhus fever in rats. This is to primarily show the effectiveness of DDT dusting in reducing the reservoir infection in the rat population and to aid in the location of human foci of infection.
During the first part of 1947, this program had three Biological Aides and three rat trappers assigned to the participating counties in the East Central, Southwestern, and Southeastern Regions. During the summer, this arrangement was changed so that the Biological Aides could devote more time to evaluation and interpretation of results. This was accomplished by two Biological Aides each having two rat trappers. The three regions were divided into two sections for the biological work and it was found that a larger trapping area could be covered than with the previous arrangement.
In June, the entomologic work formerly under the supervision of a State Entomologist, was supervised by the State Field Supervisor with the help of a laboratory technician maldng the rat ectoparasite identifications. The Biological Aides and trappers worked throughout their designated sections making entomologic and biologic determinations as to the nature and extent of control that should be exercised and the degree of dusting effectiveness. By the use of maps, these men were able to pre-determine which areas the effectiveness of the dust was holding the longest, and could in turn give the Regional Supervisors pertinent information as to which particular sections or areas were to be considered first for applying control measures. This saved considerable time and placed the control operations where the greatest need was shown, thereby eliminating sources of error which were formerly incurred on routine cyclic dusting.
It was found advisable to have the Biological Aides and trap- pers work directly in conjunction with the Regional Supervisors in field operations. This in turn, saved time and this coordination enabled field operations to exercise more effective control.
An increase in trapping stations covering larger areas enabled the program to have a more complete picture of the rat infestation and the infection in the rats. It also presented a more complete ectoparasite index, which, in turn, gave a better overall evaluation of the needs and effectiveness of the control operations.
During the Spring of 1947, it was decided to choose four towns
P1'eventable Diseases
243
that had not been previously dusted for an applied research project to determine the effectiveness of 5o/a dust on rat ectoparasite control. The work was performed in Dodge, Irwin, Putman, and Bleckley counties, and in 'the towns of Eastman, Ocilla, Eatonton, and Cochran. The basic reason for this project was to determine the degree of control that would be affected by 5o/a dust and how long the effectiveness would hold. All four towns were trapped prior to dusting and ten, thirty, sixty, ninety, and one-hundred-twenty days after dusting.
The reduction in the flea population after ten days was under the normal standard control index of fleas per rat for 10o/o DDT
dusting. As to the holding time of the effffectiveness of the 5 o/c
dust, it appeared that it was as effective as the 107o dust in rat flea control, principally the X. cheopis.
Taking into consideration methods, techniques, variable sources of human error, weather conditions, etc., and comparing these factors with those of comparable 10'/r dusted areas, it was ob-
served that 5 7o DDT dust should prove to be an effective agent
in the control of the rat ectoparasite population and present a more economical control.
GRAPH NO.1
Graph No.1 presents a graphical comparison of rat flea indices from rats trapped in thirty-six counties during 1947, in DDT dusted and undusted buildings. This graph also shows the seasonal variation of rat flea indices.
Chart No. 1 shows the indices of all rat flea species combined. These rat flea species are: X. cheopis, N. fasciatur, L. segnis, E. gallinacea, C. felis, and P. irritans.
Chart No. 2 shows rat flea indices of the principal Murine Typhus Fever vector, X. cheopis.
From these charts of Graph No. 1, 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 species of rat fleas. A substantial decrease may also be observed in the rat flea indices from DDT dusted buildings as compared with undusted buildings, of both charts with the exception of the Month of May. This exception, while not very pronounced in Chart No. 2, can be attributed in part to the fact that the E. gallinacea and L. segnis flells, which are more resistant to DDT than the X. cheopis in Chart No.2, were found in proportionately greater numbers in May than the previous or following months.
The 1947 seasonal variation may be observed from these charts for all species of fleas and X. cheopis flea. The peak season for all species of fleas was from about March through October, and for the X. cheopis flea about May through October.
10
IIIII
CHART I. SHOWING THE NUMBER Of FLEAS (ALL SPECIES) OF RATS TRAPPED IN DOT OUSTED OR UNOUSTEO BUILDINGS IN 36 COUNTIES, DURING 1947.
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CHART 2. SHOWING THE NUMBER OF X. CHEOPIS FLEAS PER RAT ON ALL SPECIES Of RATS TRAPPED IN DOT OUSTED AND UNOUSTEO BUILDINGS IN 36 COUNTIES, DURING 1947.
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GRI,!'!+i. No.1
P1"eventable Diseases
245
GRAPH NO. 1-A
Graph No. 1-A presents a graphical comparison of mites and lice indices from rats trapped in thirty-six counties during 1947 in DDT dusted and undusted buildings. This graph also compares the seasonal variation of mites and lice.
Chart No. 1 shows the indices of all rat mite species combined. These rat mite species are: L. bacoti, E. echidninus, L. Hawaiiensis, and other miscellaneous species.
Chart No. 2 shows the indices of all rat lice species combined. The rat lice species are: D. spinulosa, and other miscellaneous species.
It may be observed from these charts that DDT dusting was more effective in controlling mites than lice. Very little control of rat lice was obtained. It may be further observed, by comparing Graphs No. 1 and 1-A, that DDT dusting was more effective in controlling fleas than mites or lice.
Thomasville Typhus Investigative Project
This project, operated by the U. S. Public Health Service, Communicable Disease Center, under the general supervision of the Typhus Control Service, continued throughout the year in Brooks, Thomas, Grady, and Decatur Counties. Headquarters for this project occupy five buildings on the grounds of the U. S. Veteran's Hospital, Thomasville, Georgia.
During the year, three commissioned officers of the U.S. Public Health Service and about thirty-two U. S. Civil Service employees were employed on the project.
This investigative project was established during the latter part of 1945 for the primary purpose of evaluating the effectiveness of DDT dusting of rat runs, burrows and harborages, and rat eradication in the control of Murine Typhus Fever.
DDT dusting of all rat infested premises, both urban and rural, were conducted periodically in Brooks and Thomas counties during the latter part of 1945, and the years 1946 and 1947. Rat eradication was conducted on a county-wide basis in Decatur County during the first half of 1946. Grady County has served as the control county since the project was established. In conjunction with the application of control measures, epidemiologic and rodent investigations have been conducted continuously since 1945 in each of the four counties involved.
At the end of 1947, encouraging results were obtained to indicate a great degree of effectiveness of DDT dusting and rat eradication in the control of Murine Typhus Fever. While no official results have been formulated at this time, it is expected that part of the results, at least, will be published in scientific papers by the cooperating agencies within the near future.
IIIII
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IN DOT OUSTED AND UNOUSTED BUILDINGS IN 36 COUNTIES, OURING'I947.
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CHART 2. SHOWING THE NUMBER OF LICE PER RAT ON ALL SPECIES OF RATS TRAPPED IN DDT OUSTED AND UNOUSTED BUILDINGS IN 36 COUNTIES, DURING 1947.
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GRAPH No.l-A
Puventable Diseases
247
Typhus Fever in Georgia
For the year 1947, the incidence of Murine Typhus Fever for the State dropped to 436 reported cases as compared with 606 reported cases for the previous year, a decrease of 170 cases or 26 percent. The number of deaths dropped from 33 in 1946 to 31 in 1947, a decrease of about 6 percent.
Since the DDT dusting program was started during the last three months of 1945, and carried through 1946 and 1947, it is interesting to compare the morbidity and mortality reports of 1947 as compared with 1945. For this period, 1,111 cases were reported in 1945 as compared with L136 cases reported in 1947, a decrease of 675 cases or 61 percent. For the same period, 59 deaths were reported in 1945 as compared with 31 deaths reported in 1947, a decrease of 28 deaths or 47.4 percent.
On the basis of county comparison of morbidity reports, it is further interesting to note that the five most densely populated counties, namely, Chatham, Bibb, Richmond, Fulton, and DeKalb, comprising about one-fourth of the state population, reported 33 cases in 1947 as compared with 77 cases in 1946, a decrease of 44 cases or 57 percent. In 1945, the same group of counties reported 427 cases. Comparing the morbidity reports for 1947 with 1945, a decrease of 394 cases or about 92 percent occurred for this period. Furthermore, this group of counties reported about 7.6 percent of the cases reported for the state in 1947 and about 39 percent of the total number of cases reported for the state in 1945. From these data, the decrease in reported cases since 1945 for this group of counties may be considered significant and reflecting upon the decrease in the number of cases reported for the state during this period.
While it would be most desirable to compare the morbidity reports since 1945 for the group of counties in which DDT dusting operations were conducted with the group of counties in which no control activities were conducted, it is believed that such a comparison would not be significant for the reason that some form of rodent control activities have been conducted at some time in practically all of the counties reporting ten or more cases since 1945. In this connection, the morbidity reports for 1947 show that one county reported 37 cases; 11 counties reported 10 to 23 cases; 17 counties reported 5 to 10 cases; and 51 counties reported less than 5 cases. Since 1945, all counties in the first two groups of counties, reporting 10 or more cases, have conducted control programs, either full or part-time. The third group of counties, reporting 5 to 10 cases, all counties, with the exception of 2 or 3 have conducted control programs. In the last group of 51 counties, about one-half of this group of counties have conducted some form of rodent control programs.
248
Georgin Department of Public Health
GRAPH NO.2
Graph No. 2, shows a comparison of the number of typhus fever cases reported for the State for the year 1937 through 1947, the seasonal variation, and comparison of incidence by months, before and after DDT dusting, for the 5 year period 1940 through 1944, and years 1945, 1946, and 19Ll7.
The number of typhus fever cases reported for 1947 is the lowest number of cases reported for the State since 1934.
REPORTED INCIDENCE OF MURINE TYPHUS FEVER IN GEORGIA
1000 f-----------lli----------1--11---11---~-----1
11137
111 .. 1
GRAPH No.2
Preventnble Diseases
249
MURINE TYPHUS FEVER CONTROL
STATE OF GEORGIA
TYPHUS FEVER RATf;S REPORTED BY MONTHS IN THE FOLLOWING 21 COUNTIES PARTICIPATING IN DOT OUSTING 1 _AND RAT ERADICATION CURING 1946: AND 1947:
CASE RATES SASEO ON 100,000 POPULATION.
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GRAPH No.3
GRAPH NO.3
Graph No. 3, shows the seasonal variation and comparison of incidence by months, before and after DDT dt1sting, for the 5 year period 1940 through 1944, and the years 1945, 1946, and 1947 for twenty-one counties participating fulltime in DDT dusting operations during 1946 and 1947.
This group of twenty-one counties reported 55.6 }"o of the total number of cases reported for the State in 1945; 39.2o/o of the total number of cases reported in 1946; and 39.7o/o of the total number of cases reported in 1947.
It may be observed that a substantial decrease occurred in the monthly case rate incidence of the disease for, "the DDT
250
Geor-gia Department of Public Health
dusting years," 1947 and 1946 as compared with "the before DDT dusting years," 1945 and the five year period, 1940 through 1944.
Summary
Of the total cost of the Typhus Control Program for 1947,
State and local participation amounted to about 40 'X, and the
U. S. Public Health Service participation about 60 '7o. An aver-
age of 61 local, 3 State, 74 Federal, or a total of 137 employees were engaged in the state-wide Typhus Control Program.
Control measures applied were: DDT dusting of rat runs and harborages, rat eradication, and ratproofing of buildings.
DDT dusting and rat eradication activities were conducted in 76 counties and ratproofing activities in 5 counties. DDT dust was applied to 182,787 premises using a total of 443,107 pounds of the material, or an average of 2.4 pounds per premise. Rat eradication measures were utilized in treating 121,083 premises with poison bait, requiring 55,826 pounds of red squill bait, 511 gallons of 1080 (Sodium Florouacetate) poison water, 565 pounds of ANTU, and 297 pounds of Cyanogas. Ratproofing cost estimates were made of 976 business establishments, of which 717 were completely ratproofed. The average cost of ratproofing was about $100.00 per business establishment.
Sanitary refuse collected and disposal consultation services to municipalities accounted for the improvement of municipal refuse collection facilities and the continued operation of sanitary landfills, for refuse disposal, in at least four cities.
Investigations included epidemologic, rodent and the special Thomasville Typhus Investigative Project. Epidemologic and rodent investigations were made in all counties conducting fulltime DDT dusting programs. These investigations facilitated the location of typhus fever focal points, and insured more effective control operations. The Thomasville Investigative Project, operating in Brooks, Thomas, Grady, and Decatur Counties, continued throughout 1947 in the study of typhus fever in humans and rodents, and the evaluation of DDT dust for the control of typhus fever.
The 436 cases of typhus fever- reported in 1947 was the lowest number of cases r-eported for the State since 1934. Typhus fever morbidity in 1947 dropped 26o/o as compctr-ed 'with 1946 morbidity. For the past two years, 1947 cmd 1946, typhus fever morbidity dropped 61 o/o. The five most densely populated counties, namely, Chatham, Bibb, Richmond, Fulton, and DeKalb, had a decrease in morbidity for the past two yeaTs of 92o/o. The decrease in 1947 as compared with 1946 for these five counties 1uas 57o/o. Chatham Cmmty reached an all time low in 1947 of 8 cases.
Preventable Diseases
251
TYPHUS FEVER CONTROL SERVICE STATISTICAL REPORT
JANUARY- DECEMBER 1947
1. Typhus Fever Morbidity
Total
No. Typhus Fever cases reported for the state (1946) 606
No. Typhus Fever cases reported for the state (19L17) 436
2. Personnel
A. Employees
1. Local ---------------------------------------------------------------------- 61
2. State --------------------------------------------------------------------
3
3. Federal Civil Service ------------------------------------------ 71
4. U.S.P.H.S. Commissioned Officers --------------------
3
5. Total all personnel ---------------------------------------------- 137 B. Man Hours
1. Local ----------------------------------------------------------------------126,880 23.. FSetadteera--l---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-,_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-1L157,,360800
4. Total ----------------------------------------------------------------------279,860
3. No. Counties Service Rendered ----------------------------------
76
4. No. Field Visits ________________________________________________________________ 156,436
5. Educational A. Personal conference and contacts ____________________________128,897
B. Meetings attended ------------------------------------------------------ 263
C. Meetings addressed ---------------------------------------------------- 174
D. Number persons addressed -------------------------------------- 4,491
E. Radio talks ------------------------------------------------------------------
1
F. Slides and strip films shown -------------------------------------- 28
G. Movies shown ------------------------------------------------------------ 8L1
H. Newspaper articles ---------------------------------------------------- 16
I. Literature distributed ------------------------------------------------ 20,262
6. Investigcttions
A. Epidemiologic 1. Cases investigated 2. Blood specimens collected for laboratory tests 53,549 (Counties: Grady, Lowndes, Colquitt, Floyd, Thomas)
B. Rodent Investigations 1. No. rodents trapped -------------------------------------------- 6,048 2. No. rodents examined (dusted areas) ______________ 2,034 3. No. rodents examined (undusted areas) _______ _ 1,789 4. No rodent ectoparasites specimens examined __ 73,311 5. No. :fleas recovered from rats (dusted areas) __ 3,656
252
Georgin DepaTtment of Public Health
6. No. fleas recovered from rats (undusted areas) 7,995 7. Flea Index-dusted areas -------------------------------- 1.80 8. Flea Index-undusted areas ----------- 4.47
9. Percentage reduction of flea index ____________________ 59.70 o/o
10. No. rodent blood specimens examined ____________ 3,145 11. No. rodent blood specimens positive for typhus
fever ---------------------------------- 846 12. Percentage of rodent blood specimens positive
for typhus fever ------------------------------------------------26.90 '/o
7. Control lV1ensures
A. Ratproofing 1. Surveyed (cost estimate) Business establishments ------------------------------------ 976 Residential establishments -------------------------------Total surveyed ---------------------------------------------------- 976 2. Ratproofed Business establishments -------------------------------------- 717 Residential establishments .------------------------------Total ratproofed -------------------------------------------------- 717
B. Rat Eradication 1. Number of premises treated Business establishments --------------------------- 23,374 Residential establishments --------------------------- 97,709 Other establishments ------------------------------------------
Total treated ________________________________________________________ 121,083
2. Poisoning Number gallons poison liquid used (1080) ___ _ 511 Number pounds bait used (Red Squill) ___________ _ 55,826 Number pounds poison bait used (ANTU) ___ _ 565 Number pounds poison gas used (A-Dust) ___ _ 296.5
C. Rat, Flea Eradication- (DDT Dusting) 1. Number Business Establishments Dusted ________ 35,231 Residential Establishments Dusted __________________ 147,556
Total Dusted --------------------------------------182,787 2. Amount of DDT dust used (pounds) ................443,107 3. Amount of DDT dust per premise (pounds) .... 2.42
Preventable Diseases
253
VENEREAL DISEASE CONTROL SERVICE
During 1947 the work of the Venereal Disease Control Service has been planned and directed by the Director of the Division of Preventable Diseases. As in 19L!6, no Venereal Disease Control Officer was available to supervise the program. During the first half of 1947, three Administrative Assistants and one Education Consultant were assigned by the Venereal Disease Division of the U. S. Public Health Service to assist in the Venereal Disease Control program in Georgia. On July 1, 1947, two of the U. S. Public Health Service Administrative Assistants and the Education Consultant became employees of the Division of Preventable Diseases of the State Department of Public Health. They continued to assist the Division Director with Venereal Disease Control activities during the second half of the year. The other U. S. Public Health Service employee remained as Public Health Representative and assisted the state employees in the Venereal Disease Control program during the second half of the year.
Throughout 19L!7 emphasis was placed upon Case-Finding and Intensive Therapy at Alto Medical Center. Case-finding was accomplished through the media of Public Information, Mass Serologic Surveys and Contact Investigation.
During the first half of the year, honoraria to private physicians working in local clinics throughout the state were discontinued. This resulted in an almost complete change in function of local clinics. The treatment of syphilis in these clinics with routine schedules of arsenical and bismuth therapy over a period of months was virtually eliminated. The local health department clinics became diagnostic, educational and referral centers in relation to syphilis control. For the most part, these clinics continued to treat only gonorrhea, some cases of the "minor venereal diseases," and a few cases of syphilis for which intensive therapy employing penicillin was contra-indicated. Practically all syphilis cases treated at public expense were referred to Alto Medical Center for therapy. This change in function of the local clinics has practically eliminated the necessity for case-holding activity on the part of local clinic personnel and has freed them to do a much more effective job of case-finding. At the same time, this policy of referring syphilis patents to Alto Medical Center for therapy has resulted in the completion of prescribed thentpy for
practically 100 'lr of the patients referred. To date, all trends
indicate that this policy is sound from the standpoints of control, finance and maximum benefits to the infected.
During 1947 the Venereal Disease Control Service has encouraged private physi\(ians of the state to treat syphilis in accordance with modern concept of therapy. An attractive indexed manual, "The Management of Syphilis in General Practice," was
254
Geor-gia Department of Public Health
prepared by the service in cooperation with Emory University School of Medicine and was distributed to all private physicians in the state. Many of these physicians are now treating patients in hospitals or on the out-patient basis with intensive schedules of therapy employing penicillin.
The treatment of gonorrhea during 1947 was accomplished in most cases with a single injection of penicillin-in-oil-beeswax, or by use of aqueous penicillin given in a few injections over a period of a few hours. The fact that gonorrhea can now be treated and cured by this rapid and effective drug seems to be common knowledge among the general public. This has been made evident by the decreasing number of gonorrhea infections picked up in the secondary stations of the mass surveys, where thousands having positive or doubtful serologic tests have been given thorough physical examinations.
On the basis of research results obtained by Dr. Robert Greenblatt at University Hospital, Augusta, in the treatment of granuloma inguinale with streptomycin, most cases of this disease occurring in Georgia during 1947 were treated with this drug by Dr. Greenblatt at Augusta, or by Alto Medical Center. From results obtained to date, streptomycin appears to be far more effective in the treatment of granuloma inguinale than was antimonial therapy. Present standard procedure in the treatment of this disease employs L1 grams of streptomycin daily for 5 days. If, at the end of this time, epithelialization is evident and no Donovan bodies are demonstrable, the patient is discharged. Post-treatment observation is strictly maintained.
SuYveys
During the year, six mass Syphilis-Tuberculosis surveys were conducted. All six of these surveys were conducted with the view of measuring the efficacy of this method of case-finding in rural communities. Surveys were conducted in Moultrie and Colquitt County; Thomasville and Thomas County; Cairo and Grady County; Rome and Floyd County; Cedartown and Polk County; Valdosta and Lowndes, Lanier and Echols Counties.
The obtaining of blood samples and x-rays in these six surveys was accomplished in a period of from ten to thirty clays.
Results of these surveys indicate that this method of casefinding is equally as effective in such communities as in larger cities such as Savannah, Columbus, Macon and Augusta. From the surveys thus far conducted, we might say, in general, that the method is effective in any community having a high incidence and prevalence of syphilis and where the people of the community have been informed and arous2d to the point of active participation in the solution of their proJ:llem.
The six surveys conducted during 19L17 were conducted by a close-knit corps of technical key personnel from the State De-
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Approximately 90 percent of the testable pOJJulation was reached during six mass VD-TB surveys conducted in 1947.
256
GeorgiCi DepCi?"trnent of Public Health
partment of Public Health and from the U. S. Public Health Service, with local personnel being employed to fill non-technical positions.
Table No. 1 gives the comparative results of the six surveys conducted during 1947. It will be noted that approximately 90';/o of the testable population was reached, and that the amount of early and latent syphilis found and brought to treatment was high. The percentages of Primary and Secondary Syphilis, as well as the percentages of Latent Syphilis, were higher in proportion to the total number of persons tested in these six surveys than in the surveys in Savannah, Columbus, or Macon. It will be noted that in these six surveys 2,504 new cases of syphilis were brought to treatment.
Contact Investigation
In the Augusta survey and in the six surveys conducted during 1947, contact-investigation was employed in conjunction with mass serologic survey. This method of case-finding accounted for approximately 24% of the primary and secondary cases of syphilis found-cases which mass serologic survey would have missed. A vast majority of the cases found through this method were seronegative in the survey, but developed syphilis before or during the time they were under investigation as known contacts to primary or secondary cases. This is conclusive evidence that contact investigation is a vital adjunct to case-finding in the surveys when employed in conjunction with mass serologic survey.
In addition, a project in case-finding through contact investigation, in cooperation with the U. S. Public F ealth Service, was set up for the fiscal year beginning July 1, 1947. Eight investigators were trained, two were assigned to the surveys, and one to each of the six regional offices to investigate the contacts named in areas not having an organized epidemiologic service. To date, this project has functioned most effectively and has also resulted in more effective case finding through contact investigation in Health Officer and Nursing counties.
Alto MediccLl Cente1
Table No. 2 shows the activity report of Alto Medical Center for the year. It will be observed that the Center has operated at or above capacity for the entire period, and that there has been a steady increase in the patient load. During the year, 3,049 persons completed treatment for primary or secondary syphilis and a total of 11,785 persons completed treatment for syphilis of all types. During this period Alto has been the only State operated center for the intensive treatment of syphilis.
TCible "A" This table shows that fewer cases of syphilis were reported to
the Venereal Disease Control Service by private physicians than during 1946-1,690 as compared with 2,273 for 1947. Although this comparison does not show a significant reduction in the
Preventable Diseases
257
number of cases reported, it may be an indication that the attack
and prevalence rates are decreasing.
Table "B"
This "Summary Report of Clinic Activities" shows no significant change in the number of admissions as compared with
1946. It does show a marked decrease in patient loads and treat-
ment administered in local clinics. This is largely due to the fact
that intensive treatment at Alto has been emphasized during
1947 and treatment in local clinics with schedules of arsenic and
bismuth discouraged.
Table "C"
This table, showing "Gonorrhea Cases Reported to Venereal
Disease Control Service" during 1947, shows a slight decrease as
compared with the 16,542 cases of 1947 against 17,087 reported
for 1946.
Table "D"
This table, showing "Total Venereal Disease Cases Reported
to the Venereal Disease Control Service," shows a decrease in
the number of syphilis cases reported, 11,444 as compared with
16,101 for 1946. It is especially significant, however, that there
were 3,831 cases of primary and secondary syphilis in 1947 as
compared with 3,384 cases for 1946. This bears out the fact that the Service has concentrated its efforts on finding and treating
early infectious syphilis. The number of gonorrhea cases re-
ported shows a slight decrease, 16,561 as compared with 17,328
for 1946. There is a marked increase in the number of cases
of Other Venereal Diseases Reported, 1,653 as compared with
811 for 1946.
Tables "E" and "F"
.
With the exception of penicillin, there has been a marked de-
crease in the amount of "Free Anti-Syphilitic Drugs Distributed"
during 1947. This is attributable to the fact that syphilis cases
have been, to a much greater extent, referred to Alto for treat-
ment. Gonorrhea, for the most part, has been treated by the
private physician or by the local clinics with penicillin. Figures
shown in these tables are exclusive of drugs used at Alto Medical
Center.
Tc~ble "G"
It will be noted that "Serologic Examinations for Syphilis"
show a marked increase during 1947 as compared with 1946,
481,956 as compared with 369,3L10 for 1946. The percentage of
positive findings for 1947 was 12.4 as compared with 12.1 for
1946.
Table "H"
Educational Activities show a marked increase over 19L16, but
are still poor because of lack of personnel to do the work.
Much credit for what has been accomplished during 1947
is again due the Division of Laboratories and the Division of
Public Health Nursing for their fine contribution to the program.
1:\!l 01 CIJ
TABLE I
v. D. SURVEYS IN GEORGIA
CoMPARATIVE RESULTS
LOCATION
CITY
COUNTY
POP. PERIOD TESTED
NUMBER OF NEW CASES BROUGHT TO Rx.
SYPHILIS
G.C.
TOTAL
Ages
1550 Per Cent
Primary and Early Secondary Latent
Other
Total
1947
~
0.".",
CQ
NUMBER OF BLOOD TESTS
"<::">
!::)
Total
Neg.
Pos.
.., Db!.
""'"::d::,
Moultrie
3-5 to Colquitt 3-26-47
90.
43
~6
273
402
5-1 io Thomasville Thomas 5-21-47
90.
61
93
340
494
Cairo
6-4 to Grady 6-19-47
88.
29
34
133
196
Rotne
7-9 to Floyd 8-12-47
93.
40
73
268
381
Ceda1town
10-3 to Polk 10-23-47
25
47
181
253
Valdosta
Lowndes
Lanier Echols
10-29 to 11-19-47
53
181
525
759
;"":'l""
1
403
17.195
15.649
1.205
"" 341 ;::l
7
501
17.647
16.035
1,419
193 ""'""
..0......
9
205
8Ji98
R.140
442
116 '""tl
2
383
2s.sn
27.706
996
191
""0"'
"<:"">
0
253
14.873
14.243
555
75
~
0
759
2l.g29
19.903
1,586
340 ,"~."..
:;:s-
Totals
251
514
1.720
2.485
19
2,504
109,135 101,676
6,203
1,256
TABLE II
ALTO MEDICAL CENTER
1947
NUMBER OF PATIENTS COMPLETING COURSE OF TREATMENT
Primary
and
Early
Secondary Latent
January
1~8
136
February ____________
235
1~1
March ----------------------
286
324
April
255
373
May --------------------------- 308
277
June July
---------- 345
386
250
400
August ~
267
422
September
264
311
October
250
313
November
200
301
December
202
296
SYPHILIS
Late Latent
104 158 233 304 269 333 388 438 235 278 2ti6 :148
Congenital
Neuro~
Total
Syphilis Syphilis
17
40
564
29
73
784
33
89
965
42
87
1,061
23
96
973
51
100
1,215
65
111
1,214
44
84
1,256
27
114
950
39
77
957
37
48
852
66
81
994
Not in combination with syphilis
TOTAL
TOTAL TOTALNO
PATIENTS ADMISSIONS PATIENT.
TREATED White Colored DAYS
G.C.
18 16 20
9 18 17 24 33 22 16 24 10
Other VD
29 26 22 28 35 27 33 46 34 14 21 19
611 826 1,007 1,098 1,026 1,259 1,271 1,335 1,006 987 &97 1,023
~
162 145
749 893
9,401
<"<":'::">:'
.,... 11,189
;<:::':;>:
:;:,
187
1,006
12,770
0"'
~
140
1,153
14,401
<:':>
164 134
1,027 1,354
13,017 15,697
b
""""
<:':>
:;:,
149
1,376
15,865
""<:':>
204
1,314
"" 16,974
159
1,011
12,414
165
901
11,175
113
874
10,558
121
1,116
11,459
Total
3,049
3,730
3,3ii4
473
1,000
11,785
227
334
12,346
1,843
12,774 154,920
-
~
Ol
~
TABLE A
SYPHILIS CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE By Private Physicians
UNDER PROGRAM FOR DISTRIBUTION OF FREE ANTISYPHILITIC DRUGS
January-December, 1947
NEW CASES (Never previously treated)
White
M
r
Colored
M
F
January
16
16
29
56
February ________ . 2
6
20
44
March
9
6
30
53
April ~~~~~~~~~~~~~~~~~
7
20
63
113
May
~~ 13
12
41
68
June
3
7
36
22
July
3
1
22
27
August
2
9
46
90
September
2
2
17
16
October _ .
5
4
22
22
November_
G
8
32
49
December
r;
1
22
32
Total
117 72 98
203 134
68 53 147 37 53 95 64
OLD CASES (Previously treated)
White
Colored
1\11
F
M
F
9
13
14
84
5
10
12
22
5
3
13
8
11
10
35
53
15
16
14
25
1
1
1:l
20
6
14
12
3
6
14
13
3
1
9
13
5
6
12
21
2
3
2
15
G
3
12
6
Total
70 49 29 109 70 35 32 36 26 44 22 27
TOTAL REPORTED
White
M
F
25
29
7
16
14
9
18
30
28
28
4
8
9
1
5
15
5
3
10
10
8
11
12
7
Colored
M
F
4:l
90
:~2
66
43
61
98
166
55
93
49
42
36
39
60
103
26
29
34
4:J
34
64
34
38
~:>:) 0)
0
c;')
0""
"''.Q,.,.
~
b Total
'""c"3
187
~
"' 121 "~"""
127 312 204
-;":"3
""""
0
103 "lj
,::
85 183
."0,"."",".''
c-,
63 ~
97 "~"
117 ;":":";"-
91
Total ~~~~ 74
95
380
592
1141
71
72
164
242
549
145
167
544
834
1690
TABLE B
SUMMARY REPORT OF CLINIC ACTIVITIES SYPHILIS
January-December, 1947
NEW CASES OF SYPHILIS ADMITTED TO CLINIC
White
Colored
M
F
M
F
1 otal
January ----------------------------- 41 February ------------------------------ 34 Marcli -------------------------------------- 39 April ----------------------------------- 31
May ---------------------------------------- 43
June -------------------------------------- 50 July ------------------------------------------- 34 August ------------------------------------ 116 September ----------------------------- 58 0 ctober ---------------------------------- 46 N ovembe1 -------------------------------- 43
December -------------------------- 51
Total ---------------------------- 586
33
181
258
513
20
191
281
526
38
213
310
600
31
265
445
772
37
272
451
803
53 ' 361
457
921
40
409
563 1,046
87
748 1,033 1,984
78
351
440
927
50
269
418
783
48
227
295
613
44
285
435
815
559 3,772 5,386 10,305
OLD CASES OF SYPHILIS
ADMITTED TO CLINIC
TOTAL DOSES AD
TOTAL UNDER MINISTERED
White
Colored'
Total ADM IS- Rx
M
F
M
F
SIONS !lURING
Heavy
MONTH Arsen. Met.
'1:1
""'(I>
<:::
72
GO
440
567 1,139
1,652
4,797
6,759
8,721
;(;I:>s
64
51
509
580 1,204
1,730
4,345
5,148
6,614
<:-i~
59
69
480
666 1,274
1,874
4,296
5,645
7,230
Cl"'
~
69
61
479
632 1,241
2,013 4,133 4,928 7,356
b
83
46
525
638 1,292
'"" 2,095 3,809 4,847 7,381 Cr.>
59
49
424
556 1,088
2,009
3,536
4,280
5,436
(I>
~
Cr.>
13
13
92
138
256
1,302
(I>
Cr.>
26
25
131
210
392
2,376
RECORDS OF
41
27
132
184
384
1,311
ABOVE FIGURES
25
29
133
180
367
1,150
NOT KEPT SINCE
23
20
109
141
293
906
JUNE 31, 1947
2.4
14
136
189
363
1,178
558
464 3,590 4,681 9,293
21,836 24,916 31,607 42,658
1.\:) ~ t-'
1.\:l
C)
l'>:l
GONORRHEA CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE
TABLE C
WHITE
M
F
January ________ 112
43
February -------- 104
48
March ------------ 113
60
April ------------ 116
61
January-December, 1947
CLINICS
COLORED
M
F
466
205
~83
198
474
316
522
242
UN I<. TOTAL
PRIVATE PHYSICIANS
WHITE
COLORED TOTAL
M
F
M
F
350 1176
2
343 1076
2
395 1358 --------
381 1322
1
1
6
5
14
10
4
16
1 --------
1
5 --------
6
~
(I:)
TOTAL REPORTED
c ""l
WHITE
COLORED
(Q
"" UNI<. TOTAL ~
M
F
M
F
b
(I:)
114
44
472
210
350 1190 't3
106
48
393
202
343
1092
~
.,.;..
113
60
475
316
395 1359 ;;:l
117
61
527
242
381
1328
:(;I:s)
.,.;..
May ---------------- 156
83
743
337
1319 1 --------
3
3
7
157
83
746
340 -------- 1326 ..c..,.,
June---------------- 127 July ---------------- 162
75
564
265
482 1513
55
667
239
492 1615
-------- ---------------
-------- 127 ------- 162
75
564
265
482 1513
'"lj
55
667
239
492 1615 :;::
August _________ 219
117 1146
368
22 1972
8
2
29
September ____ 238
73
869
359
122 1661
2 --------
10
1
40
227
119 1156
369
22
1893
.0,..."..
"~"
5
17
240
73
879
364
122 1678
October _________ 158 Novembe1 ------ 113 Decen1ber ______ 95
69
753
351
87 1418
1
3 --------
4
159
54
501
233
135 1036
1 --------
3 --------
4
114
68
616
216
91 1086
-------- -------- -------- --------
95
69
756
351
87
1422
i:J::l
(I:)
54
504
233
135
1040
~
68
616
216
91 1086 ;";":"s'"-
Total ____ 1713
806 7704 3329 2900 16452 18
3
70
18
109 1731
809 7755 3347 2900 16542
TABLE D
TOTAL NEW VENEREAL DISEASE CASES REPORTED TO THE VENEREAL DISEASE
January-December, 1947
BY PRIVATE PHYSICIANS
WHITE
COLORED
M
F
M
F
SYPHILIS
Pri. and Sec...__________________ 57
69
249
382
Early Latent ------------------ 1 Late and Late Latent ___ 16
3
11
13
22
117
187
Congenital ------------------ --------
1
3
8
Prenatal ----------------------- --------
-------
--------
2
Total __________________ .. 74
95
380
592
GONOCOCCUSINFEC~ON Genito-urinary ---------------- -------Opthalmia Neo ________________________ Not Stated ------------------- 18
Total -------------------- 18
--------
-------- --------
3
70
18
3
70
18
BY CLINICS, HOSPITALS OR OTHER INSTITUTIONS
TOTAL BY ALL SOURCES
WHITE
COLORED
WHITE
COLORED
UNI<.''' TOTAL
M
264 123 168
31
--------
F
160 193 173
33 --------
M
1320 1097 1210
145
F
M
1330 2218 1644
194
--------
321 124 184
31
--------
F
229 196
1~5
34
--------
M
1569 1108 1327
148
--------
F
1712 2231 1831
202 2
---------------
'\;
3831
"'C1::>
<::
3659
C1::>
;;:l
3537 415
<-I~
0"'
2 ("'
586
559
3772
5386
660
654
4152
5978
--------
11444
b
C""Q'
C1::>
~
-------- -------- -------- --------
-------
--------
-------
-------
CQ C1::>
-------
--------
-------- -------- -------- -------- -------- ------- -------- CQ
1713
806
7704
3329 1731
809
7774
3347
2900 16561
1713
806
7704
3329 1731
809
7774
3347
2900 16561
OTHER VENEREAL DIS.
Chancroid -------------------------- -------
--------
-------
-------
99
Granuloma Ing. -------------- --------
--------
--------
--------
1
Lymphogranuloma -------- --------
--------
6
TotaL___________________ --------
--------
-------
------
106
9
633
247
99
1
154
149
1
78
22
6
10
865
418
106
9
633
247
196
1184
1
154
149
27
332
78
22
31
137
10
865
418
254
1653
t-:)
cmo
TABLE E
.3
January
February
10
March_
GO
April
-------------------
15
May ------------------
35
June ------------ ---------------------
30
July August ______
---------------- 5
----- -------
20
Septetnber
October
November ...--- .
--------------
Decem bet
-------- ------------------- 20
TotaL_
195
Total Number
of Doses __________
195
FREE ANTISYPHILITIC DRUGS DISTRIBUTED Venereal Disease Control Service
January-December, 1947
N EOARSPH ENAM IN E
.45
.6
.75
.B
3.0
4.5
6.0
10.8
45.0
120
2030
~-------
40
2315
-------
1465
-----
----- -------
80
615
-------
------
-----
955
1150
--------
1245
--------
--------
--------
-------
1535
------
--------
730
175
-------- -------- -------- --------
30 240 12245
240 12245
L'\?
~ oj::o
ARSENOXIDES
.045
.067
.45
890 510 485 910 450 270
~40
460 430 400 1005 180 6430
3350 2675 3115 2625 5140 3740 1805 2240 1700 3680 3900 2960 36930
20 ------
20
G':l
<:':>
.0..,
CQ o> .67 1;!
1430
\:::j
<:':>
650
'd
1..;.!,
440
c-1-
~
1020
<:':>
;:::;:
510
c-1-
- 1040
0
530 'i;j
410
::::
0"
~
1430
o>.
~
360
~
500
<:':>
~
380
;c_-:1::,--
8700
6430 36930
200 87000
TABLE F
FREE ANTISYPHILITIC DRUGS DISTRIBUTED Venereal Disease Control Service
January-December, 1947
TRY PARSAM IDE
SULPHARS- STOVAR-
SULFATHIA-
PHENAMINE
SOL FUADIN
ZOLE
BISMUTH
VACCINES
PENICILLIN
3.0
0.2
January _______________ ----------------------------------
February ____ ----------------------------------------------- ----
120
March
--------------------------------------------
50
April_ -------------------------------------------------------- ________
40
May
-----------------------------------------------------------
50
June
-------------------------------
July --------------------------------------------------------- --------
August -------------------------
-----------
25
20
Bottles of
0.4
0.6 Talilets 5-cc 40 Tablets
-------
800
500
60 --------
620
-------- ------
1010
--------
670
------
740
--------
430
--------
120
1037 400 332 728 804 549 535 311
Frei Ducrey
pkg
pkg
30-cc 60-cc ( 10)
(50) 100,000 units
~
231
321
110
17
161
194
3
3
3
3
13
17
"' 20,300
~
"' 11,070 ;::l
""" 17,232 :::;,
a-
135
257
16
1
15,323
('>
326
128
383
162
155
43
273
135
1
1
12
5
7
2
15
10
12,120 .(.:.::,j,
20,911
Cr.>
('>
13,080
:::;,
Cr.>
('>
18,775
Cr.>
September
----- 10
20
------
----
870
527
272
293
15
5
16,070
October ----------------
--------------------
20
-------
440
969
189
85
6
9
112,510
November
--------------------------------
--------
70
477
313
55
6
12
10,670
December -------------------------------------------- --------
500
70
611
20
79
7
1
17,380
Total
---------------------------------- 35
280
100 --------
500 6340
Total Number of Doses--------------
280
100 --------
500 6340
7780
2668 1769
104
69
188,485
105,600 80,040 106,140
1040 3450 dosage varies
m~
01
L'\J 0":>
0":>
TABLE G
LABORATORY EXAMINATIONS FOR VENEREAL DISEASES
Performed in Central Laboratory and Two Branch Laboratories
Georgia Department of Public Health
January-December, 1947
SEROLOGIC EXAMINATIONS
DARI<FIELO EXAMINATIONS
~
<:':>
.0..,
:::!
EXAMINATIONS FOR GONOCOCCI
":;:":>'
Total
Januaty
---------- ----- -------~-----
34496
Febeuary March
-------------------------------- 28432
_______ ._ ______
47193
April.
----------------------
32224
May.
49809
June __
37747
July.
--------------------
50176
August
-----------
Septetnber ___________
42031 51350
October ---------
36071
Novembet
44379
Number Number Percent Positive Negative Positive
4127 3620 5019 4579 6343 5251 5704 4745 5496 4959 5851
30369 24812 42174 27645 43466 32496 44472 37286 45854 31112 38528
12.0 12.7 10.6 14.2 12.7 13.9 11.4 11.3 10.7 13.7 13.2
Total
29 23 13 16 18 11 22 12 15 18 15
Number Number Percent Positive Negative Positive
9
20
31.0
6
17
26.1
5
8
38.5
5
11
31.3
8
10
44.4
3
8
27.3
7
15
31.8
2
10
16.7
3
12
20.
9
9
50.
9
G
GO.
Total
2551 1482 2:191 2501 246'l 239o 2448 2:lsG 245o 2510 1911
Number Number Percent Positive Negative Positive
b
<:':>
'"d
427
2124
16.7 .:;.::.>,
204
1278
13.8 "~"'"
368
2023
15.4
;<:::':s>
344 384 316
2157 2079 2080
13.8 15.6 13.2
-""'"
0
'\j
~
364
2084
14.8
0"'
~
36:3
202:]
15.2 "<:"">'
344
2112
14.
~
<:':>
377
21:)3
15.
~
282
1629
14.7 "~ "'"
Decem bet
28048
411:l
23935
14.7
16
7
9
43.8
1579
231
1348
14.8
59807 422149
12.4
208
78
135
:l5.
27074
4004
23070
14.8
SUMMARY REPORT OF EDUCATION ACTIVITIES Venereal Disease Control Service
TABLE H
January-December, 1947
.
Meetings
Meetings
Attended
Addressed
(Not
No.
Aud. Addressed)
January ----------------------------- -------Februar~r ---------------------- -------March -------------------------- 7
April ---------------------------------- -------May --------------------------------- 8 June ------------------------------ 6 July ----------------.---------------- ------August ---------------------------- ________
September ------------------------- ________
October ---------------------------- --------
N oven1ber --------------------------~~ ~~-~~December -------------------~----- --------
Total________________________ 21
--------
580
--------
640 475
----------------------
~~~-----
----~---
1695
--------
-------------------
----------------------
-~------
--------
--------
Films
No.
Au d.
24
1461
9
868
13
945
11
1841
13
2694
55
8091
50
1191
7
240
--------
--------
13
1318
22
1126
217
19775
Membership
No. of
Obtained for
Clinic No. of
Exhibits Literature Georgia Secial
Visits Conferences Displayed Distributed Hygiene Council
'"tJ
""l
21
20
9017
--------
~"".
16
10
6329
-------
:";"s
<:-!-
-------- --------
--------
6419
~ 0"
------
2189
-----
("
-------
--------
4296
--------
b
-------
--------
8091
-------
-------- ---
------
2254
-------
"'<:/,)
~ ""
<:/,)
-------- ------
-------
3153
""<:/,)
------ -------
--------
4231
-------- ------
-------
6211
-~-----
--------
------
3315
--------
---~---
6216
37
30
-----
6_1721
~ ~
-:I
Division of Tuberculosis Control
H. C. SCHENCK, M.D. CLARA B. BARRETT, M.D. FRED W. THYNG _________
__ Director _ __ Associate Clinician ______ Associate Clinician
Division of Tuberculosis Control
Our records show that 171,687 x-ray pictures, miniature and large, were interpreted by the Division of Tuberculosis Control. Out of these, 1,102 cases were found. 1,013 additional films were made by the Division of the employees at Battey State Hospital. These were interpreted by the Battey Hospital Staff. The figures showing results are not available at this time. 7,159 pictures were sent in by physicians and local health departments for interpretation.
Table No. V shows that in 1947, 2,633 new cases of tuberculosis were reported, which is somewhat more than reported in the previous year. The number of cases reported first through the death certificates is not available for 1947, but in 1944, 1945, and 1946, an average of more than 575 were first reported by death from tuberculosis for the respective years, which would indicate that reporting is far from perfect, although it is realized that some of the cases might have developed and proceeded to death without a physician having been consulted prior to death.
It is seen that of the new cases reported during the year, 40 J"a were reported through x-ray film interpretation, covered in Table I, and almost 22% were reported first by death from tuberculosis, if the previous three year average of such reporting is still effective.
Tuberculosis deaths and death rates per 100,000 population, by number and race, are as follows:
Year
1946 1947
NUMBER OF DEATHS Total White Colored
1948 467 581 lOU 415 659
DEATH RATE PER 100,000 POPULATION
Total White Colol'ed
33.5 22.9 53.5 33.2 19.4 60.3
There was an increase in the total number of deaths in 1947. This should not, however, be regarded as indicating that tuberculosis is on the increase. Reference to Table No. VIII showing the deaths per 100,000 in Georgja, indicates that the number of deaths cannot be expected to be materially reduced except at four-year intervals, if the usual pattern since the year 1927 is followed. There is, however, a rather marked reduction after a three-year period, involving the years 1941, 1942 and 1943.
Table I is designed to show the relative value in case finding of the different methods employed and different groups examined. 335 new cases, 7 ;/a, were secured through the interpretation of 4,502 sent in by physicians and local health departments. 29 new cases or 4;/a were found through 696 pictures made in the
272
Georgia DepaTtment of Public Health
central office of persons referred by private physicians in nearby
counties. 309 cases, or 2112 o/o, were found through the interpre-
tation of 12,491 x-rays made in the regular county clinics conducted by the county health departments. 328, amounting to .3o/o, were found in the examination of 107,121 in the county wide mass surveys. It may be argued that the latter is a very expensive way of finding tuberculosis; yet such examination of, for example, two million people in the state, which is probably less than the total number of people over 15 years of age, at
the same rate of .3 o/o, would disclose 6,000 new cases. It might
cost a million dollars to do that, but in long range tuberculosis work, it would probably be a justifiable expenditure. In addition, a great deal of good is brought about by the discovery of many non-tuberculous conditions which can be benefited by some form of treatment, and possibly by finding an additional 273 cases of healed tuberculosis.
The number of regular clinics was considerably increased in 1947; 190 compared against 172 in 1946.
'rable IV is a comparison of some of the tuberculosis control activities of local health departments, showing a general increase in such activities. During the year, 5,606 cases of tuberculosis were admitted to the services of the local health departments, which is about 1,500 more than the previous year. They report 1,266 admissions to sanatoria against 707 the previous year.
Tables V and VI show that 525 patients were under treatment as of December 31, 1947, and that 113 new cases were admitted during the year through these services. The total cost amounted to $28,911. Twenty-two patients were discharged for various reasons; only three deaths among them were reported.
On September 6, a consultant nurse, assigned by the U. S. Public Health Service, was added to the staff of the Division. She has been very active in stimulating tuberculosis nursing activities in the :field and has done considerable preliminary work looking toward the adoption of a nurses' manual on tuberculosis; developing an affiliation program between the Emory University undergraduate student nurses (3rd year) and Battey State Hospital; planning a three months' orientation program for Mrs. Elizabeth Fulcher, Consultant assisting in the affiliation program mentioned; instruction tours for public health nurses in the sanatorium; planning a Nurses Institute for March, 1948; and in various other activities looking toward the establishment of better tuberculosis nursing programs and the dissemination of better knowledge of tuberculosis in all its phases among the public health nurses in the state.
The long delayed installation of a central tuberculosis register was gotten under way through the assistance of a record consultant assigned by the U. S. Public Health Service, and the employment of a record analyst and additional personnel by the
T~tben~tlosis Control
273
State. The register is being established as rapidly as possible through information being secured from such sources as the Central Tabulating Unit, the reports of physicians, the sanatorium, the Division of Tuberculosis Control, the local health organizations and the Veterans' Administration. It is a project of considerable magnitude and its successful operation will depend largely upon our ability to secure information on the cases reported. The Health Department should maintain a local central register. It is expected that a field representative of the Division of Tuberculosis Control can give assistance to the local health organizations in establishing their local registers. The equipment and forms can be supplied by the Division of Tuberculosis Control.
A considerably expanded program for 1948 has been envisaged and some steps toward that end have been undertaken. We have a large amount of field equipment, but not yet enough trucks to transport it. Commitments have been made for continuance of the combined venereal disease and tuberculosis county wide mass surveys for the entire year. Three transportable units were put in operation, with each one operating in two public health regions. All of this has imposed a very heavy burden on our medical staff, which is inadequate in number for such a large program, every physician in it being required to carry an unreasonable load, and it is exceedingly doubtful that our present method of operation can be maintained unless additional medical help can be secured in some manner.
An excellent x-ray technician staff has been built up, sufficient to keep half a dozen doctors busy, instead of the three on our staff, including the Director of the Division.
Successful tuberculosis control is dependent on a number of ' factors; they consist of case discovery-and for this purpose
good diagnostic clinic facilities should be made available as well as the facilities for mass x-ray work; having found the case, facilities for their care and treatment-isolation and quarantine-must be made fully available.
It has been found that relief for the families of people with tuberculosis and for the patients who must, of necessity, live outside an institution, is inadequate to a high degree. Without its correction, control of tuberculosis will be hampered.
There are very important psychological factors included in the control of tuberculosis. Looking toward a better control of this phase of tuberculosis, the establishment of an adequate medical-social work program on a state-wide basis should be given consideration.
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Of the 107,121 people X -rayed during six county-wide mass surveys , in towns such as this, 328 were found to have tuberculosis.
Tuberculosis Control
275
TABLE I
BRIEF SUMMARY OF CLINICS AND RESULTS
Kind of Clinics
No. of No. of No. of Cases Per Clinics X-Rays Found Cent
Regular County Clinics
(14 X 17) ------------------------------ 190 12,491 309 2.5
College and High School
survey follow-up x-rays
(14 X 17) ---------------------------- 11
222
Ll 0.05 (1)
Industrial survey follow-
up x-rays (14 x 17) ____________ 9
623
L19 0.4Ll (2)
Six City-County Mass
survey follow-up x-rays (14 X 17) ---------------------------- 6 X-Rays made in Central
. 6,722 328 0.3 (3)
Office (14 x 17) ________________ Continuous 696
29 4.0
Total 1L! x 17 x-rays made
20,754 719
X-rays sent in by physicians and local health departments for interpretations __________________________ 4,502 335 7.0 X-rays sent in by physicians and local health departments on cases with previous diagnosis and no change shown ______ 2,657
Total number 14 x 17 x-rays interpreted and cases found ________ 27,913 1,05L1
Alto Medical Center films interpreted (70 mm. and 14x17) __ 8,310
Total cases found through Division Interpretations__________________
70 mm. x-rays made at combined TB-VD Mass Surveys (persons x-rayed) ____________________________107,121 70 mm. x-rays made at Industrial Plants (persons x-rayed) ________________ 11,162 70 mm. x-rays made at Schools and Colleges (persons x-rayed) ______________ 8,671 70 mm. x-rays made of Battey State Hospital employees, films made by us but interpreted by Battey Hospital Staff, results not available________________ 1,013 70 mm. x-rays made in Milledgeville State Hospital ---------------------------------- 8,510
48 1,102
0.6 (4)
276
Georgia Department of Public Health
TABLE I (continued)
BRIEF SUMMARY OF CLINICS AND RESULTS
TOTAL X-RAYS INTERPRETED ____________________________ 172,200 NUMBER CASES FOUND____________ 1,102
(1) jc calculated from 8,671 persons x-rayed in the survey (2) ';~ calculated from 11,162 persons x-rayed in the survey
(3) 'ic calculated from 107,121 persons x-rayecl in the survey
(4) follow-up completed by the hospital staff at Milledgeville, results not available
Tuberculosis Control
277
TABLE II DISTRIBUTION OF CLINICS
70MM Hx7 Total
X-ray:s made in 97 counties in 190 clinics organized by health commissioners and county public health nurses ________________________ _
LeTourneau Company, Toccoa _____________ _ Veterans Adm. Offices, Mariet~a ___________ _
Atlanta Ordnance Offices !General Depot,
MoCuolntrleiey-C-o-l-q-u-i-t-t -C--o-.,--T-B---V--D--M--a-s-s--S-u--rv-e-y--__Thomasville-Thomas Co., TB-VD Mass Smvey Cairo-Grady Co., TB-VD Mass Survey______ _ Alto Medical Center, Alto _________________ _
Muscogee-Columbus High Schools, Columbus __ Battey State Hospital Employees, Rome _____ _ Milledgeville State Hospital, Milledgeville__ _ Survey Health Workshop, Athens ___________ _
Rome-Floyd Co., TB-VD Mass Smvey_____ _ Decatur Laundry, Decatur_ ________________ _ Morgan Laundry, Decatur_________________ _
Cedartown-Polk Co., TB-VD Mass Survey____ _ Cave Springs School, Floyd County__________ _ Berry Schools, Rome_______________________ _ Columbus-Muscogee Fair _________________ _ High Schools of Decatur_________________ _ Agnes Scott College, Decatur_______________ _
General Shoe Corp., Lawrenceville, and Henson Mfg. Co., Lawrenceville __________ _
Valdosta-Lowndes Co., TB-VD Mass Smvey__ Ft. Valley State ,College, Ft. Valley _________ _ Ga. State College for Women, Milledgeville__ _ Baxley Orphanage, Baxley_________________ _ Brewton-Parker Jr. College, Mt. Vernon _____ _ Goodyear-Clearwater Mills, Cartersville_____ _ State Teachers College, Collegeboro__________ _ Commerce Mfg. Company, Commerce_______ _
1,095 1,6,10
12,491 114 93
3,386
306
16,467
893
16,757
974
8,176
537
2,461
5,8,19
3,373
36
1,013 (1) 8,510
*.,..,.
157
5
31,162
1,989
78
3
120
2
14,349
974
196
3
453
6
2,575
41
1,122
22
661
18
7L17 20,210
568 1,259
280 1,207
602 314
64 1,355
*** ***
132
**::;
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***
12,491 1,209 1,733
3,692 17,360 17,731
8,713 8,310 3,'109 1,013 8,510
162 33,151
81 122 15,323 199 459 2,616 1,144 679
811 21,565
568 1,259
132 280 1,207 602 314
138,938 25,907
X-l'ays made in Central Office of patients
referred by private physicians in State ___ _
696
Total 'Consultation X-rays interpreted_______ _
7,159
GRAND TOTAL INTERPRETATIONS MADE
(1I)NIntYerEpAreRte-d19b4y7B-a-t-t-e-y--S-t-a-f-f_--_-_-_-_-__-_-_-_-_-_-_-_-__1_3_8_,_9_3_8_____3_3_,_7_6_2 _
696 7,159
172,700 1,013
TOTAL INTERPRETED BY DIVISION OF TUBERCULOSIS CONTROL ------------------------------------------------- 171,687
* Two Surveys-follow-up completed by Battey State Hospital
';*Follow-up completed by Milledgeville State Hospital *** Follow-up completed by Milledgeville State Hospital
278
GeoTgia DepaTtment of Public Health
TABLE III
CONSULTATION SERVICE RESULTS OF INTERPRETATION OF FILMS REFERRED
BY PHYSICIANS
NEW CASES: Primary ______________________________________________________________ 50 Minimal ___ _____________________________________________________ 109 Moderately Advanced ______________________________________ 101 Far Advanced ____________________________________ 75
TSoutsaplicPioousistiv__e___-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_-_-_-_-_-_-_-_-_-_ 664
Negative ____________________________________________ _
3,377
Diagnosis not made _______________________________ _
126
CASES ON WHICH PREVIOUS DIAGNO-
SIS HAD BEEN MADE:
Films sent in for review on cases that had
been previously diagnosed and no change
shown ----------------------------------------"---------------------
TOTAL OF ALL FILMS SENT IN FOR INTERPRETATION __________ ------------------------------
335 4,167
2,657 7,159
TABLE IV
PUBLIC HEALTH TUBERCULOSIS CONTROL ACTIVITIES OF LOCAL HEALTH DEPARTMENTS
1947
Cases of tuberculosis admitted to service________ 4,160
Visits to tuberculosis cases, contacts and sus-
pects ---------------------------------------------------------------- 38,290 Visits to cases of tuberculosis___________________________ 11,147
Office visits by cases of tuberculosis________________ 7,515
Office visits by tuberculosis cases, contacts
and suspects ---------------------------------------------------- 21,775
Admissions to Sanatorium_____________________________
707
Number completed tuberculin tests__________________ 19,741
Number positive ______________ ____________________________ 4,972
Contacts broken ________________________________ _______________ 1,324
Contacts partly broken ______ ________________________ __ _ 105
Relief secured-Number of cases_____________________ 335
Tuberculosis cottages built_____________ __ ______ __________ 22
5,606
LJ5,815 12,244 13,185
27,960 1,266
23,583 5,821 1,435 196 423 6
Tuberculosis Control
279
TABLE V
NUMBER OF CASES OF TUBERCULOSIS REPORTED IN GEORGIA BY SOURCE OF REPORTING AGENCY FOR 19L15, 1946 AND 1947
1944 1945 1946 1947**
Military Reservations ____________ _ 52
Health Officer Report, Labora-
tory Report, Private Physi-
cian and Tuberculosis Division _________________________________ 1993
Death Certificate
________ 563
State Total_
_______ 2608
32
1493 587
2112
18
1938 578
2534
20
2613
*
2633
* These figures not yet available as all deaths from tuberculosis
have not been cross indexed against cases for 1947.
** 1947 figures are provisional and subject to change in final tabulation.
TABLE VI
STATE PNEUMOTHORAX AND PNEUMOPERITONEUM REFILL PROGRAM
January-December 1947
Number patients under treatment January 1, 1947 434 New cases admitted to service during year 1947 113
Total cases under treatment during 1947____________
Patients dropped from service during 1947:
Admitted to Sanatorium
_______________________ 10
Pneumothorax or pneumoperitoneum discontin-
ueel _________________________________ ----------------------------- ------- 4
Discharged to private physician_________________
2
Moved ______________________________
----------- -------+-----
3
Deaths _______ _____
___ - - -------- --------- -
2
547 -22
Total number patients under treatment December
31, 1947 --- ---- - - --------------------------- - ---- - - -- -- - --- --
525
280
Georgict Department of Public Health
TABLE VII
ARTIFICIAL PNEUMOTHORAX SERVICES
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January
372 1274- 2548.00
February
3<12 1046- 2092.00
March
347 1089- 2178.00
April
3<13 1232- 2464.00
MaY
366 1259- 2518.00
June
346 1143- 2286.00
July
295 1029- 2058.00
August ... ------- 365
September .
356
1186- 2372.00 1225- 2450.00
October
351 1250- 2500.00
November
347 1128- 2256.00
December
354 1273- 2546.00
------
Total
H 134-28268.00
7- 8.00 7-- 9.00 3- 5.00 6- 6.00 7- 8.00 1- 2.00 13- 14.00 9- 9.00 10- 10.00 6- 6.00 5- 6.00 4- 4.00
3- 6.00 3- 6.00 10- 20.00 15- 30.00 18- 36.00 3- 6.00 5- 10.00 14- 28.00 1- 2.00 6- 12.00 20- 40.00 2- <1.00
16- 32.00 19- 38.00 20- 40.00
4- 8.00 11- 22.00 25-- 50.00 23- 46.00 32- 64.00
12- 24.00 10- 20.00
6- 12.00
78- 87.00 !00-200.00 178-356.00
$ 2594.00 2145.00 2243.00 2508.00 2584.00 2344.00 2128.00 2<173.00 2462.00 2542.00 2322.00 2566.00
$28911.00
Battey State llospital
RUFUS F. PAYNE, M.D ----------------------------------------------S~(perintendent
MEDICAL STAFF:
F. C. Welchel, M.D.
John Crenshaw, M.D.
H. E. Crow, M.D.
Grover Brzozowski, M.D.
J. L. Chestnut, M.D. Frld Crenshaw, M.D. Frank Blalock, M.D.
Ingrid Stergus, M.D. M. L. Morrison, DD.S. Sarah P. Orton, M.D.
Otto Stern, M.D.
E. B. Webber, DD.S. James P. Capo, M.D.
- -----------------
Battey State Hospital
The year 1947 has shown a continued expansion of Battey Hospital. For a complete description of the hospital depart-
ments and activities, you are referred to the 1946 annual re-
port.
The table below shows the number of patients in the hospital
on the first day of each of the past five calendar years as com-
pared with January 1, 1948.
Total
1-1-43 1-1-44 1-1-45 1-1-46 1-1-47 1-1-48
562
453
418
544
986
1199
The failure to expand to an even greater extent can be ascribed to lack of personnel.
The hospital has been officially approved by the American Medical Association, the American Board of Internal Medicine for residency training in tuberculosis, both medical and surgical. Since January 1 we have added to our staff a full time pathologist and a full time internist and they, with our senior staff physicians, have made it possible to secure this approval. The University of Georgia is now rotating its residents in medicine through a three months' experience here at Battey, and an invitation to participate also was extended to Emory, which failed to accept.
Several days were spent at the Mayo Clinic at Rochester in studying the use of streptomycin among patients. While we were very favorably impressed by the results which they had gotten from the drug, we still did not feel that State Funds should be used for investigative work, because of the fact that the drug was very expensive, it would be many months or years before the results were finally known, and we could not say, from
what we had seen there, exactly which types of cases could be expected to get the maximum benefit from the use of the drug. We therefore selected those cases in which the use of the drug seemed to be indicated and recommended that they secure the funds themselves and take the drug. The first cases were quite impressive, not only to the patients themselves, but to the other patients in the wards, and there was soon a clamor from practically every patient in the hospital that he be given streptomycin and that he could raise the funds for it. Since a great majority of our patients were unable to afford the five hundred to one thousand dollars necessary for a full course of treatment, it was soon obvious that the patients themselves were getting into situations which might reflect discredit on the institution and on the whole program in general. The Patients' Relations Organization here at Battey made the suggestion that a newspaper appeal for funds would be perfectly satisfactory since there were
284
Georgia Department of Public Health
regular appeals each year for seal sales, Easter sales for crippled children, cancer drive, and other special drives for various types of diseases. Since tuberculosis is more deadly and destructive than all others combined, with the exception of cancer, we gave our consent to a newspaper drive for streptomycin funds. We did promise that the money would be used for streptomycin in a manner that would insure our securing the greatest possible knowledge about the effect of the drug, and that it would be given to no one who had not been investigated and approved by their local welfare department. The Georgia Tuberculosis Association agreed to act as treasurer for the drive. More than $110,000 has been collected. More than one hundred patients have received assistance from the funds and more than five hundred have been given streptomycin.
At the present time it appears to us that streptomycin has already made its place as a treatment procedure in tuberculosis. It appears that the drug should be prescribed to every patient with the following conditions-tuberculous meningitis, miliary tuberculosis, tracheobronchial tuberculosis, soft exudative lesions, bone tuberculosis, renal tuberculosis, glandular tuberculosis and draining sinuses of all types. Of course, we must confirm the fact that the passing of time will not see a sufficiently large number of these cases relapse to make us want to discontinue the drug. To date our results look quite impressive indeed, especially when compared with the reports and the literature from other institutions on the use of streptomycin, and we think that meningitis, miliary tuberculosis, and bone h1berculosis have all shown as much or greater promise than was expected of the drug when it was originally used. Acute spreads, soft exudative lesions all seem to be cleared nicely and rapidly with the drug and we have had very few relapses to date. It appears at the present time that collapse therapy should be used, and our most disappointing results have been those cases in which collapse therapy could not be used for one reason or another. A full and more comprehensive report on streptomycin will be given in the very near future as we are collecting data now on all cases who have completed treatment for as long as six months and we hope to report about two hundred and fifty cases of this type some time around March or April of 1948.
There was some newspaper publicity in regard to the Bangs problem which was present in the dairy herd and the records of the director will show the complete report of how this problem came about and how it was eventually handled. At the present time it appears that there is no active Bangs disease in the herd, and we are of the opinion that the disease was never in an epidemic stage on the farm.
It is expected that the personnel situation will be improved by the ruling of the Attorney General that the employees of
Bcdtey Hospital
285
Battey should be placed under the provisions of the Merit System. There has been a slight increase in compensation with the advent of the Merit System at Battey, and we are unable to determine at the present time exactly what effect this scale will have on the recruitment of new personnel. The staff employees are being charged maintenance, which is deducted from their salaries, and the Merit System has established many positions which are common to all the departments under the Merit System at the present time.
The following table gives the Personnel-Patient ratio on 10/1/45, on 7/1/46 and on 1/1/48:
PERSONNEL-PATIENT RATIO
Patient load Personnel Administrative Medical Nursing Culinary Housekeeping Laundry Maintenance Farm & Dairy
10/1/45
7/1/46
1/1/48
540 Ratio 625 Ratio 1199 Ratio
13 1:42 10 1:54 58 1:9 34 1:16 35 1:13 18 1:30 25 1:22 12 1:45
24 1:26 32 1:20 82 1:8 94 1:7 54 1:12 33 1:19 50 1:12 17 1:37
34 1:35 48 1:25 151 1:8 94 1:13 66 1:18 40 1:30 52 1:23 22 1:55
Total
205 1:2.6 386 1:1.6 507 1:2.4
The table above shows the status of personnel-patient ratio in
October 1945, July 1946 and January 1, 1948. In October 1945 there were less employees per patient than at any other time.
Fewer employees per patient than the sanatorium had ever had at any recorded time. There were more employees per patient on
January 1, 1946, than had ever been recorded. Since that time it has been possible to bring up the ratio of patients to employees to the point where it is approaching the more nearly normal
average. Attention is called to the fact that the employee ratio does not show approximately one hundred prisoners who are di-
vided between the Nursing, Culinary, Housekeeping, and Laundry Departments. If these were included, the ratio would be about one employee for each two patients, which would be about the normal average. It is regrettable that we have been unable to get more nursing personnel so that we could bring the ratio of
nurses to patients down to approximately one nurse for each six patients.
286
Georgia Department of Public Health
TABLE I
The following table shows the number of persons making application for admission to Battey and Alto during the past five years:
Year White Colored
1942
768 388
1943 575 3H
1944 524 251
1945 477 298
1946
964 586
1947 1033
616
Total
1156
889
775
775
1550
1649
It will be noted that there continues to be an increase in the number of applications received at Battey for new admissions. As we have stated previously, we are of the opinion that the number of applications is not a true index as to the amount of tuberculosis in the State, but is rather dependent upon the number of beds which are available. This certainly seems to be true within the last few years, as there has been a rapid rise in the number of applications since our number of beds has increased.
TABLE II
The following table shows applications, by age group, for admission to Battey and Alto during the past five years:
Year 1942 1943 1944 1945 1946 1947
Under 20
20-39
40-59
60 Plus
Total
White Colored White Colored White
78
50
369
254
238
47
47
302
213
179
24
53
267
136
152
40
58
216
171
164
62
85
4H
309
357
61
72
455
361
367
Colored 75 47 48 62 171 157
White Colored White Colored
83
768
388
47
575
314
81
H
524
251
57
477
:~28
131
21
964
586
150
26 1033
616
Here again it should be noted that in 1947 we had a continued increase in the number of applicants in all age groups, except those persons under twenty. This is believed to be a good indication that there is actually less new tuberculosis being transmitted in this age group than in the othe~rs.
Battey Hospitctl
287
TABLE III
The following table shows the percentage of persons rejected for admission in the different age groups in the past five years:
Under 20
2039
4059
60 Plus
Total
Year
White Colored White Colored White Colored White Colored White Colored
1942
18
58
1<1
54
20
37
<]3
66
19
52
1p43
28
50
19
49
25
53
53
85
24
51
1944
33
15
15
42
26
40
37
28
25
35
1945
2
33
16
35
20
27
55
55
21
33
1946
19
41
12
26
15
27
41
33
17
29
19<17
<]2
13
46
21
39
<]7
58
18
tl-<1
This table shows the influence of Battey on the number of applicants who have been rejected for admission in the different age groups. It will be noted that the greatest difference in rejection rates is in the group under twenty years of age and the group from twenty to thirty-nine. In 1947 there was an over-all increase among the colored in percentage rejected for admission, due to the fact that once the beds had become filled there was no alternative other than to reject the patients. The real significance of this table can probably not be appreciated unless one goes back and notes the number of persons making application in previous years as compared with the past year. It is obvious that when a physician finds that all of his far advanced hopeless cases are rejected for admission that he will automatically stop making application for this type of case, but will make his application only for the earlier cases. We feel that in the years 1943, 1944, and 19Ll5 the number of persons applying were the individuals who had the most favorable chances for recovery. This means, if this asssumption is true, that in 1947 we were having approximately six or seven hundred more than in recent years and that most of these were the more advanced, less favorable cases. We know from general observation that we are taking many cases now that in former years would not have been considered favorably at all.
TABLE IV
The following table shows the number of admissions, by color, for the past five years at Battey and Alto, as compared with
1947:
Color
1942
1943
1944
1945
I 946
1947
White ------ 586
425
Colored ----- 153
13<1
425
<170
765
738
121
210
377
362
Total .......................... 739
559
546
680
1H2
1100
288
Georgia Department of Public Health
This table shows the number of admissions, by color, for the past six years, and it will be noted that our admission rate is still quite high in 1947 as compared with previous years. There is no doubt that this will have considerable influence on the spread of tuberculosis in the State if this admission rate can be kept up.
TABLE V
The following table shows the number of patients in the hospital on the first day of each of the past five calendar years :
Total
1-1-43 562
1-1-44 !53
l-l-45 518
l-l-46 5<14
1-1-47 986
1-1-48 1199
This table shows the rather phenomenal growth in tuberculosis hospital days since 1943. On January 1, 1948, we had1,199
patients, which was more than 200 greater than on January 1, 1947, and was 650 greater than on January 1, 1946. It represents a gain of 750 patients over January 1, 1944.
TABLE VI
The following table shows the number of admissions, by diagnosis, during the past five years at Alto and Battey:
1943
Diagnosis White Col.
Fa1 Advanced 159
66
Mode1ately
Advanced 168
39
Minimal
33
Other forms
of Tbc.
22
9
Non-Tbc.
43
11
Total
425 131
1944
White Col.
1<!7
48
173
45
31
8
20
51
Vl
425 121
1945 White Col. 183 122
196
49
19
14
8
58
24
170 210
1946 White Col.
405 232
1947 White Col.
385 183
231
83
26
12
132 103 27
28
15
75
35
765 377
82
50
61
21
738 362
It will be seenthat there is a direct ratio between the number of admissions and the percentage of far advanced cases admitted. In 1944 only 35;/a of white and 40J"a of colored admissions were far advanced, while in 1946, 54 o/a of white and 62% of colored admissions were far advanced cases of tuberculosis. It will be noted, also, that there were less cases of minimal tuberculosis admitted in 1947 than were admitted in 1943. It will also be noted that there were fewer cases of moderately advanced tuberculosis admitted in 1947 than were admitted in any previous
Bctttey Hospital
289
year since 1944. In view of the fact that no moderately advanced case is ever turned down for admission, it must be assumed that we are finding fewer cases of moderately advanced tuberculosis or that fewer cases are making application, or that there are actually fewer cases of moderately advanced tuberculosis than formerly. It is suspected that we are finding a higher proportion of moderately advanced disease than ever before due to the large number of case finding programs that are in effect at the present time, and it is also suspected that the number of minimal and moderately advanced cases will continue to decrease in the next few years if tuberculosis falls as we think and hope that it will. It will also be noted that there were more extra pulmonary forms of tuberculosis admitted in 1947 than have ever been admitted previously. Most of these have been admitted for treatment with streptomycin and include glandular tuberculosis, tuberculous meningitis, some few cases of bone tuberculosis, peritonitis, miliary, and renal tuberculosis.
TABLE VII
The following table shows the number of admissions, by age groups, during the past five years at Alto and Battey:
1943
Age Group White Col.
Under 20 ______ 28
22
20-39 .......... 251
96
40-59 ----- 127
15
60 and over 19
1944
White Col.
16
13
251
80
137
27
21
1945
White Col.
24
21
351 13,1
164
51
31
4
1946
White Col.
39
38
368 217
287 113
71
1947 White
!7 379 316
41
Col. 33 181 99 2
The above table conforms fairly closely to the findings of the other tables which show the continued admission of larger proportion of older age patients. The difference was not as marked in 1947 as it was in 1946, possibly due to the fact that the Battle Hill patients admitted from Atlanta were predominantly in the older age group. Except for this, however, it shows that we are continually increasing the number of patients admitted who are over forty years of age. The exact significance is debatable, but it tends to prove that we are having less and less tuberculosis since the proportion of older age groups constantly rises.
290
Georgia Department of Public Health
TABLE VIII
The following table shows the experience, percentage basis, of different age groups approximately two years after admission to the Sanatorium:
Under 20 Age Group Died at Hospital . Still in Hospital Home--Sputa Positive Home-Sputa Negative
White Col.
4
15
22
30
14
61
48
20-39
White Col.
20
25
32
19
19
47
30
40-59
White C<>l.
10
12
27
42
22
19
41
27
60 Plus
White Col.
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 percentage. The chances for converting sputum to negative is much greater in the younger age groups than in the older age groups. This emphasizes the importance of finding the cases among the younger age groups. It must be remembered, however, that the colored have a much poorer prognosis than do the white.
TABLE IX
Table showing the number of discharges from the hospital at Alto and Battey during the past five years:
White Colored .
1943 546
1944 431
152
129
149
1945 376
168
1946 '!59
159
1947
629
267
Total
768
fi75
580
618
896
By referring to Table IV it will be noted that discharges exceeded admissions in 1942, 1943 and 1944 when hospital cases were constantly falling. During the past three years, however, the number of admissions has so far exceeded the discharges that there has been a constant rise in the number of cases in the Sanatorium.
Bcdtey Hospital
291
TABLE X
Table showing the status of patients at discharge, including the sputum status, during the past five years at Alto and Battey:
Status
Sputum
Quiescent
Positive
or arrested Negative
Improved
Positive Negative
Unimproved Positive Negative
Deaths
Total The. Non-Tbc.
1'943 Wh. Col.
140 17
37 17 127 31
60 22
75
8
48 24
1944
1945
Wh. Col. Wh. Col.
107 52 10<1
28
37 10 30
14
11<1 35 65
39
45 23 60
16
35
33
10
40 13 32
34
1946
1947
Wh. Col. Wh. Col.
4
2
88 15 111 30
26 12 64 23 72 18 123 42
87 26 106 31 65 20 5<1 22
58 54 75 101
491 109 381 141 32<!
55 10 50
52
141 399 145 535 249 25 60 14 74 18
This shows the status of patients at discharge from 1943 to 1947, and it will be noted that we are constantly having a larger increase in the number of deaths, which, within itself, reflects the fact that we are admitting far more hopeless cases than we did formerly. It should also be noted that there has been a larger number of patients discharged in the improved status than was formerly the case.
TABLE XI
Table showing the discharge status of patients, percent of total tuberculous discharges, during the past five years at Alto and Battey:
1943
White Col.
Quiescent
or Arrested 29
11
Improved
34
44
Unimproved 27
28
Deaths
10
17
1944 White Col.
1945 White Col.
1946 White Coil.
1947 White Col.
29
37
40
32
21
21
10
10
32
20
29
37
29
18
10
25
23
10
24
21
38
32
15
37
21
12
35
26
30
21
1<1
41
In this table it will be noted that we are increasing the number of patients with an improved and quiescent status considerably over former years. The fact that we have a smaller proportion discharged as quiescent or arrested is believed to reflect a change in attitude toward discharge diagnosis of the patient rather than any other reason. In other words, we are less prone to call
a case quiescent or arrested now than in former years.
292
Georgia Department of Public Health
It will also be noted that the percentage of deaths is constantly increasing so that during 1947 147o of the white patients discharged were discharged by reason of death, whereas 41% of all the colored discharges were by reason of death. This, within itself, reflects again the fact that we are taking much sicker patients than formerly.
TABLE XII
Table showing length of stay in hospital on a percentage of total cases discharged in different diagnostic categories at Alto and Battey during the past five years:
WHITE PATIENTS
Year Undor 3 Mos. 4-13 Mos.. 1'1-23 Mos. More than 2,1 Mos.
Far Advanced '43 '44 '45 '46 '47
21 29 39 ,19 37 49 40 ,14 35 46 21 10 11 10 10
9 21
Moderately Advanced '43 '44 '45 '46 '47
32 29 42 29 37 52 50 ,15 46 38 14 11 9 18 15
2 10 4 7 10
Minimal
'43 '44 '45 '46 '47
48 ,15 50 31 57
42 31 40 53 33
10 20 10 11
'I
5
This table shows what is necessary to bring an ordinary case of tuberculosis under control. The great majority of all cases leaving under three months either leave against advice or die, and it will be noted that in 1946 almost half of the far advanced cases fell in this category, whereas it has decreased significantly during 1947. As compared with former years, it appeared that patients were staying for a considerably longer time than previously.
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:
White
Far Advanced
Moderately Advanced
Year '43 '44 '45 '46 '47 '43 '44 '45 '46 '47
Under
3
Mos. 10 6 13 29 22
3-12
Mos. 15 13 12 20 30
'I
13-24
Mos. 12 11
4 14
Over
24
l\los. 5
3
00 0
Colored Far Advanced Moderately Advanced '43 '44 '45 '46 '47 '43 '44 '45 '46 '47
5 20 25 31 3 12 23 46 7
04 3
0
Battey Hospital
293
TABLE XIV
Converting the above table into percentage basis we find the following picture as regards the far advanced cases:
Under 3 Mos. 3-13 Mos. .... . 12-24 Mos. ..... . Over 24 Mos.
White
FAR ADVANCED
'42 '43 '44 '45 '46 '47
33 24 17 46 54 32 47 36 37 'J3 37 44 1<1 29 31 11 7 20
6 11 15 0 2 'J
Colored
FAR ADVANCED
'42 '43 '44 '45 '46 '47
50 30 50 59 50 34 40 35 30 35 46 50 7 35 10 6 2 10
3 0 10 0 2 6
The two tables above show the influence of public health measures on isolation of far advanced hopeless cases. It will be noted that during 1946 half, or more, of the patients who died with far advanced disease did so within three months after entering the Sanatorium. The same thing is not so obvious for previous years in the white cases, but it is among the colored. The same thing is not as marked in 1947, but this, we think, is due to the influence of streptomycin. Streptomycin was given to all of our patients who were considered hopeless early in 1947 and a great many of them are undoubtedly surviving now who would not have done so a year ago. The very fact that they have lived longer with streptomycin is some indication, within itself, of the fact that the drug is well worth using. For those patients who die within three months after admission to the Sanatorium it is obvious that hospitalization has been no influence so far as the spread of tuberculosis is concerned, since these patients have already infected their contacts at home. Table 13 should also be studied very closely to see the influence of treatment when tuberculosis is found early. It will be noted that no cases of minimal tuberculosis have died during the past six years, and very few cases of moderately advanced tubercu-
losis have progressed and died, whereas most of the deaths have been among those persons who had far advanced disease when discovered and sent to the Sanatorium. This, within itself, is sufficient reason to urge the further extension of case finding programs all over the State. With a case finding program which will uncover asymptomatic, moderately advanced disease, the death rate can be lowered markedly over what it is at the present time if the patients 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 that new cases might be admitted for treatment. At the present time we are making an effort to keep patients in the hospital until they can have three to four hours of exercise daily. During this time they can be given vocational training, if necessary, to help them when they return home; but, most important of all, they can be observed closely through
294
Georgia Department of Public Health
their convalescence to see if they G-an tolerate exercise sufficiently well to be discharged.
TABLE XV
The following table shows trends in treatment procedures in use at the Sanatorium in 19L12 and at Battey in 1947. The type treatment used is indicated as percentage of total patients discharged alive whose diagnosis on admission falls within the group under which the percentage is listed.
White Patients
Colored Patients
Far Adv. Mod. Adv. Min.
Far Adv. Mod. Adv. Min.
Year
'42 '47 '42 '47 '42 '47
'42 '47 '42 '47 '42 '47
Bed rest only
21 15 18 11 23 2<1
20 17 16 31 42 66
Phrenic Crush
8 4 17
8 13 0 33
Pneumothorax*
29 2 45 7 50 8
<16
48 5 25
Thoracoplasty**
16
4
0
12
Pneumoperitoneum
21 42 16 <18 3 28
20 53 17 46 0 33
Diagnostic only*** _
10 12 9 20 7 40
16 0 14
Streptomycin ---------
19
18
*This includes all cases in which pnemnotborax was the primary procedure used. It includes
all auxiliary procedures such as pneumolysis. **This includes all cases regardless of (lther preceeding treatment such as pneumothorax
3
or pneumoperitoneum. ***This 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 hospital. These include many cases which were started on pneumothorax and failed to respond and, also, includes 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 that relatively few are placed on bed 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 patients than any other hospital. It will also be noted that, in 1947, 20o/a of the patients discharged in the far advanced category had been given streptomycin. A lesser number had been given it in moderately advanced disease and none had been given to minimal tuberculosis. Many of these patients entered the' Sanatorium and left against advice as soon as it was discontinued. This was the patient's privilege, of course, but it has greatly hampered our efforts to :find out what happened in all of these cases, since we were unable to follow them as well on the outside as we could have if the patients had been in the Sanatorium.
Battey Hospital
295
TABLE XVI
The following table shows follow-up results of 3,032 cases which have been discharged from the Sanatorium. This includes all cases discharged from January 1, 1940, until December 31, 1945. Non-tuberculous cases are not included.
Died of Tuberculosis .. . Died of Other Causes ... . At Home with Active Disease. Iteadmi tted to I-Iospital... ........................... Unknown and Moved from County............ On Rehabilitalion or Referred for Service---
Presumably Well ........................................ Suitably Employed or in School ....................
Total ......................................................
772
or
26 ~c
27
or
10:>
15<1
or
5'''
131
or
4%
507
or
16~:
657
or
22 ~0
784
or
26%
3032
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 re-admitted to Sanatorium and dying, since these cases were not referred to the service. This follow up service was done jointly by the Georgia Tuberculosis Association and Vocational Rehabilitation Service.
Division of Laboratories
T. F. SELLERS, M.D.
_____ Director
E. J. SUNKES, Dr.P.H.
_Assistant DiTector
JANIE MORRIS, M.S., Chief Bacteriologist ________ _CultuTe Unit
E. H. RUNYON, Co-Chief Bacteriologist _ Microscopy Unit
KATIE L. CALHOUN, Co-Chief Bacteriologist ___ Microscopy Unit
E. L. WEBB, A.B., Chief Serologist _ ___
_____ Serology Unit
F. H. STUBBS, M.S., Director
_ Albany Branch Labomtory
C. S. ADAMS, Director
_______ Waycross Branch Lab01atory
MADGE REYNOLDS, Director
Battey Laboratory
ROXIE NEVIL, Director
Alto Labo,mtory
Division of Laboratories
The work in the Division of Laboratories in 1947 reflects unprecedented activities. These were featured by an increased demand for routine services, expansion of facilities, and transfer of institutional laboratory work to the direction and supervision of the Division. A new record was established in the number of specimens examined, surpassing by several thousand the banner year of 1943, during the peak of the laboratory's contribution to the war effort in examining specimens of blood for all selective service registrants in the State.
DIAGRAM I
GROWTH OF LABORATORY WORK
1920-1947
1300,000
700,0.00 600,000 500,000
400,000
300,000
200,000
100,000
0 1920
II
19Z5
I 1930
1935
1940
1943
1!46
300
Georgia Department of Public Health
In illustrating the growth of laboratory services in Diagram I, five year intervals are chosen from 1920 through 1945. For comparing more recent activities, the year 19L16 and the year 1947 covered by this report are added. The war years brought a period of abnormal growth and for this reason the year of 1943 is included in the diagram.
The five-year intervals show a consistent growth in laboratory services. It will be observed that 1946 reveals an increase over 1945 and that 1947 with a total of 724,300 examinations surpassed the peak war year of 1943 in which 679,349 specimens were examined. The increase for the past two years is attributable both to a continuation of normal growth and the placing of the laboratories of the Alto Medical Center in July 1946 and Battey State Hospital in March 1947 under the Division of Laboratories.
For the purpose of outlining the growth of work by laboratories in Diagram II, two year intervals have been selected, beginning in 1937 when branch laboratories were established. It will be recognized that 1943 was the peak war year for the laboratory load. The unusual growth of work in the Central laboratory for that year was due to the establishment of temporary services to the defense program in which the branch laboratories were not called upon to participate.
600,000
GROWTH
DIAGRAM II
OF WORK BY LABORATORIES 1937-1947
400,000 300,000
200,000
100,000 0
1937
1939
1941
1943
1945
Division of Laboratories
301
Branch laboratories were opened in Albany and Waycross in September, 1937, and the graph represents only four months' work for that year. Some recession is noted in the Albany laboratory during the war years, due to the loss to the Service of public
health workers in the field. The Waycross laboratory, on the other hand, overcame such loss by rendering certain phases of service to nearby shipbuilding yards until these plants were closed.
It will be further observed that the Central laboratory, in1947, approached the volume of the peak war year 1943, and that the Albany laboratory surpassed in 1947 any previous year's work. The Waycross laboratory, on the other hand, shows a continued slight decrease since its banner year of 1943. The graph for 1947 shows the addition of the laboratories of the Alto Medical Center and Battey State hospital to the laboratory system.
DIAGRAM ill
GROWTH OF LABORATORY WORK BY UNITS
1r too.ooo
5.00,000
1937_1947
420,000
300,000 240,000
I MICROSCOPY
0 CULTURE
SEROLOGY
mCUNICAL
180,000
120,000
.J60,000
0
193 7
1939
1941
1943
1945
1947
The period 1937-1939 in Diagram III shows a steady growth in the diagnostic units of the laboratory. During the war years, however, the microscopy unit exhibited a sizable decrease as a result of the suspension of intestinal parasite survey work, occasioned in part by the loss of field personnel. The continued drop
302
Georgia Department of Public Health
in malaria prevalence also was a contributing factor. The post war years show a steady rise with 1947 surpassing the previous peak year of 1939.
In the culture unit the work remained quite constant during the war years, varying by less than 1,000 specimens from year to year. With the return of more physicians to their practice following the war, an upward trend is noted reaching the peak of 37,088 specimens in 1947.
The serology unit exhibited an abnormal growth during the war period as a result of a screening service to Selective Service Boards on all registrants prior to induction. A decided drop is noted for the 1945 interval but the load still remained above the 1939 level. It will be observed that 1947 almost reached the peak war year of 1943.
It should be pointed out that a part of the growth illustrated for the year 1947 is clue to the transfer of the operation of the laboratories of the Alto Medical Center and Battey State Hospital to the Division of Laboratories. The graph for that year also shows the addition of the clinical type of examinations performed in these two laboratories.
It will be observed in Table 1 that the laboratories examined 724,300 specimens in 1947 as compared to 529,597 in 1946, an increase of 194,703 or 36.8 per cent. An increase is to be noted in all of the long established units of the laboratory, the greatest being in serology, followed in order by the microscopic and culture units. The larger increase shown for clinical tests occurred entirely in the institutional laboratories lately transferred to the laboratory system.
In the serology unit the increase over the previous year resulted from a continued growth in the routine section, establishment of added facilities in connection with community-wide surveys, and a marked increase in the number of patients referred to the Alto Medical Center from these surveys.
It will be observed that the examinations for tuberculosis and diphtheria showed the greatest increase in the microscopic unit. It is of particular interest to note the 25.2 per cent decline in rabies examinations. Malaria and gonococcus examinations showed a continuation of the decline observed in recent years.
In the culture unit the volume increase is not as marked as in the other two units, but it resulted in a considerable increase in the amount of work involved. The stool and urine examinations exhibited the largest increase followed by specimens of blood submitted for the agglutination series. Blood culture examinations showed some decrease from the previous year.
In Table 2 is given the distribution of the specimen load by laboratories. It will be noted that the Central laboratory shows the largest increase. This is attributed chiefly to added facilities in connection with the community-wide survey work. The Albany
Division of LaboTatories
303
TABLE 1 COMPARATIVE CLASSIFICATION OF SPECIMENS-1947-1946
1947 1946 Increase m DecTease
Tuberculosis -----------Diphtheria ________________ Gonorrhea ________________ Malaria ______________________
Intestinal Parasites Rabies ---------------------Miscellaneous __________ Agglutination Series Blood Cultures ________ Stool & Urine
Cultures -------------Syphilis Serology ____ Clinical Tests __________ Grand totals________ _____
Microscopy ________________
Culture -------------------Serology _________________ Clinical Tests __________
UnsatisfactoTy Microscopy -------------Culture ______________________
Serology ------------------
37,689 5,630 29,608 6,994 48,277 1,243 5,240 14,015 9,018
13,991 512,536
40,059 724,300
134,617 37,088 512,536 40,059
1,059 155
6,239
20,983 3,140 32,513 7,633 38,722 1,662 3,819 12,669 9,880
11,723 378,978
7,875 529,597
108,472 34,272 378,978
7,875
1,018 79
5,709
++ 16,706 2,490 2,905
639
I
I
9,555
419
++
1,421 1,346
862
I
I
2,268
-f--133,558
+ 32,184
-f--194,703
+ 26,145
+ 2,816
-f--133,558
+ 32,184
+++
41 76 530
79.6%
+ 79.3?'o +- 8.9%
- 8.4%
+ 24.5o/o
- 25.2%
+ 37.2o/o
-+
10.6% 8.7l)'o
19.3o/o
++ 35.2o/o
+408.7%
+ 36.8o/o
24.1%
++ 8.2o/o
+ 35.2% -f--408.7?'o
TABLE 2 SPECIMEN LOAD BY LABORATORIES-1947-1946
1947 1946 IncTease or DecTease
Central Laboratory, Atlanta -------------------- 471,013 Southwestern Branch,
Albany __________________ 97,690 Southeastern Branch,
Waycross ______________ 66,766 Alto Medical
Center, Alto ________ 54,910 Battey State
Hospital, Rome ____ 33,921 GRAND TOTALS ____ 724,300
352,197 89,799 67,673 19,928
529,597
-f--118,816
+ 7,891 907
+ 34,982 + 33,921
+194,703
+ 33.7?'o
I
I
8.8o/o
1.3o/o
-f--175.5?'o
+ 36.8o/o
304
Georgia Department of Public Health
laboratory shows a moderate increase but a slight decrease is observed for the Waycross laboratory. The comparison for the Alto Medical Center is made against six months operation in 1946. No comparison is made for the,Battey State Hospital since the operation for this laboratory was transferred to the Division of Laboratories in March.
Diagram IV gives a graphic presentation of the distribution of the specimen load among the laboratories. It will be observed that the Central laboratory examined 65.1 per cent of the specimens with the branch and institutional laboratories relieving to the extent of 34.9 per cent of the volume. The Albany laboratory continues to examine the largest fractional part of the load carried by the branch and institutional laboratories.
In Diagram V the distribution of the specimen load by units is given. Due to the addition of the clinical type of work performed in the institutional laboratories, comparison with the previous year will be somewhat altered. As a whole, however, the distribution by units is quite similar to that for the previous year.
The specimen load by units of each laboratory is illustrated in Diagram VI. It is interesting to note the greater proportionate amount of microscopic and culture work performed in the branch laboratories in relation to the serology work, compared to the distribution of the specimen load in the Central laboratory. This relationship has been observed ever since the establishment of the two branch laboratories, but no satisfactory explanation can be offered for its occurrence.
The specimen load by types examined in each laboratory is given in Diagram VII. A consolidated report of the examinations made in the five laboratories for 1947 is given in Table 3. An analysis of the examinations made in each of these laboratories will be found in tables 4-11 inclusive.
.-
Division of Laboratories
305
DIAGRAM TI[
SPECIMEN LOAD BY
LABORATORIES 1947
CENTRAL 471,013
65.1%
SEROLOGY 512,536
70.8%
.DIAGRAM Jl
SPECIMEN LOAD
BY UNITS 1947
306
Georgia Department of Public Health
DIAGRAM 1li
SPECIMEN LOAD BY UNITS IN EACH LABORATORY 1947
CENTRAL LABORATORY
ALBANY LABORATORY
WAYCROSS LABORATORY
BATTEY LABORATORY
Division of Laboratories
307
DIAGRAM J2li
SPECIMEN LOAD BY TYPES 1947 HANDLED IN EACH LABORATORY
381,039 74.3%
SEROLOGY
CENTRAL 21,213 57.2%
OJLTURE
MICROSGOPY
ALTO 23,084 57.6%
BATTEY
16,975 42.4%
CLINICAL
308
Georgia Department of Public Health
TABLE 3 CONSOLIDATED REPORT FOR 1947
Total
Tuberculosis-Microscopic___________________________ _ 30,177 Tuberculosis-Culture ---------------------------------- 3,688 Tuberculosis-Animal Inoculation ____________ 891 Tuberculosis-Concentrate __________________________ 2,933
Diphtheria ______________________________________________________ 5,630
Gonorrhea-Microscopic ------------------------------ 18,126 Gonorrhea-Culture -------------------------------------- 11,482
Malaria __________________________________________________________ 6,994
Intestinal Parasites-Eggs __________________________ 46,561
Intestinal Parasites-Amebic Dysentery____ 1,116
Intestinal Parasites-Egg Counts ________________ 576
Intestinal Parasites-Worm for
Identification ----------------------------------------------
24
Rabies-Microscopic ------------------------------------ 1,171
Rabies-Animal Inoculation ________________________
72
Miscellaneous ---------------------------------------------- _ 5,176 TOTAL FOR MICROSCOPY _____________________ 134,617
Agglutinations ------------------------------ _______________ 14,015
Typhoid Fever -------------------------------------------Typhus (Brill's) Fever ____________________________
Brucellosis ______------------------------------______________
Tularemia -----------------------------_____________________
Blood Cultures ------------------------------------------------ 9,018 Eberthella Typhosa -----------------------------------Salmonella ---~--------------------------------------________
Brucella -----------------------------------------------------Others ---------------------------------------------------------Stool and Urine Cultures ------------------------------ 13,991
Eberthella Typhosa ------------------------------------
Salmonella -------------------------------------------------Shigella --------------------------------------------------------
Others ----------------------------------------------------------
Miscellaneous --------------------------------------------------
64
TOTAL FOR CULTURE ____________________________ 37,088
Syphilis Serology ------------------------------------------ 512,536 Clinical Tests ------------------------------ ____________________ 40,059
GRAND TOTAL ------------------------------------------ 724,300
Positive
3,841 464 187 394 760
2,316 2,108
66 12,754
10
24
435 24
23,383
68 342 172 106
47 8
67 16
131 75
154
Division of LaboratoTies
309
TABLE 4 REPORT OF CENTRAL LABORATORY FOR 1947
Total
Tuberculosis-Microscopic __________________________ 16,550 Tuberculosis-Culture ---------------------------------- 803 Tuberculosis-Animal Inoculation ______________ 102
Diphtheria........... _...._..__..... ----------------------------- 4,062
Gonorrhea-Microscopic ----------------------------- 10,264 Gonorrh ea-Culture -------------------------------------- 8,802
Malaria ---------------------------------------------------------- 2,528
Intestinal Parasites-Eggs __________________________ 19,974
Intestinal Parasites-Amebic Dysentery____ 836
Intestinal Parasites-Egg Counts --- 290
Intestinal Parasites-Worm for
I dentification ______________________________________________
14
Rabies-Microscopic -------------------------------------- 833
Rabies-Animal Inoculation ------------------------
72
Miscellaneous ------------------------------------------------ 3,631
TOTAL FOR MICROSCOPY ---------------------- 68,761
Agg1utinations ----------------------------------------________ 8,271
Typhoid Fever -----------------------------------------Typhus (Brill's) Fever ---------------------------Brucellosis ------------------------------------------------
Tularemia -------------------------------------------------Blood Cultures ----------------------------------------------
Eberthella Typhosa ------------------------------------
5,519
Salmonella - Brucella ------------------------------------------------------
Others -------------------------------------------------------Stool and Urine Cultures ----------------------------
Eberthella Typhosa ---------------------------------Salmonella --------------------------------------------------
7,423
Shigella -------------------------------------------------------Others ---------------------------------------------------------TOTAL FOR CULTURE______________________________ 21,213
Syphilis Serology ------------------------------------------ 381,039 GRAND TOTAL -------------------------------------------- 471,013
Positive
1,522 44 11 671
1,268 1,782
43 4,115
3
14 296
24
48 134 83
62
25 1 33 8
100 13
113
310
Georgia Department of Public Health
TABLE 5
COMPARATIVE CLASSIFICATION OF SPECIMENS-1947-1946 CENTRAL LABORATORY
194'1 1946 Increase or Decrease
Tuberculosis __
17,455
Diphtheria ___
4,062
Gonorrhea _________
19,066
Malaria -----------------
2,528
Intestinal Parasites_ 21,114
Rabies ---------------------Miscellaneous ____________
905 3,631
Agglutination Series __ 8,271
Blood Cultures
5,519
Stool and Urine
Cultures ------------------ 7,423
Syphilis Serology ---- 381,039
GRAND TOTALS ___ 471,013
MICROSCOPY ---- 68,761
CULTURE ------------ 21,213
SYPHILIS
SEROLOGY ------ 381,039
Unsatisfactor-y
MICROSCOPY
784
CULTURE ------------
65
SEROLOGY ________ 4,341
16,906 2,046 21,10L! 3,436
16,458 1,103 2,167 7,250 5,920
6,523 269,284
352,197 63,220 19,693
269,284
830 52 4,117
+ 549
+ 2,016 2,038
908
+ 4,656 198
I
I
1,464
+ 1,021
401
+ 900
+111,755
+ 118,816
++
5,541 1,520
+111,755
46
I
I
13
+ 224
++
3.2 '/o
98.5/o
- 9.7'/o
- 26.4/o
+ 28.3/o
- 18.0/o
++
67.6/r
14.1 /o
- 6.8 fu
++
13.8/o
41.5 'lc)
++
33.7/o 8.8/r
+ 7.7/o
+ 41.5 /o
TABLE 6 REPORT OF ALBANY BRANCH LABORATORY FOR 1947
Total
Tuberculosis-Microscopic ______________________ 2,477
Tuberculosis-Culture
______________ _
9
Diphtheria ________________________________________________ 1,009
Gonorrhea-Microscopic _____________________________ 4,708
Gonorrhea-Culture _____________________________
130
Malaria ________________________________________________________ 3,278
Intestinal Parasites-Eggs __________________________ 11,415
Intestinal Parasites-Amebic Dysentery __ 161
Intestinal Parasites-Worm for
Identification ________________________________________
6
Positive
193 1
54 749
26 10 3,552 7
6
Division of Laboratories
311
TABLE 6 (continued) REPORT OF ALBANY BRANCH LABORATORY FOR 1947
Total
Rabies-Microscopic ------------------------------------ 228
Miscellaneous ----------------------------------------------- 970
TOTAL FOR MICROSCOPY________________________ 24,391
Agg1utinations -------------------------------------------- ____ 4,139 Typhoid Fever -------------------------------------------Typhus (Brill's) Fever ---------------------------Brucellosis ------------------------------------------------Tularemia ----------------------------------------------------
Blood Cultures ---------------------------------------------- 2,509 Eberthella Typhosa ---------------------------------Salmonella -----------------------------------------------Brucella -----------------------------------------------------Others --------------------------------------------------------
Stool and Urine Cultures ------------------------------ 4,757 Eberthella Typhosa ---------------------------------Salmonella -------------------------------------------------Shigella ------------------------------------------------------
TOTAL FOR CULTURE ---------------------------- 11,405 Syphilis Serology ------------------------------------------ 61,894 GRAND TOTAL -------------------------------------------- 97,690
Positive 87
15 127 65
32
8 1 22
14 51
9
TABLE7
COMPARATIVE CLASSIFICATION OF SPECIMENS-1947-1946 ALBANY BRANCH LABORATORY
1947
Tuberculosis ______________
Diphtheria ---------------Gonorrhea -----------------Malaria ---------------------Intestinal Parasites __
Rabies -----------------------Miscellaneous -----------Agglutination Series__
Blood Cultures ----------
2,486 1,009
4,838 3,278 11,582
228
970 4,139 2,509
1946 Increase or Decrease
1,762 +
719
I I
5,352
724
41.1 o/o
++ 290
40.3o/a
514 - 9.6%
+ + 3,226
52
1.6o/o
+ 8,831
I I
2,751
31.2%
421
193 - 45.8o/a
862
++ ++ 3,811
108
12.5%
328
8.6o/o
2,861
352 - 12.3%
_312
Georgia Depa1tment of Public Health
TABLE 7 (continued)
COMPARATIVE CLASSIFICATION OF SPECIMENS-1947-1946 ALBANY BRANCH LABORATORY
Totctl Positive
Stool and Urine Cultures ------------------ 4,757
Syphilis Serology ---- 61,894
GRAND TOTALS ____ MICROSCOPY ______ CULTURE ____________
SEROLOGY __________
Unsatisfactory MICROSCOPY ______ CULTURE ______________
SEROLOGY __________
97,690 24,391 11,405 61,894
176 72
1,234
2,971
++ ++ 58,983
1,786 2,911
60.1o/o 4.9o/c
89,799 21,173 9,643 58,983
++++
7,891 3,218 1,762 2,911
I
I
8.87'c
15.2o/c
+ 18.3o/c ++ 4.9o/o
119 18
864
+++
57 54 370
TABLE 8 REPORT OF WAYCROSS BRANCH LABORATORY FOR 1947
Total
Tuberculosis-Microscopic ________________________ 2,289 Tuberculosis-Culture ----------------------------------
Diphtheria ------------------------------------------------------ 557
Gonorrhea-Microscopic ------------------------------ 3,084 Gonorrhea-Culture ------------------------------------ 916
Malaria ---------------------------------------------------------- 1,175
Intestinal Parasites-Eggs -------------------------- 14,556
Intestinal Parasites-Amebic Dysentery____ 114
Intestinal Parasites-Egg Counts ________________ 286
Intestinal Parasites-Worm for
Identification ----------------------------------------------
4
Rabies-Microscopic ------------------------------------ 110
Miscellaneous ------------------------------------------------ 255 TOTAL FOR MICROSCOPY ____________________ 23,346
Agglutinations -----------------------------------------~--- 1,605 Typhoid Fever ------------------------------------------
Positive 149 35 278 69 13
5,045
4 52
5
.-
~-- ~-------
-~----,-.-,..,--~-
Division of Laboratories
313
TABLE 8 (continued) REPORT OF WAYCROSS BRANCH LABORATORY FOR 1947
1947
1946 lncrease or Decrease
Typhus (Brill's) Fever------------------------------
81
Brucellosis _____________________________________c____________
24
Tularemia ____________________________________________________
12
Blood Cultures ------------------------------- _____________ 981
Eberthella Typhosa ----------------------------------
7
Salmonella _____ ---------------------------------------------
1
Brucella ______________________________________________________
11
Others --------------------------------------------------------
7
Stool and Urine Culture ------------------------------ 1,811
Eberthella Typhosa ----------------------------------
10
Salmonella --------------------------------_______________
6
Shigella ------------------------------------------------ ______
1
TSyOpThAilLis SFeOroRloCgyU_L___T___U__R___E____-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_
4,397 39,023
GRAND TOTAL -------------------------------------------- 66,766
TABLE 9
COMPARATIVE CLASSIFICATION OF SPECIMENS-1947-1946 WAYCROSS BRANCH LABORATORY
1947
Tuberculosis -------------Diphtheria ---------------Gonorrhea __________________
Malaria ---------------------Intestinal Parasites __ Rabies -----------------------Miscellaneous
---------~--
Agglutination Series .. Blood Cultures __________ Stool and Urine
Cultures __________________ Syphilis Serology ______
2,289 557
4,000 1,175 14,960
110 255 1,605 981
1,811 39,023
GRAND TOTALS ______ 66,766
MICROSCOPY ---- 23,346
CULTURE ------------ 4,397
SYPHILIS
SEROLOGY ---------- 39,023 Unsatisfactory
MICROSCOPY ------
99
CULTURE ______________
18
SEROLOGY
664
-~
1946
2,315 375
3,892 971
13,433 138 740
1,608 1,099
Increase or Decrease
26 - 1.1 o/o
182
48.5o/o
++ ++ 108
2.8o/o
+ + 204
21.0o/o
+ + 1,527
11.4o/o
28 - 20.3o/o
485 - 65.5o/o
3 - .186%
118 - 10.7o/a
2,229
418 -18.8o/o
40,873
1,850
4.5%
--
67,673
907 - 1.3o/o
+ + 21,864
1,482
6.8o/o
4,936
539 - 10.9o/o
40,873
1,850
4.5o/o
69
I I
30
9
I I
9
728
64
314
Georgia Department of Public Health
TABLE 10 REPORT OF BATTEY STATE HOSPITAL LABORATORY FOR 1947
Total
Tuberculosis-Microscopic __________________________ Tuberculosis-Concentrate -------------------------Tuberculosis-Culture ---------------------------------Tuberculosis-Animal Inoculation ______________
Diphtheria ---------------------------------------------------Gonorrhea-Microscopic ____________________________:_ Gonorrhea-Culture --------------------------------------
8,835 2,933 2,876
789
1
43 9
Malaria ----------------------------------------------------------
11
Intestinal Parasites-Eggs __________________________ 614
Intestinal Parasites-Amebic Dysentery ____
4
Miscellaneous ------------------------------------------------
74
TOTAL FOR MICROSCOPY________________________ 16,189
Blood Cultures ---------------------------------------------Miscellaneous -----------------------------------------------TOTAL FOR CULTURE______________________________ Serologic Tests for Syphilis ________________________
Rh Factor -----------------------------------------------------Blood Groups -----------------------------------------------TOTAL SEROLOGY -----------------------------------Blood:
Hemato1ogy -----------------------------------------------Chemistry -------------------------------------------------U n classified -----------------------------------------------Spinal Fluid:
Microscopic -----------------------------------------------Chemical -----------------------------------------------------Urine:
Physical -----------------------------------------------------Chemical ----------------------------------------------------Miscellaneous -------------------------------------------------TOTAL FOR CLINICAL---------------------------GRAND TOTAL -----~--------------------------------------
9 64 73 139 243 302 684
11,914 258 590
542 497
2,782 9
383 16,975 33,921
Positive 1,951 394 419 176
10
42
Division of Laboratories
315
TABLE 11 REPORT OF ALTO MEDICAL CENTER FOR 1947
Total
Tuberculosis-Microscopic ___________________ _
26
Diphtheria ------------------------------------------------------
1
Gonorrhea-Microscopic __________________________
27
Gonorrhea-Culture ____________________________________ _ 1,625
Malaria ----------------------------------------------------------
2
Intestinal Parasites-Eggs __________________
2
Intestinal Parasites-Amebic Dysentery____
1
Miscellaneous ----------------------------------------
246
TOTAL FOR MICROSCOPY____________________ 1,930
B1ood ---------------------------------------------- _________________ 18,740 Spinal Fluid _______________________________________________ 11,156
TOTAL FOR SEROLOGY_______ ------------------ 29,896
Urinalysis ______ --------------------------------------------
602
Milk _____________ -------------------------------------------------
15
Blood Counts __________________________________
144
Occult Blood _____________________________________
1
Blood Typing ____________________________________________ _
1
Organisms _______ __ ___ _________ _______ ______ _______ _
9
S. F. Cell Counts____________ __ ___ ____ ____ __ ___ ____ _ 11,156
S. F. Total Protein __________
_ ______ _ 11,156
TOTAL FOR CLINICAL ______________________ GRAND TOTAL ____________________________________
23,084 54,910
Positive
11 231
86 12,055
1,180 13,235
DISCUSSION OF WORK BY UNITS
MICROSCOPY UNIT
Tuberculosis
The transfer of the operation of the laboratory at Battey State Hospital at the beginning of the year to the Division of Laboratories brought about some alterations in the policy regarding the examination of specimens for tuberculosis. It was decided expedient to make all cultural and animal inoculation studies at the Battey laboratory where facilities were more commodious for this type of work. Most of the animals and some of the physical equipment were therefore moved to this institutional laboratory in the early part of the year.
316
Georgia Department of Public Health
The general policy now provides that in cases where three negative examinations by direct smear have been obtained in either of the laboratories, to honor requests for a culture examination on the fourth specimen. Such specimens are referred by the examining laboratories to the Battey laboratory. Request will also be honored for confirmation by animal inoculations on positive cultures. Specimens of urine or miscellaneous exudate or body fluids are referred to the Battey Hospital for both the culture and animal inoculation. Concentrate of sputa or other types of specimens are examined microscopically and if positive are so reported without further work, except on further request for confirmation.
Table 12 gives an analysis of the types of examinations made for tuberculosis in the various laboratories. It will be observed that the microscopic examinations increased in all laboratories with a total of 11,585 examinations in excess of the previous year. The culture and animal inoculations in the Central laboratory showed a decrease as this work was moved to the Battey laboratory during the year. Examinations on concentrates were made only in the Battey laboratory.
The classification of auxiliary examinations for tuberculosis made in the Battey laboratory as presented in table 13, shows that only cultures were made on most of the specimens. It is our policy to make cultures also on specimens submitted for animal inoculation.
The chief contributing factor in the impressive increase noted in the examinations for tuberculosis was the continued and enlarged program of community-wide surveys in syphilis and tuberculosis control begun in 1946.
The microscopy unit of the Central laboratory participated in an evaluation study of the direct smear technic arranged with the laboratory of the Communicable Disease Center of the U. S. Public Health Service. The latter laboratory made culture examinations on these specimens for evaluating the efficiency of the direct smear method. Thus far, the results have been quite stimulating and gratifying. This study will continue into the next year and upon its conclusion will be fully reported.
TABLE 12 EXAMINATIONS FOR M. TUBERCULOSIS-1947-1946
Centnd Albany Waycross Alto Battey Total
MicToscopic
1947 1946
16,550 2,477 2,289 26 8,835 30,177
14,625 1,740 2,225
2
18,592
+1,925 +737 +64 +24 +8,835 + 11,585
Division of Laboratories
317
TABLE 12 (continued) EXAMINATIONS FORM. TUBERCULOSIS-1947-1946
Central Albany Waycross Alto Battey Total
Cultures
1947
803
9
1946
1,672
22
90
2,876
3,688 1,784
-869
Concentnde
1947 1946
-13
-90
+2,876 +1,904 2,933 2,933
Animal Inoculations
1947
102
1946
609
+2,933 +2,933
789
891
609
Totals
1947 1946
-507
+789 +282
17,455 16,906
2,!!86 1,762
2,289 2,315
26 15,433 37,689
2
20,983
+549 +724 -26 +24 +15,433 + 16,706
TABLE 13
ANALYSIS AUXILIARY TUBERCULOSIS EXAMINATIONS-1947 BATTEY STATE HOSPITAL LABORATORY
CULTURES
ANIMAL INOCULATION
TYPE SPECIMEN
Micro.
Total
Pos.
Total
Culture Pas.
Unsat.
Micro. Total Pos.
Culture Total Pos. Unsat.
Total
Animal Pas.
Sputum __________ 2,304 242 2,101 348 203 81 3 63
6 18 75 16
Gastric Lavage 510 24 468 39 42 463 5 400 35 63 434 102
Pleural Fluid__ 93
6 89 11
4 86 1 68
Urine ______________ 153 12 132 11 21 142 11 116
4 18 79 11 9 26 136 34
Spinal Fluid __ 37
37
5
34
21
13 28
3
Synovial Fluid 6
6
1
6 ----
5
1
6
1
Miscellaneous _ 45
3 43
4
2
30 ----
24
1
6 26
9
TOTALS ________ 3,148 287 2,876 419 272 842 20 697 Cultures for Pathogenicity
55 145 784 176
5
3
Total
789 179
~
t-' 00
Unsat.
6 29
7 6 6
----
4
58
a
(<:)
0-.::
~
'~"'"
b
(<:)
'"d
~ -.::
<"-\-
;:l
(<:)
-;::5 <:-1-
0
"\j
~ 0"'
~
'<":"'>"
:::r::
(<:)
~
<:-!-
;:s-
58
Division of Laboratories
319
Diphtheria-
A conspicuous increase occurred in the number of specimens and positive findings for diphtheria as shown in Table 14. This increase began in September in both branch and Central laboratories, but was more pronounced in the latter where a considerably larger proportion of the specimens examined were found to be positive. The general state-wide increase in specimens reflects an actual rise in the incidence of diphtheria. The larger percentage in positive results at the Central laboratory was partially due to the use of a blood-cystine-tellurite plating medium for primary isolation, in addition to the usual Loeffler's slant. This method will probably be introduced into the branch laboratories during the next year.
TABLE 14 CLASSIFICATION OF DIPHTHERIA EXAMINATIONS-1947
Positive Negative Doubtful Total
Diagnostic -------------------------------- 711 Release and Carrier ________________ 32 Virulence ---------------------------------- 17
4,348 494 7
21 5,080 526 24
GRAND TOTALS
760 4,849
21 5,630
Gonorrhea-
Table 15 gives the tabulation on the examinations for N. gonorrhea for the past five years. It will be noted that there is some decrease in the number of specimens examined as compared to 1946 and also a decrease in positive results.
TABLE 15
MICROSCOPIC EXAMINATIONS FOR N. GONORRHOEAE FIVE YEAR PERIOD 1943-1947
1943 1944 1945 1946 1947
Number Specimens __ 11,784 14,133 18,822 20,597 18,126 Number Positive ______ 1,642 2,249 2,650 3,204 2,316 Per Cent Positive ____ 13.9o/o 15.9% 14.1% 15.6% 12.8o/o
The distribution of the specimens examined by the microscopy and culture units will be observed in Table 16. It will be seen that a greater proportion of the cultural work is done in the Central laboratory which is easily accessible to the Venereal Disease clinics of the City of Atlanta and Fulton County. This type of work was discontinued at the branch laboratories during
320
Georgia Department of Public Health
the year due to a lack of requests from local clinics. A satisfactory medium has not yet been found whereby the organisms will be kept alive during the time required for transportation from more distant points.
TABLE 16 CLASSIFICATION OF EXAMINATIONS FOR N. GONORRHOEAE-1947
MicToscopic
Central Albany Waycross Alto Battey Total
Number Specimens_ 10,264 4,708 Number Positive ...... 1,268 749 Per Cent Positive ___ 12.4% 15.97~
Culture
Number Specimens .. 8,802 130 Number Positive ..... 1,782 26 Per Cent Positive ___ 20.2 jlo 20.0 j!c
3,084 278
9.0'/o
916 69
7.5%
27 43 18,126 11 10 2,316 40.7% 23.3%12.8%
1,625 9 11,482
231
2,108
l4.2% .... 18.3%
Malaria-
A comparison for the examinations for malaria will be observed in Table 17 covering the last five years. It will be seen that there was a slight decrease in the total number of specimens examined. The sixty-six positive results show a considerable decrease in comparison to the positive results on a slightly larger number of specimens in the previous year. Sixty-two of these cases were traced to infection acquired in the Pacific area with only one unquestionable case originating in the State. All evidence seems to suggest that the incidence of malaria continues to be exceedingly low and at the present time does not constitute a major Public Health problem. Reference is made to Table 18 for distribution of the malaria examinations by the various laboratories.
TABLE 17
EXAMINATIONS FOR MALARIA FIVE YEAR PERIOD-1943-1947
1943 1944 1945 1946 1947
Number Specimens __ 11,951 9,379 12,691 7,633
Number Positive ______
77
41
80 270
Increase or Decrease Over Preceding Year
+ + Number Specimens __ -7,238 -2,572 +3,312 -5,058
Number Positive __ - 213 - 36
39 190
6,994 66
-639 -204
Division of Lctboratories
321
TABLE 18 EXAMINATIONS FOR MALARIA-1947
Central Albany Waycross Alto Battey Total
Number Specimens 2,528 3,278 1,175
Number Positive ____ 43
10
13
2 11 6,994 66
Intestinctl Pa'rasites-
A new specimen container consisting of a %, ounce tin box in
an outer one,.ounce tin, easier for the patient to use and facilitating gross examination of the specimen, was adopted. A new method for quantitative hookworm determination was run in parallel with the standard Stoll dilution technic. This new method devised by Doctor Paul Beaver gives promise of replacing the more cumbersome, time consuming and less accurate Stoll method. The principle of this procedure is based on the standardization of a direct fecal smear by means of a photoelectric light meter. Egg counts of standardized direct smears can be interpreted as can Stoll counts in terms of eggs per cubic centimeter and worm burden.
Table 19 shows the distribution of the intestinal parasite examinations over the period 1943 to 1947. An increase of 10,872 specimens examined will be observed over the previous year. It will be noted that there has been a steady increase in this type of work since 1944 except for ova counts, which decreased due to the policy of making counts only on specimens from surveys conducted by the Division of Hookworm Control.
TABLE 19
INTESTINAL PARASITE EXAMINATIONS FIVE YEAR PERIOD-1943-1947
1943 1944 1945 1946
1947
Total-Ova ____________ 20,772
Increase or Decrease ______ -7,643
Ova Counts ____________ 3,007
Increase or Decrease ______ +538
Amebic Dysentery 429
Increase or Decrease ______ -250
20,022 24,057 35,713 46,585
-750 +4,035 +11,656 +10,872
2,032 2,029 2,251
576
-975 441'
-3 +222 -1,675
555
758 1,116
+12 +114 +203 +358
322
Georgia Depc~rtment of Public Health
It will be seen in Table 20 which gives the distribution of examinations by laboratories that ova counts are made only in the Central and Waycross laboratories. It is interesting to note that of the 1,116 specimens examined for E. histolytica, only
10 were found to be positive. Table 21 gives the results of the classification of intestinal parasite examinations.
TABLE 20 INTESTINAL PARASITE EXAMINATIONS
Central Albany Waycross Alto Battey Total
Ova
Positive
4,115
Negative ________ 15,859
Total -------------- 19,974 Ova Cmmts ______ 290
Amebic Dysentery
Positive __________
3
Negative _._______ 833
Total ______________
836
Worms for
I dentijication _ 14
3,552 7,863 11,415
7 154 161
6
5,045 9,511 14,556
286
114 114
4
\ 42 12,754 2 572 33,807 2 614 46,561
576
10
1
4 1,106
1
4 1,116
24
TABLE 21 CLASSIFICATION OF INTESTINAL PARASITE FINDINGS-1947
Single Infection
Worms for Identification ------------------------------ 24
H ookworm ------------------------------- _______________________ 11,948
Round Worm -------------------------------------------------- 609
Pin Worm -------------------------------------------------------- 277
Whip Worm ---------------------------------------------------- 83
Dwarf Tapeworm ------------------------------------------ 49
Others -------------------------------------------------------------- 20
Dmtble Infection
Hookwork and Round Worm __________________________ 158
Hookworm and Pin Worm"___________________________ 68
Hookworm and Whip Worm__________________________ 15
Hookworm and Dwarf Tapeworm __________________ 12
Hookworm and Rat Tapeworm______________________
1
Pin Worm and Dwarf Tapeworm ________________ _
1
Round Worm and Wh}p Worm________________________
9
Triple Infection
Hookworm and Whip Worm and Dwarf
Division of Laboratories
323
TABLE 12 (continued) CLASSIFICATION OF INTESTINAL PARASITE FINDINGS-1947
Tapeworm ----------------------------------------------Hookworm and Round Worm and Whip
Worm ___________________________________________
Total Specimens Positive for Ova of: Hookworm ____________________________________ Round Worm _________________________________________ _ Pin Worm ___________________________ Whip Worm ___________________________ _
Dwarf Tapeworm Others _________________________________ _
2
3
12,212 782 346 117 66 21
Miscellaneous-
The classification of miscellaneous examinations is presented in Table 22. The number of examinations for Vincent's organisms refers to specimens submitted for this examination and does not include other specimens in which the organisms were incidentally found. The same is true for the figures representing the examinations for trichomonads. The performance of the heterophile antibody test for infectious mononucleosis or glandular fever has been transferred to the serology unit and will be incorporated in the work of that unit in subsequent reports.
TABLE 22 CLASSIFICATION OF MISCELLANEOUS EXAMINATIONS
Totals
Vincent's ----------------------------------------------
Trichomonads ______________
______ ___ _
Chancroid (B. ducrey) ________________
Tr. pallidum (Darkfield) _ Meningitis _____________________________________ Organisms ___________________________________ _
Cultures -------------------------------------------Heterophile Antibody (Glandular
Fever) _______________________________________________
Unclassified ___________________________________ _
373 454
73 208 118 323 1,272
1,624 795
GRAND TOTAL ----------------------------
5,240
Positive 118
102 32 70
251
573
324
Georgia Department of Public Health
Rabies-
It will be observed in Table 23 which gives the classification of animal heads examined microscopically for rabies in the Division of Laboratories that a total of 1,171 examinations were made, which is a decrease of 525, compared to the previous year. There was a drop of approximately 9 per cent in positive findings. Dogs represent about two-thirds of the total animal examinations. A pronounced decrease is noted in the number of fox heads examined. They dropped from 341 in 1946 to 78 in 1947. It is interesting to observe, however, that of the fox heads examined 83 per cent were found to be positive.
Table 24 shows a similar classification of the examinations made for rabies by the municipal laboratories. Reference may be made to Table 25 and Map 1 for distribution by counties of the animal heads fou,nd positive for rabies by the State and Municipal laboratories.
It is sometimes found desirable to confirm the results of microscopic examinations by inoculation of brain tissue into mice. Table 26 gives an analysis of the results of this work in which a total of 72 such inoculations were made.
TABLE 23
CLASSIFICATION OF ANIMAL HEADS-1947 EXAMINED MICROSCOPICALLY FOR RABIES-STATE LABORATORIES
CENTRAL
ANIMAL
Specimens
Pos.
Dog _________
-------------------
Cat _________________________________
Hog _______________
---------------------
Cow and Calf
Fox __
----------------
Mule and Horse_______
----------------
Squirrel __ __ _ ____ __ _ _ __
Rabbit
-------------------
Rat ____________________________________
Goat _
---------------------------------
Wildcat
---------
Opossum
Raccoon __
-----
* Monkey ---------------------------------
571 139
3 45 50
6 9 1 3 4
1 1
199 28 25 40
2
1
1
GRAND TOTAL __
----------------
833
296
ALBANY
Specimens
Pos.
119
49
55
9
3
11
6
21
18
3
5
2
1
4
2
3
3
1
----
1
228
87
WAYCROSS
Specimens
Pos.
76
39
19
4
2
3
1
7
7
3
1
----
----
110
52
TOTALS
Specimens
766 213
8 59 78 12 14 3
4 8 3
Pos.
b
287 41
'<"::": I'"J."l '0""
;::l
32 ._0_,., 65
3 t-< ~
0"' 0 "l
.~,..,_
0
3 3
"'("I>l"
IJ.l
2
1
1,171
435
* Purchased by Atlanta man 18 days previously in Kendall. Florida. Monkey was shipped a few days before from Colombia, S. A. Incubation period
suggests infection in some unknown manner before shipment into this country.
C!:l
~
<:.n
Cl:l 1:\:)
0)
TABLE 24
CLASSIFICATION OF ANIMAL HEADS-1947 EXAMINED MICROSCOPICALLY FOR RABIES-MUNICIPAL LABORATORIES
ANIMAL
COLUMBUS
Spec.
Pos.
Dog ...................................... 34
7
Cat ........................................ 5
----
Fox ...................................... 2
2
Squirrel .............................. 1
----
Racoon ....................................
----
Cow ...................................... 1
GRAND TOTAL................ 43
9
SAVANNAH
Spec.
Pos.
27
12
13
1 1
42
12
AUGUSTA
Spec.
Pos.
38
9
6
1
44
10
MACON
Spec.
Pos.
25
5
6
31
5
c;"':l
...Cl:l
0
cQ
"(::">
b
Cl:l
TOTALS
..,~
(::>
.,..._
Spec.
Pos. ;:l
124
Cl:l
33 .;;,:.S.._
30 2
1 2
..0.......
2
----
'\j :;::
1
----
0"'
~
1
---- "<:"-,
160
36 ~ Cl:l .,..._. ~
Division of Laboratories
327
TABLE 25
EXAMINATION OF POSITIVE HEADS-BY COUNTIES
(State and Municipal Laboratories)
Cmmty
Dog
Baker _ _____________________________________ 2
Baldwin
3
Banks __
1
Bartow _______________________________ _ 1
Bibb ________ ------------------------------- 5 Brooks _________________________________ _ 6 Calhoun _________________________________ _ 1
Carroll __ ______ _____ __________________ _ 3 Chatham________________________________ 12
Chattooga ________________________________ 5
Cherokee __________________________________ 2
Clayton _________________________________ _ 7 Clinch ______________________________________ _ 1
Cobb _______ --------------------------------- 1
Coffee ---------------------------------------- 5 Colquitt ____________________________________ 5
Cook __________________________________________
Coweta -------------------------------------- 1 Dawson ___________________________________ _
Decatur ---~-------------------------------- 8
DeKalb ------------------------------------ 11
Dodge ---------------------------------------- 2 Dougherty __ ________________________ ____ 5
Douglas ______________________________________ 1
Early ---------------------------------------- 2 Echols ____________________________________ _
Fannin ________ _____________________________ 1
Fayette ______________________________________ 4
Floyd ---------------------------------- ______ 6
Forsyth ------------------------------------ 1
Fulton ---------------------------------------- 64
Gilmer -------------------------------------Glascock _________________________________
Glynn __________________ ________________
25
Gordon _______________ _________________ _ 3
Fox Other
1
1
1
1
3
2
1
1
1
2
2
2
2
1
1
1
1
1
1
2
1
1
1 1
7 1 1
Total
2 5 1 1 7 11 2 4 12 6 2 9 1 3 7 8 1 1 1
10
11 2 6 1 5 1 1 5 7 1
71 1 1
25 3
328
Georgia Department of Public Health
TABLE 25-(Continued)
EXAMINATIONS OF POSITIVE HEADS-BY COUNTIES
(State and Municipal Laboratories)
Co~mty
Dog
Grady _____________________________ ___________ 1
Greene -------------------------------------- 1 Gwinnett _____________________________ ____ 4
Habersham -----------------------------Hall ------------------------------------------ 4 Hancock ___________________ ________________ 3 Haralson ____________________________________ Harris ________________ _________________________ ___
Heard ---------------------------------------- 1 Henry -------------------------------------- 5 Irwin _______________________________ __________ 2
Jackson -------------------------------------Jasper -------------------------------------- 3 Johnson ____________________________________ Lamar ___________________________________ ____ 6
Lanier ---------------------------------------Laurens -----------------------------------Lowndes --------------------------------- 1 McDuffie ------------------------------------ 8 Meriwether ______________________________ 2
Miller ---------------------------------------- 2 Mitchell ------------------------------------ 3 Monroe ------------------------------------ 2 Montgomery ---------------------------- 1 Morgan ------------------------------------ 3 Murray ------------------------------------ 1 Muscogee __________________________________ 7
Newton ------------------------------------ 2 Peach ---------------------------------------- 3 Pickens ------------------------------------ 1 Pike ------------------------------------------ 1 Polk ___________ _______________________________ 4
Putnam -------------------------------------- 2 Randolph ---------------------------------- 2
Fox Other
1
1
1
1
1
1
5
1
1
2
4
1
1
4
1
2
1
1
3
1
1
2
1
2
3
2
2
1
2
2
1
1
1
4
3
1
2
Total
3 2 5 1 5 8 1 1 1 11 2 1 8 1 8 1 1 4 9 3 4 4 7 1 5 1 9 5
6 1 2 5 9 5
Division of Laboratories
329
TABLE 25-(Continued)
EXAMINATIONS OF POSITIVE HEADS-BY COUNTIES
(State and Municipal Laboratories)
County
Dog
Richmond ---------------------------------- 12 Seminole ---------------------------------Spaleling ------------------------------------ 1 Stewart -----------------------------------Surnter -------------------------------------- 1 Talbot ----------------------------------------
Taliaferro ---------------------------------TayIor _______________________________c________
Thomas -------------------------------------- 11 Tift -------------------------------------------Treutlen ------------------------------------ 1 Troup ---------------------------------------- 5 Upson ---------------------------------------- 1 Walker -------------------------------------- 7 Walton -------------------------------------- 1 Ware ------------------------------------------ 3 Warren -------------------------------------- 1 Washington -----------------------------Wayne ---------------------------------------- 4 Whit:field __-------------------------------- 2 Worth ----------------------------------------
GRAND TOTAL______________________ 319
Fox Othe1
1
2
2
1
2
1
1
6
7
1
2
3
5
1
4
2
2
2
1
68
84
Total
13 4 1 1 1 2 1 1 24 1 1 10 6 7 2 9 3 2 4 2 1
471
TABLE 26 ANIMAL INOCULATIONS FOR RABIES
Type Specimen
Dog .___________________________________________________ Cat ________ ._____________ .... ____________________________
Fox _______ .__ .. __ .... _....................... ---- ...... Cow ____________________________________________________
Mule ........ ____ .. ____ ._......... _.... __ .............. Horse _______ ... ____ .. __ ........ __ .... __ .... _........... Squirrel ______________________________________________
Raccoon .......... ___ .......... ____ .____ .... __ ........ Goat ........ __ .... __ ._______________ .. _____ .___ .... _____ Monkey ..... ___________________________ .. ____________
Micro.Mouse-
29 9 4 3
----
----
1 1 1
----
Micro.Mouse+
12
-------
3 1 2 ----
----
-------
Micro.Mouse-
-------
-------------
----------
Micro.- Micro. Uns Micro. Uns
Mouse+ Mouse-
Mouse+
1
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
----
GRAND TOTAL ------------------------------ 48
18
----
1
----
----
Micro.+ Checks
2 1
----
1
----
----
----
1 5
~ ~
0
~
~
Total
44
0
""(Q
"i;:">
10
b
~
'1::3
4 7
:;:,
"".,.....
;;l
~
;.,:.:..l..
1
2 ..0......
1 :'1;:::1
0"
""~
1
(';
1
~
~
:;:,
1~ ~
72
Division of Laboratories
331
MAP
SHOWING
MAP ANIMAL HEADS MICROSCOPICALLY POSITIVE
1947
FOR RABIES
GRAND TOTAL 471
332
Georgia Department of Public Health
Rabies Control
The incidence of rabies during 1947 has shown a considerable decline when considered on a state-wide basis. This decline may be attributed to the vaccination program of dogs, to increased emphasis on the control of stray animals and possibly to a low point in the disease cycle. In some areas of the State, particularly in Floyd, Fulton, DeKalb, Gwinnett, Richmond and Glynn counties, as shown in Map 2, rabies has been prevalent. The disease appears to be endemic in these areas where the dog population is quite heavy.
The counties in the north and south central sections of the State have been relatively free of the disease during the year. The south central portion suffered a serious epidemic in 1945 and part of 1946 due chiefly to fox rabies. During this period dog vaccination was quite adequate. Fox control programs were instituted which, coupled with the disease itself, resulted in an adequate depletion of the fox population. The laboratory only occasionally received positive heads from this area throughout 1947, and veterinarians have reported very few clinical cases in any animals.
In the counties bordering Florida the disease is endemic in character. This is particularly true with respect to the fox. State Officials in Florida have at the same time reported rabies is quite prevalent in the counties bordering on Georgia. A conference has been held with the authorities in Florida with respect to closer coordination and uniformity of laws and methods used by the two States. Control measures in this area in both states are somewhat complicated, due to the fact that there are many large plantations maintained by absentee owners for fishing, hunting, and other recreational purposes. Under these circumstances it is rather difficult to secure cooperation in a control program.
In July and August, 1947, rabies began to be reported quite frequently in McDuffie and Warren counties. Efforts were exerted toward preventing the spread of the epidemic in these and surrounding counties but it is feared that, clue to lack of proper local cooperation, these efforts were not successful. In all probability, the infection was spread from these foci.
Loss in domestic animals has shown a decided decline as compared with 1946. This corresponds with a decrease in fox rabies. During the year domestic animals with an estimated value of $28,343 died of rabies throughout the State and $7,950 was expended for treatment of domestic animals following exposure to rabid animals, whereas a loss of $138,678 was reported for the previous year.
It will be observed in Table 27 that 180,409 clogs were reported vaccinated in 1947. This represents about 7,000 less than the number vaccinated in Hl46. However, 230,000 tags were issued
Division of Laboratories
333
MAP 2
FRINCIPAL AREAS OF RABIES INFECTION IN [947
[ill.... PREDOMINANTLY "DOG RABIES (ENDEMIC) ~ ENDEMIC DOG AND ~ FOX RABIES
SP~~ FROM ORIGIN4L
FOCI OF FOX RABIES AUGUST 1947
334
Georgia Department of Public Health
in 1947 and there is reason to believe that probably 220,000 dogs were vaccinated. This discrepancy is probably clue to some defects in our reporting system, which will be corrected.
In July 1947 a meeting was called by the Georgia Department of Public Health for the purpose of studying the rabies picture in southeastern states. Representatives from the U. S. Public Health Service and the states of Texas, Louisiana, Alabama, Florida, North Carolina, South Carolina, and Tennessee attended this conference. Valuable information was obtained in regard to furthering the rabies control program. Plans were laid for a second meeting to be called next year in Montgomery under the auspices of the Veterinary Division, U. S. Public Health Service.
Rabies control is a long range program and will require several years to reach the ultimate objective of eradication. To this end the coordinated cooperation on a national basis among the Veterinary Division of the U. S.Public Health Service, the Federal Fish and Game Service, U. S. Bureau of Animal Industry and Health departments of the several states is highly desirable.
H~tman Antimbic Treatment
There was a continuation of the drop first observed in 1945 in the number of antirabic treatments distributed. A total of 1,358 treatments were furnished in 1947 compared to 1,735 in 1946, a decrease of 21.7 per cent. This drop is attributed chiefly to the more effective efforts made in rabies control and, to some extent, to more conservatism in recommending treatment in some cases of questionable exposure. Approximately 73 per cent of the treatments supplied were for patients exposed to dogs. Only 61 treatments were distributed for fox bites as compared to 106 in 1946.
Table 28 gives the distribution of antirabic treatments over a period of the past five years and Table 29 shows the types of treatment distributed. It will be observed from Map 3 that treatments were furnished in 126 of the 159 counties.
Human Cases of Rabies and Treatment Paralysis
Only one case of human rabies occurred during the year. The history is rather incomplete in this case but it is given in the following abbreviated form:
D.L.L.-Colored female, age 33, Valdosta, Lowndes, Georgia, was bitten severely on leg by suspicious dog in the latter part of March. The patient did not consult a physician relative to the advisability of treatment. First symptoms appeared on April 13 and two days later a clinical diagnosis of rabies was made. Death occurred on April 17 but permission for autopsy was not obtained and therefore laboratory confirmation of clinical diagnosis could not be made.
Division of Laboratories
335
There were no cases of post-vaccinal treatment paralysis reported in the State during the year. For the first time, an attempt was made to collect data on persons applying for treatment who had previously received one or more courses of antirabic vaccine. More or less complete information was obtained on 56 such cases. Of this number 28 received six or more injections of vaccine prior to termination of treatment. It is our policy to recommend for persons previously treated only six doses of vaccine, regardless of the type of exposure or the time interval since last treatment.
TABLE 27
RABIES DATA BY COUNTIES FOR THE CALENDAR YEAR 1947
County
Percent Dog Clinical Dogs Population Cases Vaccinated Vaccinated
Appling ------------------------------------------ 0
1,464
81
Atkinson ---------------------------------------- 0
477
54
Bacon ---------------------------------------------- 0
1,052
100
Baker ---------------------------------------------- 1
1,115
100
Baldwin ---------------------------------------- 44
710
23
Banks---------------------------------------------- 0
608
56
Barrow ------------------------------------------ 0
461
28
Bartow -------------------------------------------- 0
441
14
Ben Hill ---'------------------------------------ 1
843
47
Berrien ------------------------------------------ 0
374
19
Bibb ------------------------------------------------ 1
3,191
30
BBlreacnktlleeyy --_-_-_-:-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- 00
843
70
540
62
Brooks -------------------------------------------- 0
1,017
37
Bryan -------------------------------------------- 0
167
21
Bulloch ------------------------------------------ 0
2,941
91
Burke -------------------------------------------- 0
4,396
100
Butts ---------------------------------------------- 17
1,445
100
Calhoun ------------------------------------------ 11
1,222
94
Camden ------------------------------------------ 0
0
0
Candler ------------------------------------------ 0
270
24
Carroll -------------------------------------------- 1
3,053
74
Catoosa ------------------------------------------ o
638
42
Charlton ---------------------------------------- 0
190
28
Chatham ---------------------------------------- 0
6,394
44
Chattahoochee ------------------------------ 0
244
13
Chattooga -------------------------------------- 1
1,542
67
Cherokee _______________ :________________________ 3
126
8
Clarke -------------------------------------------- 0
800
20
Clay ------------------------------------------------ 4
1,429
100
Clayton ------------------------------------------ 0
888
60
336
Georgia Depctrtment of Public Health
TABLE 27-(Continued) RABIES DATA BY COUNTIES FOR THE CALENDAR YEAR 1947
County
Pmcent Dog Clinical Dogs Population Cctses Vaccinated V accinctted
Clinch -------------------------------------------- 8
451
74
Cobb ---------------------------------------------- 4
2,348
49
Coffee -------------------------------------------- 7
433
18
Colquitt ------------------------------------------ 4
3,853
93
Columbia ---------------------------------------- 2
471
40
Cook ------------------------------------------------ 3
730
52
Coweta -------------------------------------------- 1
2,508
77
Crawford -------------------------------------- 0
145
17
Crisp ---------------------------------------------- 0
1,163
53
Dade ---------------------------------------------. 0
238
32
Dawson ------------------------------------------ 0
430
77
Decatur ------------------------------------------ 12
1,632
59
DeKalb ------------------------------------------ 3
3,451
100
Dodge -------------------------------------------- 3
732
23
Dooly ---------------------------------------------- 0
1,386
75
Dougherty -------------------------------------- 1
1,813
51
Douglas ------------------------------------------ 0
69
6
Early ---------------------------------------------- 11
3,032
100
Echols -------------------------------------------- 2
506
100
Effiingham --------------------------------- __ 0
930
77
Elbert -------------------------------------------- 0
490
20
Emanuel ---------------------------------------- 0
1,672
57
Evans -------------------------------------------- 0
937
100
Fannin ------------------------------------------ 2
673
37
Fayette ------------------------------------------ 0
696
68
Floyd ---------------------------------------------- 8
1,175
18
Forsyth ------------------------------------------ 1
150
11
Franklin ---------------------------------------- 0
584
30
Fulton -------------------------------------------- 0
20,829
L12
Gilmer -------------------------------------------- 2
1,148
100
Glascock ---------------------------------------- 1
0
0
Glynn -------------------------------------------- 9
829
30
Gordon ------------------------------------------ 0
1,442
63
Grady -------------------------------------------- 0
1,079
44
Greene -------------------------------------------- 3
602
35
Gwinnett ---------------------------------------- 0
288
8
Habersham ------------------------------------ 0
1,014
55
Hall ------------------------------------------------ 24
3,200
70
Hancock ---------------------------------------- 15
206
13
Haralson ---------------------------------------- 0
1,139
63
Harris -------------------------------------------- 7
509
35
Hart ----------------- ------------------------------ 0
480
24
Heard -------------------------------------------- 0
1,085
100
Division of Labomtories
337
TABLE 27-(Continued) RABIES DATA BY COUNTIES FOR THE CALENDAR YEAR 1947
County
Percent Dog Clinical Dogs Percent Dog Cases Vaccincdecl Vaccinated
Henry -------------------------------------------- 3
967
51
Houston ------------------------------------------ 0
674
47
Irwin ---------------------------------------------- 0
407
25
Jackson ------------------------------------------ 0
1,770
71
Jasper ------------------------------------------ 38
155
12
Jeff Davis -------------------------------------- 0
692
63
Jefferson ---------------------------------------- 0
163
7
Jenkins ------------------------------------------ 0
295
20
Johnson ------------------------------------------ 0
258
16
Jones ---------------------------------------------- 60
593
57
Lamar -------------------------------------------- 11
1,412
100
Lanier -------------------------------------------- 2
220
31
Laurens ------------------------------------------ 0
1,379
33
Lee-------------------------------------------------- 0
232
24
Liberty -------------------------------------------- 0
365
33
Lincoln ------------------------------------------ 0
617
76
Long ---------------------------------------------- 0
289
57
Lowndes ---------------------------------------- 45
455
12
Lumpkin ---------------------------------------- 0
40
5
McDuffie ---------------------------------------- 16
251
18
Mcintosh ---------------------------------------- 0
0
0
Macon ---------------------------------------- 0
215
11
Madison --------------------------------------- 0
1,876
100
Marion ------------------------------------------ 0
550
62
Meriwether ------------------------------------ 2
501
22
Miller ------------------------------------------ 4
693
55
Mitchell ----------------------------------------- 2
1,241
43
Monroe ----------------------------------------- 3
550
41
Montgomery ---------------------------------- 0
680
56
Morgan ------------------------------------------ 5
224
14
Murray ----------------------------------------- 0
282
20
Muscogee --------------------------------------- 0
6,486
69
Newton ----------------------------------------- 11
1,168
50
Oconee ------------------------------------------ 0
0
0
Oglethorpe -------------------------------- 0
1,179
68
Paulding -------------------------------------- 7
1,522
95
Peach ------------------------------------------- 1
513
40
Pickens ---------------------------------------- 0
0
0
Pierce ------------------------------------------- 1
383
26
Pike ----------------------------------------------- 8
585
45
Polk ----------------------------------------------- 4
700
20
Pulaski ------------------------------------------ 0
1,040
85
Putnam ----------------------------------------- 48
575
54
338
Georgia Department of Public Health
TABLE 27-(Continued) RABIES DATA BY COUNTIES FOR THE CALENDAR YEAR 1947
County
Population Clinical Dogs Population
Cases Vaccinated Vaccinated
Quitman ---------------------------------------- 0
341
79
Rabun -------------------------------------------- 1
900
92
Randolph -------------------------------------- 18
1,538
74
Richmond -------------------------------------- 0
4,062
40
Rockdale ---------------------------------------- 0
298
31
Schley -------------------------------------------- 0
109
17
Screven ------------------------------------------ 0
2,108
81
Seminole ---------------------------------------- 14
682
64
Spalding ---------------------------------------- 1
1,483
42
Stephens ---------------------------------------- 0
231
14
Stewart ------------------------------------------ 8
1,550
100
Sumter ------------------------------------------ 0
675
22
Talbot -------------------------------------------- 5
910
88
Taliaferro -------------------------------------- 0
0
0
Tattnall ------------------------------------------ 0
847
42
Taylor ------------------------------------- _____ 3
1,067
7\J
Telfair -------------------------------------------- 0
651
34
Terrell -------------------------------------------- 8
644
31
Thomas ------------------------------------------ 27
2,630
91
Tift ------------------------------------------------ 7
669
29
Toombs ------------------------------------------ 0
135
6
Towns -------------------------------------------- 0
300
49
Treutlen ---------------------------------------- 0
0
0
Troup -------------------------------------------- 4
2,785
51
Turner -------------------------------------------- 0
321
24
Twiggs ------------------------------------------ 0
415
36
Union ---------------------------------------------- 0
1,328
100
Upson -------------------------------------------- 11
1,199
38
Walker ------------------------------------------ 11
1,994
52
Walton -------------------------------------------- 0
2,015
78
Ware ---------------------------------------------- 0
997
29
Warren ------------------------------------------ 2
288
23
Washington ---------------------------------- 0
797
26
Wayne -------------------------------------------- 22
2,322
100
Webster ------------------------------------------ 0
187
32
Wheeler ------------------------------------------ 0
357
33
White ---------------------------------------------- 0
79
10
Whitfield ---------------------------------------- 11
1,301
40
Wilcox -------------------------------------------- 0
872
55
Wilkes -------------------------------------------- 0
927
52
Wilkinson -------------------------------------- 0
625
45
Worth -------------------------------------------- 0
2,142
80
GRAND TOTAL-------------------------- 641 180,409
Division of Laboratories
339
TABL..E 28
ANTIRABIC TREATMENTS AND RABIES MORTALITY
'
1943 1944 1945 1946
Human Treatments ____________ 2,296
Human death during or
after treatment ________________
1
Human death without treat-
ment ----------------------------------
2,784 2,426 1,735
2
3
2
2
2
1
TOTAL DEATHS ______________
1
4
5
3
1947 1,358
1 1
TABLE 29 CLASSIFICATION ANTIRABIC TREATMENT BY TYPE
1947 Type Treatment Number Percent
Precautionary ________ 550
40.5
MInitledn-s--i-v--e-----_-_-_-_-_-_-_-_-_-_-_-__-_-_-_- 71920
52.3 6.8
Drastic -------------------- 6
0.4
1946 Number Percent
714
41.2
890
51.3
124
7.1
7
0.4
GRAND TOTAL ____ 1,358
1,735
Cult?fre Unit
Culture examinations on blood, stool, and urine specimens, agglutination series, and a miscellany of special bacteriologic tests performed in this unit of the laboratory increased from 34,272 in 1946 to 37,088 for the current year, an overall gain of 8.2 percent. It will be noted, however, in Table 30 that the request for cultural studies on blood specimens decreased somewhat as contrasted to a more marked increase in requests for the other types of examinations.
TABLE 30 CULTURAL STUDIES 1947-1946
19L17
Agglutination Series __ 14,015 Blood Culture ______________ 9,018 Stool and Urine
Cultures ____________________ 13,991 Miscellaneous ____________ 64
1946 12,669
9,880
11,723
Increase or Decrease
+1,346
- 862
+10.6% -8.7%
+2,264
+19.3%
GRAND TOTAL __________ 37,088 34,272 +2,816
+ 8.2%
340
Georgin Department of Public Health
MAP 3 DISTRIBUTIO~ OF AN11RABIC TREATMENT
1947
Division of Laboratories
3L!l
It will be observed in a study of Tables 31, 32, and 33 that the positive agglutination tests and stool and urine cultures for E. typhosa increased over the previous year while the positive blood cultures remained about the same. There was a decrease in the number of positive agglutination tests for endemic typhus fever but the 106 positive results for tularemia is a peak for the last five year period.
TABLE 31
POSITIVE AGGLUTINATION TESTS
1943 1944 1945 1946 1947
Typhoid ------------------------------------ 106 92 55 32 68 Typhus (Endemic) Fever ........ 839 705 632 446 342
Brucellosis -------------------------------- 96 163 186 181. 172
Tularemia -------------------------------- 84 46 55 64 106
GRAND TOTAL ...................... 1,125 1,006 928 723 688
TABLE 32 POSITIVE BLOOD CULTURES FOR FIVE YEAR PERIOD
E. typhosa ----------Salmonella -------------------------------Brucella -----------------------------------Other Organisms ......................
1943
115 19 30 16
1944
93 14 53 10
1945 73 12 60 12
1946
49 4 51 24
1947
47 8 67 16
GRAND TOTAL ______________________ 180 170 157 128 138
TABLE 33 POSITIVE STOOL AND URINE CULTURES
E. Typhosa ................................ Salmonella -------------------------------Shigella -----------------------------------Other Organisms ......................
1943
162 52
203 2
1944
143 200 135
1945: 19L!6
191 86 79 103 108 50
1
1947
131 75 154
GRAND TOTAL ---------------------- 419 478 378 240 360
In Table 34 the number of blood cultures found positive for various organisms in the different laboratories is given. Table 35 classifies by types the clinical and carrier cases of typhoid and
342
Georgia. Department of Public Health
Tables 36, 37, 38, and 39 list the isolations for Salmonella, Shigella, Brucella, and E. typhosa in the various laboratories.
During the year two outbreaks of food poisoning occurred. One, involving 26 cases, was due to hemolytic Staphylococcus aureus in chocolate pies. The other was possibly caused by Streptococcus viridans which was found in turkey and turkey gravy.
Critical typing of these isolated organisms is done only in the Central laboratory. Branch laboratories refer such isolations to the Central laboratory for this time consuming work.
Organism
TABLE 34 POSITIVE BLOOD CULTURES-1947
Atlanta Albany Wayc1oss Other Totals
Brucella ---------------------------- 33
22
E. typhosa ------------------------ 25
8
Salmonella ----------------------- 1
1
SSttaapphh.. aaulbrueus s___-_-_-_-_-_--:-_-_-_-_-_-_-_-_-_-_-_-_-_
2 0
0 0
Sh. alkalescens __ , _____________ 0
0
Streptobacillus
moniliformis ---------------- 1
0
Hem. streptococcus __________ 3
0
Strep. viridans ------------------ 1
0
Streptococcus
(Gamma type) ------------ 1
0
11
1
67
7
7
47
1
5*
8
6
0
8
1
0
1
0
1
1
0
0
1
0
0
3
0
0
1
0
0
1
GRAND TOTAL ______________ 67
31
* One case of osteomyelitis
26 14 138
Type
TABLE 35 TYPHOID CASES AND CARRIERS 1947
Cases
New Ca1riers
Old Carriers
A------------------------------------------------------ 20*
6
1
B1 ---------------------------------------------------- 3
1
1
B2 ----------------------------------------------------
5
1
0
B3 ----------------------------------------------------
2
c ------------------------------------------------------ 7
1
0
3
2
E ------------------------------ __________ ------------- _ 19
0
2
F -------------------------------------------- __________ 1
0
0
H --------------------------------- ____ _______________ __ 0
1
0
J ------------------------------------------------------ 1
0
0
W form -------------------------------------------- 2
0
0
A and B1 ------------------------------------------ 1
0
0
GRAND TOTAL ---------------------------- 61
13
6
* one case originally found in 1946
TABLE 36 SALMONELLA ISOLATIONS 1947
Group Type
Central Blood Stool
Albany Ind.* Blood Stool
Waycross
Other Labs.
Totals
Ind. Blood Stool Ind. Blood Stool Ind. Blood Stool Ind.
A
B S. paratyphi B ............
1
S. typhi murium ..........
5
S. saint paul ..
S. derby
C S. cholerae suis ............
S. oranienburg ................
S. bareilly ..
S. montevideo
S. hartford
S. norwich
Ss..-
newport muenchen
................. .
S. litehfield
D S. enteritidis
S. sendai ....
S. panama ........................
1
E S. give S. a11atum ------8. meleagridis ................
Misc.S. kentucky .................. S. waycross*** ............
GRAND TOTAL
1
13
10
27
12
1
1
3
1
1
1
8
2
1
1
1
1
6
1
51
28
3 2
2**
3
2 1
4
2 1
1 35
1 4
1 9
1
21
1 3
3 4
t::l
~-
""c""""
~
1
1
1 1
l 1
~
2
3 6 2 1
1 6 2
too;
:;:,
.., 1
c0"
2
1 1 2
..,:.,;.:.,..
c
1
1
""(I:)
1 1
""
1
6
5
5
10
75
55
*** ***
Individuals One from case of osteomyelitis
A new type isolated from urine
Ci:l
C""i':"l
344
GeoTgia Depctrtment of Public Health
Type
TABLE 37 SHIGELLA ISOLATIONS-1947
Central Albany Waycross Other Total
Sh paradysenteriae
TTyyppee III ---_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 43
1
1
4
9
1
5
Type III ____________________ 29
1
30
Type IV _____________________ _
1
1
Type VI _____________________ _
1
1
Sh. sonnei ________________________ 22
6
5 33
Sh. ambigua ____________________ 3
3
Sh. dispar ________________________ 1
1
Sh. alkalescens ______________ 51
11
1
8* 71
GRAND TOTAL ____________ 113
20
* Three from urine
2
19 154
Type
TABLE 38 BRUCELLA ISOLATIONS-1947 Central Albany Wctycross Other
Total
Abortus
17* (14) **----
Suis ------------ 16 (12) 21 (15)
Un-
classified***
1 ( 1)
'J.l (10)
17 (14) 1 (1) 49 (38)
1 ( 1)
Grand Total __ 33
22
11
* Isolations ** Individuals *** Failed to grow on transplants
1
67 (53)
TABLE 39 ISOLATIONS OF E. TYPHOSA 1947
Type
A
B,
B" B3
c
E F H J ... New type** W form
A and B1 ***
GRAND TOTAL
Central Blood Stool Ind.*
5
30
12
1
7
2
3
12
4
1
6
2
4
16
9
9
20
1:3
1
1
1
1
1
2
1
i
25
100
46
Albany Blood Stool Ind.
3
2
5
1
1
1
3
2
5
2
2
3
3
2
l
8
14
14
Waycross Blood Stool Ind.
5
8
8
1
1
1
1
2
1
Other Labs. Blood Stool Ind.
3
3
3
3
3
1
l
6
4
6
7
10
11
13
7
13
* Individuals ** U ndesignated *** Colonies were picked at random and bacteriophage at)plied.
Fifteen were type A and 49 type B 1
Totals Blood Stool Ind.
16
43
28
0
2
8
6
12
2
9
4 7 4
;"""0":"""""s'''
5
21
12
..0.....,
18
27
23
1
1
;t:-:<,
2
1
os;-
1
1
1
~
.,..;..
2
1
0
2
1
1
"C"l>'
""
53
131
84
~
>!::.. 1:11
346
Georgia Department of Public Health
Of special interest in this highly specialized service is a new
type of Salmonella which was isolated in the Waycross laboratory and given the name S. waycross. This organism was isolated
from a patient who had a urinary tract infection. The antigenic formula of S. waycross is XLI; Z4, Z23 Another interesting finding was a typhoid carrier who excreted two bacteriophage
types, A and B1, in the same specimen. Both types were isolated from 5 of 11 specimens. Of 64 colonies picked 15 were type A
and 49 type B1. Twelve cultures of E. typhosa were typed for other states and
Alaska. Friedlander's bacillus, type B, was isolated from sputum
from a patient with pneumonia. Streptobacillus moniliformis was isolated by blood culture from a case of rat bite fever.
Seventy miscellaneous cultures for identification were submitted by hospital laboratories. These included various types of Proteus, Paracolon, Coliforms, B. alcaligenes, B. pyocyaneus,
Friedlander's bacillus, Hemophilus sp., and non-pathogenic fungi.
TABLE 40 CULTURES FOR FUNGI 1947
Neg. Number
Positive-Type
Hair __________ 26
Skin, including nails __ 103 Sputum ____ 41 Miscellaneous ____ 6
287 M~crosporum aud?uini ____________ 265 Microsporum cams ------------------ 17 Microsporum gypseum ------------ 1 Trichophyton tonsurans __________ 3 M. canis and M. audouini ________ 1
23 Trichophyton rubrum ____________ 14 Microsporum canis __________________ 4 Microsporum audouini ____________ 3 Trichophyton mentagrophytes . 2
2 Candida albicans
2 Candida albicans
Grand Total176
314 TT.. mruebnrtuamgro--p--h--y--t--e-s----_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_ 124
T. tonsurans ---------------------------- 3 M. gypseum ------------------------------ 1 M. audouini ------------------------------ 268 M. canis ------------------------------------ 21 M. audouini and M. canis ________ 1
C. albicans -------------------------------- 4
., Very little fungus culturing had been clone until this year when an outbreak of ringworm occurred in the Atlanta schools. Most of the 313 specimens of hair were sent in by the City
Division of Laboratories
347
Health Department. The infected hairs were extracted under a fluorescent light, which probably accounts for the high percentage (91.7 percent) of positives. Table 40 gives the classification of the type of fungi found in various types of specimens.
SEROLOGY UNIT
Syphilis Serology-
The serology load for the Division of Laboratories amounts to 512,536 specimens in 1947, an increase of 133,558 or 35.2 percent over the previous year. The community-wide surveys were responsible for 111,783 specimens, the greater portion of this increase. Specimens originating from these surveys are examined only in the Central laboratory where facilities have been enlarged. The serology volume in the branch laboratories as shown in Table 41 deviated but slightly from that in 1946. The increase shown for the Alto laboratory resulted from the elevated patient load from the community-wide surveys. Only the emergency type of serology is done in the Battey laboratory, routine specimens being referred to the Central laboratory.
TABLE 41 SYPHILIS SEROLOGY 1947
Blood
Central Albany Waycross Alto Battey Total
1947 ---------------- 379,784 61,601 38,937 18,740 684 499,746
1946
268,504 58,602 40,725
5,908
373,739
Increase or
decrease Spinal Fluid 1947 ---1946 ----------------
+111,280
1,255 780
Increase or decrease ------ + 475
Blood and Spinal Fluid 1947 ---------------- 381,039 1946 --------------- 269,284
Increase or decrease ------ + 111,755
+ 2,999 - 1,788
293
86
381
148
---
88
62
---
61,894 58,983
39,023 40,873
-1- 2,911 - 1,850
+12,832 +684 11,156 3,930
+ 7,226
---
29,896 684 9,838
+20,058 +684
+126,007 12,790 5,239
+ 7,551
512,536 378.978
+ 133,558
The adoption of the Quantitative Kahn test in 1946 as a routine procedure on 4 plus, zone, and atypical reactions in the Standard Kahn test has added considerably to the work involved in this unit of the laboratory. The quantitative test was applied to 49,251 specimens as compared to 25,084 in 1946. Quantitative determinations were made on 9.6 percent of the specimen volume.
348
Georgie& Depnrtment of Public Health
In order to provide for the examination of specimens ariSmg from the community-wide surveys, it was necessary to expand facilities by equipping a separate section of the serology unit in rooms vacated as a result of the removal of the animal work for tuberculosis to the Battey laboratory. The serologic work in previous surveys had been clone in a mobile laboratory unit operated by the U. S. Public Health Service. Specimens coming from these surveys are transported by express messenger service and reach the laboratory in excellent condition within 24 hours after collection. These specimens receive the same type of examination as those handled in the routine section, except screening is clone by the Mazzini instead of the presumptive Kahn test. Table 42 shows the specimens examined in community-wide sur-
TABLE 42
SPECIMENS EXAMINED IN COMMUNITY-WIDE SURVEYS
Counties
Specimens
Colquitt ------------------------------------------------------ Thomas-----------------------------------------------------------Grady -------------------------------------------------------------Floyd -------------------------------------------------------------Polk ---------------------------------------------------------------Lowndes-Lanier-Echols ---------------------------MinoT Surveys
Bartow -----------------------------------------------------------Spalding ----------------------------------------------------------
17,195 17,742
8,720 28,895 15,159 21,760
1,188 1,124
Positive
1,205 1,408
450 960 554 1,731
20 31
TOTAL------------------------------------------------------------ 111,783 6,359
TABLE 43
MULTIPLE SEROLOGIC TESTS
Kahn Presumptive -------------------------------------------------------------------- 116 Kahn Standard -------------------------------------------------------------------------- 620 Kahn Quantitative..................... ------------------------------------------------- 317 Kolmer Complement-Fixation ---------------------------------------------- 574 Kline Diagnostic ------------------------------------------'------------------------- _ 557 Kline Quantitative -------------------------------------------------------------------- 29 Mazzini -------------------------------------- ___ ---------------------------------------------- 637 Mazzini Quantitative ---------------------------------------------------------------- 33 Eagle Flocculation ------------------------------ ------------------------------------ 520 Hinton ---------------------------------------------------------------------------------------- 462 Cardiolipin V.D.R.L. ---------------------------------------------------------------- 534 Heterophile Antibody ---------------------------------------------------------------- 39
GRAND TOTAL ------------------------------------------------------------------------ 4,438
DIVISION OF LABORATORIES
veys. Community-wide surveys were conducted in Colquitt, Thomas, Grady, Floyd, Polk, Lowndes, Lanier and Echols counties during the year.
As a special service the multiple serological tests are performed by request in the Central laboratory on specimens which have given repeated unexpected positive or conflicting results in :coutine work. Reference to Table 43 will show the extent to which these tests were performed. There has been a steady increase in the demand for this type of service since it was established in 1944. It may be necessary to increase facilities to meet a future demand or place certain limitations on requests for these multiple tests.
The Central laboratory participated in the 1947 national serology evaluation study conducted under the auspices of the U. S. Public Health Service. Reference to Table 44 will show that creditable ratings in both sensitivity and specificity were achieved in the performance of these tests as judged by the results obtained in the laboratories of the author-serologists.
TABLE 44 NATIONAL SEROLOGY EVALUATION STUDY 1947
Georgia Laboratory Author Serologist Laboratory
Test
Sensitivity SpecificitY Sensitivity Specificity
Kahn Presumptive ___________________
91.8
96.7
83.5
99.7
Kahn Standard -------------------------------- 80.8
100.0
81.6
100.0
Kline Diagnostic ---------------------------- 81.2
100.0
83.4
100.0
Kolmer Complement-Fixation ____ 74.1
98.5
83.4
98.5
Eagle Microflocculation __________________ 71.4
99.5
81.5
100.0
Hinton Flocculation ________________________ 91.7
99A
81.5
99.3
Mazzini Flocculation ______________________ 84.3
100.0
77.1
100.0
VDRL Slide (Cardiolipin) ____________ 88.7
100.0
Twenty-five laboratories inclusive of those in our system entered a total of 35 test procedures in an intra-state evaluation study conducted by the Central laboratory. This study consisted of the preparation and distribution of 100 sera containing syphilitic reagin and an equal number containing no reagin. These specimens were distributed to participating laboratories at the rate of 20 specimens a month during the first 10 months of the year.
As a result of this study, approval for satisfactory test performance was given to 20 of these laboratories. Four laboratories could not be approved and approval was withheld in the case of one pending further observation of the work. Assistance was offered and rendered to laboratories which did not meet the criterion for approval.
350
Georgia Department of Public Health
The Army Medical School has permitted the Third Army Medical laboratory to adopt the method developed in the Central laboratory for conducting technical proficiency surveys in serology with laboratories under its supervision.
An added feature to the work in the serology unit is the Rh and blood grouping tests begun February 1. This service is limited to prenatal and related cases. Table 45 giving the distribution of this work among the laboratories shows that a total of 29,477 specimens were examined. The demand for this work is steadily growing and may require enlargement of facilities in the near future.
TABLE 45
RH AND BLOOD GROUP TEST
Central Albany Waycross
Positive ------------------------------ 19,722 Negative ------------------------------ 3,802
3,971 578
1,383 288
Total
25,076 4,668
GRAND TOTAL________________ 23,524 4,549 1,671 29,744
Biologics and Drugs-
In Table 46 is given the distribution of 15 kinds of sera and vaccine and 20 different drugs by the Division of Laboratories. Ferrous sulfate, Frei antigen and BAL in oil were supplied for the first time. Some of these products are available only to clinics while others are furnished to physicians as well under a general policy covering their distribution.
It will be observed in Table 47, showing a marked increase or decrease in biologics compared to the previous year, that most of the products were in greater demand. Attention is called especially to the increased use of Penicillin with a corresponding lessening of demand for Arsenic and Bismuth preparations previously used in the treatment of syphilis. There was a drop of the equivalent of approximately one and a half million cc's in the distribution of American Red Cross dried plasma, probably due to some overstocking in the previous year and to the establishment of blood banks in more hospitals.
Table 48 shows the distribution of specimen outfits by the different laboratories. Needles and syringes are supplied only from the Central laboratory. The preparations made by the Media and Vaccine Unit are given in Table 49. Reference to the previous year's report reveals a considerable increase in the demand made on this unit of the laboratory.
DIVISION OF LABORATORIES
351
TABLE 46
BIOLOGIC PRODUCTS AND DRUGS DISTRIBUTED
Product
Central
Sera and Vaccine
Diphtheria Antitoxin, units ________________ 67,657,000
Diphtheria toxoid, cc. ------------------------
83,075
Diphtheria Schick Test, tests ____________
53,220
Ducrey Vaccine, tests ________________________
3,650
Pertussis Vaccine, cc. ---------------------------- 137,455
Smallpox Vaccine, points ____________________ 150,020
Tetanus Antitoxin, units ____________________ 10,711,000
Tetanus Toxoid, cc. ____________________________
930
Tuberculin, Diluted, cc. ______________________
12,580
Tuberculin, PPD. tests ________________________
8,710
Typhoid Vaccine, cc. ----------------------------
577,670
(1) Antirabic Treatments
(persons treated) ----------------------------
1,358
Immune Serum Globulin, cc. ______________
10,394
Diphtheria-Pertussis Vaccine, cc. ____
710
Diphtheria-Pertussis-Tetanus
Vaccine, cc. ------------------------------
10,660
Dntgs
Silver Nitrate, ampoules ___________ _____
115,737
Pandy's Reagent, oz. --------------------------Procaine Solution, cc. -------------------------Yeast, lbs. ---------------------------------------------Tetrachlorethylene, caps. ____________________
20 100 16,245 28,808
Hexylresorcinol Crystoids, vials ________ Gentian Violet, tablets ________________________
512 6,799
Clinitest, tablets ----------------------------------
40,600
Plasma, cc. -------------------------------------------- 2,941,500
Ferrous Sulfate, tablets ----------------------
26,000
Penicillin, C.S.S., units _______________________.4,812,000,000
Penicillin in Beeswax and Oil, cc. ____
510,280
Fuadin, amps. ---------------------------------------Frei Antigen, test -------------------------------Sulfathiazole, tablets -------------------------Streptomycin, gram -----------------------------BAL in Oil, amps. -------------------------------(2) Distilled Water, cc. ____________________
6,980 1,060 311,200
1 1,487 1,464,950
(3) Bismuth Subsalicylate, cc. ________ (4) Arsenicals, amps. ________________________
191,370 78,525
Albany vVaycross
4,931,000 7,390 1,730
9,580 12,460 1,132,500
4,895,000 7,260 3,190
8,720 9,325 325,500
58,920 162
48,350
63 104
4,729
4,725
3,500
11,500
5,200
249,200 810 900
105,300
(1) Only four vials of vaccine are supplied by the Branch laboratories for each patient for whom treatment is requested. The remainder of the treatment is forwarded from the Central laboratory.
(2) Distributed in 50 cc. and 100 cc. bottles.
(3) Distributed in 30 cc. and 60 cc. bottles.
(4) Equivalent to 157,910 doses of 0.6 gm. or less.
352
Geor-gia Depar-tment of Public Health
TABLE 47
BIOLOGICS SHOWING MARKED INCREASE OR DECREASE OVER 1946 DISTRIBUTION
PRODUCTS Sera and Vaccine
1947
Diphtheria Antitoxin Pertussis Vaccine ____________________ Smallpox Vaccine ________________ Tetanus Antitoxin __________________ Typhoid Vaccine _______ ___________ _
Diphtheria-Pertussis-Tetanus Dntgs Silver Nitrate Amps. ________ ___ Tetrachlorethylene _______ ________
Hexylresorcinol Crystoids Plasma ____________________ __ _________
77,483,000 155,755 171,805
12,169,000 684,940 10,660
125,191 43,808
512 2,941,500
Penicillin, units ---------------------- 4,812,000,000
Fuadin
_____
6,980
Sulfathiazole ____________________________
459,080
Distilled Water______________________ 1,819,450
Bismuth Subsalicylate, cc. ____
192,180
Arsenicals -------------------------------Gentian Violet_________________________
79,425 6,799
Clinitest __________________ _____________
40,600
Ferrous Sulfate _____________________
26,000
Frei Antigen ___________ ________________
1,060
BAL in oil __ ___________________ __
1,487
1.946
58,973,000 5,011
128,310 10,253,500
607,580 500
89,824 33,751
104 4,419,000 2,167,700,000
10,000 311,200 1,934,600 233,940 135,225
2,008 22,800
Increase
01' Decrease
++
18,510,000 150,744
+++
+
43,495 1,915,500
77,360 10,160
+
+
35,367 10,057
+
408
+ 1,477,500 2,644,300,000
+
3,020 147,880
115,150
41,760
++
55,800
4,791 17,800
TABLE 48 DISTRIBUTION OF SPECIMEN OUTFITS BY LABORATORIES-1947
Cennal Albany "YVctycross
Keidel Tubes _____ ----------------------------------------
*
Keidel Butts ---------------------- -------------- - ---DaTkfield Outfits -------------------------------------
Throat Culture Outfits ----------------------------
Intestinal Parasite Outfits, Routine ____
::: Intestinal Parasite Tins, Su1~vey ________
Slide Outfits --------------------------------------------Slides _____ -----------------------------------------------------
Sputum Outfits----------------------------------------Stool Culture Outfits -----------------------------N. I. H. Outfits ------------------------------------Dental Caries Outfits _________________________
Tryptose Broth Outfits __________________________
Petroff Needles ----------------------------------------
156,166 187,829
928 6,057 17,135 50,577
17,605 144
24,913 10,492
473 67
88 980
Needles
1292 GGaauuggee,, 21 iannchd---1--1--/--2---i-n--c--h---_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_--_-_-_-_-__-_-_-_-_-_--___ 1569 24 Gauge, 3/2 inch -------------------------- _____________________ 109 26 Gauge, 3/8, 1/2 and 5/8 inch _____________________ 222
20,921 38,732
65 1,445
7,132 13,097
2,817 2,928
3,832 4,031
10
13 Gauge, 2 1 /2 inch ________________________________
406 Doz. 1 only
3,594 16,928
68 2,370 1,483 22,172
1,584 1,100 2,397 2,370
Divi:;ion of Laboratories
353
TABLE 48 (continued)
DISTRIBUTION OF SPECIMEN OUTFITS BY LABORATORIES-1947
Central Albany Waycross
Syringes 1 cc Tuberculin ---------------------------------------------------- 108 2 cc Hypodermic ---------------------------------------- 662 5 cc Hypodermic -------------------------------------------------- 108 10 cc Hypodermic -------------------------------------------------- 267
1,145 only
* Statistics for Central Laboratory include items sent to the Albany and
Waycross Branch Laboratories.
TABLE 49
MEDIA AND VACCINE UNIT
Media-in ccs.
Meat Infusion Double -------------------------------Meat Infusion Broth ------------------------------- -Beef Extract Broth --------------------------------- .. Pork Infusion Broth --------------------------- ----- Sugar Broth ---------------------------------------- ... Tetrathionate Broth ----------------~---------------. Tryptose Phosphate Broth ------------------- ___ Meat Infusion Agar -----------------------------------Beef Extract Agar -------------------------------- --Desoxycholate Citrate Agar ------------ ------Endo's Stock Agar ----------------------------------- _ Kligler's Triple Sugar Iron Agar __________
McConkey's Agar ---------------------------------------Peizer's Stock Agar ----------------------------------- _ Pork Infusion Agar -----------------------------------S. S. Agar -----------------------------------------------------Tryptose Agar ------------------------------------- _____ Wilson Blair Agar -------------------------------------Conradi's Bile -----------------------------------------------Loeffler's Blood Serum -------------------------------Petragnani's -------------------------------------------------Miscellaneous Media -----------------------------------
Solutions and Indicato?s ,
Dyes for Media -------------------------------------------Reagents for Media -----------------------------------Bismuth Sulfite Mixture ---------------------------Glycerine Salt Solution -----------------------------Salt Solution ---------------------------------------~------- Silver Nitrate Solution -----------------------------Miscellaneous Solution ------------------------------
Central Albany Waycross
150,000 31,400 59,000
7,950 14,400 36,000 220,000 24,000 18,700 24,000 21,000 19,500 71,000
2,000'
4,550. 9,300 4,000 10,500 1,500 18,200
16,400 15,750
3,000 100 700 900
3,200 5,100 2,700 1,750
3,000 5,800
29,000 22,800 143,000 103,000 16,450 52,000 55,710
29,800 1,500 35,000 57,000
8,300
3,300 7,000 11,200 25,000
14,100
1,700 30,577 22,000 72,000 716,000 69,000 124,753
52,000 69,000
26,125
354
Georgia Department of Public Health
TABLE 49 (continued)
MEDIA AND VACCINE UNIT
Media-in ccs.
1 o/o Silver Nit~ate
Number Ampoules made __
Number Ampoules filled ___________ _
Number Ampoules distributed __ .
SteTile Distilled Water
Water filled, cc.
________________ _
Water distributed, cc. ____ _
Diluted Tubenulin (Old)
Tuberculin diluted, cc. ---- . _
Tuberculin distributed, cc. _
1947
96,100 92,500 95,400
1946
80,000 94,000 84,000
Increase OT decrease
+ 16,100 +- 1,500
11,400
1,725,000 1,900,600 1,861,000 1,953,300
-175,600 - 92,300
17,005 13,000 17,275 12,745
++
4,005 4,530
New QuarteTs joT Bmnch LaboTatoJies-
The regional buildings planned in 1946 are nearing completion in Albany, Macon, and Waycross. Adequate space has been provided for the branch laboratories in these buildings. Modern steel tables, cabinets, and other necessary equipment have been ordered for these branch laboratories. The Albany and Waycross laboratories will be moved into the new quarters and a new branch laboratory will be established in Macon during the early part of next year.
Personnel-
There were 25 resignations among the personnel in the Division of Laboratories during the year. The turnover in the technical staff is still quite high and requires an undue amount of time in instruction for replacements. An attempt will be made to elevate the compensation schedule in the lower brackets of this classification, as it is felt that the present salary scale is inadequate in maintaining a trained technical staff. The replacement of employees in the other classifications has not been as difficult as in previous years. It was necessary to make additional appointments for enlarging the staff to meet the demands for expansion of laboratory facilities. Resignations and appointments were classified as follows:
Technical 34
Technical 17
APPOINTMENTS
Clerical
Porters
6
3
RESIGNATIONS
Clerical
Porters
5
1
Dieners 5
Dieners 2
Total 48
Total 25
Division of Laboratories
355
Visitors
There were 336 professional visitors registered in the laboratory guest book as compared to 274 visitors in 1946. They registered from the following localities:
1. Foreign countries-Puerto Rico, China, Venezuela, Costa Rica, London, Peru, Egypt, 9.
2. Other States in the United States, 57. 3. Georgia, 269. 4. Military personnel, 1.
In addition to the above there were numerous visitors from high schools, colleges and lay organizations interested in health work.
Manual of Methods-
With the assistance of the heads of the various units of the laboratory, a Manual of Methods was prepared for the information and guidance of the technical staff. This manual was prepared in loose-leaf form so as to permit insertion of changes or addition of technics from time to time. Sixty complimentary copies of this manual were furnished upon request to other laboratories.
Division of Vital Statistics
LEALON M. LACY ______________________________________________________ Acting Director WILLIAM E. UZZELL ______________ ---------------------------------------- Statistician LACY H. GARVIN ________________________ Central Statistics Unit Supervisor RoY ANDERSON ---------------------------------------------------- Field Supervisor
Division of Vital Statistics
The Division of Vital Statistics is charged with the responsibility for the collection and filing of certificates for all births, deaths, stillbirths, adoptions, legitimations, marriages, annulments and divorces occurring in the state of Georgia. However, the law governing the reporting of marriages, annulments and divorces was repealed by the 19L17 Legislature and this is no longer a function of the Division of Vital Statistics.
Field Supervision: The supervision of a state-wide registration system with over 986 registrars required constant travel on the part of the field agents. The liason activities with registrars, ordinaries, doctors, funeral homes, hospitals, midwives, health officers, county nurses, and with medical colleges were emphasized during the year in the promotion of better registration of vital events in the State.
Birth Registmtion: The special dual birth registration system continues to improve the quantity and quality of birth registration in Georgia to such an extent that several states are studying the system and are now taking steps to adopt it. In 1944, only 44 percent of our birth certificates included the medical information required by law, whereas now, 98 percent of the certificates filed includes this confidential medical information.
Delayed Birth Registration: 11,747 delayed birth certificates were filed during 1947 as compared to 16,140 for 1946. 41 percent of these were filed by State procedure, 59 percent by Court Order procedure. 20 percent or 2,297 of the 11,747 delayed certificates filed during the year were for births that occurred prior to 1919, the first year of birth registration in the State.
Certified Copies of Births and Deaths: 19,226 certified copies of birth certificates were issued during 1947, or a decrease of 3,414 from the 22,680 issued in 1946. The number of death certificates issued increased from 2,044 in 1946 to 2,371 during 1947. The free verification services rendered for governmental agencies, especially for welfare, social security, retirement and military purposes, average approximately 50 searches per day during the year.
Death Registration: The Division cooperated during the year with the United States Committee for the Sixth Decennial Revision of International List of Diseases and Cause of Death. The International Committee is attempting to obtain more statistical uniformity between fatal and non-fatal diseases. The accuracy of mortality and morbidity statistics depend to a large extent upon the the cooperation of the local physician in reporting illness and the causes of death. We are duly appreciative of the cooperation given by physicians to improve public health statistics.
360
Georgia Department of P~tblic Health
Legal Activities: The necessary correction and amendment of birth certificates by court orders, especially for change of name, adoption, and legitimation increased during 1947, with 474 adoptions, 126 legitimations, and 22 name changes recorded.
Statistical Activities: Requests for vital statistics, special tabulations, and statistical information by other health divisions and departments, as well as from civic and health organizations, increased during the year. During the year the Division of Vital Statistics assumed the responsibility for the statistical study of the health, and economic and social conditions of Georgia as required by the Hospital Planning and Construction Program under the Hill-Burton Act. The transfer of the Central Tabulating Unit to the Division, and the employment of a statistician, gave impetus during the year to the development of a wellrounded statistical program within the CENTRAL STATISTICS UNIT. We are now in a better position to render statistical services and to further utilize the tremendous store of health data that has been and is being accumulated in the Division of Vital Statistics. The statistical and machine tabulating services are available to all divisions of the State Department of Health.
STATISTICS
Population Estimates: In 1947 the Division of Vital Statistics initiated the annual estimating of the population of the counties and cities by race in Georgia. This was done in order to avoid the inflation of rates of vital events as appeared in the rates of recent years. The 1940 enumerated population was used for the years 1940 through 1946, since there was insufficient data for determining the shifts in population that were occurring. Because of the great increases and decreases in certain urban and rural areas during that period, inflated or deflated rates occurred. Any comparison of the rates of this period with the rates of 1947 should be made with reservation.
The United States Bureau of the Census provides an estimated total population for the State each year. The method used by the Central Statistical Unit in estimating the population for each county and city is based on records of births, deaths, and elementary school enrollment for each area. These estimates will be as of July first of each year until the next official census.
Natural Increase in Population: A record breaking 94,311 current live births were registered in Georgia during the year 1947, which was an increase of 30,004 births more than recorded ten years ago in 1938, and 8,612 over that of 1946. In contrast to a net increase of 30,004 live births, there was only a net decrease of 4,837 deaths in 1947 over 1938. This resulted in a birth-death ratio of 328 births per 100 deaths for the year as compared to the rate of 191 births per 100 deaths for 1938.
Information and Statistics
361
Birth Rate: The record 94,311live births registered in Georgia in 1947 resulted in a birth rate of 29.17 which is 40.64 per cent higher than the corresponding rate of 20.74 for 1938, and is the highest annual birth rate recorded since 1919, the first year of birth registration in Georgia. The Georgia birth rate of 29.17 per 1,000 population is 12.24 per cent greater than the 1947 birth rate of 25.99 for the provisional United States rate.
Death Rate : The crude death rate of 890.19 deaths for each 100,000 population in 1947 was the lowest ever recorded, and was 17.91 per cent lower than the 1938 rate of 1,084.50. The greatest decrease in death rate from 1938 to 1947 was recorded for Typhoid and Paratyphoid Fever (-93.07 o/o), Scarlet Fever (-92.68 o/o), Malaria (-91.50 o/o), and Dysentery (-90.63%). The greatest increases were for Cirrhosis of the Liver (42.95%), Cancer (33.19o/o), Heart Disease (23.90o/o), and Cerebral Hemorrhage-Embolism-Thrombosis (12.40%). The five leading causes of death in Georgia for 1947 were Heart Diseases, Cerebral Hemorrhage-Embolism-Thrombosis, Cancer, Nephritis, and Malformations and Early Infancy Diseases. The death rate of Nephritis decreased in 1947 by 30.40 per cent, and Malformations and Early Infancy showed a decrease of 21.51 per cent.
Stillbirths, Infant and Mater-nal Mortcdity: Continued progress was made during 1947 in the saving of newborn babies and their mothers, in spite of a record number of births that taxed obstetric and pediatric facilities throughout the State. Death associated with child bearing reached an all-time low in 1947 with a Maternal Mortality rate of 2.61, an Infant Mortality rate of 34.34, and a Stillbirth rate of 26.05 per 1,000 live births. In 1938, the Maternal Mortality rate was 6.54; Infant Mortality rate, 67.67; and the Stillbirth rate, 52.71.
CAUSE OF DEATH
Typhoid Fever. Deaths from Typhoid Fever dropped from 121 in 1938 to 9 in 1947, or a decrease of 93.07 per cent in the death rate.
Typhus Fever. 47 deaths were recorded in 1938 and 31 in 1947. The death rate in 1947 declined 37.08 per cent, or from a rate of 1.51 in 1938 to 0.95 in 1947.
Malaria Fever. 146 deaths in 1938 and 13 in 1947 were registered for Malaria Fever, resulting in 91.50 per cent decrease in the rate for 1947.
Smallpox. No deaths were recorded during 1947 or 1938 from smallpox.
Diseases of Childhood. Measles deaths declined from 157 in 1938 to 17 in 1947, or a decrease in the death rate of 89.72 per cent. One death was recorded in 1947 and 13 in 1938 for Scarlet Fever, a decrease of 92.68 per cent. Whooping Cough deaths decreased from 225 in 1938 to 95 in 1947, a decrease of 59.58 per cent.
362
Georgict Department of Public Health
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
IN THE UNITED STATES AND GEORGIA:
1945
Cause of Death
International U. S. Rate Code No.
Georgia Rate Georgia Rank
ALL CAUSES -------------------------
1,062.1
894.8
6
Typhoid and Paratyphoid Fever --- 1,2
0.4
0.9
43
Meningococcus Meningitis ...........
6
1.3
1.3
23
Scarlet Fever ---------------
8
0.2
0.1
8
Whooping Cough -------------------------------- ____
9
1.3
2.0
32
Diphtheria -----------------------------------
10
1.2
2.3
40
Tuberculosis, all fonns --------------------
13-22
40.1
34.7
20
Dysentery ------------------------------------------------- 27
1.2
1.7
36
Malaria --------------------------------------------------- 28
0.3
0.8
41
Syphilis -------------------------------------------
30
10.7
11.6
30
Measles -------------
35
0.2
0.3
29
Poliomyelitis ------------------------------------------------ 36
0.9
0.4
5
Cancer and other malignant Tumors .... -15-55
134.5
76.6
4
Diabetes Mellitus ---------------------------------------- 61
26.6
11.7
3
Pellagra ------------------------------------------------- 69
0.7
3.4
47
Alcoholism, ethylism ---------------------------- 77
1.7
2.1
28
Diseases of the Heart -------- ---------- 90-95
321.5
178.3
4
Pneumonia, all forms ----------------- -------- 107-109
H.1
47.0
32
InC!uenza ------------------------------------
33
7.7
14.4
43
Diarrhea, enteritis, etc. ---------------------119,120
8.7
12.2
38
Appendicitis ------------------------------------------------ 121
Cirrhosis of the Liver ............
124
5.1 9.5
5.4
28
5.0
7
Nephritis ---------------------------------------------130-132
66.7
88.1
44
Diseases of Pregnancy ................ .............140-150
4.3
7.6
44
Congenital Malformations -------------- 157
12.3
9.5
4
Premature Birth ----------------------- ____
159
24.0
29.0
40
Suicide ------------- _____ .------- ----------- --- ___ .--- _.......16 3,16'1
11.2
6.9
5
Homicide ------------------------------------------------165-168
5.6
15.0
48
Accidental Deaths _ -------------------- ___________ 169-195
72.7
66A
13
Motor-Vehicle Accidents --
170
21.3
22.3
30
Live Births -------------------- -----------------
20.2
25.8
10
Stillbirths ---------------------Infant Mortality -----------
23.9
29.4
43
38.3
42.2
33
White -------------Negro -----------------Maternal Mortality --
35.6
36.2
30
56.2
52.7
13
2.1
3.2
44
Source: National Office of Vital Statistics, Special Reports, Vol. 27, No. 3, July 24, 1947.
Diphtheria. The number of deaths from this disease decreased from 106 to 42 deaths, or a decrease in rate of 62.17 per cent, or a change in death rate from 3.41 in 1938 to 1.29 in 1947.
Influenza. There was a net decrease of 435 deaths from influenza in 1947, or a decrease in rate of 56.12 per cent from the rate of 1938. The rate decreased from 25.87 in 1938 to 11.35 in 1947.
Dysentery. The death rate from this condition showed a decrease of 90.63 per cent, or a decline from 192 deaths in 1938 to 19 deaths in 1947.
Pellagra. The number of deaths decreased from 365 in 1938 to 102 in 1947, or a decrease in rate of 73.23 per cent. The rate was 3.15 in 1947 and 11.77 in 1938.
Information and Statistics
363
Cerebral Hemorrhage, Embolism and ThTombosis. The deaths from this condition increased from 2,727 in 1938 to 3,197 in 1947, or an increase of 12.40 per cent in the annual death rate. The rate in 1938 was 87.97 as compared to 98.88 in 1947.
H ea1t Diseases. This leading cause of death in Georgia, as well as in the nation, continued to increase during 1947 with a rate of 209.68 deaths per 100,000 population as compared to 169.23 in 1938. The 6,779 deaths during 19L17 from this cause was 23.90 per cent higher than the death rate of 1938, when 5,246 deaths were registered. (In 1945, the last year for which national estimates are available, only three states had a death rate lower than Georgia for this disease, with a national rate of 321.5 as compared to 178.3 death rate for Georgia.)
Pneumonia,. Pneumonia deaths, which in recent years have shown a steady decline, decreased 54.57 per cent during 1947 with the rate of 40.02 as compared to 88.10 for 1938.
Diarrhea and Enteritis (-2 years). The number of deaths from this condition decreased from 691 in 1938 to 119 in 1947. The rate decreased from 22.29 in 1938 to 3.68 in 1947, or 83.49 per cent decrease.
Appendicitis. The number of deaths from Appendicitis decreased from 287 in 1938 to 126 in 1947. The death rate was 9.25 in 1938 and 3.89 in 1947. This is a decrease of 57.94 per cent.
Poliomyelitis. Only 4 deaths were recorded in 1947, as compared to 18 in 1938, or a decrease of 79.31 per cent in the rate with a death rate of 0.58 per 100,000 population in 1938 to 0.12 in 1947. (In 1945, only three states in the nation had a lower death rate from polio, with a 0.4 rate in Georgia compared to 0.9 national rate.)
Lethargic Encephalitis. Deaths from this disease showed a decrease of 71.87 per cent, or 3 deaths in 1947, as to 10 during 1938.
lV1eningococcus lV1eningit'is. There was a decrease of 4.68 per cent in the death rate from this cause, although there were 20 deaths both in 1938 and in 1947. The decrease in rate is due to an increase in population in 1947. The death rate in 1938 was 0.64 and 0.61 in 1947.
Tuberculosis, all forms. The death rate from Tuberculosis decreased from 52.00 in 1938 to 33.21 per 100,000 population in 1947, or a rate decrease of 36.13 per cent and a net decrease of 538 deaths from the 1,612 deaths recorded in 1938.
Syphilis. A decrease of 35.47 per cent in the syphilis death rate was recorded with 478 deaths in 1938 and 322 in 1947. The death rate per 100,000 in 1938 was 15.42 and 9.95 in 1947.
Cancer. 2,680 deaths or 751 more deaths than in 1938 were reported for cancer in 1947, and the death rate increased from 62.23 to 82.89, or an increase of 33.19 per cent over the 1938 rate.
364
Geor-gia Depa1tment of Public Health
Diabetes Mellitus. The death rate from this disease is on the upward trend with 448 deaths reported in 1947, compared to 420 for 1938, or an increase of 2.28 per cent in the death rate.
Cir-'rhosis of the Live1. Deaths from this cause increased from 141 deaths in 1938 to 210 in 1947, resulting in 42.95 per cent increase in the rate.
Nephritis. The number of deaths in 1938 was 3,531 as compared to 2,563 in 1947. The death rate decreased from 113.91 in 1938 to 79.27 in 1947, or a 30.40 per cent decrease.
Malfor-mation and Ear-ly Infancy Diseases. Death from these causes decreased from 2,431 deaths in 1938 to 1,990 deaths in 1947, or a elecrease 0f 21.51 per cent in death rate.
Suicide. Suicides decreased from 295 in 1938 to 233 in 1947, or a death rate decrease of 2L1.29 per cent. The suicide rate in 1938 was 9.51 and 7.20 in 1947.
Homicide. The homicide rate decreased 17.63 per cent during 1947, with 582 deaths reported in 1938 and 500 in 1947. In 1945, Georgia had the highest homicide rate in the United States with a rate of 15.0, as compared to the national rate of 5.6. The Georgia rate in 1947 was 15.46 as compared to a 18.77 rate in 1938.
M oto1'-Vehicle Accidents. The death rate decreased from 25.43 in 1938 to 24.86 in 1947, or a rate decrease of 2.24 per cent. 804 lives were lost due to Motor-Vehicles in 1947 as compared to 789 in 1938. The decrease in rate is due to an increased population in 1947.
All Othe1' Accidents. Deaths from other accidents declined from 1,336 deaths in 1938 to 1,306 deaths during 1947, or a decrease of 6.33 per cent in the rate from that of 1938. The 1938 death rate was 43.12 as compared to 40.39 in 1947.
Unknown and Ill-Defined Cc6~tses. The death rate from illdefined causes dropped 4.73 per cent, or from 29.38 in 1938 to 27.99 in 1947.
All Other- Causes. Deaths from all other causes decreased 35.90 per cent, or from 168.94 in 1938 to 108.28 in 1947. The number of deaths decreased from 5,237 in 1938 to 3,502 in 1947.
Information and Statistics
365
TABLE I
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, LIVE BIRTHS AND RATES PER 1,000
POPULATION, STILLBIRTHS, INFANT ANP MATERNAL
MORTALITY WITH RATES PER 1,000 LIVE BIRTHS, BY COLOR, IN GEORGIA FOR THE YEAR 1947
AND THE PERCENT CHANGE IN THE
RATES: 1938-1947
CAUSE OF DEATH
NUMBER
RATE
PERCENT CHANGE IN THE RATES: 19381947
Total White Colored Total White Colored Total White Colored
ALL CAUSES .......... 28,780 17,022 11,758
Typhoid and Par-
typhoid Fever ............
9
4
5
Typhus Fever ................ 31
17
14
llfalaria ............................ 13
9
4
Smallpox ........................
Measles ............................ 17
11
6
Scarlet Fever
1
1
Whooping Cough ........ 95
37
58
Diphtheria ..................... . 42
32
10
Influenza ...................... 367
163
204
Dysentery ...................... 19
8
11
Poliomyelitis ..................
4
2
2
Lethargic Encephalitis ..
3
1
2
Menin?oc?c:cus
Meningitis ------------------ 20
11
9
Tuberculosis, all forms 1,074 415 659
Syphilis .......................... 322
61 261
Gonorrhea ------------------------
5
1
4
Cancer ... .. .................... 2,680 1,938 742
Diabetes Mellitus ........ 448
311
137
Pellagra .......................... 102
65
37
Cerebral Hemorrbag~?,
Embolism
and Thrombosis .... 3,197 1,691 1,506
Heart Diseases .............. 6,779 4,495 2,284
Pneumonia ...................... 1,294
615
679
Diarrhea and Enteritis,
under 2 Yrs. ................ 119
55
64
Appendicitis
126
68
58
Cirrhosis of Liver ........ 210 157
53
Nephritis ........................ 2,563 1,484 1,079
Malformation and Early
Infancy Diseases
1,990 1,298 692
Suicide ------------------- .......... 233
212
21
Homicide ........................ 500 126 374
Motor-vehicle
Accidents .................. 804
605
199
All Other Accidents .... 1,306 794 512
Unknown and IJJ.
defined Causes ........ 905
318
587
All Other Causes ........ 3,502 2,017 1,485
890.2 795.7 1075.1 -17.9 -12.9 -22.5
0.3
0.2
0.5 -93.1 -93.0 -92.8
1.0
0.8
1.3 -37.1 -52.4 + 2.4
0.4
0.4
0.4 -91.5 -86.8 -95.1
0.5 0.03
2.9 1.3 11.4
0.6 0.1
0.1
o.5 0.04 1.7
1.5 7.6
0.4 0.1
0.04
o.5 -89:7 -91.4 -81.5 -92.7 -92.7
5.3 -59.6 -69.6 -47.5
0.9 -62.2 -60.1 -68.2 18.7 -56.1 -61.6 -49.0
1.0 -90.6 -93.1 -86.8 0.2 -79.3 -86.2 -59.1
0.2 -71.9 -86.7 -48.6
0.6
0.5
0.8 - 4.7 -32.0 + 86.4
33.2 19.4 60.3 -36.1 -36.2 -33.3
10.0
2.9 23.9 -35.5 -26.5 -33.4
0.2
0.04 0.4 -77.6 -73.3 -77.5
82.9 90.6 67.8 + 33.2 + 33.7 +29.5
13.9 14.5 12.5 + 2.3 - 7.4 + 28.5
3.2
3.0
3.4 -73.2 -64.6 -80.6
98.9 209.7
40.0
3.7 3.9 6.5 79.3
61.6 7.2 15.5
24.9 40.4
28.0 108.3
79.0 210.1
28.7
2.6 3.2 7.3 69.4
60.7 9.9 5.9
23.3 37.1
14.9 94.3
137.7 + 12.4 + 6.9 + 22.0 208.8 + 23.9 + 36.1 + 6.8
62.1 -54.6 -56.9 -50.8
5.9 -83.5 -86.8 -78.6 5.3 -57.9 -67.6 -36.2
4.8 + 43.0 + 45.4 + 32.2
98.7 -30.4 -31.1 -28.1
63.3 -21.5 - 6.7 -38.0 1.9 -24.3 -26.2 -25.9 34.2 -17.6 -11.0 -15.2
18.2 - 2.2 + 2.9 -16.6 46.8 - 6.3 - 3.8 - 8.5
53.7 - 4.7 + 7.5 - 5.8
135.8 -35.9 -33.7 -37.2
Live Births .................. 94,311 62,394 31,917
Stillbirths ........................ 2,457 1,174 1,283
Infant Mortality ............ 3,239 1,771 1,468
Maternal Mortality ...... 247
107
140
29.2 26.1 34.3 2.6
29.2 18.8 28.4 1.7
29.2 +40.6 +49.7 +27.0 40.2 -50.6 -47.6 -48.5 46.0 -49.3 -51.7 -43.3 4.4 -60.1 -66.6 -49.5
Note: These figures exclude non-residents of Georgia and include births and deaths of Georgia residents occurring in other states.
1947 rates based on the estimated population as of July 1, 1947.
366
Georgia Department of Public Health
TABLE II
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: 1938
CAUSE OF DEATH
NUMBER
RATE
Total
White Colored Total White Colored
ALL CAUSES .................................... Typhoid and Paratyphoid Fever............
'J:'yphus Fever ----- Malal"ia ........................................................ Smallpox .................................................... Measles ........................................................ Scarlet Fever ............................................ Whooping Cough ....................................
Diphtheria -------- Influenza ---------------------------------------------------Dysentery .................................................... Poliomyelitis ..............................................
Lethargic Encephalitis ------------------------Meningococcus Meningitis .................... Tuberculosis, all forms .......................... Syphilis ...................................................... Gonorrhea ..................................................
Canyer ---------------- Diabetes Mellitus ...................................... Pellagra ...................................................... Cerebral Hemorrhage, Embolism
and Thrombosis -----------------------------------Heart Diseases ..........................................
Pneumonia ----------------------------------------------Diarrhea and Enteritis, under 2 Yrs. Appendicitis .............................................. Cirrhosis of Liver .................................... Nephritis .................................................... Malformation and Early Infancy
Diseases .................................................. Suicide ........................................................ Homicide .................................................... Motor-vehicle Accidents ........................ All Other Accidents ................................ Unknown and Ill-defined Causes ........
All 0 ther Causes --------
334ii
47 146
157 13
225 106 802 192
18 10 20 1,612 478 21 1,929 420 365
2,727 5,246 2,731
691 287 141 3,531
2;131 295 582 789
1,336 911
5,237
LIVE BiliTHS ........................................ 64,307 STILLBIRTHS ........................................ 3,390 INFANT MORTALITY .......................... 4,352 MATERNAL MORTALITY ................ 421
18,109 51 33 63
118 11
112 71 393 107 13
6 15 602 77
3 1,343
311 170
1,465 3,059 1,321
385 194 100 1,996
1,289 266 131 545 764 274
2,818
38,613 1,386 2,267 198
15,508 70 14 83
39 2
113 82 409 85
5 4 5 1,010 401 18 586 109 195
1,262 2,187 1,410
306 93 41
1,535
1,142 29
451 241 572 637 2,419
25,694 2,004 2,085 223
1081.5 3.9 1.5 4.7
5.1 0.4 7.3 3.4 25.9 6.2 0.6 0.3 0.6 52.0 15.4 0.7 62.2 13.5 11.8
88.0 169.2
88.1 22.3
9.3 4.5 113.9
78.4 9.5
18.8 25.4 43.1 29.4 168.9
20.7 52.7 67.7
6.5
91'1.0 2.6 1.7 3.2
6.0 0.6 5.7 3.7 19.8 5.4 0.7 0.3 0.8 30.4 3.9 0.2 67.8 15.7 8.6
73.9 154.4
66.7 19.4
9.8 5.0 100.7
65.1 13.4
6.6 27.5 38.6 13.8 142.2
19.5 35.9 58.7
5.1'
1386.7 6.2 1.3 7.4
3.5 0.2 10.1 2.9 36.6 7.6 0.4 OA 0.4 90.3 35.9 1.6 52.4 9.7 17A
112.8 195.6 126.1 27.4
8.3 3.7 137.3
102.1 2.6
40.3 21.8 51.2 57.0 216.3
23.0 78.0 81.1
8.7
Note: These figures exclude non-residents of Georgia and include births and deaths of Georgia residents occur1ing in other states.
Rates based on the estimated population as of July 1, 1938.
TABLE III
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, IN GEORGIA FOR THE YEARS: 1850, 1860, 1870, 1880, 1890, 1900, 1920, 1930, 1940, 1947
CAUSE OF DEATH
1850
ALL CAUSES ........................................ Typhoid and Paratyphoid Fever ......................... Malaria ............................... Smallpox ............................ Measles .............................................................. . Scarlet Fever ............................................. Whooping Cough Diphtheria ........................................................ Dysentery, Diarrhea and Enteritis ................ Diabetes Mellitus .................................................... Tuberculosis, all forms ......................... Cancer ...................................................................... Pneumonia ........................................................ ---
Heart Diseases ---------- Accidents Suicide ........................................................................ Homicide .................................................................. AI! Other Causes ....................................................
9,896 557 185
74
202 385 344 654
6 379
60 651 603 569
14 23 5,190
1860
12,755 887 568 8 47 217 334 440
1,061 14
550 81
1,268 723 943 20 20
5,574
1870
13,051 772 705 18 270 12 92 417
1,414 10
996 131 1,363 274 786
14 116 5,661
NUMBER OF DEATHS
1880
1890
1900
20,777 987
1,060
2 496
31 650 1,309 2,011 24 1,882
240 1,685 1,451
1,088
28 63 7,770
20,424 1,000
937
440 8
89 553 2,353 24 2,324 293 1,738 1,405 1,143 29 94 7,984
26,941
1,766 1,226
46
201 44
222
819 2.235
49 2,830
382 2,598
2,127 1,382
48 178
10,788
1920
32,243 549 559 3 61 32 373 401
1,725 182
2,362 1,124 2,766 1,892 1,603
128 479 18,004
1930
35,188 500 442
128 38
257 135 1,347 352 2,175 1,552 2,580 4,099 1,992 296 569 18,726
1940
32,285 68 89
23 16 108 59 693 349 1,533 1,959 2,055 6,176 2,057 282 616 16,202
~
0
"'l
~
1947 28,780
~
;0"<;-":<-
9
13
17 1
~
95 42
V:l
<-<-
195 ~
448
1,074 2,680 1,294
"""<-"<-
""<-<-
~
"" 6,779
2,110
233
500
13,290
~ ~
-::J
~ ~
00
RATES PER 100,000 POPULATION
1850
ALL CAUSES ...................................................... Typhoid and Paratyphoid Fever ---------- Malaria Smallpox
MSceaal's!leets Fever....-..-...........-.-.-..........-..-..-.-.-.-.-..-.-.-.-.-..-.-.-.-.-..-.......-.-. Whooping Cough
Diphtheria ------------------- Dysentery, Diarrhea and Enteritis .................... Diabetes Mellitus ------------------------------------------Tuberculosis, all forms Cancer ........................................................................ Pneumonia ..... Heart Diseases Accidents
Suicide -------------------------------------------- Homicide ....................................................................
All Other Causes ---------------
1092.1 61.5 20.4
8.2 22.3 42.5 38.0 72.2
0.7 41.8
6.6 71.8 66.5 62.8
1.5 2.5 572.7
1860
1206.4 83.9 53.7 0.8 4.5 20.5 31.6 41.6
100.4 1.3
52.0 7.7
119.9 68.4 89.2
1.9 1.9 527.2
1870
1102.2 65.2 59.5 1.5 22.8 1.0 7.8 35.2
119.4 0.8
84.1 11.1 115.1 23.1 66.4
1.2 9.8 478.1
1880
1347.2 64.0 68.7 0.1 32.2 2.0 42.1 84.9
130.4 1.6
122.0 15.6
109.3 94.1 70.5 1.8 4.1
503.8
1890
1111.6 54.4 51.0
24.0 0.4 4.8
30.1 128.1
1.9 126.5
16.0 94.6 76.5 62.2
1.6 5.1 434.5
1900
1219.1 79.9 55.5 2.1 9.1 2.0 10.0 37.1
101.1 2.2
128.1 17.3
117.6 96.2 62.5 2.2 8.1
488.2
1920
1113.2 19.0 19.3 0.1 2.1 1.1 12.9 13.8 59.6 6.3 81.6 38.8 95.5 65.3 55.3 4.4 16.5
621.6
1930
1207.4. 17.2 15.2
4.4 1.3 8.8 4.6 46.2 12.1 74.6 53.3 88.5 140.6 68.4 10.2 19.5 642.6
NOTE: Figures for the year 1910 not available. SOURCE OF DATA: 7, 8, 9, 10, 11 and 12th Census of the United States-Vital Statistics 1850-1900
Vital Statistics Annual Report of the Georgia Department of Public Health: 1920, 1930, 1940 and 1947
1940
1033.5 '\2.2 2.8
0.7 0.5 3.5 1.9 22.2 11.2 49.1 62.7 65.8 197.7 65.9 9.0 19.7 518.7
~
('>
0
""' 1947
'Q
~.
~
890.2 0.3
b
0.4
('>
"(:3
0.5
~
0.03 2.9
1.3 6.0
~""'
:(;'>s
""' 13.9
33.2
82.9 40.0
..0....
209.7
65.3 7.2
~
15.5 411.1
:0::-":
C':>
1:!::
('>
.
<""::'-
Infor-mation and Statistics
369
TABLE 4
DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS, ILLEGITIMATE BIRTHS (EXCLUSIVE OF STILLBIRTHS) AND
STILLBIRTHS WITH RATES PER 1,000 LIVE BIRTHS, IN GEORGIA, 1920-1947
INFANT MORTALITY
NUMBER
RATE
Year Total White Col. Total White Col.
1920 1921 1922 1923 192<1
1925 1926
1927 1928 1929
1930 1931 1932
1933 1934 19S5
1936 1937 1938
1939 1940 1941
1942 19<13
1914 19<15
1916 1947
5305
4905
'1937 5384 5674 470<1
4<105 4578 4875 4464 <1713
4234
4097 4079 2628 4316
4319 3968 4352 3817
3737 3955 3559
3661 3398 3181 3068 3239
2961 2606 2509
2938 2989 2486
2299 233<1 257<!
2343 2<168
2137 2122
2119 2651 2227 2114
2014 2267 1960
1851 1988
1756 1911 1761 1728 1694
1771
23<!4 2299 2428
24-16 2685
2218
2106 22<14
2301 2121 2245
2097 1975 1960 2458 2089
2205 1954 2085 1857
1886 1967
1803 1750 1637 1453
137'1 1468
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 <19.3
46.7 44.1
42.4 35.8 34.3
71.1 58.5 59.1
58 A 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 28.4
127.1 105.3
107.'1 108.3
122.0 103.9 115.3
97.7 10<!.0
93.1 96.5 86.5 77.5
78.2 93.5 80.5 87.2
75.6 81.1
71.5 73.1 7'1.2 66.8 62.1 59.4
52.7 46.8 46.0
MATERNAL MORTALITY
NUMBER
RATE
Total White Col. Total White Col.
558 267 291 9.3 6.4 15.8
568 266 302 8.6 6.0 13.8
658 316 342 10.1 7.4 15.1
573 288 285 9.0 7.0 12.6
708 362 346 11.2 8.7 15.7
6<!1 299 3<12 10.8 7.8 16.0
485 222 263 9.6 6.9 14.4
578 291 287 9.3 7.4 12.5
622 312 310 10.3 8.2 14.0
5<19 284 265 9.4 7.9 11.6
658 361 297 10.9 9.7 12.8
616 322 294 10.0 8.6 12.1
620 310 310 9.7 8.1 12.2
463 227 236 7.6 6.4
9.'1
505 262 243 7.8 6.8
9.2
458 230 228 7.2 6 9
8.8
491 251 240 8.0 6.9
9.5
471 240 231 7.4 6.3
8.9
421 198 223 6.5 5.1
8.7
356 175 181 5.5 <!.5
7.0
342 146 196 5.3 3.8
7.6
315 133 182 <!.6 3.2
6.9
299 146 153 <!.1 3.2
5.7
303 150 153 3.9 3.0
5.4
276 122 154 3.6 2.5
5.6
250 102 148 3.3 2.2
5.4
229
85 1<!4 2.7 1.5
4.9
247 107 140 2.6 1.7
4A
ILLEGITIMATE BIRTHS
NUMBER
RATE
Year Total White Col. Total White Col.
1920
1921 1922
1923 1924
19~5
1926 1927 1928
1929
1930 1931
1932 1933 1934 1935
1936 1937
1938 1939 19!0 1941
1942 1943 1944 1945
1946 1947
2695 474 2221 44.9 11.4 120.4
3077 516 2561 46.4 11.6 117.4 3606 500 3106 55.4 11.8 137.4 4045 5<13 3502 63.5 13.2 155.0 4089 57<! 3515 64.5 13.9 159.7 401<1 53<! 3480 67.3 14.0 163.0 3155 <161 2694 62.5 14.3 147.5
4089 637 3452 65.7 16.2 150.3 3868 482 3386 6<!.2 12.6 153.0 4061 515 3546 69.4 14.4 155.7
4141 512 3629 68.7 13.8 156.1 4429 5<17 3882 71.7 14.6 160.1 5125 600 4525 80.5 15.7 177.6
5101 582 4519 84.0 16.3 180.4 5089 651 4438 78.8 17.0 168.9 5031 643 4388 79.5 17.2 169.1
4878 598 4280 79.2 16.5 169.2 4739 526 4213 74.0 13.8 163.1 472<1 580 414<1 73.5 15.0 161.3
4960 596 4364 76.4 15.3 167.9 5046 565 4<181 78.0 14.5 173.8
5134 607 4527 75.7 14.7 170.8 5038 578 <1460 69.8 12.8 165.2 4911 537 437<1 62.7 10.7 155.2
4885 592 4293 63.4 12.0 155.8 5385 721 466<1 71.8 15.2 169.2 5289 681 4608 61.7 12.1 157.0
6056 744 5312 64.2 11.9 166.4
STILLBIRTHS
NUMBER
RATE
Total White Col. Total White Col.
3389 3820 3862
3958 3864 3455 2972
3836 3478 3541
3796 3678 3847
3700 4120
3987 3666
3677 3390 3228
3078 2903 2786 266<1
2523 2208
2421 2459
1608
1720 1716 1802 1675
1435 1246 1604
1335 1374
1<151 1424 1492
1382 1673
1532 1457
H99 1386 1337
1326 1276 1268
1238 1137 1036
1161 117<1
1781 2100 2146
2156 2189 2020
1726 2232
21<13 2167 2342
225<1 2355
2318 24<17
2455
2209 2178 2004
1891 1752
1627 1518 1426
1386 1172 1260
1283
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 A 52.7
49.7 47.6 42.8
38.6 34.0
32.8 29.4
28.3 26.1
38.6 38.6
40.4 43.9 40.5
37.5 38.7 40.8
35.0
38.4 39.2 37.9
39.0 38.7 43.6 41.0
40.1 39.3
35.9 34.3
34.1 30.9 28.1
24.7
23.0 21.8 20.6
18.8
96.6 96.2 9'1.9 95.4 99.5 9<!.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 40.2
370
Georgia De]Jartment of Public Health
TABLE 4 (continued)
DEATHS AND BIRTHS (EXCLUSIVE OF STILLBIRTHS) AND RATES
PER 1,000 POPULATION, IN GEORGIA: 1920-1947
Year
BIRTHS
NUMBER
RATE
Total White Col. Total White Col.
DEATHS
NUMBER
RATE
Total White Col. Total White Col.
1920
1921 1922 1923 1921
1925 1926 1927 1928
1929 1930 1931
1932 1933
1934 1935 1936
1937 1938 1939 1940 19<ll
1942
1943 1944 1945
1946 1947
60061
66378 65082 63681 63386
59610 50493
62246 60259 58521 60318
61774 63690
6074<1 64615 63290
6HH7 64012 64307
64910 6-169f>
67785
72189 78327 77018 74994
85699 94311
41618 44555 <12.475 41088 41379
38254 32226 39281
38135 35751 37064
37531 38209 35692
38333 37345 30320 38181
38613 38923
~8911
41277 45192 50149 4946<1
47422 56354
62394
18<143
21823 22607 22593 22007 21356
18267 22965 22124
22770 23254 24243 25481 25052
26282 25945
25297 25831 25694 25987
25784 26508
26997 28178 27554 27572
29345 31917
20.7 22.9 22.5 22.0
21.8 20.5 17A
21.4 20.7 20.1 20.7
21.0 21.5 20A
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 29.2
24.5 26.0 24.6 23.6 23.6 21.6 18.1
21.9 21.0 19.6 20.1
20.4 20.4 18.8 20.1
19.4 18.7 19.4 19.5
19.5 19.1 20.1
22.2 24.6 24.3
23.3 27.6 29.2
15.4
18.4
19.3 19.5 19.2 18.8
16.3 20.7 20.2 21.1 21.7
22.5 23.5 23.0 24.0
23.6 22.9 23.2 23.0
23.1 23.8 24A
24.9 26.0 25.4
25.4 27.0 29.2
32243 29552 31714
84082 34797 31278 29906 31869
36085 35340
35188 32989 32122 3118<1 35590
34313
37293 34411
33617 r:I8S6
32285 :;1570
28807 29488
2880~
28456
27405 28780
17212
15<139 16540 17763
17750 15860 151<]1
16230 18642 18245 18036
17012 16813 168-17
19157 18677 20156
18493 18109 17486
17313 16717 15820 16414
16118 16310 16160
17022
15031 1<1113 15174
16319 17047 15418 11765
15639 17443 17095 17152 15977 15309
14337 16<133
15636 17137 15918 15508
14370 14972 14862 12987 13074
12685 12146 1124 5 11758
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 8.9
10.1
9.0 9.6 10.2 10.1
9.0 8.5 9.0 10.3 10.0 9.8
9.2 9.0
8.9 10.0
9.7
lOA 9.4 9.1
8. 7 8.5 8.1 7.8 8.1
7.9 8.0 7.9 8.0
12.5 11.9 12.9
14.1
14.9 13.6
13.2 14.1 15.9 15.8 16.0
14.8 14.1 13.2 15.0
14.2 15.5 14.3 13.9 12.8
13.8 13.7 12.0 12.0 11.7
11.2 10.4 10.8
TYPHOID
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
1947
549 27<1 275 19.0 16.2 22.9
798 351 447 27.5 20.5 37.7
714 326 388 24.6 18.9 33.1
601 244 357 20.7 14.0 30.8
681 292 389 23.5 16.7 33.9
675 264 411 23.3 14.9 36.2
519 181 328 17.9 10.7 29.3
653 285 368 22.5 15.9 33.2
4<14 182 262 15.3 10.0 23.9
340 140 200 11.7 7.7 18.5
500 207 293 17.2 11.2 27.3
513 201 312 17.5 10.8 28.9
363 133 230 12.3 7.1 21.2
251 105 146
8.4 5.5 13.4
316 110 206 10.5 5.8 18.8
261 100 161
8.6 5.2 14.6
195
68 127
6.4 3.5 11.5
139
54
85
4.5 2.7 7.6
121
51
70
3.9 2.6 6.2
83
38
45
2.7 1.9 4.0
68
27
41
2.2 1.3 3.8
55
22
33
1.7 1.1 3.0
24
6
18
0.8 0.3 1.7
23
8
15
0.7 0.4 1.4
24
9
15
0.8 0.4 1.4
27
11
16
0.9 0.5 1.5
11
6
5
0.4 0.3 0.5
9
4
5
0.3 0.2 0.5
TYPHUS FEVER
NUMBER
RATE
Total White Col. Total White Col.
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.2
0.03 0.1
10
8
2
0.3
0.5
0.2
6
2
4
0.2
0.1
0.4
1
1
0.03
0.1
9
8
1
0.3
0.4
0.1
7
5
2
0.2
0.3
0.2
8
4
4
0.3
0.2
0.4
29
26
3
1.0
1.4
0.3
28
21
7
0.9
1.1
0.6
28
23
5
0.9
1.2
0.5
44
35
9
1.4
1.8
0.8
54
43
11
1.8
2.2
1.0
<17
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
31
17
14
1.0
0.8
1.3
Information and Statistics
371
TABLE 4 (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1947
Year
MALARIA
NUMBER
RATE
Total White Col. Total White Col.
MEASLES
NUMBER
RATE
Total White Col. Total White Col.
1920
1921 1922 1923 1924 1925 1926 1927 1928 1929 1930
1931 1932
1933
1934 1935 1936 1937 1938 1939 1940 1941 1942 1943
1914 1945 1946 1917
559 2!2 317 19.3 H.3 26.'!
61
41
20
2.1
2A
1.7
<!68 195 273 16.2 11.4 23.0
93
66
27
3.2
3.9
2.3
584 256 328 20.2 14.8 27.9
5
3
0.2
0.1
0.3
489 201 288 16.9 11.6 24.8 3!7 252
95 12.0 14.5
8.2
4<10 181 259 15.2 10.3 22.6 550 359 191 19.0 20.5 16.7
285 102 183
9.8 5.8 16.1
11
4
7
OA
0.2
0.6
288 107 181
9.9 6.0 16.2
58
43
15
2.0
2.4
1.3
296 113 183 10.2 6.3 16.5 105
79
26
3.6
4.4
2.4
582 253 329 20.0 14.0 30.1 143 106
37
4.9
5.9
3.4
677
322 355 23.3 17.6 32.8
:n
26
5
1.1
1.4
0.5
<!42 186 256 15.2 10.1 23.9 128
94
3!
4.4
5.1
3.2
307 119 188 10.5 6.5 17.4
62
37
25
2.1
2.0
2.3
316 136 180 10.7 7.2 16.6
15
6
9
0.5
0.3
0.8
364
193 171 12.2 10.2 15.7
72
50
22
2.4
2.6
2.0
418 212 206 13.9 11.1 18.8 540 401 139 18.0 21.0 12.7
387 186 211 12.8 9.1 19.2
25
15
10
0.8
0.8
0.9
606 321 285 19.8 16.5 25.7
g
5
3
0.3
0.3
0.3
235 113 122
7.6 5.8 11.0
10
8
2
0.3
OA
0.2
1<!6
63
83
<!.7 3.2 7A 157 118
39
5.1
6.0
3.5
101
<!0
61
3.2 2.0 5A
51
24
27
1.6
1.2
2.4
89
35
54
2.8 1.7 5.0
23
H
9
0.7
0.7
0.8
75
29
46
2.4 1.4 4.2 157
94
63
5.0
4.6
5.8
76
24
52
2.4 1.2 4.8
60
23
37
1.9
1.1
3.4
37
15
22
1.2 0.7 2.0
27
20
7
0.9
1.0
0.6
34
12
22
1.1 0.6 2.0
68
<!9
19
2.2
2A
1.8
26
12
H
0.8 0.6 1.3
7
3
4
0.2
0.1
0.4
12
6
6
0.4 0.3 0.6
44
20
21
1.4
1.0
2.2
13
9
<l
OA OA 0.4
17
11
6
0.5
0.5
0.5
SCARLET FEVER
NUMBER
RATE
Year Total White Col. Total White Col.
WHOOPING COUGH
NUMBER
RATE
Total White Col. Total White Col.
1920 1921
1922 1923 1924 1925
1926
1927 1928 1929
1930 1931
1932 1933 193<!
1935
1936 1937
1938 1939
1940 19!1 1942 1943 1944
1945 1946 1947
32
31
1
28
25
3
24
20
4
20
17
3
20
16
4
11
8
3
13
12
1
25
20
5
36
29
40
33
38
33
5
46
38
8
19
17
2
19
19
17
16
1
23
21
2
1<1
11
3
11
10
1
13
11
2
19
16
3
16
15
1
9
8
1
2
2
6
5
1
2
1
1
5
<l
1
1
1
1
1
1.1 1.8 0.1 373 240 133 12.9 14.2 11.1
1.0 1.5 0.3 183
93
90
6.3
5A
7.6
0.8 1.2 0.3 130
51
79
4.5
3.0
6.7
0.7 1.0 0.3 25! 116 138
8.8
6.7 11.9
0.7 0.9 0.4 435 203 232 15.0 11.6 20.2
OA 0.5 0.3 313 167 146 10.8
9A 12.9
0.5 0.7 0.1 141
74
67
4.9
4.2
6.0
0.9 1.1 0.5 229 118 111
7.9
6.6 10.0
1.2 1.6 0.6 163
99
64
5.6
5.5
5.9
1.4 1.8 0.6 280 171 109
9.6
9.4 10.1
1.3 1.8 0.5 257 121 136
8.8
6.6 12.7
1.6 2.0 0.7 113
59
54
3.8
3.2
5.0
0.6 0.9 0.2 112
52
60
3.8
2.8
5.5
0.6 1.0
223 116 107
7.5
6.1
9.8
0.6 0.8 0.1 33! 169 165 11.1
8.8 15.1
0.8 1.1 0.2 149
77
72
4.9
4.0
6.5
0.5 0.6 0.3
67
30
37
2.2
1.5
3.3
0.4 0.5 0.1 142
75
67
'!.6
3.8
6.0
0.4 0.6 0.2 225 112 113
7.3
5.7 10.1
0.6 0.8 0.3 134
61
73
4.3
3.1
6.5
0.5 0.7 0.1 108
52
56
3.5
2.6
5.2
0.3 0.4 0.1 140
69
71
4.5
3.4
6.5
0.1 0.1
101
35
6(i
3.2
1.7
6.1
0.2 0.2 0.1 170
76
94
5.4
3.7
8.7
0.1 0.0 0.1
65
25
40
2.1
1.2
3.7
0.2 0.2 0.1
65
44
21
2.1
2.2
1.9
0.03 0.04
60
28
32
1.9
1.4
2.9
0.03 0.04
95
37
58
2.9
1.7
5.3
372
Georgia Department of Public Health
TABLE 4 (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1947
Year
DIPHTHERIA
NUMBER
RATE
Total White Col. Total White Col.
INFLUENZA
NUMBER
RATE
Total White Col. Total White Col.
1920 401 283 118 13.8 16.7 9.8 2581 1516 1065 89.1 89A 88.7
1921 H5 294 121 14.3 17.2 10.2
278 159 119
9.6
9.3 10.0
1922 411 277 13,1 14.2 16.1 llA 1014 615 399 35.0 35.7 34.0
1923 274 199
75
9.5 llA 6.5 1500 880 620 51.7 50.6 53 A
1924 230 ] 67
63
7.9
9.5 5.5
886 512 374 30.5 29.2 32.6
1925 185 119
66
6A
6.7 5.8 1384 773 611 47.7 43.7 53.9
1926 251 199
52
8.6 11.2 4.6 1493 800 693 51.4 44.9 61.8
1927 272 187
85
9.4 10.4 7.7
971 480 491 33A 26.7 4'1.3
1928 240 177
63
8.3
9.8 5.8 2041 1204 837 70.2 66.5 76.5
1929 183 139
44
6.3
7.6 4.1 2513 1150 1093 87.5 79.4 101.1
1930 135 102
33
4.6
5.5 3.1
964 532 432 33.1 28.9 40.3
1931 158 122
36
5.4
6.6 3.3 1301 703 598 44.3 37.8 55.4
1932 169 139
30
5.7
7.4 2.8 1170 69,1 476 39.5 37.0 43.9
1933 187 152
35
6.3
8.0 3.2 1237 694 543 41.5 36.6 49.8
1934 188 152
36
6.3
8.0 3.3 1009 563 446 33.6 29.5 40.7
1935 161 116
45
5.3
6.0 4.1 1357 781 576 44.8 40.5 52.3
1936 123
83
40
4.0
4.3 3.6 1842 1058 784 60.3 54.4 70.8
1987 108
66
42
3.5
3.4 3.8 1436 739 697 46.7 37.6 62.6
1938 106
74
32
3.4
3.7 2.9
802 393 409 25.9 19.8 36.6
1939
95
65
30
3.0
3.3 2.7
950 495 455 30.4 24.8 40.5
1940
59
,14
15
1.9
2.2 1.4
92,1 503 421 29.6 24.7 38.8
1941
63
36
27
2.0
1.7 2.5
994 483 511 31.6 23.5 47.0
19,12
55
42
13
1.8
2.1 1.2 482 200 282 15.4
9.8 26.0
1943
47
32
15
1.5
1.6 1.4
624 319 305 20.0 15.7 28.1
1944
40
34
6
1.3
1.7 0.6
7,12 342 '100 23.8 16.8 36.9
1945
71
51
20
2.3
2.5 1.8 173 206 267 15.1 10.1 24.6
1946
45
32
13
1.4
1.6 1.2
423 191 232 13.5
9.4 21.4
1947
42
32
10
1.3
1.5 0.9
367 163 204 11.4
7.6 18.7
Year
DYSENTERY
NUMBER
RATE
Total White Col. Total White Col.
TUBERCULOSIS (ALL FORMS)
NUMBER
RATE
Total White Col. Total White Col.
1920
1921 1922 1923
1924 1925 1926
1927 1928 1929
1930 1931
1932 1933
1934 1935 1936 1937 1938
1939 1940
1941 1942 1913 194<1 1945 1946
1947
170 116
54
5.9 6.8 4.5 2362 882 1480 81.6 52.0 123.3
146
88
58
5.0 5.1 4.9 2531 892 1639 87.4 52.1 138.1
112
69
,13
3.9 4.0 3.7 2683 991 1692 92.6 57.4 144.2
151
90
61
5.2 5.2 5.3 2642 965 1677 91.1 55.5 144.5
187 104
83
6.5 5.9 7.2 2620 917 1703 90.3 52.3 148.4
194 119
75
6.7 6.7 6.6 24<18 872 1576 84.4 49.3 139.0
207 129
78
7.1 7.2 7.0 2278 807 1471 78.5 45.3 131.2
277 172 105
9.5 9.6 9.5 2307 798 1509 79.4 44.4 136.2
304 189 115 10.5 10.4 10.5 2375 832 1543 81.7 45.9 141.0
204
99 105
7.0 5A 9.7 2190 742 1448 75.3 40.6 133.9
305 158 147 10.5 8.6 13.7 2175 774 1401 74.6 42.0 130.6
177
R6
91
6.0 4.5 8.4 2165 700 1465 73.7 37.7 135.8
141
85
56
4.8 4.5 5.2 1933 665 1268 65.3 35.4 116.9
153
86
67
5.1 4.5 6.1 1777 675 1102 59.6 35.6 101.1
219 123
96
7.3 6.4 8.8 1772 605 1167 58.9 31.7 106.5
163
86
77
5.4 4.5 7.0 1731 649 1082 67.1 33.6 98.2
156
78
78
5.1 4.0 7.0 1713 o'18 1065 56.1 33.3 96.2
130
67
63
4.2 3.4 5.7 1549 559
990 50.3 28.5 89.0
192 107
85
6.2 5A 7.6 1612 602 1010 52.0 30.4 90.3
127
65
62
4.1 3.3 5.5 1533 543
990 49.1 27.2 88.1
126
67
59
4.0 3.3 5.4 1533 544
989 49.1 26.7 91.2
109
52
57
3.5 2.5 5.2 1385 501
884 44.0 24.3 81.3
86
43
43
2.8 2.1 4.0 1265 465
800 40.5 22.8 73.7
79
42
37
2.5 2.1 3A 1304 499
805 41.7 24.5 74.2
63
2<1
39
2.0 1.2 3.6 1107 418
689 35.4 20.5 63.5
60
28
32
1.9 1.4 2.9 1108 434
674 35.5 21.3 62.1
36
19
17
1.2 0.9 1.6 1048 467
581 33.5 22.9 53.5
19
8
11
0.6 0.4 1.0 1074 415
659 33.2 19A 60.3
Information and Statistics
373
TABLE 4 (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1947
Year
SYPHILIS
NUMBER
RATE
Total White Col. Total White Col.
1920
1921 1922
1923 1924 1925
1926 1927 1928
1929 1930 1931 1932
1933 1934 1935
1936 1937 1938 1939
1940 1941 1912
1943 1944 1945
1946 1917
204 34 170
7.0 2.0 14.2
296 56 240 10.2 3.3 20.2
421 70 351 14.5 4.1 29.9
371 73 298 12.8 4.2 25.7
425 81 344 1'1.7 4.7 30.0
'154 72 382 16.6 4.1 33.7
409 59 350 1'1.1 3.3 31.2
457 65 392 15.7 3.6 35.4
494 100 394 17.0 5.5 36.0
461 82 379 15.9 4.5 35.0
'129 77 352 1'1.7 4.2 32.8
413 54 359 H.1 2.9 33.2
425 73 352 14.4 3.9 32.5
391 57 3M 13.1 3.0 30.6
444 87 357 14.8 4.6 32.6
403 85 318 13.3 4A 28.9
H4 77 367 14.5 4.0 33.2
496 96 ,100 16.1 4.9 35.9
478 77 401 15.4 3.9 35.9
473 61 412 15.1 3.1 36.7
587 127 460 18.8 6.2 42.4
503 110 393 16.0 5.3 36.2
162 97 365 14.8 4.8 33.6
435 102 333 13.9 5.0 30.7
372 98 274 11.9 4.8 25.2
358 76 282 11.5 3.7 26.0
309 59 250
9.9 2.9 23.0
322 61 261 10.0 2.9 23.9
CANCER
NUMBER
RATE
Total White Col. Total White Col.
1124 766 358 38.8 45.2 29.8 1210 803 407 41.8 '16.9 3'1.3 1212 782 430 41.8 45.3 36.6 1263 870 393 43.6 50.0 33.9 1393 913 ,180 '18.0 52.1 'Jl.8 1311 891 420 '15.2 50A 37.0 1257 860 397 '13.3 '18.2 35A 1470 995 '175 50.6 55.4 42.9 1510 1013 497 52.0 55.9 45.4 1456 988 468 50.1 5'1.1 43.3 1552 1105 4'17 53.3 60.0 -11.7 1580 1106 474 53.8 59.5 43.9
1531 1052 479 51.7 56.1 '14.2 1647 1213 434 55.2 6'1.0 39.8 1762 1272 490 58.6 66.5 44.7
1715 1239 476 56.6 64.2 43.2
1751 1239 512 57.3 63.7 46.3
1797 1320 477 58.4 67.2 '12.9 1929 1343 586 62.2 67.8 52.4
2003 1426 577 64.1 71.3 51.3
J959 1380 579 62.7 67.7 53.4
2139 1473 666 68.0 71.6 61.3
2120 1509 611 67.9 74.0 56.3
2097 1547 550 67.1 75.9 50.7 2256 1616 640 72.2 79.3 59.0
24H 1735 706 78.1 85.1 65.0 2420 1731 689 77.5 8'1.9 63.5 2680 1938 7'12 82.9 90.6 67.8
Year
DIABETES MELLITUS
NUMBER
RATE
Total White Col. Total White Col.
PELLAGRA
NUMBER
RATE
Total White Col. Total White Col.
1920 182 139
43
6.3
8.2 3.6 432 210 222 1'1.9 12.4 18.5
1921 202 U4
58
7.0
8.4 4.9 512 23,1 278 17.7 13.7 23A
1922 255 182
73
8.8 10.6 6.2 527. 2-19 278 18.2 14.4 23.7
1923 2,19 182
67
8.6 10.5 5.8 t14J 227 217 15.3 13.1 18.7
1924 247 161
86
8.5
9.2 7.5 337 181 156 11.6 10.3 13.6
1925 234 174
60
8.1
9.8 5.3 366 181 185 12.6 10.2 16.3
1926 223 138
85
7.7
7.7 7.6 425 225 200 14.6 12.6 17.8
1927 259 177
82
8.9
9.9 7.4 617 292 325 21.2 16.3 29.3
1928 329 227 102 11.3 12.5 9.3 846 358 438 29.1 19.8 44.6
1929 302 201 101 10.4 11.0 9.3 871 33'1 537 30.0 18.3 49.7
1930 352 240 112 12.1 13.0 10.4 713 255 458 2<1.5 13.8 42.7
1931 322 224
98 11.0 12.1 9.1 563 192 371 19.2 10.3 3L!A
19S2 343 260
83 11.6 13.9 7.7 492 205 287 16.6 10.9 26.5
1933 349 241 108 11.7 12.7 9.9 421 179 212 14.1
9.5 22.2
193,1 389 275 114 12.9 14.'1 10.4 351 163 188 11.7
8.5 17.2
1935 388 297
91 12.8 15.4 8.3 365 190 175 12.0
9.9 15.9
1936 391 299
92 12.8 15.4 8.3 391 184 207 12.8
9.5 18.7
1937 392 281 111 12.7 14.3 10.0 370 175 195 12.0
8.9 17.5
1938 420 311 109 13.5 15.7 9.7 365 170 195 11.8
8.6 17A
1939 368 247 121 11.8 12.'1 10.8 271 13'1 137
8.7
6.7 12.2
1940 349 258
91 11.2 12.7 SA 235 1]8 117
7.5
5.8 10.8
19<11 376 278
98 12.0 13.5 9.0 204 106
98
6.5
5.1
9.0
1942 370 275
95 11.8 13.5 8.8 181 104
77
5.8
5.1
7.1
1943 430 325 105 13.8 15.9 9.7 175
89
86
5.6
4.4
7.9
1944 375 249 126 12.0 12.2 11.6 131
74
57
4.2
3.6
5.3
1945 380 289
91 12.2 14.2 8.4 106
77
29
3.4
3.8
2.7
1946 395 281 114 12.6 13.8 10.5 93
67
26
3.0
3.3
2A
1947 448 311 137 13.9 14.5 12.5 102
65
37
3.2
3.0
3.'1
374
Georgia Department of Public Health
TABLE 4 (continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1947
Year
CE;REBRAL HEMORRHAGE
NUMBER
RATE
Total White Col. Total White Col.
HEART DISEASE
NUMBER
RATE
Total White Col. Total White Col.
1920
1921 1922
1923 1924
1925
1926 1927 1928 1929
1930 1931 1932
1933 193<1
1935 1936 1937 1938
1939 19<10
1941
1942 1943 19<1<1 19,15
1946 1947
1336 14,19
1563
172'1 1766
1995 2006
2171 2394 2299
2523 2340 2382 2159
2310 2410
2638 2636 2727 3048 3035
3033 2873
2945 2974
3137 2819 3197
807
839 887 1002
963 10<1<1 1078 1195
1297 1257 1317
1256 1269
1195 1222 1337 1<125 1<1,14
V165 1598
1574 1513 1538 1<169
1523 1655
1523 1691
529 "16.1 610 50.0 676 53.9 722 59.5 803 60.9 951 68.7 928 69.1 976 74.7 1097 82.4 10,12 79.1 1206 86.6 108,1 79.7 1113 80.5
964 . 72.4 1088 76.8 1073 79.5 1213 86.4
1192 85.7 1262 88.0 1<150 97.6 1461 97.2
1520 96A 1335 92.0 1476 9'1.3 1<151 95.2 1482 100.4 1296 90.2
1506 98.9
<17.6 49.0 51 A 57.6 5<1.9
59.0 60.5
66.5 71.6 68.8 71.5
67.6
67.6 63.1 63.9
69.3 73.2 73.5 73.9 79.9 77.2
73.5 75.5 72.1
74.7 81.2
7<1.7 79.0
,1,1.1
51.4 57.6
62.2 70.0 83.9
82.8 88.1 100.2 96.3 112.4
100.5 102.6
88.4
99.3 97A 109.6
107.1 112.8
129.0 13<1.6 139.9
123.0 136.0 133.7
136.5 119.4
137.7
1892 1768 1996 2388
2<124
2297
2'129 2929 3307 3691 1099
3948 <1102
3993 5019 5071 5606 528<1 52,16
5117 6!76
5780 5251
5775 5678 5779 5961
6779
1053 923
1953 1186 1165 1077
1198 1497 1717 1923 2109
2101 2308 2360 2901 2961
3270 3132 3059 32<10 3662
3316 3165
3662 3620 3805
3927 ,1,195
839 8,15
943 1202 1259 1220
1231 1432 1590 1768
1990 1847 1794 1633 2118 2110
2336 2152 2187 2177 25H
2<16'1 2086
2113 2058 1974
2034 228<1
65.3 61.0
68.9 82.3 83.5
79.1 83.7 100.9 113.8 126.9 140.6 13,1.4
138.6 133.8 166.9 167.3
183.6 171.7 169.2 173.5
197.7 183.8
168.1 184.9
181.8 185.0 190.8
209.7
62.1
5'1.0 61.0 68.2
66A 60.9 67.2
83.3 94.8 105.3 114.5
113.0 123.0 12<1.6 151.8 153.5 168.0 159,5
154.4 162.1 179.6
161.1 155.3 179.7
177.6 186.7
192.7 210.1
69.9 71.2 80.3 103.6
109.7 107.6 109.8
129.3
1'15.3 163.5 185.4
171.2 165.5 1<19.8
193.3 191.6 211.0
193.4 195.6 193.7 231.7
226.7 192.2
194.7 189.6
181.9 187.4 208.8
PNEUMONIA
DIARRHEA AND ENTERITIS (Under 2 Years)
NUMBER
RATE
Year Total White Col. Total White Col.
NUMBER
RATE
Total White Col. Total White Col.
1920
1921 1922 1923 1924 1925
1926
1927 1928 1929
1930 1931 1932
1933 1934
1935 1936 1937
1938 1939 1940 19H 19<12 19<13
1944 19,15
1946
1947
2766 H70 1296 95.5 86.7 108.0 1252 759
1925 1050 875 66A 61A 73.7 1230 722
2664 14<17 1217 91.9 83.9 103.7 1175 686
3199 1596 1603 110.3 91.8 138.1 118~ 698
2922 1382 1540 100.7 78.8 134.2 1322 736
2335 1135 1200 80.5 64.2 105.8 9<19 510
2<1<12 1180 1262 . 8<1.1 66.2 112.6 873 462
2132 1015 1117 73A 56.5 100.8 810 HO
2776 VIM 1335 95.5 79.5 122.0 730 43<1
2316 1165 1151 79.6 63.8 106.4 526 292
2580 12,10 1340 88.5 67.4 124.9 721 453
U65 1255 1210 83.9 67.5 112.2 545 291
24<14 1204 1240 82.5 6<1.1 11;1.3 390 25<!
231"1 1172 1V12 77.6 61.9 104.8 493 32<1
3030 1580 1450 100.8 82.7 132.3 651 .378
3035 1572 1463 100.2 81.5 132.9 507 308
3803 2012 1791 124.6 103.4 161.8 549 303
3077 1490 1587 100.0 75.9 142.6 480 2'17
2731 1321 1410 88.1 66.7 126.1 691 385
2299 1209 1090 73.6 60.5 97.0 416 217
2055 1019 1036 65.8 50.0 95.5 395 215
171<1 800 9H 54.5 38.9 84.1 435 218
lfH2 737 875 51.6 36.2 80.6 284 138
173'1 796 938 55.5 39.1 86A 292 132
1581 747 83<1 50.6 36.6 76.8 340 172
1500 713 787 48.0 35.0 72.5 312 159
1M1 68<1 657 42.9 33.6 60.5 148
58
1294 615 679 40.0 28.7 62.1 119
55
493 .
508
"189 <185 586 439 411 370 296 234 268 25,1
136
169 273 199 246 233 306 199 180 217 146 160 168 153
90 64
43.2
"12.5 40.5 40.8 45.6
32.7 30.1
27.9 25.1 18.1 2<1.7 18.6
13.2 16.5
21.7 16.7 18.0
15.6 22.3
13.3 12.6
13.8 9.1
9.3 10.9 10.0
4.7
3.7
44.7 42.2 39.8 <10,1
42.0
28.8
25.9 24.5
24.0 16.0 24.6
15.7 13.5 17.1 19.8
16.0 15.6
12.6 19.4 10.9
10.6 10.6
6.8 6.5
8.4 7.8
2.8 2.6
<11.1
42.8
"11.7 41.8 51.1
38.7 36.7
33.4 27.0 21.6
25.0 23.5 12.5
15.5 2<1.9
18.1
22.2 20.9
27.4 17.7 16.6
20.0 13.5
1'1.7 15.5
14.1
8.3 5.9
Information and Statistics
375
TABLE 4 (continued)
DEATHS' AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1947
APPENDICITIS
NUMBER
RATF
Year Total White Col. Total White Col.
CIRRHOSIS OF LIVER
NUMBER
RATE
Total White Col. Total White Col.
1920 236 152
84
8.2
9.0
7.0
93
61
32
3.2
3.6
2.7
1921 276 190
86
9.5 11.1
7.3
83
52
31
2.9
3.0
2.6
1922 300 208
92 10.4 12.1
7.8 78
43
35
2.7
2.5
3.0
1923 281 183
98
9.7 10.5
8.4
90
54
36
3.1
3.1
3.1
1924 318 210 108 11.0 12.0
9.4
98
69
29
3.4
3.9
2.5
1925 357 212 145 12.3 12.0 12.8 117
77
40
4.0
4.4
3.5
1926 289 178 111 10.0 10.0
9.9
99
62
37
3.4
3.5
3.3
1927 330 211 119 11.4 11.7 10.7 125
75
50
4.3
4.2
4.5
1928 364 236 128 12.5 13.0 11.7 102
61
H
3.5
3A
3.8
1929 330 228 102 11.3 12.5
9.4 128
H
54
!.1
4.1
5.0
1930 333 211 122 11.4 11.5 11.4 134
30
5,1
'1.6
'1.3
5.0
1931 347 23,1 113 11.8 12.6 10.5 124
87
37
1.2
4.7
3.4
1932 358 255 103 12.1 13.6
9.5
91
61
30
3.1
3.3
2.8
1933 323 218 105 10.8 11.5
9.6 116
73
43
3.9
3.9
3.9
193,1 339 226 113 11.3 11.8 10.3 110
73
37
3.7
3.8
3A
1935 300 202
98
9.9 10.5
8.9 142
97
,15
4.7
5.0
4.1
1936 312 201 111 10.2 10.3 10.0 139
87
52
4.6
'1.5
4.7
1937 319 230
89 lOA 11.7
8.0 151
95
56
4.9
4.8
5.0
1938 287 19,1
93
9.3
9.8
8.3 1<!1 100
41
'1.5
5.0
3.7
1939 280 186
9,1
9.0
9.3
8.4 152 111
41
'1.9
5.6
3.6
19'10 276 159 117
8.8
7.8 10.8 145 102
43
4.6
5.0
'1.0
1941 230 135
95
7.3
6.6
8.7 15,1 110
44
'1.9
5.3
4.0
1942 174 102
72
5.6
5.0
6.6 157 123
34
5.0
6.0
3.1
1943 188 118
70
6.0
9.0
6.1 152 104
48
4.9
5.1
4.4
19H 175 105
70
5.6
5.2
6.4 159 108
51
5.1
5.3
5.7
1945 171
89
82
5.5
4.'1
7.6 157 113
4<1
5.0
5.5
4.1
1946 117
62
55
3.7
3.0
5.1 183 137
,16
5.9
6.7
4.2
1947 126
68
58
3.9
3.2
5.3 210 157
53
6.5
7.3
4.8
NEPHRITIS (ACUTE AND CHRONIC)
NUMBER
RATE
Year Total White Col. Total White Col.
MALFORMATION, EARLY INFANCY
NUMBE:R
RATE
Total White Col. Total White Col.
1920
1921 1922 1923 1924
1925
1926 1927 1928
1929
1930 1931 1932
1933 1934 1935
1936 1937 1938
1939 1940
1941 1942
1943 1944
1945 1946
1947
2200 2446 2903 3139 34<19 3228
3385 3620 4105 4003 3787 3226 3216
3118 3301 3155 3446 3458 3531 3041 33,18
3381 3187 3139 2901 2863 2576 2563
1258
1347 1592
1684 1787 1715 1721
1970 2162
2187 2060
179'1 1753
1769 1903 1803 1910
191~
1996 1771 1848
1816
1766 1749 1589
1558 1<117 HS<l
942
1099
1311 1455 1662 1513 166,1
1650 19,13
1816
1727 1432
1463 1349
1398 1352 1536
1539 153o
1270 1500
1565 1421
1390 1312 1305
1159
1079
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 10,!.5
109.8 104.1
112.9 112.4 113.9
97.4 107.2 107.5 102.0
100.5 92.9
91.7 82.5
79.3
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.'! 93.4 99.6 93.5
98.1 97.7 100.7
88.6 90.7 88.2
86.6 85.8
78.0 76A 69.5
69A
78.5 92.6
111.7 125.4 144.9 133.4 148.4
148.9
177.5 167.9 160.9 132.8
134.9 123.8
127.6 122.8 138.8
138.3 137.3 113.0
138.2 144.0
130.9 128.1 120.9
120.2 106.8
98.7
1878 2480
2842 2878
2995 2526
2239 2192
1859 1742 1890
1827 1662
1639 1904
1736 1797 1663 2,131
2155 2034 2163
2020 2048 1855
1.761 1.859
1990
1245 1446 1505 1636 167<1 1434 1251 124,1
1132 1050 1185 1111 102,1
994 1126 1076 106,1
1028 1289 1199 1098 1206 1137 1234 1102 1108 1229 1298
633 1034 1337 1242 1321 1092
988 9,18
727
692 705 716 638 645 778 660
733 635 1142 956 936 957 883 814 753 653
630 602
64.8
85.6 98.4 99.2
103.2 87.0 77.1 75.5
64.0 59.9 64.8
62.2 56.1 54.9
63.3 57.3
58.8 54.1 78.4
69.0 65.1 68.8
64.7 65.6 59.4 56 A
59.5
61.6
73.4 8'1.5 87.2
94.0 95A 81.1
70.2 69.5 62.5
57.5 64.3 59.7
5'!.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
60.7
52.7 87.1
113.9 107.0 115.1
96.3 88.1
85.6 66.4
64.0 65.7 66A 58.8
59.2 71.0 59.9 66.2 57.1
102.1 85.1
86.3 88.1
81.3 75.0 69A
60.2 58.0
63.3
376
Georgia Department of Public Health
TABLE 4 (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1947
SUlCI DE
NUMBER
RATE
Year Total Wflite Col. Total White Col.
1920 1921 1922 1923 1924 1925 1926 Hl27 1928 1929 1930
19~1
1932 1933 1934 1935 1936 1937 19:38
lf);=~9
1940 1941 1942 1943 1944 1945 19<16 194 7
128 110 18
4A
6.5 1.5
167 142 25
5.8
8.3 2.1
181 152 29
6.2
8.8 2.5
166 150 16
5.7
8.6 1.4
195 173 22
6.7
9.9 1.9
189 169 20
6.5
9.6 1.8
15<1 134 20
5.3
7.5 1.8
198 179 19
6.8 10.0 1.7
24~
210
33
SA 11.6 3.0
287 268 19
9.9 14.7 1.8
296 273 23 10.2 14.8 2.1
313 282 31 10.7 15.2 2.9
304 279 25 10.3 14.9 2.3
312 276 36 10.5 14.6 3.3
297 265 32
9.9 13.9 2.9
300 270 30
9.9 14.0 2.7
311 28t1 27 10.2 14.6 2.4
315 288 27 10.2 14.7 2.4
295 266 29
9.5 13.4 2.6
316 290 26 10.1 14.5 2.3
282 246 36
9.0 12.1 3.3
236 212 24
7.5 10.3 2.2
219 203 16
7.0 10.0 1.5
165 152 13
5.3
7.5 1.2
185 167 18
5.9
8.2 1.7
212 188 2<1
6.8
9.2 2.2
234 218 16
7.5 10.7 1.5
233 212 21
7.2
9.9 1.9
HOMICIDE
NUMBER
RATE
Total White Col. Total White Col.
479 100 379 16.5 5.9 31.6
5-19 143 406 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 Hl 369 17.6 7.9 33.3
512 ln9 353 17.6 8.8 32.3
523 149 374 18.0 8.2 34.6
569 158 'Ill 19.5 8.6 38.3
5n 179 US 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
589 155 431 19.3 8.0 39.2
6"1 1so 505 20.8 6.9 45.4
582 131 451 18.8 6.6 40.3
560 109 451 17.9 5.5 40.1
616 111 505 19.7 5.4 46.5
619 120 529 20.6 5.8 48.7
519 102 417 16.6 5.0 38.4
4:l8 102 336 14.0 5.0 31.0
'154 107 347 14.5 5.2 32.0
485 103 382 15.5 5.1 35.2
564 127 437 18.1 6.2 40.3
500 126 374 15.5 5.9 34.2
MOTOR-VEHICLE ACCIDENTS
ACCIDENTS (TOTAL)
NUMBER
RATE
NUMBER
RATE
Year Total White Col. Total White Col. Total White Col.
Total White Col.
1920
1921 1922 1923 1924 1925
1926 HJ27 1928
1929 1930 19:11
1932 1933 1934 1935
1936 1937 1938
1939 19<10
1941 1942 1943 1944 1945
1946 1947
140 100
40
4.8 5.9 3.3 1603 85:3 750 55.3 50.3 62.5
132 108
24
4.6 6.3 2.0 1456 788 668 50.3 46.1 56.3
203 1<!2
61
7.0 8.2 5.2 1508 846 662 52.0 49.0 56.4
267 189
78
9.2 10.9 6.7 1575 850 725 54.3 48.9 62.5
313 239
74 10.8 13.6 6.5 1772 915 827 61.1 53.9 72.1
348 238 110 12.0 13.5 9.7 1682 947 735 58.0 53.6 64.8
370 266 104 12.7 14.9 9.3 1585 928 657 54.6 52.1 58.6
433 288 145 14.9 16.0 13.1 1831 1035 796 63.0 57.6 71.9
472 319 154 16.3 17.6 1<1.1 1901 1090 811 65.4 60.2 74.1
531 335 196 18.3 18.3 18.1 1978 1113 865 68.0 60.9 80.0
612 425 187 21.0 23.1 17.4 1992 1164 828 68.4 63.2 77.2
655 428 227 22.3 23.0 21.0 2010 J 243 767 68.4 66.9 71.1
585 426 159 19.7 22.7 14.7 1914 1182 732 64.6 63.0 67.5
675 473 202 22.6 25.0 18.5 1992 1213 779 66.8 64.0 71.5
809 574 235 26.9 30.0 21.4 2251 1389 862 74.9 72.7 78.7
942 646 296 31.1 33.5 26.9 2428 1453 975 80.1 75.3 88.5
991 692 299 32.4 35.5 27.0 2775 1682 1093 90.9 86.4 98.7
964 680 284 31.3 34.6 25.5 2<113 1495 918 78.4 76.1 82.5
789 545 244 25.4 27.5 21.8 2125 1309 816 68.6 66.1 73.0
669 483 186 21.4 24.2 16.5 1850 1186 664 59.2 59.4 59.0
802 556 246 25.7 27.3 22.7 2057 1217 840 65.9 59.7 77.4
946 657 289 30.1 31.9 26.6 2208 1412 796 70.2 68.6 73.2
673 474 199 21.5 23.3 18.3 2056 1328 728 65.8 65.2 67.1
606 421 185 19A 20.7 17.0 1925 1192 733 61.6 58.5 67.5
644 45<! 190 20.6 22.3 17.5 2011 1249 762 64.4 61.3 70.2
688 481 207 22.0 23.6 19.1 1990 1275 715 63.7 62.5 65.9
807 595 212 25.8 29.2 19.5 2148 1452 696 68.7 71.2 64.1
804 605 199 24.9 28.3 18.2 2110 1399 711 65.3 65A 65.0
Information ancl Statistics
377
v TABLE
NUMBER AND PER CENT OF BIRTHS (EXCLUSIVE OF STILLBIRTHS)
BY PERSON IN ATTENDANCE AND COLOR, IN GEORGIA: 1929-1947
Number Total Physician Midwife Other
Total
1929
58,521 38,448 19,956 117
1930 .
60,318 39,416 20,728 174
1931
61,774 38,322 23,315 137
1932 ............ 63,690 37,981 25,578 131
1933 ............ 60,744 35,112 25,396 236
1934 ............ 64,615 39,498 25,043
74
1935 ........... 63,290 37,312 25,737 241
1936 ............ 61,617 36,659 24,661 297
1937 - 1938
64,012 39,510 24,262 240 61,307 40,111 23,970 226
1939 ............ 64,910 40,856 23,769 285
1940 .....
64,695 11,637 22,807 251
1941
67,785 44,872 22,715 198
1942 ............ 72,189 50,099 21,968 122
1943 ....
78,327 57,192 21,018 117
1944
77,018 57,582 19,318
88
1945 ...
74,994 55,896 19,023
75
1946 ....
85,699 66,508 19,1<13
48
1947 ------------ 94,311 74,352 19,813 146
White
1929 1930 .... 1931 1932 ...... 1933 ............ 1931 1935 ............ 1936 ............ 1937 ............ 1938 1939 ............ 1940 ............ 1941 . 1942 ............ 1943 1944 -
1945 1946 1917 ............
35,751
37,064 37,531
38,209
35,692 38,333 37,345
36,320 38,181
38,613 38,923 38,911 41,277
45,192
50,l<J9 49,461 17,422
56,354 62,391
32,229
33,240
32,663 32,169
29,597 33,052 31,798
31,111 33,412
34,01<1 34,448
34,907 37,612 42,077
47,795 47,556
15,708 54,683 60,918
3,429
93
3,695 129
4,761 107
5,944
96
5,919 176
5,226
55
5,373 174
1,998 211
4,615 151
1,473 126
4,275 200
3,830 174
3,51! 121
3,035
80
2,277
77
1,853
55
1,661
50
1,613
28
1;121
55
Colored
1929
22,770
6,219 16,527
24
1930
23,251
6,176 17,033
45
1931 ............ 24,243
5,659 18,554
30
1932 -------- 25,181
5,812 19,631
35
1933 ............ 25,052
5,515 19,477
60
1934 - 26,282
6,416 19,817
19
1935
25,945
5,514 20,364
67
1936 ............ 25,297
5,548 19,663
86
1937
25,831
6,098 19,647
86
1938 ............ 25,694
6,097 19,497 100
1939
25,987
6,408 19,494
85
1940
25,784
6,730 18,977
77
1911
26,508
7,260 19,171
77
1942 ....
26,997
8,022 18,933
42
1943
28,178
9,397 18,741
40
1944 ....
27,554 10,026 17,495
33
1945 ....
27,572 10,188 17,359
25
1946 -
29,345 11,825 17,500
20
1947 ............ 31,917 13,'134 18,392
91
NOTE: Figur~s prior to 1929 not available.
Total
Percent Physician Midwife Other
100.0
65.7
34.1
0.2
100.0
65.3
34.4
0.3
100.0
62.0
37.7
0.3
100.0
59.6
40.2
0.2
100.0
57.8
41.8
0.4
100.0
61.1
38.8
0.1
100.0
59.0
40.7
0.3
100.0
59.5
40.0
0.5
100.0
61.7
37.9
0.4
100.0
62.4
37.3
0.3
100.0
62.9
36.6
0.5
100.0
64.4
35.3
0.3
100.0
66.2
33.5
0.3
100.0
69.4
30.4
0.2
100.0
73.0
26.8
0.1
100.0
74.8
25.1
0.1
100.0
71.5
25.1
0.1
100.0
77.6
22.3
0.1
100.0
78.8
21.0
0.2
100.0
90.1
9.6
0.3
100.0
89.7
10.0
0.3
100.0
87.0
12.7
0.3
100.0
81.2
15.6
0.2
100.0
82.9
16.6
0.5
100.0
86.2
13.6
0.2
100.0
85.1
14.4
0.5
100.0
85.7
13.8
0.5
100.0
87.5
12.1
0.4
100.0
88.1
11.6
0.3
100.0
88.5
11.0
0.5
100.0
89.7
9.8
0.5
100.0
91.1
8.6
0.3
100.0
93.1
6.7
0.2
100.0
95.3
4.5
0.2
100.0
96.2
3.7
0.1
100.0
96.4
3.5
0.1
100.0
97.0
2.9
0.1
100.0
99.6
2.3
0.1
100.0
27.3
72.6
0.1
100.0
26.5
73.2
0.3
100.0
23.3
76.5
0.2
100.0
22.8
77.1
0.1
100.0
22.1
77.7
0.2
100.0
24.5
75.4
0.1
100.0
21.3
78.5
0.2
100.0
21.9
77.7
0.4
100.0
23.6
76.1
0.3
100.0
23.7
75.9
0.4
100.0
24.7
75.0
0.3
100.0
26.1
73.6
0.3
100.0
27.4
72.3
0.3
100.0
29.7
70.1
0.2
100.0
33.3
66.5
0.1
100.0
36.4
63.5
0.1
100.0
37.0
63.0
0.0
100.0
40.3
59.6
0.1
100.0
42.1
57.6
0.3
CJ.!l
-:j
00
TABLE VI
~
~
NUMBER AND PERCENT OF BIRTHS (EXCLUSIVE OF STILLBIRTHS) BY PLACE
0
"l
OF OCCURRENCE AND COLOR, IN GEORGIA: 1929-1947
(Q
"~'
NUMBER OF BIRTHS
Total
1929 1930
--------------------- -------------- 58521 ------------------------------------- 60318
1931 ------- ------------ - ------
-------- 61774
1932 - ------------------------
-------- 63690
1933 ----- ----------------------------------------- 60744
1934 ---- ----------------------- --------- ---- 64615
1935 --------- ----------------------- ------ 63290
1936 1937
-------- 61617
------------------- ----- ------ ----- 64012
1938 ------------ ---------------- - -- 64307
1939 ------------ ------
---------- 64910
1940 ----- ---------------------------- -------- 64695 1941 ------------------------------ ------ 67785
1942
---------------------------------- --- 72189
1943 ------------ ------- 78327
1944
------ ------------------------- 77018
1945
---------------------- 74994
1946 ---- --- -------- -------------- --------- 85699
1947 ------------------------- -------- 94311
TOTAL
White
35751 37064 37531 38209 35692 38333 37345 36320 38181
~8613
38923 38911 41277 45192 50149 49464 47422 56354 62394
Colored
22770 23254 24243 25481 25052 26282 25945 25297 25831 25694 25987 25784 26508 26997 28178 27554 27572 29345 31917
Total
52559 53199 54694 55622 52786 55650 53953 51226 51517 50312 48946 46361 44677 43025 42609 38242 35345 34469 33234
HOME
White
31492 31956 32302 32559 30230 31875 30352 28280 28490 27538 26129 23989 22096 20222 19026 15447 12850 11883 9971
Colored
21067 21243 22392 23063 22556 23775 23601 22946 23027 22774 22817 22372 22581 22803 23583 22795 22495 22586 23263
HOSPITAL
Total
White Colored
5960
7119 7078 8066
7958 8931
9300 10323 12462
13945 15863
18248 23047 29114
35652 38725
39596 51157
60997
4258
5108 5227
5648 5462 6426
6957 7975 9658
11031 12722 14853
19132 24925
31061 33973 34524
44405 52348
1702 2011 1851
2418 2496 2505
2343 2348 2804
2914 3141
3395 3915 4189
4591 4752
5072 6752 8649
OTHER
b
~
Total White Colored 'd
~
"l
2
1
1 ---
<:-!-
;:l
2 2 1
2
.... ~
2 1
-
:;:5
<:-!-
34
32
37
36
2 1
-0--..,
68
65
3
33
33
50
44
6~
101
72
29 a-
86 61
69 49
"" 17
12
<""::". "
50
45
5
66
62
4 ilj
51
44
53
48
73
66
80
75
7 5
~
~
7 5
;~ ;so
TABLE VI (continued)
NUMBER AND PERCENT OF BIRTHS (EXCLUSIVE OF STILLBIRTHS) BY PLACE
OF OCCURRENCE AND COLOR, IN GEORGIA: 1929-1947
PERCENT NUMBER OF BIRTHS
Total
1929 --------------- -------------------------- 100.0
1930 . - - .... 100.0
1931 -------- ------
100.0
1932 - -- 100.0
1933 ------ ----- 100.0 193L ........ ----------- 100.0
1935 - -- 100.0
1936 -------- -- 100.0
1937 .................. ........ 100.0
1938 ........... ---- 100.0
1939 ...... -----------
100.0
1940 - --. - 100.0
1941 --- ..... -- 100.0
1942 ........................ -- 100.0
1943 ... - .............. ------ 100.0
1944 .... ---- - 100.0
1945 ........ ----- 100.0 1946 ------------------------------------------------ 100.0
1947 . --- 100.0
TOTAL
White
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Colored
100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Total
89.8 88.2 88.5 87.3 86.9 86.1 85.2 83.1 78.2 80.5 75.4 71.7 65.9 59.6 54.4 49.7 47.1 40.2 35.2
HOME
White
88.1 86.2 86.1 85.2 84.7 83.2 81.3 77.9 71.3 74.6 67.1 61.7 53.5 44.7 37.9 31.2 27.1 21.1 16.0
Colored
92.5 91.4 92.4 90.5 90.0 90.5 91.0 90.7 89.1 88.6 87.8 86.8 85.2 84.5 83.7 82.7 81.6 77.0 72.9
HOSPITAL
Total
White Colored
Total
OTHER White Colored
10.2
11.9
7.5 0.0
0.0
0.0
11.8
13.8
11.5
13.9
8.6
7.6
0.0
0.0
-.-.-.-.
12.7
14.8
9.5
0.0
0.0
....
13.1
15.3
10.0
13.8
16.8
9.5 0.1
0.1
0.0
14.7
18.6
9.0 0.1
0.0
0.0
16.8
22.0
9.3 0.1
0.2
0.0
19.5
25.3
10.9 0.1
0.1
21.7
28.6
11.3 0.1
0.1
0.0
24.4
32.7
12.1 0.2
0.2
0.1
28.2
38.2
13.2 0.1
0.2
0.1
34.0
46.4
14.8 0.1
0.1
0.0
40.3
55.2
15.5 0.1
0.1
0.0
45.5
61.9
16.3 0.1
0.1
0.0
50.3
68.7
17.2 0.1
0.1
0.0
52.8
72.8
18.4 0.1
0.1
0.0
59.7
78.8
23.0 0.1
0.1
0.0
64.7
83.9
27.1 0.1
0.1
0.0
-~
a
~
:;:l
""<:"!-
a
<:S
:;:l..
tQ
<:"!-
:;:l
""<:"!-
Cr.>
""<:"!-
C':> Cr.>
NOTE: Figures prior to 1929 not available.
C>:l
-:] ~
~
00 0
TABLE VII
NUMBER AND PERCENT OF DEATHS (EXCLUSIVE OF STILLBIRTHS) BY PLACE
OF OCCURRENCE (HOME, HOSPITAL, ETC.) AND MEDICAL ATTENDANCE,
BY COLOR, IN GEORGIA: 1944-1947
C!:l
<:'>
0-;:
OTHER AND NOT <:Q
TOTAL
HOME
HOSPITAL
INSTITUTION
STATED
~
Total
With
Without
Medical Medical Number
Attendance Attendance
TOTAL
1944
----------------------------
28803
1945 ------------- ------------------- 28456
1946 27405
1947 - 28780
WHITE
1944 ------------------------------------- 16118
1945
16310
1946 --------------------------- ..... 16160
1947
17022
COLORED
194~
1945 1946 1947
--------------
--
----------------
12685 12146 11245
11758
25261 24941 23959 25321
14906 14952 14726 15710
10355 9989 9233 9611
3542 3515 3446 3459
1212 1358 1434 1312
2330 2157 2012 2147
18968 17926 16982 17693
9437 9163 9067 9448
9531 8763 7915 8245
b
Percent Number Percent Number Percent Number Percent
<:'>
"d
~
,.;..
:;l
65.9 63.0
8047 8569
27.9 30.1
952 933
3.3
836
3.3
1028
2.9 3.6
;.<,::.'s.>..
62.0
8476
30.9
859
3.1
1088
4.0
61.5
9094
31.6
1033
3.6
960
3.3
..0.....,
58.6
5673
35.2
538
3.3
470
2.9
~
56.2
6006
~6.8
508
3.1
633
3.9
.a,_-
56.1 55.5
5941 6393
36.8 37.6
486 580
3.0 3.4
666 601
4.1 3.5
~ ""
i:l:i
7ii.1 72.1
2374 2563
18.7 21.1
414 425
3.3 3.5
366 395
2.9 3.3
.",..'...
70.4
2535
22.5
373
3.3
422
3.8
~
70.1
2701
23.0
453
3.9
359
3.0
NOTE: Figures prior to 1944 not available. These figures exclude nonresidents of Georgia and include residents of Georgia with deaih occurring in other states.
Information and Statistics
381
TABLE VIII
ESTIMATED POPULATION AS OF JULY 1, 1947 AND THE CENSUS ENUMERATED POPULATION AS OF APRIL 1, 1940, BY COLOR,
IN EACH COUNTY IN GEORGIA
ESTIMATED POPULATION AS OF JULY I. 1947
CENSUS ENUMERATED POPULATION AS OF APRIL, 1940
Total
White
Colored
Total
White Colored
TOTAL -----------------------Appling ----------------------------
Atkinson -------------------------Bacon ------------------------ ------Baker -----------------------------*Baldwin --------------- --------Banks ---------------------------Barl'ow --------------------------Bartow-----------------------------Ben Hill ---------------------------Berrien ----------------------------
B~~i:b:.b~~t--\-~---:-:-:-:-:-:-:-:-:-:-::-:-:-:-:-:-:-:-:-:-:-:-:-::-:-:
Brooks -----------------------------Bryan --------------------------------
Bulloch -------------------------Burke ----------------------------Butts -----------------------------Calhoun ---------------------------
Camden ---------------------------Candler ---------------------------Canol! ---------------------------Catoosa --------------------------Charlton --------------------------
Chatham -------------------------Chattahoochee ---------------Chattooga ----------------------Cherokee .......................... Clarke ................................
Clay --------------------------------Clayton --------------------------Clinch -----------------------------Cobb ---------------------------------Coffee --------------------------------
Colquitt -------------------------Columbia ----------------------Cook ---------------------Coweta ----------------------------Crawford ..........................
Crisp --------------------------------
Dade--------------------------------- Da\vson -------------------------Decatur ---------------------------DeKalb ..... ----------------
Dodge ------------------------------Dooly ------------------------------Dougherty -------------- --------
Douglas --------------------------Early ---------------------------------
Echols -----------------------------Effingham ----------------------Elbert ----------------------------Emanuel --------------------------
Evans -------------------------------Fannin ---------------------------Fayette ---------------------------Floyd -----------------------------Folsyth -------------------------FFuraltnoknli_n_____-__-_-__-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_--_-_-_
7
Gilmer----------------------------
Glascock -------------------------Glynn -----------------------------Gordon ---------------------------Grady -----------------------------
3,233,060 13,300
6,900 7,700 6,200
17,021 6,400
13,000 26,300 H,OOO 14,200
110,100 9,100 6,700
18,900 6,100
2!,000 24,500
8,700 9,900 6,500 7,200
31,000 11,000
4,700
155,200 1,800
20,000 19,200 30,000
6,400 12,500
5,100 52,000 22,000
33,100 8,300
11,100 26,000
6,200
16,000 6,000
'1,000 23,300 88,200
17,600 15,200 36,300
9,500 18,000
2,500 9,100
16,800 19,500
6,600 13,500
7,100 58,200 10,100
15,000 463,800
9,100
3,700 45,800 16,500 18,500.
2,139,300 11,000 5,300
6,7"oo 2,600 8,221 5,800 10,600 22,200
9,500 12,,100 64,,100
6,000 5,600 8,900
3,700 1.5,000
6,200 4,600 3,100
2,900
'1,500 2'1,600 10,700
3,500 85,200
1,300 18,200 18,400 20,400
1,900 9,300
3,300 45,000
17,000 25,000
3,300
7,900 15,800
2,800 8,600
5,700 3,950 12,500
75,000 12,100
6,900
19,000 7,500
8,700 1,600 5,500 11,300 12,800 4,200
13,425
'1,700 50,200 10,025 13,000
332,200 9,050 2,800
28,200 15,500 11,900
1,093,700 2,300 1,600 1,000 3,600 8,800
600 2,400 4,100
4,500 1,800 ,15,700
3,100 1,100 10,000
2,400 9,000
18,300 4,100 6,800
3,600 2,700
6,400 300
1,200
70,000 500
1,800
800 9,600 4,500 3,200 1,800
7,000 5,000 8,100 5,000
3,200 10,200
3,400
7,400
300 50
10,800 13,200
5,500 8,300
17,300 2,000
9,300
900 3,600 5,500 6,700 2,400
75 2,400 8,000
75 2,000
131,600
50 900 17,600 1,000 6,600
3,123,723
14,497 7,093 8,096
7,344 16,411
8,733 13,064 25,283 H,523 15,370 83,183
9,655
6,871 20,497
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
7,06'1 11,655
6,,137
38,272 21,5<11
33,012 9,433
11,919 26,972
7,128 17,5<10
5,89'1 4,479 22,23<1 86,9,12
21,022
16,886 28,565 10,053 19,735
2,964 9,646 19,618
23,517 7,,101
14,752
8,170 56,H1 11,322
15,612 392,886
9,001
11,547 21,920
18,445 19,65<1
2,038,278 11,856 5,<122
7,042 3,049 7,713 8,072 10,605 21,073
9,674 13,033
48,239 6,331 5,727 9,990
3,735 16,168
6,654 4,891 2,810
2,.<186
5,996
26,903 10,576
3,760 65,027
3,110
16,720 19,229
18,335 2,077
8,671 3,938 31,990 16,165
24,955 3,769
8,728 16,H9
3,105 9,426 5,597 4,,115 11,,173
72,973 14,0,15
7,555 13,028
7,880
9,56'1 1,899 5,644
11,887 15,206
<1,908
14,675 5,503
47,500
11,281 13,342
2 6 9 , 7<13 8,952 3,326
13,356
17,242 12,930
1,085,445 2,641 1,671
1,05'1 4,295 8,698
661 2,459 4,210
4,849 2,337 35,544 3,324 1,144
10,507 2,553
9,842 19,866
4,291
6,572 3,,124
3,107
7,253 323
1,496 52,9,13
2,028 1,812
897 10,063
4,987 2,984
2,499 6,282
5,376 8,957 5,664 3,191
10,823 4,023 8,114
297
64 10,761 13,969
6,977 9,331
15,537 2,173
10,171 1,065 4,002
7,731 8,311
2,493
77 2,667
8,6'11 41
2,270 123,143
49 1,221
8,564
1,203 6,724
382
Georgia Department of Public Health
TABLE VIII (continued)
ESTIMATED POPULATION AS OF JULY 1, 1947 AND THE CENSUS ENUMERATED POPULATION AS OF APRIL 1, 1940, BY COLOR,
IN EACH COUNTY IN GEORGIA
ESTIMATED POPULATION AS OF JULY I. 1947
CENSUS ENUMERATED POPULATION AS OF APRIL, 1940
Total
White
Colored Total
White Colored
Gree::1e
Gwinnett Habersham Hall Hancock ....... Haralson Harris Hart ________ ,, ...... .
Heard ....... Henry
Houston Irwin ........................... Jackson .....................
Jasper ........................ __
Jeff Davis Jef.ferson ................ Jenkins ......................
J"ohnson ......
Jones .... . Lamar ..............
Lanier ---------Laurens ........ Lee
Liberty -Lincoln _____ ................ .
Long Lowndes
Lumpkin McDuffie Mcintosh
Macon
Madison --------------- ......... lVlarion
Meriwether Miller Mitchell __________ .............. .. Monroe ______ .... ______ _
Montgomery Morgan Murray _________ _
Muscogee
Newton ....................
Oconee
Oglethorpe
Paulding
Peach
Pickens
Pierce ........
Pike ................
Polk
____________ ,_,,,..
Pulaski Putnam ...... Quitman Rabun Rando]J1h
Richmond
Rockdale
Schley --- Sc1even
Seminole Spalding _______________,__ ,
Stephens Stewart
Sumter ... Talbot Taliaferro Tattnall
13,200
27,100 14,300 35,000 12,000
12,000 11,000 12,100
7,100 15,000
17,600 12,100
18,200
7,900 7,100 18,800
10,500 10,400
7,200 9,600 5,200 33,000 7,200 11,000
6,000 3,600 34,000 5,600 10,500
6,000 15,200 11,800
6,900 20,300 10,100
22,600 10,200
7,600 12,100 10,600
100,000 18,300 6,500 11,000 11,400
11,000 7,800
11,600 9,100
28,'100 9,100 7,700 3,100
7,000 14,800 94,'100 7,400
1,100 17,000
7,900 28,600 H,100
9,800 24,700
7,700 4,900
15,000
6,100
23,700 13,700 31,800
3,500 11,000
4,300
8,500 4,900 7,400
8,200
7,100 15,200
3,000 5,600 7,600 4,300 6,000
2,900 5,'100 4,100
19,200 2,100 4,500
3,100 2,500
19,600 5,400 5,300
2,600 5,200 9,300 2,900
8,800 6,800 11,000 5,200
4,500 5,500 10,400
70,000 11,700
4,700
6,000 10,300
4,600
7,500 9,500 4,600 23,900
4,200 3,000 1,000
6,900 5,000 56,700 5,000
1,700 6,900 4,900
19,900 12,000 2,400 9,900
2, 700 1,600 11,000
7,100 3;100
600 3,200
8,500 1,000 6,700 3,600 2,200 7,600
9.'100 5,000 3,000 4,900 1,800
11,200 6,200 4,'100 1,300 4,200 1,100
13,800 5,100
6,500 2,900 1,100 14,400
200 5,200 3,400
10,000 2,500 4,000
11,500
3,300 11,600 5,000 3,100
6,600 200
30,000 6,600 1,800
5,000 1,100 6,400
300 2,100
4,500 4,500
4,900 4,700 2,100
100 9,800
37,700 2,400
2,700 10,100
3,000 8,700
2,100 7,400 14,800 5,000
3,300 4,000
13,709 29,087 14,771 31.822 12,764 11,377 11,428 15,512
8,610 15,119
11,303 12,936 20,089
8,772
8,841 20,040 11,843 12,953
8,331 10,091
5,632 33,606
7,837 8,595 7,042 4,086
31,860 6,223
10,878 5,292 15,947 13,431 6,954 22,055
9,998 23,261 10,749
9,668
12,713 11,137 75,494 18,576 7,576
12,130 12,832 10,378
9,136 11,800
10,375 28,467
9,829
8,514 3,435 7,821
16,609 81,863
7 ,721
fi,033 20,353
8,492
28,427 12,972 10,603 24,502
8,1<11
6,278
16,243
6,554 25,751
14,101 31,483
3,581
12.853 4,626
11,551 6,023 7,955
3,984 8,178
16,548 3,777
7,231
8,583 5,306 8,029 3,250 5,668
1,017 19,861
1,895 3,077
3,423 2,625
17' 186 6,003 5,565
2,135 5,053 10,326
3,129 10,334
6,753 10,996
4,596 5,788 5,936
10,756
g:m 5,317 6,934 11,531
4,012 8,656
9,346 5,310 23,698 4,470
3,417 1,057 7,686
5,205 48,494
5,274
1,999 8,746 5,035 19,'185
11,116 2,882 9,504 2,'160
1,997 12,076
7,155 3,366
667 3,339 9,183 1,524
6,802 3,961 2,587 7,164
7,319 4,758 3,541 4,995
1,610 11,457
6,537 4,921 5,081
4,423 1,615
13,7 45 5,942 5,518
3,619 1,461 14,674
220 5,313 3,157 10,894 2,605
3,825
11,721 3,245
12.265 6,153 3,880 6,777 381
26,016
6,422 2,259 5,496 1,298
6,366 480
2,45<1
5,065
4,769 5,359
5,097 2,378
135 11,104
33,369 2,448
3,034 11,607
3,457 8,9<12 1,856
7,721 14,998
5,681
4,281 4,167
Infonnation and Statistics
383
TABLE VIII (continued)
ESTIMATED POPULATION AS OF JULY 1, 1947 AND THE CENSUS ENUMERATED POPULATION AS OF APRIL 11940, BY COLOR,
IN EACH COUNTY IN GEORGIA
ESTIMATED POPULATION AS OF JULY I. 1947
CENSUS ENUMERATED POPULATION AS OF APRIL, 1940
Total
White
Colored Total
White Colored
Taylor --------------------Telfair
Terrell -----------------------------r_rhomas ------ Tift------------------------------------
Toombs -----------------------------Towns ___ .................. Treutlen .................
Troup ------------------Turner
Twiggs ...... ------ union ............................ Upson
Walker ----------------------------
Walton ------------------------------
Ware
----------
Warre11 ---------- Washh1gton ....................
Wayne ---------------------Webster -----
Whe~ler
White Whitfield Wilcox __ _
Wilkes Wilkinson
Worth
9,300 12,600 17,100 36,400 20,500
16,000 4,300 6,000 46,'100 8,500 9,000
7,000 24,000 31,700 20,500 29,400
9,400 22,000 13,100 1,000
6,500 6,000 30,000
10,100 13,000
9,600
19,900
4,700 8,300
5,100 21,'100 14,700 11,800 1,300
4,400
29,600 1,900 3,100 6,950 16,700 29,900
13,<100 21,700
2,900
9,100 10,600
1,500 4,300
5,700 27,700
6,500 4,800 5,100 10,200
4,600 4,300 12,000 15,000 5,800 4,200
1,600 16,800
3,600 5,900
50 7,300 1,800 7,100 7,700 6,500 12,900 2,500 2,500 2,200
300 2,300 3,600 8,200 4,500 9,700
10,768 15,H5 16,675 31,289 18,599 16,952
1,925 7,632 13,879 10,846 9,117 7,680 25,061
31.024 20,777 27,929 10,236 24,230
13,122 4,726 8,535 6,417
26,105 12,755 15,081 11,025
21,37<1
5,586 10,358 4,7H
17,309 13,106 12,'134
4,925 5,333 27,52'i
7,036 3,253 7,669 17,377 28,789 H,l68
20,389 3,571
10,357
10,328 1,834 5,855
6,050 21,610
7,879
6,041 5,618
11,399
5,182 !,787 11,961 13,980 5,493 4,518
2,299 16,352
3,810 5,861
11 7,687 2,235 6,609 7,540 6,665 13,873 2,791 2,892 2,680
367 1,'165 4,876 9,043 5,107 9,977
* Excludes State Milledgeville Hospital.
NOTE: The Georgia total population is that for the estimated total population excluding armed forces overseas as of July 1, 1917, Bureau of the Census, U. S. Department: of Commerce, Current Population ReiJorts, Series P-25.. No. 4. The esthnates of the IJOpulations of the counties and races are based on the ratios of births, deaths, and elementary school enrollments within each area.
SOURCE: Division of Vital Statistics, Georgia Department of Public Health.
384
Georgia Department of Public Health
TABLE IX
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1938 AND 1947
COUNTY OF RESIDENCE
LIVE BIRTHS
Number
Rate Per 1,000 Population
1947 1938
1947
1938
STILLBIRHIS
Number
Rate Per I,000 Live Births
1947 1938
1947
1938
TOTAL .................. 9<1,311
Appling .....
410
Atkinson
190
Bacon ____ --------------------- 260
BakEr ....................... 176
Baldwin
462
Banks -------------------------- 200
Barrow -------- 318
Bartow ...............
818
Ben Hill ..
460
Berrien --------------- ..... 442
Bibb ............................ 3012
Bleckley ..........
251
Brantley ..
211
Brooks ___________ ............ 623
Bryan -------------------------- 169
Bulloch ....................... 703
Burke .....
750
Butts .......................... 228
Calhoun ...................... 274
Cmnden ................. .
180
Candler .........
213
Carroll ........................ USB
Catoosa .................
331
Charlton .........
166
Chatham ...................... 3926
Chattahoochee ............
44
Chattooga ........
649
Cherokee
602
Clarke .......................... 902
Clay ........................... 178
Clayton ...................... 340
Clinch ........................ 19<1
Cobb .......................... 17<18
Coffee .......................... 817
Colquitt ........................ 1074
Columbia .................... 252
Cook ............................ 343
Coweta
833
Crawford ........
192
Crisp .................. .
498
Dade ............................ 175
Da,vson ........................ 118
Decatllr ------- 683 DeKalb ........................ 3124
Dodge .......................... 536
Dooly .......................... 446
Doughe1ty .................. 102<1
Douglas ........................ 298
Early ............................ 627
Echols ----------------
59
Effingham .................. 227
Elbert
478
Emanuel
539
Evans ......................... 199
Fannin ........................ 393
Fayette ----------------- 183
Floyd ............................ 171<1
Forsyth ........................ 332
Franklin ---------------------- 377
Fulton .......................... 12689
Gilmer ........................ 291
Glascock ....................
85
Glynn .......................... 834
Gordon .......
534
64,307
320 220 196
208 24<1
189
260 523
256 389 1380
197 182 531
141 641 625
157 258 146
178 748 160
117 217<1
177
508 478 468 136 189 170 688 57<1
767 213
266 496
169 <126 115 119
508 1377 544
408 477
219 471
78 217 409 503 134
353 190 1033 2<16 305 6824 225
111 409 438
29.2
30.8 27.5
33.8 28.4 27.1
31.3 2<1.5
31.1 32.9
31.1 27.4 27.6
31.5 33.0
27.7 29.3 30.6
26.2 27.7 27.7 29.6
30.2 30.1 35.3
25.3 2<1.4
32.5 31.4 30.1 27.8
27.2 38.0
33.6 37.1
32.4 30.4 30.9 32.0 31.0
31.1 29.2
29.5 29.3 35.4 30.5
29.3 28.2
31.4 34.8 23.6 24.9
28.5 27.6 30.2 29.1 25.8 29.5
32.9 25.1
27.4 32.0 23.0 18.2 32.4
20.7 22.<1
27.7
25.2 24.0
14.4 17.0 18.9
19.0 18.7
23.2 17.5
19.7 23.7 23.3
21.7 21.7 20.4 16.5
22.8 21.8 18.0 20.1
15.5 23.8 20.1 18.4 30.0 21.0 17.9 18.1
17.2 21.9 18.1
25.7 23.1 22.1 21.3 18.7
21.9 23.0 23.9 31.6 19.9 18.5
22.7
21.1 20.8 21.1 23.7 28.3
19.7 20.8 19.2
17.3 23.5
20.6 19.7 20.0 17.5
19.7 26.5
23.1 19.8 23.3
2,457 7 2 11
13 15
3 10 25 15 8 75 11 11 23
8 31 15
5 8 5
26 .. 6
2 147
12 13 31
5
4 32 30 29
4 3 20 7 24 4 2 18 65 12 5 31 5 15
12 22 H
5 3 5 32 4 4 30<1 7 3 21 11
3,390 12
10 17
8
23 6
10
14 19 22
77 12 11 41
7 35
57
6 9 8 13 M
11 105
9 19 18 31 15 11 13 23 28 3<1 11 22 14
12 26
5 5 36
52 22 28 10 10 21
2 21 21 30 13 17
6 40
9 16 301 13
6 22 14
26.1 17.1 10.5 42.3 73.9 32.5 15.0 31.4 30.6 32.6 18.1 24.g 43.8 52.1 36.9 47.3 48.4 20.0 21.9 29.2 27.8
27.8 18.1 12.0 37.4
18.5 21.6 34.4 28.1 5.9 20.6 18.3 36.7 27.0 15.9
8.7 24.0 36.5 48.2 22.9 16.9 26.4 20.8 22A 11.2 30.3 16.8 23.9
52.9 46.0 26.0 25.1
7.6 27.3 18.7 12.0 10.6 24.0 2<1.1 35.3 25.2 20.6
52.7
37.5 45.5
86.7 38.5 94.3
31.7 38.5 26.8 74.2
56.6 55.8
60.9 60.4 77.2 49.6 54.6
91.2 38.2 34.9 54.8
73.0 45.5
94.0
48.3 50.8
37.4 37.7 66.2 110.3 58.2
76.5 33.4
48.8 44.3 51.6 82.7
28.2 71.0 61.0 43.5 42.0 70.9 37.8 40.4
68.6 21.0 <15.7 44.6 25.6 96.8 51.3 59.6 97.0 48.2 31.6 38.7 36.6 52.5 44.1 57.8 54.1 53.8 32.0
Information and Statistics
385
TABLE IX (continued)
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS
AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN
,.
GEORGIA: 1938 AND 1947
COUNTY OF RESIDENCE
LIVE BIRTHS
Number
Rate Per 1,000 Population
1947 1938
1947
1938
STILLBIRTHS
Number
Rate Per 1,000 Live Births
1947 1938
1947
1938
Grady .......................... Greene .......................... Gwinnelt .................... Habersham ................ Hall ..............................
Hancock ...................... 1-Iaralson .................... Hal"ris .......................... Hart ............................ Heard .......................... Henry .......................... Houston ...................... Irwin ..........................
Jackson ...................... Jasper .......................... Jeff Davis .................. J.effe1son .................... Jenldns ...................... Johnson ......................
Jones .......................... Lamar ........................ Lanier ........................ Lau1ens ....................... Lee .............................. Liberty ........................
Lincoln ...................... Long ............................ Lowndes ...................... Lun,pkin .................... McDuffie .................... Mcintosh ....................
Macon .........................
Madiso11 ----- Marion ... ----------------- M:eriwether ................ Miller .......................... Mitchell ...................... Monroe ........................ Montgomery ................ Morgan ...................... Murray ........................
Muscogee -------------------Newton ........................ Oconee ........................ Oglethol"Pe .................. Paulding ....................
Peach .......................... Picken.s ........................ Pierce .......................... Pike .............................. Polk ............................ Pulaski ......................
Putnam ....................... Quit.man ...................... Rabun .......................... Randolph .................... Richmond ....................
E:ockdale .................... Schley ..........................
Screven -----------------Seminole ......................
Spalding --Stephens ......................
Stewart ......................
Sumter--
524
330 823 483
1027 326 377 322 3<18
166
474 650
382
551 182 277 527
285 321
206 269 103
918 230 298
155 110 1031 160
296 190 <166
339 201 643
277 714 247 153
387 293
3380 575 198 283
358 292
259 364 266
868 249 204
93 268 424
2387 215 132 54<1 253
805 418
284
699
424 285 631
322 558 319
300 246 318 159
355 233 334 487
191 201 512
207 295
197 187
76 848
180 195 165
62 715 125
231 115 406 306
228 461 197 626
264 262 319 294
1226 40<1
156
266 261
237 206 302 274
573
162 217
103
150 340
1522 154
114 468 204 456 239 269
551
28.3 25.0 30.4
33.8 29.3 27.2 31.4
29.3 28.8 23.4
31.6 36.9 31.6 30.3
23.0 37.4 28.0 27.1
30.9 28.6
28.0 19.8 27.8
31.9 27.1 25.8
30.6 30.3 28.6 28.2
31.7 30.7 28.7 29.1
31.7 27.4 31.6 24.2
20.1 32.0
27.6 33.8 31.4 30.5 25.7
31.4 26.5
33.2 31.4 29.2
30.6 27.4 26.5 30.0
38.3 28.6
25.3 29.1 30.0
32.0 32.0 28.1
29.6 29.0 28.3
20.1
11
21
21.9
12.
12
21.1
11
29
22.7
6
11
16.5
24
26
22.7
7
H
20.6
7
8
20.5
10
22
18.3
8
8
15.6
4
5
20.7
10
19
20.3
14
16
25.0
11
18
20.7
9
9
21.1
4
9
23.2
13
13
23.1
14
25
15.2
12
<I
21.<1
11
24
20.1
<I
17
18.0
9
16
13.8
1
5
24.4
36
43
20.8
6
2<1
22.7
2
17
18.2
2
5
14.0
2
6
22.2
22
<10
23.0
5
4
23.9
4
12
19.<1
7
9
23.3
11
29
18.5
7
H
30.1
5
18
18.9
18
38
19.2
10
17
23.7
28
44
21.1
9
21
24.0
11
17
2<1.4
10
22
28A
12
12
20.9
95
68
22.4
12
24
18.1
11
7
18.6
10
20
18.8
4
12
22.4
1<1
19
18.8
2
8
21.8
7
11
23.8
6
18
21.2
2<1
28
16.9
7
6
23.8
9
17
23.0
1
2
21A
4
4
18.6
lS
31
20.4
36
86
21.2
10
7
20.1
6
5
20.1
21
25
25.7
2
11
19.1
21
47
18.1
16
22.1
5
15
19.6
30
19
21.0 36.4 13.4 12.4 23.4 21.5 18.6 31.1 23.0 24.1 21.1 21.5 28.8 16.3 22.0 46.9 26.6 42.1 34.3 19A 33.5
9.7 39.2 26.1
6.7 12.9 18.2 21.3 31.3 13.5 36.8 23.6 20.6 2<1.9 28.0 36.1 39.2 36A 71.9 25.8 <11.0 28.1 20.9 55.6 35.3 11.2 47.9
7.7 19.2 22.6 27.6 28.1 <14.1 10.8 1<1.9 30.7 15.1 46.5 45.5 38.6
7.9 26.1
17.6 42.9
49.5
42.1 46.0 34.2
46.6 43.9
26.7 89A 25.2 31.4
53.5 68.7 53.9
18.5 47.1 64.7 48.8
19.3 81.<1
86.3 85.6
65.8 50.7
133.3 87.2
30.3 96.8
55.9 32.0 51.9
78.3 71A 45.8
78.9 82A 86.3
70.3 79.5 64.9
69.0
'10.8 55.5 59.4 44.9
75.2
46.0 80.2
38.8 36.4
65.7 48.9 37.0
78.3 19.<1 26.7
91.2 56.5 45.5
43.9
53.<1 53.9 103.1
66.9 55.8 34.5
386
Ge01gia Department of Public Health
TABLE IX (continued)
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1938 AND 1947
COUNTY OF RESIDENCE
LIVE BIRTHS
Number
Rate Per 1,000 Population
1947 1938
1947
1938
TTalailabfeorrt ~--~::
228
20<1
29.6
21.3
120
165
24.5
24.9
Tattnall .. ------- 450
322
30.0
19.1
Taylor ---
252
282
27.1
24.8
Telfair -
370
318
29.4
19.5
Terrell -- ------- 456
414
26.7
21.7
Thomas - Tift
937
603
25.7
17A
659
<192
32.1
28.8
Toombs -------------- 538
327
33.6
17.1
Towns -------- 113
110
26.3
22.0
Treutlen ---
l59
145
26.5
17.8
Troup ---
1495
83<1
32.2
21.3
'I'urner -
25<1
242
29.9
19.1
Twiggs -------
263
226
29.2
23.8
Union
21<1
221
30.6
30.2
Upson Walker -----
700
552
29.2
26.4
968
540
30.5
18.7
Walton
571
<18<1
27.9
20.9
Ware
898
Wanen --------- 258
549 219
30.5 27.4
19.1 17.8
Washington ..
650
5<16
29.5
20.8
Wayne
459
346
35.0
25.1
Webster Wheeler ..
127 171
132 202
31.8 26.3
24.4 19.5
White
185
160
30.8
22.6
Whitfield .......
958
551
31.9
23.5
Wilcox
25<1
Wilkes
..............
336
277 335
25.1 25.8
19.1 20.3
Wilkinson 262
216
27.3
18.8
Worth
621
578
31.2
24.6
Residents of Georgia,
births occurring in
other states..................
147
Military Reservations 166
STILLBIRTHS
Number
Rate Per 1,000 Live Births
1947 1938
1947
1938
5
8
21.9
39.2
6
7
50.0
42.1
19
19
42.2
59.0
<1
12
15.9
42.6
9
22
24.3
69.2
9
37
19.7
89.4
33
<17
35.2
77.9
18
19
27.3
38.6
11
19
20.4
58.1
1
5
8.8
45.5
5
9
31.4
62.1
34
46
22.7
55.2
17
15
66.9
62.0
8
15
30.4
66.4
6
8
28.0
36.2
21
32
30.0
58.0
24
14
21.8
25.9
17
32
29.8
66.1
22
46
24.5
83.8
5
7
19A
32.0
22
39
33.8
71A
8
H
17.4
40.5
5
3
39.4
22.7
3
9
17.5
44.6
10
3
5<1.1
18.8
19
23
19.8
<11.7
6
14
23.6
50.5
5
18
H.9
53.7
8
10
30.5
46.3
'22
36
35.4
62.3
NOTE: These figures exclude nonresidents of Georgia and include residents of Georgia with birth occurring in other states. Live birth rates based on the estimated population as of July 1, 1938 and 1947.
Information and Statistics
387
TABLE X (continued)
INFANT AND MATERIAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1938 AND 1947
INFANT MORTALITY
COUNTY OF RESIDENCE Number
Rate Per 1,000 Live Births
1947 1938
1947
TOTAL
___ 323P
Appling ............................
4
Atkinson
3
Bacon
Baker
......................
5
Baldwin
28
Banks Barrow
3
5
Bartow
31
Ben Hill
...................... 23
Berrien
12
Bibb Bleckley
100 8
Brantley _
4
Brooks ....
29
Bryan ..... ......................... 10
Bulloch
21
Burke -
19
Butts
6
Calhoun
7
Camden ...
4
Candler
5
Carroll
49
Catoosa
9
Charlton ---
l
Chatham
139
Chattahoochee
7
Chatlooga
20
Cherokee _
15
Clarke ....
29
Clay
14
Clayton
10
Clinch Cobb ......
-------------- 5 53
Coffee
36
Colquitt
30
Columbia
6
Cook Coweta
---------------- 9 14
Craw.fo\d
14
Crisp ---
18
Dade
3
Daw~on
4
Decatur
31
DeKalb
78
Dodge .....
VJ
Dooly .
13
Dougherty
34
Douglas
10
Early .....
22
Echols
Effingham
10
Elbert
19
Emanuel
15
Evans
D
Fannin
17
Fayette Floyd
... Ji
12 64
Forsyth ---
16
Franklin
11
Fulton
----------- 419
Gilmer
8
4352 13 11 22 7 18 10 29 42
20 18 llO 18 18 32 15 27 37 8 14
9 15 5G 12 -
8 179
10 32 27 28
8 17 12 41 29 39 7 21 18 10 33
5 3 39 79 29 19 28 16 28 7 26 26 33 10 32 13 66 13 ll 420 15
34.3 9.8
15.8 26.9 28.4 60.6 15.0 15.7 37.9 50.0 27.1 33.2 31.9 19.0 46.5 59.2 29.9 25.3 26.3 25.5 22.2 23.5 52.4 27.2 24.1 35A 159.1 30.8 21.9 32.2 78.7 29.4 25.8 30.3 44.1 27.9 23.8 26.2 16.8 72.9 36.1 17.1 33.9 45A 25.0 26.1 29.1 33.2 33.6 35.1
44.1 39.7 27.8 45.2 43.3 65.6 37.3 48.2 29.2 33.0 27.5
1938
67.7 40.6 50.0 112.2 33.7 73.8 52.9 111.5 80.3 78.1 46.3 79.7 91.4 98.9 60.3 106.4 42.1 59.2 51.0 54.3 61.6 84.3 74.9 75.0 68.4 82.3 56.5 63.0 56.5 59.8 58.8 89.9 70.6 59.6 50.5 50.8 32.9 78.9 36.3 59.2 77.5 43.5 25.2 76.8 57 A 53.3 46.6 58.7 73.1 59 A 89.7 119.8 63.6 65.6 74.6 90.7 68.4 63.9 52.8 36.1 61.5 66.7
MATERNAL MORTALITY
Number
Rate Per 1,000 Live Births
1947 1938 1947 1938
247
421
2.6
6.5
1
1
2.4
3.1
1
5.3
2
7.7
5.1
4.8
1
2.2
8.2
2
7.7
3
3
3.7
5.7
2
1
4.3
3.9
2
3
1.5
7.7
10
8
3.3
5.8
1
9.5
5.5
5
6.4
9.4
2
14.2
5
6
7.1
9.4
3
4.0
6A
1
4.4
6.4
2
2
7.3
7.8
1
6.8
1
1
4.7
5.6
5
3
5.3
4.0
1
3.0
17
17
4.3
7.8
1
5.6
4
7
6.2
13.8
2
4.2
1
2.1
3
5.6
22.1
3
15.9
1
5.2
5.9
4
3
2.3
4.4
2
J
2.4
7.0
l
11
3.7
14.3
3
4
8.7
15.0
1
2
1.2
4.0
1
2
5.2
ll.8
1
2.3
1
8:5
8.4
4
7.9
5
5
1.6
3.6
3
6
5.6
11.0
1
3
2.2
7.4
1
2.1
l
3.4
18.3
5
4.8
10.6
1
12.8
3
3
13:2
13.8
2
l
4.2
9.8
6
6
11.1
11.9
3
22.4
1
2.8
2
5
1.2
4.8
2
8.1
1
2
2.7
6.6
21
20
1.7
2.9
1
4A
388
Georgia Department of Public Health
TABLE X
INFANT AND MATERIAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1938 AND 1947
COUNTY OF RESIDENCE
INFANT MORTALITY
Number
Rate Per 1.000 Live Births
1947
1938
1947
1938
Glascock .......................... 3
1
35.3
9.0
Glynn ................................ 29
33
34.8
80.7
Gordon .............................. 17
19
31.8
43.4
Grady .............................. 27
40
51.5
94.3
Greene ................................ 11
15
33.3
52.6
Gwinnett .......................... 27
41
32.8
65.0
Habersham ...................... 17
15
35.2
46.6
Hall ------------------------------- 38
<16
37.0
82A
Hancock ............................ 10
12
30.7
37.6
Haralson .......................... 11
10
29.2
33.3
Harris .... ......................... 8
25
24.8
101.6
Hart.................................... 4
28
11.5
88.1
Heard ...................
12
21
72.3
132.1
Henry ................................ 17
21
35.9
59.2
Houston .......................... 16
14
24.6
60.1
Ir,vin ------------ 12
19
31.4
56.9
Jackson ............................ 15
32
27.2
65.7
Jasper .............................. 11
14
60.4
73.3
Jeff Davis ----------------------- 15
16
54.2
79.6
J <rfferson .......................... 11
43
20.9
84.0
Jenkins ............................ 12
11
42.1
53.1
Johnson --------------.............. 5
19
15.6
61A
Jones ..........................
11
15
53.4
76.1
Lamar ................................ 13
14
48.3
7<!.9
Lanier .............................. 1
6
9.7
78.9
Laurens ........ ................... 50
61
54.5
71.9
Lee -------------------------........... 10
16
<13.5
88.9
Liberty .............................. 16
17
53.7
87.2
Lincoln ....... ...................... 1
8
6.5
48.5
Long .................................. 2
4
18.2
64.5
Lowndes ............................ 33
<17
32.0
65.7
Lumpkin .......................... 3
10
18.8
80.0
McDuffie ............................ 12
19
<10.5
82.3
Mcintosh ....... .................... 10
9
52.6
78.3
Macon ................................ 25
36
53.6
88.7
Madison ............................ 10
21
29.5
68.6
Marion ---------------- 6
12
29.9
52.6
Meriwether .................... 19
35
29.5
75.9
Miller ................................ 13
7
46.9
35.5
Mitchell ............................ 34
50
47.6
79.9
Monroe ............................ 9
2<1
36.4
90.9
Montgomery .................... 8
12
52.3
45.8
Morgan .............................. 13
20
33.6
62.7
Murray .............................. 15
17
51.2
57.8
Muscogee .......................... 110
71
32.5
57.9
Newton ............................ 20
36
34.8
89.1
Oconee .............................. 9
14
45.5
89.7
Oglethorpe ...................... 14
19
19.5
71.4
Paulding .......................... 8
11
22.3
42.1
Peach ................................ 14
17
47.9
71.7
Pickens ............................ 2
10
7.7
48.5
Pierce ....... ........................ 15
24
<11.2
79.5
Pil<e .................................... 11
22
41.4
80.3
Polk .................................. 24
37
27.6
64.6
Pulaski .............................. 8
19
32.1
117.3
Putnam ............................ 7
17
34.3
78.3
Quitman ............................ 4
3
43.0
29.1
Rabun .............................. 6
9
22.4
60.0
Randolph ..................... .... 23
23
54.2
67.6
Richmond ........................ 56
94
23.5
61.8
Rockdale .......................... 7
15
32.6
97.4
Schley ............. ................... 7
6
53.0
52.6
MATERNAL MORTALITY
Number
Rate Per 1,000 Live Births
1947
1938
1947
1938
9.0
2.4
12.2
2.3
3
<1
5.7
9.4
2
2
6.1
7.0
1
1.6
2
3
4.1
9.3
5
3
<J.9
5.4
8
1
24.5
3.1
3
12.2
3
2.9
9.4
2
12.6
1
2.8
3
<1
4.6
17.2
2
5.2
3
15.7
2
3.6
10.0
7
1.9
13.7
7.0
9.7
3.4
4.9
4
21.4
1
13.2
5
5
5.4
5.9
1
5
4.3
27.8
1
6.1
1
16.1
2
6
1.9
8.4
1'
8.0
2
3.4
8.7
1
8.7
<1
3
8.6
7.4
1
2
2.9
6.5
1
5.0
4.4
2
2
3.1
4.3
3
1
10.8
5.1
2
4
2.8
6.4
1
3
4.0
11.4
2
1
13.1
3.8
1
4
2.6
12.5
1
3.4
7
6
2.1
4.9
2
3
3.5
7.4
1
6.4
1
1
3.5
3.8
1
2
2.8
7.7
1
2
3.4
8.4
2.7
2
3.8
7.3
2
5
2.3
8.7
2
12.3
3
2.4
8.8
11
1.3
7.2
1
6.5
7.6
Information and Statistics
389
TABLE X (continued)
INFANT AND MATERIAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS IN EACH yOUNTY IN GEORGIA: 1938 AND 1947
COUNTY OF RESIDENCE
INFANT MORTALITY
MATERNAL MORTALITY
Number
Rate Per 1,000 Live Births
Number
Rate Per I,000 Live Births
1947 1938
1947
1938
1947 1938 1947 1938
Screven .............................. 16
31
29.4
66.2
Seminole .......................... 9
8
35.6
39.2
Spalding .......................... 48
61
59.6
133.8
Stephens .......................... 7
11
16.7
46.0
Stewart: ............................ 9
21
31.7
78.1
Sumter ------- 39
29
55.8
52.6
Talbot ................................ 7
10
30.7
49.0
Taliaferro ........................ 4
13
33.3
78.8
Tattnall ............................ 13
21
28.9
65.2
Taylor .............................. 5
17
19.8
60.3
Telfair .............................. 14
18
37.8
56.6
Tenell .............................. 23
35
50.4
84.5
Thomas ............................ 20
47
21.3
77.9
Tift .................................... 20
47
30.3
95.5
Toombs .............................. 20
28
37.2
85.6
Towns ................................ 3
3
26.5
27.3
Treutlen ............................ 6
8
37.7
55.2
Troup .................... ........... 61
75
40.8
89.9
Turner .............................. 12
22
47.2
90.9
Twiggs ............................ 13
20
19.4
88.5
Union ................................ 5
20
23.4
90.5
Upson ................................ 37
41
52.9
74.3
Walker ... .......................... 30
28
31.0
51.9
Walton .............................. 18
31
31.5
64.0
Ware ................................ 36
31
40.1
56.5
Wan-en .............................. 11
20
42.6
91.3
Washington ...................... 24
37
36.9
67.8
Wayne .............................. 12
29
26.1
83.8
WebsteJ' ............................ 3
10
23.6
75.9
Wheeler ............................ 3
9
17.5
44.6
White ................................ 5
15
27.0
93.8
Whitfield .......................... 36
54
37.6
9S.O
Wilcox .............................. 18
13
70.9
46.9
Wilkes .............................. 10
10
29.8
29.9
Wilkinson.......................... 9
12
34.4
55.6
Worth ................................ 22
49
35.4
84.8
Residents of Georgia,
birth or death occurring
in other states ................
18
2
2
3.7
4.3
2
9.8
6
13.2
3.7
4.3
5.4
2
9.8
1
6.1
1
2.2
3.1
1
3.5
3
8.1
9.4
2
4.8
3
11
3.2
18.2
1
4
1.5
8.1
2
2
3.7
6.1
1
8.8
1
1
6.3
6.9
4
8
2.7
9.6
1
1
3.9
4.1
1
3.8
1
4
1.4
7.2
1
3
1.0
5.6
5
10.3
6
1.1
10.9
1
4.6
2
3.7
1
2.2
2
15.2
1
2
5.8
9.9
2
12.5
3
1.0
5.4
2
7.2
2
1
6.0
11.9
1
1.6
2
6
3.2
10.4
4
NOTE: These figures exclude nonresidents of Georgia and include residents of Georgia. with death occurring in other states.
390
Georgia Department of Public Health
TABLE XI
DEATHS (EXCLUSIVE OF STILLBIRTHS) AND DEATH RATES PER
100,000 POPULATION FROM THE TEN LEADING CAUSES OF DEATHS, BY COLOR, IN GEORGIA: i938 AND 1947
1947
NUMBER Total White Col.
ALL CAUSES
1-}Ieart Diseases ----------- 2-Cerebral Hemorrhage, Embolism
and Thrombosis -------- ........... 3-Cancel" .......................................................... 4-Nephritis .................................................... 5-Accidents .................................................... 6-Malformation and Early Infancy
Diseases ----------- 7-Influenza and Pneumonia ------ 8-Tuberculosis, all fonns ............................ 9-Homicide ..................................................... 10-Diabetes Mellitus ........................................
All Other Causes .......................................
28780
6779
3197 2680 2563 2110
1990 1661 1074
500 448
5778
17022 4495
1691 1938 gg,j 1399
1298 778 41fi 126 311 3087
11758 228,1
1506 742
1079 711
692 883 659 374 137
2691
RATE PER 100,000 POPULATION
Total White Col.
890.2
209.7
98.9 82.9 79.3 65.3
61.6 51 A 33.2 15.5 13.9 178.7
795.7
210.1
79.0 90.6 69.'! 65A
60.7 36.3 19.'1
5.9 H.5 V1,1.3
1075.1 208.8
137.7 67.8 98.7 65.0
63.3 80.7 60.3 3'1.2 12.5 246.0
1938
Total White Col.
Total
ALL CAUSES
1-Heart Diseases ........................................... 2-Influenza and Pneumonia ........................ 3-Nephritis ...................................................... 4-Cerebral Hemmorrhage, Embolism
and Thrombosis .......................................... 5-Malformation and Early Infancy
Diseases ... -------------- 6-Acciden ts ........................................ 7-Cancer ........................................................... 8-'ruberculosis. all forms .............................. 9-Dysentery, Diarrhea & Enteritis ........ 10-Homicide ........................................................
All Other Causes ......................................
33617 5U6 U533 3531
2727
2,131 2125 1929 1612 1072
582 8829
18109
3059 17H 1996
1465
1289 1309 1343
602 592 131
1609
15508
2187 1819 1535
1262
11'12 816 586
1010 480 451
4220
108,1.5
169.2 114.0 113.9
88.0
78.4 68.6 62.2 52.0 34.6 18.8 28,1.8
White Col.
914.0
151.'! 86.5
100.7
73.9
65.1 66.1 67.8 30.4 29.9
6.6
232.6
1386.7 195.6 162.6 137.3
112.8
102.1 73.0 52.4 90.3 42.9 10.3
377.4
NO'I'E: These figures exclude nonresidents of Georgia and include deaths of Georgia Tesidents occurring in other states.
Rates based on the eslimated population as of July 1, 1938 and 1947.
lnformation and Statistics
391
TABLE XII
DEATHS (EXCLUSIVE OF STILLBIRTHS) AND DEATH RATES PER
1,000 POPULATION IN EACH COUNTY IN GEORGIA: 1938 AND 1947
DEATHS
COUNTY OF RESIDENCE
Rate Per 1,000 Number Population
1947 1938 1947 1938
TOTAL ........ 28780
Appling
73
Atkinson ..
35
Bacon
59
Baker ....
37
Baldwin.
203
Banks ...
39
Barrow
100
Bartow
193
Ben Hill
149
Berrien
96
Bibb
1056
Bleckley ....
77
Brantley
51
Brooks
195
Bryan_
54
Bulloch .....
188
Burke .
210
Butts
82
Calhoun
75
Camden
5<1
Candler ...
63
Carroll
306
Catoosa
66
Charlton
45
Chatham
1578
Chattahoochee
2L1
Chattooga
136
Cherokee
164
Clarke
295
Clay
59
Clayton
84
Clinch
52
Cobb ..
412
Coffee
211
Colquitt
254
Columbia .....
75
Cook
92
Coweta
236
Crawford
60
Crisp
147
Dade.................. 50
Dawson
27
Decatur ...
214
DeKalb ............ 828
Dodge
107
Dooly
139
Dougherty ........ 344
Douglas ............ 71
Early
163
Echols
18
Effingham ...... 9<1
Elbert
177
Emanuel .......... 174
Evans .............. 49
Fannin ............ 105
Fayette ............ 67
Floyd
491
Forsyth ............ 103
Franklin .......... 109
Fulton .............. 4418
Gilmer
66
Glascock .......... 26
33617 100 49 108 55
197 85
159 265
181 137
1114 106
75 234
86 225
317 97
99 101
97 329
73
50
1777 53
166
172 353
72 119
66 361
201 292
97 117 215
85 235
43 31 282 725
214 185 304
95 172
28 130 23<1
233 82
117 91
54<!
53 14<1
4679 72 31
8.9 5.5 5.1 7.7
6.0 11.9
6.1 7.7 7.3 10.6
6.8
9.6 8.5 7.6
10.3 8.9
7.8 8.6 9A 7.6
8.3 8.8 9.9 6.0 9.6 10.2 13.3
6.8 8.5 9.8
9.2 6.7
10.2 7.9
9.6 7.7 9.0 8.3 9.1
9.7 9.2 8.3
6.8 9.2 9A 6.1 9.1 9.5
7.5
9.1 7.2
10.3 10.5
8.9
7.4 7.8 9.4
SA
10.2 7.3
9.5 7.3 7.0
10.8
7.0 6.2
13.9 6A
11.6
7.7 11.6
9.6
13.2 8.2
14.1 10.6
9.8 10.3
13.2 7.6
10.3 10.2
8.7 15.1
9.8 8.9 7.1 10.2
16A 5.5 9.8 7.6
13.5 9.6
10.8 8.5 9.5 9.0 8.8
10.1
9.3 8.1 11.0
12.7 8.9 8.2
11.0 9.7
8.9 9.6 13.3 9.2
8.7 10.2 11.8
11.9 8.9
10.6 7.8
9.9 lOA
4.3 8.2 13.5 8.5 6A
DEATHS
COUNTY OF RESIDENCE
Rate Per I,000 Number Population
1947 1938 1947 1938
Glynn.
Gordon Grady . Greene Gwinnett. Habershmn ...... Hall Hancock ....
Haralson Harris Hart Heard. Henry .
Houston Irwin Jackson Jasper Jeff Davis Jeferson . Jenldns
Johnson Jones Lamar
Lanier ........ . Laurens Lee Liberty Lincoln Long
Lowndes Lumpkin ...... McDuffie ..... Mcintosh . Macon .............. Madison .......... !VI arion
Meriwether ...... Miller Mitchell . l\llonroe ............
Montgomery .... :Morgan Murray Muscogee.
Newton Oconee Oglethorpe Paulding
Peach ... Pickens Pierce .. Pil<e Polk Pulaski
Putnan1 Quitman Rabun F.:andolph ........ Richmond ........ Rockdale Schley
Screven
Seminole
276 121 171 125
229 124 317
119
99 106
6<1 5<1
162 143
89 147
91 78
135 101
H 85
97 21 355 67 101 31 30 293 45 84
84
154 100
65
191 85
203 103
62 137
75 822
177 69
94 85 103
68 120
77 236
71 82 31 41 169 959 71 43
130 69
293 1<10 200 165
251 108 310 128 112 1<13
1<13 88
159
107 95
212 103
95 236
99 96 98 127 38
435 112
113 <l1 30 345 47 120 89 191 140
78 24S
45 241 1<10
94
155 86
830 223
83 128
105 151
105 120
132 249 116 135
31 <15
156
1076
77 65 217 63
6.0 7.3
9.2 9.5 S.5 S.7 9.1 9.9 S.3 9.6
5.3 7.6 10.8 8.1
?A
8.1
11.5 10.5
7.2
9.6 7.1 ll.S 10.1 4.0
lO.S 9.3 9.2
5.2 8.3
8.6 8.0 8.0 14.0
10.1 8.5 9.4 9.4 SA 9.0
10.1 8.2
11.3 7.1 S.2 9.7
10.6 8.5
7.5 9A 8.7 10.3 S.5
8.3 7.8
10.6 10.0
5.9 11.4 10.2
9.6 9.8
7.6 8.7
14.2 7.4 9.5
12.7 SA 7.6 9.2
9.1 7.7 11.9 S.2
8.6 9.3 9.3 7.1 9.0
llA
10.9 10.6
7.3 7.0 10.0 12.3 6.9
12.5 13.0 13.2
4.5
6.8 10.7
8.7 12.4 15.0 10.9
8.5 10.3 10.2
4A 9.1 11.2 8.6 11.9
8.3 14.2
12.4 9.6
9.0 7.5
14.3 9.6 8.7
11.5 9.2
12.1 14.8
6.9 6.4 8.5 14A 10.6
11.5 9.3 7.!>
392
Georgia Department of Public Health
TABLE XII (continued)
DEATHS (EXCLUSIVE OF STILLBIRTHS) AND DEATH RATES PER
1,000 POPULATION IN EACH COUNTY IN GEORGIA: 1938 AND 1947
DEATHS
DEATHS
COUNTY OF RESIDENCE
Rate Per 1,000 Number Population 1947 1938 1947 1938
COUNTY OF RESIDENCE
Rate Per 1,000 Number Population
1947 1938 1947 1938
Spalding
Stephens Stewart Sumter Talbot Taliaferro _
Tattnall .... Taylor
Telfair -Terrell -- Thomas Tift Toombs
Towns Treutlen
Troup Turner
298
358 10.4 15.0
71
109 5.0 8.2
88
121 9.0 9.9
280
291 11.3 lOA
7'1
95 9.6 9.9
41
71 8.4 10.7
87
115 5.8 6.8
7'1
96 8.0 8.5
118
160 9A 9.8
159
215 9.3 11.3
312
361 8.6 10.4
182
237 8.9 13.9
137
165 8.6 8.6
38
40 8.8 8.0
59
62 9.8 7.6
415
447 8.9 11.4
68
97 8.0 7.7
Twiggs .... Union ...... Upson Walker Walton W Wararree~---
Washington Wayne ... Webster Wheeler Whice Whitfield. Wilcox Wilkes Wilkinson Worth
82
8'1 9.1 8.8
38
61 5.4 8.3
234
245 9.8 11.7
237
216 7.5 7.5
17'1
219 8.5 9.5
271
295 9.2 10.5
103
113 11.0 9.2
176
272 8.0 10.3
107
116 8.2 8A
H
,16 10.3 8.5
45
67 6.9 6.5
48
63 8.0 8.9
227
24'1 7.6 lOA
75
86 7.4 5.9
142
161 10.9 9.7
100
114 lOA 9.9
144
237 7.2 10.1
Residents o.f Georgia. death occurring in other states ............
326
NOTE: These figures exclude nonresidents of Georgia and include residents of Georgia with death occurring in other states.
Rates based on the estimated population as of July 1. 1938 and 1947.
Information and Statistics
393
TABLE XIII
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM HEART
DISEASES AND CEREBRAL HEMORRHAGE, EMBOLISM AND
THROMBOSIS IN EACH COUNTY IN GEORGIA: 1938 AND 1947
HEART DISEASES
CEREBRAL HEMORRHAGE, EMBOLISM AND THROMBOSIS
COUNTY OF RESIDENCE
Number
Rate Per I00,000 Population
Number
Rate Per I00,000 Population
1947
1938
1947
1938
1947
1938
1947
1938
TOTAL
6779
Appling
12
Atkinson
10
Bacon ..
18
Baker --------------------
6
Baldwin
42
Banks
12
Barrow
34
Bartow
30
Ben Hill
26
Berrien
34
Bibb -------------- 229 Bleck ley .................. 16
Brantley ------------------
6
Brooks -------------------- 33
Bryan
11
Bulloch ------------------- 54
Burke
49
Butts
15
Calhoun ----------- 19
Camden ...
12
Candler ----
16
Carroll ---------
79
Catoosa .......
21
Charlton
7
Chatham .................. 408
Chattahoochee ........
1
Chattooga
30
Cherokee .................. 43
Clarke -
62
Clay -----------------------
6
Clayton .................... 20
Clinch .........
15
Cobb ........................ 90
Coffee .................... 48
Colquitt ....................
63
CCooolukmb..i..a....................
18 22
Coweta
...........
41
Crawford ................ 15
Crisp 41
Dade
.........
15
Dawson ..................
2
Decatur
40
DeKalb ............
215
Dodge 32
DDoooulgyherty..............
36 84
Douglas
21
Early 43
Echols
4
Effingham ....
20
Elbert .................... 31
Emanuel
29
Evans ......................
7
Fannin 23
Fayette --- 1<1
Floyd - 108
Forsyth
19
Franklin ................ 23
52<16
15
6 20
6 19
21 34
36 33 17
209
12 6
38 13
33 62 14 17
17 18 45 10
6 390
'I 22 25
43 11 19
8
58 27 51
23 10
32 16 33
8 6
52 118
26 21 53
23 22
5 19
30
33 11 11
9 83
8
29
209.7
90.2 14<1.9 233.8
96.8 246.8 187.5 261.5
114.1 185.7 239.'1
208.0
175.8 89.6
174.6 180.3 225.0
200.0
172.'1 191.9 184.6
222.2 25<1.8 190.9
148.9 262.9
55.6
150.0 224.0 206.7
93.8 160.0 294.1 173.1
218.2 190.3 216.9
198.2 157.7 2<11.9
256.3 250.0
50.0 171.7 243.8
181.8 236.8
231.'1 221.1 238.9 160.0
219.8 184.5
1<18.7 106.1 170.4
197.2 185.6
188.1 153.3
169.2
10<1.9
75.6 257.0
69.3 111.8
189.1 247.8 130.6
240.6 101.3 264.3
120.1
78.1 166.5 200.1 111.7
202.3 147.2
150.0 254.3 181.9
121.1 97.0
122.0
360.8 41.5 129.9 109.9
164.9 146.3
173.1 103.1
153.0
121.0 153.5
239.1
79.9 120.'1
207.4 178.4
166.2 159.3 203.'1
158.6 108.3 108.8
231.0 221.6
110.9 181.7 172.4 152.4
125.8
141.9 73.3 97.5
158.0 65.1
166.0
3197
12 7 7 6 19 3 11 22 18 10 87 1<1
7 19
5 12 23
7 10
5 8 23 6 1 193 2 11 16 26 6 10 1 42 2<1 28 1<1 12 30 3 10 6 4 24 88 8 15 40 9 9
16 11 19
7 18 10 48
6 17
2727
2 4 6 3 12 9 1<1 22 19 17 93 5 7 20 10 28 21 3 9 11 7 29 10 3 177 3 10 18 35 3 10 6 30 24 20 11 5 15 4 20 5 1 26 36 23 12 33 7 8
15 15 16
4 8 8 33 3 13
98.9
90.2 101.4
90.9 96.8 111.6 46.9 84.6 83.7 128.6 70.'1 79.0 153.8 104.5 100.5 82.0 50.0 93.9 80.5 101.0 76.9 111.1 74.2 5<1.5 21.3 124.4 111.1 55.0 83.3 86.7 93.8 80.0 19.6 80.8 109.1 84.6 168.7 108.1 115.'1 <18.4
62.5 100.0 100.0 103.0
99.8 45.5 98.7 110.2 9<1.7
50.0
175.8 65.5 97.'1 106.1 133.3 140.8
82.5 59.4 113.3
88.0
14.0 50.4 77.1 34.7 70.6 81.0 102.0 79.8 138.5 101.3 117.6 50.0 91.1 87.6 153.9 94.7 68.5 31.5 79.'1 164.6 70.7 78.0 97.0 61.0 163.7 31.1 59.0 79.1 134.2 39.9 91.1 77.3 79.1 107.6 60.2 114.4 40.0 56.5 51.9 108.1 103.9 26.6 101.7 48.'1 95.8 62.2 143.8 67.5 40.3
136.1 76.2 61.0 51.6 53.3 86.6 62.8 24.4 74.4
394
Georgia Department of Public Health
TABLE XIII (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM HEART
DISEASES AND CEREBRAL HEMORRHAGE, EMBOLISM AND
THROMBOSIS IN EACH COUNTY IN GEORGIA: 1938 AND 1947
HEART DISEASES
CEREBRAL HEMORRHAGE, EMBOLISM AND THROMBOS-IS
COUNTY OF RESIDENCE
Number
Rate Per I 00,000 PotJulation
Number
Rate Per I 00,000 Po11ulation
1947
Fulton
........ 1075
Gilmer
12
Glascock
6
Glynn
73
Gordon
30
Grady ...
34
Greene
'19
Gwinnett
49
Habersham
26
HHaancl~l -~1~-
75 23
Haralson
22
Harris
38
Hart
16
Heard ...
7
Henry
35
Houston
39
Irwin ...
22
Jackson
32
Jasper
21
Jeff Davis
14
Je.ferson
33
Jenkins
18
Johnson
22
Jones ...
15
Lamar
25
Lanier
6
Laurens
81
Lee
19
Liberty
22
Lincoln
11
Long
11
Lowndes
66
Lumpldn
6
McDuffie
22
Mcintosh
32
Macon
31
Madison
23
Marion
7
Meriwether
42
Miller
19
Mitchell ----
39
MMoontngroo~e~;:;;--.
28 14
Morgan ....
31
Murray
17
Muscogee ...
202
Newton ...
39
Oconee
15
Oglethorpe
18
Paulding
14
Peach
28
Pickens ...
10
Pierce ...
26
Pil<e ............
13
Polk
53
Pulaski
11
Putnam ....
19
Quitman
12
Rabun
.........
8
Randolph 44
1938
831 14 4 49 16 22 39 36 11 50 26 2,1
21 18 14 24 12 10 27 10
8 41 12 13 10 15
7 51 15 16
2 6 58 5 24 9 25 21 3 41 8 20 22 13 24 3 138 33 10 23 8 20 H 25 19 31 10 17 9 4 24
1947
231.8 131.9 162.2 159.4 181.8 183.8 371.2 180.8 181.8 214.3 191.7 183.3 345.5 132.2
98.6 233.3 221.6 181.8 175.8 265.8 189.2 175.5 171A 211.5 208.3 260.4 115.4
2'15.5 263.9 200.0 183.3 305.6 194.1 107.1 209.5 533.3 203.9 194.9 101.4 206.9 188.1 172.6 274.5 184.2 256.2 160.'! 202.0 213.1 230.8 163.6 122.8 254.5 128.2 224.1 142.9 186.6 120.9 246.8 387.1 114.3 297.3
1938
1947
240.1 164.7
83.2 237.7 85.0
104.4 299.5 120.2
77.4 147.7 184.7
164.7 174.8
103.8 137.4 140.2
104.8 74.8
114.9
110.2 92.2
184.8 88.2
94.4 101.8 144.7 127.'!
146.6 173.6 186.6
22.1 135.8
179.9 92.1
248.5 152.0 143.'!
127.2 39.6
168.3
78.1 75.8 175.6 119.0
183.7 28.9
235.8 183.1
115.8 160.9
57.5 189.2 128.0 180.7
165.1 114.6 104.2
186.6 200.5
57.0 131.1
479 6 3
24 9
21 14 27 11 30 15 13 11
8 9 15 15 8 16 16 13 14 14 6 15 6 1 30 7 16 5 4 32 6 8 6 22 13 11 4 4 30 8 10 16 5 106 23 5 5 16 11 10 16 9 23 11 12
2 26
1938
1947
1938
370 4
3 24
5 13 13
16 10 18 10
6 13 13
3 15 10
6 21
6 4
23 10
7 4
11
3 22 10 15
2 4 28
6 20
5 10 19
8 19
2 21
11 9
13 6
82 14
3 13 10
15 11
8 7
20
9 H
1 5
9
103.3 65.9 81.1 52.4 54.5
113.5 106.1
99.6 76.9 85.7 125.0 108.3 100.0 66.1 126.8 100.0 85.2 66.1 87.9 202.5 175.7 74.5 133.3 57.7 208.3 62.5 19.2 90.9 97.2 145.5 83.3 111.1 94.1 107.1 76.2 100.0 14<1. 7 110.2 159.'! 118.2 39.6 132.7 78.'! 131.6 132.2 47.2 106.0 125.7 76.9 45.5 HOA 100.0 128.2 137.9 98.9 81.0 120.9 155.8
28.6 175.7
106.9 47.1 62.4 116.'! 26.6
61.7 99.8 53.4 70.4 53.2
71.0 41.2 108.2 75.0 29.4
87.6 87.3 44.9 89.4 66.1 46.1
103.7 73.5 50.8 40.7 106.1
5'!.6 63.2 115.7
174.9 22.1 90.5 86.9
110.5 207.1
84.5 57.3 115.1 105.7
78.0 19.5
79.5 87.8 82.4
99.5 57.9 140.1 77.7
34.7 90.9 71.8 141.9
100.5 57.8 60.8
73.9 93.8 153.7
22.3 71.3
49.2
Information ancl Statistics
395
TABLE XIII (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM HEART
DISEASES AND CEREBRAL HEMORRHAGE, EMBOLISM AND
THROMBOSIS IN EACH COUNTY IN GEORGIA: 1938 AND 1947
HEART DISEASES
.CEREBRAL HEMORRHAGE, EMBOLISM AND THROMBOSIS
COUNTY OF RESIDENCE
Number
Rate Per I00,000 PoJJUiation
Number
Rate Per I00,000 PoiJulation
1947
1938
1947
1938
1947
1938
1947
1938
Richn1ond .............. 291
Rockdale -------- 16
Schley ----------------
9
Screven ------- 28 Seminole ................ 23
Spalding ................ 60
Stephens
18
Stewart ....:::::::::::::::: 26
Sumter .................... 58
'.ralbot -- 21
rraliaferro
9
Tattnall
------ 2,1
':raylor .................... 19
Telfair ----------------- 33 Terrell .................... 39
r_rhomas .................. 68
TToiofmt b~:..-.-.-.-.-.-...-..-.-..-.-.-.-.
,11 36
Towns ....................
5
Treutlen
6
Troup ---------------------- 80
Turner -------------------- 22
Twiggs -------------------- 17
Union
6
Upson -------------------- 53
Walker ----- 72
Walton ----
41
Ware ...................... 79
Wanen
19
Washington ---------- 37
Wayne .................... 25
Webster --------
5
Wheeler ------------------ 8
White --- 11
Whitfield
46
Wilcox -------------------- 19
Wilkes .................... 40
Wilkinson ............ H
Worth ---------------- 25
Residents of
of Georgia, death occurring in other
states ----------------
219
308.3
293.7
116
117 122.9 156.9
16
216.2
220.3
9
10 121.6 137.7
8
20,!.5
141.3
2
3
'15.5
53.0
28
16,!.7
120.2
11
15
6'1.7
6'1.'1
9
291.1
113.6
11
8 139.2 100.9
52
209.8
218.0
2,1
15
83.9
62.9
2<1
127.7
181.5
10
7
70.9
52.9
19
265.3
155.9
10
14 102.0 114.9
'19
23,!.8
17<1.7
12
34 170.0 121.2
19
272.7
198.2
17
5 220.8
52.1
8
183.7
120.9
2
7
'10.8 105.8
10
160.0
59.2
7
6
'16.7
35.5
10
20,1.3
88.1
15
7 161.3
61.7
16
261.9
98.2
16
23 127.0 141.1
28
228.1
146.7
23
13 13,1.5
68.1
52
186.8
150.0
46
33 126.'1
95.2
29
200.0
169.7
17
10
82.9
58.5
11
225.0
57.4
15
6
93.8
31.3
5
116.3
100.0
6
5 139.5 100.0
2
100.0
24.5
3
6
50.0
73.6
52
172.'1
133.0
55
31 118.5
79.3
12
258.8
9'1.7
'1
6
47.1
47.4
10
188.9
105.1
8
6
88.9
63.1
5
85.7
68.'1
6
1
85.7
13.7
32
220.8
153.3
33
28 137.5 13,1.2
33
227.1
11<1.6
18
21
56.8
72.9
26
200.0
112.2
19
23
92.7
99.3
39
268.7
139.0
32
18 108.8
6'1.2
9
202.1
73.2
16
3 170.2
2'!.4
41
168.2
155.9
24
32 109.1 121.7
12
190.8
86.9
17
15 129.8 108.7
7
125.0
129.6
8
2 200.0
37.0
14
123.1
135.1
8
'1 123.1
38.7
12
183.3
169.5
1
14.1
25
153.3
106.8
18
13
60.0
55.6
16
188.1
110.6
'1
10
39.6
69.1
21
307.7
127.0
21
13 161.5
78.6
15
1<15.8
130.9
18
10 187.5
87.2
37
125.6
157.6
10
11
50.3
16.9
53
22
NOTE: These figures exclude non1esidents of Georgia and include residents of Georgia with death occurring in other states. Rates based on the estimated populat'ion as of July 1. 1938 and 1947.
396
Georgia Department of Public Health
TABLE XIV
.DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
CANCER AND NEPHRITIS IN EACH COUNTY IN GEORGIA:
1938 AND 1947
GANGER
NEPHRITIS
COUNTY OF RESIDENCE
NUMBER
RATE PER 100,000 POPULATION
NUMBER
RATE PER 100,000 POPULATION
1947
1938
1947
1938 1947 1938
1947
1938
TOTAL ..
2680
Appling
3
Atkinson ... .
4
Bacon .... .
'l
Balrer ------------
5
Baldwin ......................
8
Banks .......................
4
Barrow .............
12
Bartow -------- 15 Ben Hill ...................... 13
Berrien ........................
5
Bibb ..........
108
Bleckley ..............
6
Brantley .... .
3
Brooks
21
Bryan ........................
6
Bulloch ... .
10
Burke ......................... 14
Butts .........................
5
Calhoun ....
6
Camden
3
Candler
5
Carroll ....
30
Catoosa
8
Charlton .....
7
Chatham .................. 152
Chattahoochee
5
Chattooga .
12
Cherokee .................. . 21
Clarke ..........
28
Clay
3
Clayton
8
Clinch ............
2
Cobb .........
59
CoHee
................... 10
Colquitt ............
24
Columbia -----
4
Cook
................. .
6
Coweta ................... 26
Crawford ..
6
Crisp ..........
8
Dade
..................... .
3
Dawson
1
Decatur
24
DeKalb ....................... 96
Dodge
6
Dooly
................... 10
Dougherty ..... .
36
Douglas .. .
6
Early ...................... 12
Echols ....................
3
Effingham
9
Elbert .... .
17
Emanuel .................... 10
Evans
2
Fannin ................... 11
Fayette ........................
5
Floyd ....................... 52
Forsyth ........................
5
Franklin .................... 14
1929
7 6 17 2 10 16 10 10 66 7 3 7 5 13 16 4 3 4 2 23 4
99
12 11 25
4 8 1 22 15 11 4 8 11 3 8 3 2 9 59 11 9 20 7 5 2 2 16 12 4 6 9 38 1 4
82.9
22.6 58.0
51.9 80.6 47.0
62.5 92.3 57.0 92.9
35.2 98.1 65.9
44.8
111.1 98.'1
41.7 57.1
57.5 60.6 46.2
69.4 96.8 72.7
148.9 97.9
277.8
60.0 109.4
93.3 46.9 64.0 39.2
113.5 15.5
72.5 48.2 54.1
100.0 96.8
50.0 50.0 25.0 103.0
108.8 34.1
65.8 99.2 63.2
66.7 120.0
98.9 101.2
51.3 30.3 81.5
70.4 89.3 49.5
93.3
62.2
14.0
90.0 69.3 100.0 18.0 72.9 58.1 72.9 59.6 83.5 70.1 39.0 30.7 77.0 44.0 52.2 42.1 26.5 59.8 20.2 61.9 38.8
91.6
70.8 48.4 95.8 53.2 72.9 12.9 58.0 67.2 33.1 41.6 63.9 41.4 38.9 43.2 62.3 53.1 35.2 79.3 45.8 46.6 87.2 67.5 25.2 72.7 18.1 81.3 45.8 51.6 40.0 97.5 72.3
8.1 22.9
2563
5
2 5 5 19 7 10 21 8
6 107
7
7 29
14 15 16
7 1 3 25 3 6 132 2 13 12 59 5 3 5 31 11 24 8
,j
30 3
10 9
6 14
73 5
13 39
4 21
1 5 26 15 3 3 5 51 17 19
3531
6
2 11
2 31 10 22 31 21
7 122
21 15 38
5
12 38
9 11
8
7 51
4
2 198
4
18
9 51
5 8 1 37 13 36 11 7 17 10 15
'l 2 25 100 20 37 23
6 15
2 14 31 31 10
5
12 47 2 16
79.3
37.6 29.0 64.9 80.6 111.6 109.4 76.9 79.8 57.1 42.3 97.2 76.9 104.5 153.4
58.3 61.2 183.9 70.7 15.4 -11.7 80.6 27.3 127.7 85.1 111.1 65.0 62.5 196.7 78.1 24.0 98.0 59.6 50.0 72.5 96.'1 36.0 115.'1 48.'1 62.5 150.0 150.0 60.1 82.8 28.'1 85.5 107.4 42.1 116.7
'10.0 s-1.9 154.8 76.9 45.5 22.2 70.'1 87.6 168.3 126.7
113.9
42.0 25.2
141.4 23.1
182.4 90.0
160.3 112.5 153.1
41.7 154.3
210.2 195.1
166.5
77.0 40.6 124.0
94.6 97.0 119.7
70.7 137.2
38.8 40.7
183.2
'll.5 106.3
39.6 195.5
66.5 72.9
12.9 97.6
58.3 108.3 114.4
55.9 64.0
129.7 81.1 83.1
53.1 97.8 134.4
83.3 191.8 100.3
57.8 75.6
72.7
127.0 157.'1 118.2 129.0
33.3 130.0
89.5 16.3
91.6
Information and Statistics
397
TABLE XIV (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
CANCER AND NEPHRITIS IN EACH CoUNTY IN GEORGIA:
1938 AND 1947
CANCER
NEPHRITIS
COUNTY OF RESIDENCE
NUMBER
RATE PER 100,000
RATE PER 100,000
POPULATION
NUMBER
POPULATION
1947
1938
1947
1938 1947 11938
1947
1938
Fulton ---------------------Gilmer --------------------Glascock ....................
Glynn ------------------Gordon ____ -------------
Grady ---------------Greene - ---------------Gwinnett ---------------Habersham ---- Hall
Hancock -------------------Haralson -------------------Harris -------Hart ---------------------------Heard -------------------------Henry
Houston -------------------Irwin ------------------------- Jackson ---------- ----------Jasper ........__.,._..__........ Jeff Davis .................. Jefferson ..........._..______
Jenkins -- Johnson - Jones -- Lamar ---...... Lanier ----------- Laurens ................._.._. Lee .................-........_.....
Liberty -....... Lincoln ...................... Long
Lowndes -.. Lun1pkin ---------- McDuffie --- Mcintosh ..............._.... Macon ............-------.. Madison ---..- Marion ........................
Meriwether --- Miller --- Mitchell ......................
Monroe ----------- Montgomery .............. Morgan ....... Murray ........................ Muscogee ....................
Newton ---Oconee Oglethorpe ................ Paulding ....
Peach -- Pickens Pierce ......... Pike ..............................
Polk - Pulaski ---- Putnam ......................
Quitman ----Rabun -- Randolph ....................
483 5 2
22 10 12 13 27 15 27
9 10 10
5 7 13
7 9 15 9 3 13
8 5 4 10 2 19 7 6
4
30 2 3 6 9
10 8
14 6
14
9 6 6 6 75
15 10
6 11
7 8 5 7
30 1 9
1 4 15
337 4 1
19 7 3
11 11
4 22
4
9 11
8 4 10 3 1 15 6 4 11
3 4 7 2 16 5 3 3
16 3 3 6 11 7 6
17 3
17 8 4 7 9
44 11
3 5 12 10 10 2 11 15 7 10 2 2 9
104.1
5'1.9 54.1 48.0 60.6 64.9 98.5 99.6 101.9 77.1 75.0 83.3 90.9 41.3 98.6 86.7 39.8 74.4 82A 113.9 40.5 69.1 76.2 48.1 55.6 10,1.2
38.5 57.6 97.2 54.5
111.1 88.2 35.7 28.6
100.0 59.2 84.7
115.9 69.0 59.4 61.9 88.2 78.9 19.6 56.6 75.0 82.0 153.8 54.5 96.5 63.6 102.6 13.1 76.9 105.6 44.0 116.9 32.3 57.1 101.4
97A 47.1 20.8 92.2 37.2 14.2 107.5 36.7 28.2 65.0 28.4 61.7 91.6 46.1 39.3 58.4 26.2 29.9 63.9 66.1 46.1 49.6
21.8 10.7 67.5 36.4 46.0 57.9 35.0 33.1
19.6 55.2 31.1 101.4 63.0 42.4 79.3 69.8 29.3 64.4 63.8 36.6 53.6 86.8 75.2 61.0 31.7 35.0 86.2 94.6 91A 14.5 95.6 55.5 72.9 109.8 44.6 28.5 49.2
422 8 2 17 5 13 3 10 11 33 9 9
6
6
26 8 2
24 11 4
6
9 10 10 19
3 34
1 6 1 2 23 6
4 5 11 9 7 20 10 19 10 1 21 3 1! 15 10 14
6 1 11 9 9 18 11 10 3 7 10
538 1 1
32 12 30 12
26 7
38 15 15
7 18
5 21 10
8
28 10 13
7 5 6
9 16
3 49
6
7 4
3 32
2
8
6 19 23
9 10
3 21
16 6
12 5
86 18 10 11 18 16
7 14 11 20 17
6 1
5 13
91.0 87.9 51.1 37.1 30.3 70.3 22.7 36.9 76.9 94.3 75.0 75.0 54.5 49.6
173.3 15.5 16.5
131.9 139.2
54.1 31.9 85.7 96.2 138.9 197.9 57.7 103.0 55.6 54.5 16.7 55.6 67.6 107.1 38.1 83.3 72.4 76.3 101.4 98.5 99.0 84.1 98.0 52.6 173.6 28.3 11.0 82.0 153.8 127.3 52.6
9.1 141.0
77.6 98.9 63.4 120.9 129.9 96.8 100.0 67.6
155.5 47.1 20.8 155.2
63.8 142.4
92.2 86.8
49.3 112.2 106.6
102.9 58.3
103.8
49.1 122.7
87.3 59.9
119.2 110.2 149.8
31.6 36.7 43.6
91.6 154.4
51.6 1<10.8
69.4 81.6
41.2 67.9 99.3
36.8 82.3 101.4
108.9 139.3 118.9
41.0 29.3 79.5
127.7 54.9 91.8 48.2
147.0 99.9
115.8 76.9
129.3
151.3 64.0
101.2 95.6 73.9
177.1 65.9
22.3
71.3 71.0
398
Georgia Department of Public Health
TABLE XIV (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
CANCER AND NEPHRITIS IN EACH COUNTY IN GEORGIA:
1938 AND 1947
CANCER
NEPHRITIS
COUNTY OF RESIDENCE
NUMBER
RATE PER 100,000
RATE PER 100,000
POPULATION
NUMBER
POPULATION
1947
1938
1947
1938 1947 1938
1947
1938
Richmond .................... 111
Rockdale .................... 13
Schley ........................
1
Screven ------
7
Seminole ------------
l!
Spalding ...................... 28
Stephens ......................
6
Stewart ......................
5
Sumter ...................... 32
'falbot ..........................
4
rraliaferro ..................
3
Tattnall ......................
5
'faylor ........................
8
Telfair ........................
6
Terrell ........................ 16
Thomas ........................ 27
Tift ..............................
9
Toombs ........................
9
'"ro,vns -------
5
Treutlen ......................
3
Troup .......................... 36
Turner ---
2
Twiggs ........................ 10
Union ..........................
4
Upson .......................... 17
Walker ........................ 24
Walton ........................ 21
Ware --------- 22
Warren ......................
9
Washington ................ 17
Wayne ....................
8
Webster........................
6
Wheeler ......................
4
White ..........................
1
Whitfield .................... 25
Wilcox ........................
8
Wilkes.......................... 11
Wilkinson....................
9
Worth .......................... 10 Residents of Georgia,
death occurring in
other states ................
58
120.8
6
175.7
5
22.7
11
<11.2
3
50.6
26
97.9
7
42.6
1
51.0
15
129.6
8
51.9
5
61.2
7
33.3
6
86.0
9
47.6
7
93.6
15
74.2
8
13.9
8
56.3
2
116.3
2
50.0
25
77.6
5
23.5
1
111.1
1
57.1
5
70.8
16
75.7
11
102.'1
11
74.8
8
95.7
18
77.3
1
61.1
3
150.0
2
61.5
4
66.7
16
83.3
3
79.2
17
84.6
6
93.8
6
50.3
30
77.8 82.6 88.3 47.2 37.9
109.0 52.9 32.8 53.5
83.4 75.6 41.4 52.9
55.2
36.7 43.3 46.8
41.8 40.0
24.5 63.9
39.5 42.1 13.7
24.0 55.5 47.5
39.2 65.0
68.4 29.0 55.5
19.3 56.5
68.4 20.7 102.8 52.3
25.6
67
124
3
9
7
11
H
11
5
1
2<1
35
3
17
3
8
21
20
6
7
3
7
11
1
2
12
8
16
12
22
22
40
20
30
14
22
1
1
9
6
11
66
7
10
4
7
2
7
23
21
18
28
16
21
27
63
13
23
15
20
10
8
2
3
2
4
15
11
11
17
3
5
10
28
5
12
9
23
27
71.0 10.5 159.1 82.4
63.3 83.9
21.3 30.6 85.0
77.9 61.2
73.3 21.5 63.5 70.2
60.4 97.6 87.5
23.3 150.0
88.4 82.4 44.4
28.6 95.8
56.8 78.0 91.8
138.3 68.2 76.1
50.0 30.8 250.0
46.7 29.7 76.9
52.1 45.2
166.3 123.9
194.3 47.2 50.5 146.7
128.5 65.6
71.3
73.0 105.8
23.7 105.7
98.2 115.3 115.4 175.5
114.9 20.0
73.6 168.8
79.0 73.6
95.7 115.0
97.2
90.7 224.6 186.9
76.0 58.0 55.5
38.7 155.4
72.7
34.6 169.3
104.7
98.0
NOTE: Those figures exclude nonresidents of Georgia and include residents of Georgia
with death occurring in other states. I,;ates based on the estimated population as of July 1, 1938 and 1917.
Information and Statistics
399
TABLE XV
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
ACCIDENTS AND MALFORMATIONS, EARLY INFANCY DISEASES IN EACH COUNTY IN GEORGIA:
1938 AND 1947
*ACCIDENTS
MALFORMATIONS AND EARLY INFANCY DISEASES
COUNTY OF RESIDENCE
NUMBER
RATE PER I 00,000 POPULATION
NUMBER RATE PER I00,000 POPULATION
1947
1938
1947
1938 1947 1938
1947
1938
TOTAL ----------------- 2110
Appling .........
10
Atkinson --------------------
2
Bacon
I
Bal<::er --
1
Baldwin -------------- 16
Banks ..........................
2
Barrow ------------
9
Bartow ------------------------ 22
Ben Hill --
8
Berrien -
6
Bibb ----------------------- 59
Bleckley --
I
Brantley
4
Brooks
14
Bryan ..........
12
Bulloch ----------------------- 24
Burke - 18
Butts --------------------
7
Calhoun -------
2
Camden --------- 15
Candle1
10
Carroll ...................... 19
Catoosa ------------
2
Charlton ---------------------
6
Chatham .................... 105
Chattahoochee
1
Chattooga ..................
7
Cherokee .................... 16
Clarke
19
Clay ............................
8
Clayton ...................... 12
Clinch ----
3
Cobb 56
Coffee Colquitt
......-
17 14
Columbia ....................
5
Cook ..........................
4
Coweta
22
Crawford -------- 11
Crisp ....
15
Dade
6
Dawson Decatur
.........-.-.-.-..-..-....
3 18
DeKalb Dodge
.................-
60 10
Doo]y -
8
Dougherty ....
17
Douglas ......................
9
Early ...... --------- 16
Echols -----
Effingham ----
9
Elbert 11
Emanuel 21
Evans -
7
Fannin
Fayette Floyd
.........-.................
2 31
2125
15 I 4 2
13 4
10 18
6 8 71 2 2 11 8 12 14 14 5 13 4 18 8 5 124 6 12 9 21 l 12 6 27 9 19 6 12 10 4 15 1 4 20 52 11 12 16 2 9
7 21 20
6 5 5 28
65.3
75.2 29.0 51.9 16.1 94.0 31.3 69.2 83.7 57.1 12.3 53.6 14.0 59.7 74.1 196.7 100.0 73.5 80.5 20.2 230.8 138.9 61.3 18.2 127.7 67.7 55.6 35.0 83.3 63.3 125.0 96.0 58.8 107.7 77.3 42.3 60.2 36.0 81.6 177.4 93.8 100.0 75.0 77.3 68.0 56.8 52.6 46.8 94.7 88.9
98.9 65.5 107.7 106.1 51.9 28.2 58.4
68.5
104.9 50 A 51.'! 23.1 76.5 36.0 72.9 65.3 43.7 47.7 89.8 20.0 26.0 48.2
123.2 40.6 45.7
147.2 11.1
194.5 40.4 48.'1 77.6
101.7 114.7
62.2 70.8 39.6 80.5 53.2 109.3 77.3 71.2 40.3 57.2 62.4 95.9 37.6 51.9 81.1 20.8 106.2 78.2 69.9 45.8 62.2 69.7 19.3 45.1
63.5 106.7
76.3 77.4 33.3 54.1 53.3
1990
3 1 6 3 17 1 3 24 18 8 63 4 3 H 6 10 12 3 5 2 2 33 7 2 105 7 12 13 18 6 7 3 35 19 26 5 5 9 4 10
4 19 57
8 10 26
I 6
7 9 8 7 5 3 47
2431
6
9 10
5 13
8 16 24 11
8 65
9 6 18 10 16 12 4 7 4 13 32 9 7 103 7 13 18 17 6 8 6 20 21 18 4 8 10 I 18 3 3 23 47 16 11 18 9 9 4 15 15.
20 6
19 7
30
61.6
22.6 14.5 77.9 18.4 99.9 15.6 23.1 91.3 128.6 56.3 57.2 41.0 44.8 74.1 98A 41.7 49.0 31.5 50.5 30.8 27.8 106.5 63.6 42.6 67.7 388.9 60.0 67.7 60.0 93.8 56.0 58.8 67.3 86.'1 78.5 60.2 15.0 34.6 64.5 62.5
100.0 81.5 64.6 45.5 65.8 71.6 42.1 33.3
76.9 53.6 .Jl.O 106.1 37.0 42.3 80.8
78A
12.0 113.'! 128.5
57.8 76.5 72.0 116.6 87.1 80.2 47.7 82.2 90.1 78.1 78.9 153.9 51.1 39.2 42.1 61.8 59.8 131.3 86.1
87.3 1<12.'1
95.3 72.5 76.7 79.1 65.2 79.8 72.9 77.3 52.7 94.1 54.2 41.6 63.9 37.6 51.9 97.3 62.3 79.7 90.0 63.2 66.6 57.0 78.5 86.7 45.4 145.3 136.1 76.2 76.3 77.4 126.5 75.8 57.1
400
Georgia Department of Public Health
TABLE XV (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
ACCIDENTS AND MALFORMATIONS, EARLY INFANCY DISEASES IN EACH COUNTY IN GEORGIA :
1938 AND 1947
*ACCIDENTS
MALFORMATIONS AND EARLY INFANCY DISEASES
COUNTY OF RESIDENCE
NUMBER
RATE PER 100,000 POPULATION
RATE PER 100,000
NUMBER
POPULATION
1947
1938
1947
1938 1947 1938
1947
1938
Forsyth ...........
10
Franklln ..... .
7
Fulton ------------- 240
Gilmer ........................
8
Glascock ....................
1
Glynn ......................... 18
Gordon ..
17
Grady ...........
10
Greene .....
7
Gwinnett .................... 29
Habersham ..
11
Hall ........
30
Hancock ....................
8
:Haralson ....
9
Harris ........
12
Hart ...........................
3
Heard ......
3
Henry .....
15
Houston .................... 18
Irwin _______ _
3
Jackson ...
11
Jasper
.................. .
4
Jeff Davis
7
Jefferson
10
Jenldns .................... 13
Johnson ............
6
Jones .......
10
Lamar --------
3
Lanier .........
2
Laurens
27
Lee ..............................
6
Liberty ..................... 11
Lincoln ... -----------------
1
Long ..........
3
Lowndes ___ _
17
Lumpkin
3
McDuffie ....................
9
Mcintosh ...
13
Macon ______ _
8
Madison .....
10
Marion ------
7
Merlwether
13
Miller ..........................
7
Mitchell ...................... 14
Monroe .....
12
Montgomery
7
Morgan ... -------
10
Murray ... ----------
3
Muscogee
67
Newton
14
Oconee
3
Oglethorpe ................
8
Paulding ....................
3
Peach ........
10
Pickens .......................
7
Pierce -
8
Pike--
6
Polk ............................ 19
Pulaski ......................
9
1
99.0
8.1
12
10
118.8
81.4
9
46.7
51.5
5
5
33.3
28.6
296
51.7
85.5
333
256
71.8
74.0
'1
87.9
47.1
6
7
65.9
82.4
1
27.0
20.8
1
27.0
21
39.3
101.9
19
20
41.5
97.0
17
103.0
90.3
8
11
48.5
58.5
10
54.1
47.5
20
30
108.1
142.4
10
53.0
76.8
4
6
30.3
46.1
16
107.0
53.4
16
14
59.0
46.7
8
76.9
56.3
7
10
49.0
70.4
20
85.7
59.1
25
28
71A
82.7
12
66.7
85.2
2
8
16.7
56.8
7
75.0
48.0
8
6
66.7
41.2
9
109.1
74.9
5
16
45.5
133.2
4
24.8
23.1
1
11
8.3
63.5
6
42.3
58.9
8
10
112.7
98.1
15
100.0
87.6
4
10
26.7
58.4
9
102.3
78.6
9
9
51.1
78.6
5
24.8
37.4
7
11
57.9
82.3
15
60.4
63.9
9
19
49.5
80.9
10
50.6
110.2
9
8
113.9
88.2
8
94.6
92.2
9
11
121.6
126.7
19
53.2
85.6
3
28
16.0
126.2
7
123.8
51.4
5
5
'17.6
36.7
5
57.7
36.3
1
13
9.6
94.4
7
138.9
71.2
6
4
83.3
40.7
10
31.3
96.5
'1
8
<11.7
77.2
3
38.5
54,6
1
1
19.2
18.2
21
81.8
60A
24
35
72.7
100.6
5
83.3
57.9
3
10
<11.7
115.7
6
100.0
70.0
10
11
90.9
128.3
1
16.7
11.0
6
66.2
83.3
1
2
27.8
'15.3
18
50.0
55.8
18
31
52.9
96.2
2
53.6
36.8
2
35.7
6
85.7
62.1
5
8
47.6
82.8
11
216.7
185.9
6
'1
100.0
67.6
11
52.6
63.0
11
17
72.4
97.4
5
84.7
30.3
5
12
42.4
72.7
4
101.4
52.8
1
9
1<1.5
118.9
16
64,0
65.7
8
18
39A
73.9
1
69.3
9.8
10
5
99.0
48.8
13
61.9
49.2
23
26
101.8
98.5
5
117.6
39.9
6
14
58.8
111.7
6
92.1
54.9
3
7
39.5
64.1
8
82.6
61.2
7
10
57.9
76.5
4
28.3
38.6
'1
9
37.7
86.8
61
67.0
10,1.2
68
34
68.0
58.1
14
76.5
77.7
11
20
60.1
111.0
6
46.2
69.5
6
9
92.3
10,1.2
7
72.7
49.0
5
11
45.5
76.9
3
26.3
21.6
3
6
26.3
43.1
13
90.9
123.0
8
6
72.7
56.7
19
89.7
173.7
2
6
25.6
54.8
6
69.0
43.4
10
9
86.2
65.1
8
65.9
69.5
8
9
87.9
78.2
14
66.9
51.8
10
1<1
35.2
51.8
3
98.9
31.3
4
7
44.0
72.9
Information and Statistics
401
TABLE XV (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
ACCIDENTS AND MALFORMATIONS, EARLY INFANCY DISEASES IN EACH COUNTY IN GEORGIA:
1938 AND 1947
*ACCIDENTS
MALFORMATIONS AND EARLY INFANCY DISEASES
COUNTY OF RESIDENCE
NUMBER
RATE PER 100,000 POPULATION
RATE PER 100,000
NUMBER
POPULATION
1947
1938
1947
1938 1947 1938
1947
1938
Putnam ......................
3
Quitman ......................
2
Rabun ........................
3
Ii:andolph ..
16
Richmond .................. 50
Rockdale ......................
5
Schley ..........................
3
Screven _________
10
Seminole ....................
2
Spalding .................... 32
Stephens ..................
5
Stewart ......................
6
Sumter ........................ 13
Talbot ........................
3
Taliaferro ..................
2
Tattnal! ....................
8
Taylor .......................
7
Telfair ------------------
5
Terrell ---- 11 Thomas ------ 26 Tift ------- 16
,.roombs ......................
2
Towns ..........................
1
Treutlen --------
7
'l..roup .......................... 30
Turner ........................
3
Twiggs --------------
8
Union ..........................
7
Upson ----------- 11
Walker ------- 14
Walton ---- 12
Ware --------- 14
Warren -----------
5
Washington ------ 11
Wayne --------
6
Webster ------
2
Wheeler ------------
3
White ----------------
6
Whitfield ----------- 16
Wilcox ------------
2
Wilkes ----------
3
Wilkinson ------ 19
Worth ................
11
Residents of Georgia, death occurring in
other states -----------
13
39.0
142.7
5
64.5
3
3
42.9
42.8
5
12
108.1
65.6
7
60
53.0
80.5
36
67.6
<1
6
68.2
106.0
3
18
58.8
77.3
8
5
25.3
63.1
5
22
111.9
92.2
29
7
35.5
52.9
6
5
61.2
41.0
4
29
52.6
103.4
19
5
39.0
52.1
3
1
40.8
15.1
2
6
53.3
35.5
7
5
75.3
44.0
4
6
39.7
36.8
6
7
6<!.3
36.7
9
19
71A
54.8
10
12
78.0
70.2
15
13
12.5
67.9
7
2
23.3
40.0
5
116.7
61.3
<1
41
64.7
104.9
36
4
35.3
31.6
4
8
88.9
84.1
5
2
100.0
27.3
5
19
45.8
91.0
19
5
44.2
17.4
23
13
58.5
56.1
7
21
47.6
74.9
19
10
53.2
81.3
1
15
50.0
57.0
16
15
45.8
108.7
8
2
50.0
37.0
3
46.2
29.0
1
100.0
14.1
3
24
53.3
102.6
23
19.8
9
3
23.1
18.1
7
10
197.9
87.2
7
16
55.3
68.2
12
11
64.9
120.8
96.8
44.6
6
71A
85.5
12
47.3
65.6
<11
38.1
55.0
9
54.1
123.9
3
68.2
53.0
13
47.1
55.8
5
63.3
63.1
34
lOlA
1<12.5
9
42.6
68.1
10
40.8
82.1
15
76.9
53.5
6
39.0
62.6
9
<10.8
136.0
6
46.7
35.5
15
43.0
132.1
9
47.6
55.2
21
52.6
110.1
27
27.5
77.9
22
73.2
128.7
15
43.8
78.3
1
46.5
20.0
6
66.7
73.6
47
77.6
120.2
14
47.1
110.5
14
55.6
147.2
14
71.4
191.'1
23
79.2
110.2
16
72.6
55.5
12
3<1.1
51.8
20
64.6
71.3
12
10.6
97.5
22
72.7
83.7
21
61.1
152.2
8
1<18.1
7
67.7
10
50.0
141.3
23
76.7
98.3
10
89.1
69.1
7
53.8
42.3
8
72.9
69.8
30
60.3
127.8
NOTE: These figures exclude nonresidents of Georgia and include residents o.f Georgia with death occurring in other states.
Rates based on the estimated population as of July 1, 1938 and 19<17.
* Accidents a1e allocated to county of accident instead of county of residence.
402
Georgia Department of Public Health
TABLE XVI
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
INFLUENZA AND PNEUMONIA, AND ALL FoRMS OF TUBERCULOSIS IN EACH COUNTY IN GEORGIA:
1938 AND 1947
COUNTY OF RESIDENCE
TOTAL Appling ... Atkinson Bacon BBaalkdewri~ .. Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bl'yan 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 Decatue DeKalb Dodge Dooly ..::. Dougherty Douglas ......: Early Echols Effingham Elbert Emanuel Evans ... Fannin ........ Fayette ... Floyd Forsyth
INFLUENZA AND PNEUMONIA
TUBERCULOSIS, ALL FORMS
NUMBER
RATE PER 100,000 POPULATION
RATE PER 100,000
NUMBER
POPULATION
1947
1938
1947
1938 1947 1938
1947
1938
1661
11 5 2 2
22 4 2
11 11
7 54
5 5 8 1 13 16 8 4 1 5 16
3 1 76 1 5 14 15 5 7 2 24 21 H 4 5 12 6 6 1
16 25 10 11 13
6 9 1 5 14 8 4 15 5 25 6
3533 21 6 7 7 22 5 15 34 21 10
104 13 10 21 6 19 39 15 10 7 11 22 6 7
154 4
18 23 44 10 11
5 46 17 38
4 16 30
9 31
'1 1 31 65 32 31 34 11 33
10 33 21
6 17
8 58
3
51.4 82.7 72.5 26.0 32.3 129.3 62.5 15.4 41.8 78.6 '19.3 49.0 54.9 7'1.6 42.3 16.4 54.2 65.3 92.0 40.4 15.4 69.4 51.6 27.3 21.3 49.0 55.6 25.0 72.9 50.0 78.1 56.0 39.2 46.2 95.5 42.3 48.2 45.0 <16.2 96.8 37.5 16.7
68.7 28.3 56.8 72.4 35.8 63.2 50.0 40.0 54.9 83.3 41.0 60.6 111.1 70.4 43.0 59.4
114.0 146.9
75.6 90.0 80.9 129.5 45.0 109.3 123.4 153.1 59.6 131.5 130.1 130.1 92.0 92A 64.3 127.3 157.7 88.2 104.7 111.1 59.2 58.2 1<12.4 142.5 41.5 106.3 101.1 168.7 133.0 100.2 6'1.5 121.3 76.2 114.4 41.6 127.8 112.9 116.7 167.6 83.1 26.6 121.2 87.4 133.3 160.7 1<18.2 106.0 166.'1
90.7 167.6
80.1 77.4 113.2 86.6 110.4 24.4
1074 1
3 11
3 9 1
50 1
2 11
1 5 3 2 3 2 1 91 1 13 7 4
4 2 H 5 7 1 3 9 1 9 1
3 25
2 2 16 4 6 1 3 7 1 1 3
2,1 '1
1612 1 1 1 2
19 3 4
14 7 5
58
2 2 10 15 2 3
6 13
6
110
11 7 17 1 7 4
27 5 6 5 8
13 1
10 5 1 8
36 4 4
19 6
10
10 6 4 2 5 3
46
33.2 7.5
48.4 64.6
23.1 34.2
7.1
45.4 11.0 29.9 26.5
8.3 '14.9 11.5 50.5 46.2 27.8
9. 7 18.2 21.3 58.6 55.6 65.0 36.5 13.3
32.0 39.2 26.9 22.7 21.1 12.0 27.0 34.6 16.1 56.3 16.7
12.9 28.3 11.4 13.2 44.1 '12.1 33.3 40.0 33.0 <11.7
5.1 15.2 22.2
<11.2 39.6
52.0 7.0
12.6 12.9 23.1 111.8 27.0 29.2 50.8 51.0 29.8 73.4 20.0
8.8 30.8 33.8 49.0 21.0 26.5
60.6 35.0 58.2
101.8
64.9 30.8 65.2 13.3 63.8 51.6 71.2 22.4 18.1 52.0 63.9 '18.9 13.0 54.1 103.9 26.6 31.3 48.4 16.7 20.7 82.8 57.8 50.4
90.7 30.5 15.3 25.8 33.3 32.5 87.6
lnformcdion and Stcttistics
403
TABLE XVI (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
INFLUENZA AND PNEUMONIA, AND ALL FORMS OF TUBERCULOSIS IN EACH COUNTY IN GEORGIA:
1938 AND 1947
INFLUENZA AND PNEUMONIA
TUBERCULOSIS, ALL FORMS
COUNTY OF RESIDENCE
NUMBER
RATE PER 100,000 POPULATION
RATE PER 100,000
NUMBER
POPULATION
1947
1938
1947
1938 1947 1938
1947
1938
Franklin -------------------
8
Fulton
209
Gilmer
1
Glascock
1
Glynn
15
Gordon ....
13
Grady
10
Greene
9
Gwinnett ---------- 18
Habetsham
7
Hall
17
Hancock
7
Haralson
1
}larris ....................
5
Hart ------------------
7
Heard
2
Henry
10
Houston
9
Irwin
---------
6
Jackson
8
Jasper -
6
Jeff Davis
9
Jefferson
4
Jenldns
7
Johnson --------------
3
Jones
6
Lamar
7
Lanier
1
Laurens
32
Lee
7
Liberty
6
Lincoln
1
Long
1
Lowndes
13
Lumpkin
1
McDuffie
10
Mcintosh
8
M:acon
10
Madison -----------------
5
Marion
3
Meriwether
7
Miller ---------------
4
Mitchell ......
10
Monroe
5
Montgomery
4
Morgan ...
9
Murray
4
Muscogee
36
Newton ...
9
Oconee
3
Oglethorpe
8
Paulding
13
Peach
4
Pickens ------
4
Pierce
7
Pike ..
3
Polk
12
Pulaski
5
Putnam
4
26
53.3
148.8
1
4
472
45.1
136.4
226
3<19
5
14.0
58.8
4
2
27.0
1
33
32.8
160.1
11
8
22
78.8
116.9
3
8
23
75.8
109.1
1
7
14
68.2
107.5
2
8
31
66.4
103.5
6
15
17
49.0
119.7
2
2
33
48.6
97.5
5
8
9
58.3
63.9
6
5
10
33.3
68.6
4
5
11
45.5
91.6
1
7
25
57.9
144.2
2
2
6
28.2
58.9
3
11
66.7
64.3
6
2
12
51.1
104.8
7
1
16
49.6
119.7
4
1
23
44.0
97.9
1
3
8
75.9
88.2
5
15
121.6
172.8
3
17
21.3
76.6
2
11
12
66.7
88.2
4
6
12
28.8
87.1
3
2
10
83.3
101.8
2
10
7
72.9
67.5
1
8
3
19.2
54.6
1
48
97.0
137.9
8
14
17
97.2
196.7
3
2
10
54.0
116.6
3
3
2
16.7
22.1
1
3
27.8
67.9
2
30
38.2
93.1
11
7
71.4
128.9
1
12
65.8
124.2
5
8
10
67.8
168.9
1
5
22
144.9
126.1
8
11
15
47.1
90.8
2
14
50.0
185.0
2
1
29
34.5
119.0
6
10
2
39.6
19.5
1
1
24
41.2
90.9
1
5
13
49.0
103.8
8
5
8
52.6
73.2
2
H
74.4
107.2
2
3
11
37.7
106.1
3
4
66
36.0
112.8
35
57
22
49.2
122.1
6
10
6
46.2
69.5
3
2
12
72.7
83.9
.8
2
12
11<1.0
86.2
1
5
11
36.4
104.0
7
7
11
51.3
100.5
3
2
12
60.3
86.7
2
3
16
33.0
139.1
7
39
42.3
H4.2
11
15
21
54.9
250.0
1
4
18
51.9
197.6
2
3
6.7 48.7 41.0
24.0 18.2
5.4 15.2 22.1 14.0 14.3 50.0 33.3
9.1 16.5
40.0 39.8 33.1
5.5
10.6 38.1 28.8 27.8 10.4 19.2 24.2 41.7 27.3
17.6 35.7 47.6 16.7 52.6 25.'1 29.0 29.6
9.9 4.4 78.4
16.5 28.3 35.0 32.8 46.2 72.7
8.8 63.6 38.5 17.2
38.7 11.0 26.0
22.9 100.8
23.5 20.8 38.8 42.5 33.2 61.'1 50.1 14.1 23.6 35.5 31.3 58.3 11.5 29A 11.7
8.7 7.5 12.8 55.1 34.6 49.6 4<1.1 1<1.5 101.8 77.2
40.2 23.1 35.0 11.0 45.3 34.1 18.4 82.8 84.5 63.0 12.1 13.2 41.0
9.8 18.9 39.9 18.3 23.0 38.6 97.4 55.5 23.2 14.0 35.9 66.2 18.3 21.7 60.8 55.5 41.7 32.9
404
Georgie~ Department of Public Health
TABLE XVI (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
INFLUENZA AND PNEUMONIA, AND ALL FORMS OF TUBERCULOSIS IN EACH COUNTY IN GEORGIA:
1938 AND 1947
INFLUENZA AND PNEUMONIA
TUBERCULOSIS, ALL FORMS
COUNTY OF RESIDENCE
NUMBER
1947
1938
RATE PER 100,000 POPULATION
RATE PER 100,000
NUMBER
POPULATION
1947
1938 1947 1938
1947
1938
Quitman_
!1
Habun ...
2
Randolph
9
Hichmond .
50
Hockdale
5
Schley .......
1
Screven .....
13
Seminole ....................
2
Spalding .....
18
Stephens ...
7
Stewart
3
Sumter ..................... 22
Talbot .. ....
5
Taliaferro .
4
Tattnall ...................
5
Taylor
7
Telfair ......
7
Terrell ....
7
Thomas
29
Tift ........
5
Toombs
13
Towns ..
1
Treutlen
1
Troup
30
Turner
5
Twiggs
4
Union ...
2
Upson .....
18
Walker ..
7
Walton ...................... 15
Ware ...
17
Warren
11
Washington
10
Wayne ....
4
Webster
8
Wheeler .......... ......
1
White .......
Whitfield
12
Wilcox
6
Wilkes ....
9
Wilkinson
5
Worth ........................
7
Residents of Georgia,
death occurring in
other states ...
96.7
133.7
1
32.3
2
28.6
28.5
3
3
42.9
42.8
19
60.8
103.8
7
8
47.3
43.7
85
53.0
114.0
53
66
56.1
88.5
9
67.6
123.9
3
4
40.5
55.1
3
22.7
53.0
7
123.7
20
76.5
85.9
11
29.4
47.2
10
25.3
126.2
2
25.3
36
62.9
150.9
11
18
38.5
75.4
12
19.6
90.7
2
3
14.2
22.7
17
30.6
139.5
3
3
30.6
24.6
25
89.1
89.1
10
4
40.5
14.3
6
64.9
62.6
2
1
26.0
10.4
8
81.6
120.9
3
4
61.2
60.4
21
33.3
124.3
2
13.3
11.8
8
75.3
70.5
1
8.8
20
55.6
122.7
1
5
7.9
30.7
32
40.9
167.7
3
7
17.5
36.7
61
79.7
175.9
9
9
24.7
26.0
21
24.4
122.9
7
7
34.1
41.0
12
81.3
62.7
5
1
31.3
5.2
4
23.3
80.0
2
2
46.5
40.0
5
16.7
61.3
1
3
16.7
36.8
54
64.7
138.1
20
21
43.1
53.7
5
58.8
39.5
2
2
23.5
15.8
7
44.4
73.6
1
1
11.1
10.5
11
28.6
150.4
1
1
14.3
13.7
30
75.0
143.7
5
11
20.8
52.7
18
22.1
62.5
19
21
59.9
72.9
22
73.2
95.0
4
11
19.5
17.5
27
57.8
96.3
9
14
30.6
49.9
11
117.0
113.8
5
2
53.2
16.3
25
45.5
95.1
2
7
9.1
26.6
5
30.5
36.2
3
3
22.9
21.7
3
200.0
55.5
2
50.0
9
15.4
87.1
1
1
15.4
9.7
6
84.8
2
1
33.3
14.1
40
40.0
171.0
13
19
13.3
81.2
15
59.4
103.7
2
19.8
17
69.2
102.8
2
5
15.4
30.2
12
52.1
104.7
4
6
41.7
52.3
27
35.2
115.0
6
9
30.2
38.3
25
37
NOTE: These figures exclude nonresidents of Georgia and include residents of Georgia with death occurring in other states.
Rates based on the estimated population as of July 1, 1938 and 1947.
Information and Statistics
405
TABLE XVII
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
HOMICIDE AND DIABETES MELLITUS IN EACH COUNTY IN
GEORGIA: 1938 AND 1947
*HOMICIDE
DIABETES MELLITUS
COUNTY OF RESIDENCE
NUMBER
RATE PER 100,000
RATE PER 100,000
POPULATION
NUMBER
POPULATION
1947
1938
1947
1938 1947 1938
1947
1938
TOTAL --------------------- 500
582
15.5
18.8 448
420
13.9
13.5
Appling ------------------------ 1 Atkinson --------------------- Bacon .....
1
7.5
7.0
2
1
15.0
7.0
2
25.2
1
14.5
1
12.9
2
25.7
Baker
1
2
16.1
23.1
Baldwin ------------------------ 3 Banks -------------------- __________ 1
3
17.6
17.7
15.6
5
35.3
29.4
1
9.0
Barrow ............................
2
15.'1
14.6
,j
29.2
Bartow ..........................
3
11.4
10.9
1
1
3.8
3.6
Ben Hill Berrien ...
Bibb
------------------------ 21
Bleckley -------------------
1
H.3
7.3
2
2
H.3
14.6
2
11.9
3
2
21.1
11.9
32
19.1
40.5
20
12
18.2
15.2
2
1
22.0
10.0
Brantley
1
13.0
1
1<!.9
Brooks ---------------------------- 4 Bryan ---------------------------- 2
Bulloch --------------------------
Burke --------------------------- 8
Butts ______ --------
7
5
21.2
21.9
7
1
32.8
15.4
1
1
3.4
10
32.7
32.6
2
5
80.5
52.6
7
37.0
30.7
1
16A
15A
3
10.2
2
8.2
6.5
Calhoun ----------------------- 2 Camden ------- ---------------- 1 Candler ---------------------------- 2
Carroll ---------------------------- 2 Catoosa ...........................
1
20.2
8.8
1
15.4
15.0
2
27.8
20.2
2
6.5
5.<!
7
1
15A
22.6
13.5
9.1
Charlton -------------------------- 1
3
21.3
61.0
1
21.3
Chatham ------------------------ 33 Chattahoochee --------------
34
21.3
31.5
23
20
1'!.8
18.5
3
31.1
1
1
55.6
10.4
Chattooga ---------------------- 4
Cherokee ---------------------CCllaayrke_____---------------------------- 22
20.0
2
2
6.7
7.7
2
31.3
26.6
1
10.0
5.9
7
30.8
3
26.7
11.5
Clayton ---------------------------- 2
Clinch ----------------------------- 3
Cobb -------------------------------- 3
Coffee ---------------------------- 4
Colquitt -------------------------- 5
Columbia ------------------------ 2
Cook
1
2
16.0
18.2
1
2
58.8
25.8
1
6
5.8
15.8
5
4
18.2
17.9
3
7
15.1
21.1
2
2
24.1
20.8
2
9.0
16.0
2
8.0
18.2
19.6
1
9.6
2.6
5
13.6
22A
3
6.0
9.0
1
10.4
3
24.0
CCorawweftoa rd-----_-__-_-_-_------------------- 13
5
11.5
18.8
3
2
16.1
25.9
3
11.5
11.3
3
38.9
Crisp -------------------------------- 3
6
18.8
32.'1
1
6.3
5.4
Dade --------------------------------
Dawson __ -------------
Decatur ................
3
4
12.9
15.6
3
7
12.9
27.4
DeKalb ---------------------------- 12
Dodge ------- ------------------------ 1
Dooly ------------------------
Dougherty ---------------------
4
Douglas ---------
Early ------------------------------ 5
EEcffhionlgs ha-m------_-_-_-_-__-_-_-_-_-_-_-_--_-------- 1
7
13.6
9.4
18
1
5.7
4.2
1
5.2
3
8
11.0
34.9
5
1
9.6
5
27.8
25.2
4
4
40.0
145.3
5
L!5A
4
8
20A
10.8
1
4.2
2
19.7
10.4
5
13.8
21.8
1
9.6
4
22.2
20.2
44.0
27.2
Elbert --------------------
3
Emanuel ---------------------- 3
Evans .... -----------------
Fannin ....................
1
17.9
5.1
2
6
15.'1
22.9
2
1
12.9
1
11.9
5.1
10.3
3.8
15.2
6.7
Fayette ............................ 1
1
14.1
10.8
Floyd -----------
9
7
15.5
13.3
11
18.9
15.2
Forsyth --------------------------
1
9.9
o4 Franklin ---------
Fulton ----------------------------- 1
1 103
22.4
5.7
3
29.8
70
1 80
20.0 15.1
5.7 23.1
406
Georgin Department of Public Health
TABLE XVII (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
HOMICIDE AND DIABETES MELLITUS IN EACH COUNTY IN
GEORGIA: 1938 AND 1947
*HOMICIDE
DIABETES MELLITUS
COUNTY OF RESIDENCE
NUMBER
RATE PER I00,000
RATE PER I 00,000
POPULATION
NUMBER
POPULATION
1947
1938
1947
1938 1947
1938
1947
1938
Gilmer
Glascock
Glynn
12
Gordon
1
Grady
4
Greene
1
Gwinnett
Habersham .
3
Hall
6
Hancock
1
Haralson
Harris
3
Hart
1
Heard -
1
Henry
1
Houston
2
IJarcwksion~:::
1 2
Jasper
2
Jeff Davis
1
Jefferson
3
Jenkins
2
Johnson
3
Jones
Lan1ar
Lanier ...
1
Laurens
9
Lee
Liberty
1
Lincoln
1
Long
1
Lowndes
3
Lumpkin.
McDuffie
Mcintosh
Macon ...
Madison
M-arion Meriwether
,,
Mille1
2
Mitchell
8
MlVIoonnrLogoe~~~:y
1 1
Morgan
2
Murray ------
Muscogoee --
20
Newton
2
Oconee
1
Oglethorpe
1
Paulding --
Peach
1
Pickens
1
Pierce
1
Pike
------
1
Polk
4
Pulaski
2
Putnam -Quitman
Rabun
Randolph
7
Richmond
22
22.0
11.8
23.5
20.8
26.2
29.1
7
6.1
5.3
6
15.3
29.1
2
10.6
21.6
3
16.2
7.6
7.7
4
1
30.3
7.7
16.7
2
5
7.4
16.7
21.0
2
14.1
17.1
14.8
2
2
5.7
5.9
8.3
7.1
4
5
33.3
:l5.5
6.9
1
8.3
2
27.3
16.6
8.3
3
8.3
17.3
2
11.5
2
14.1
19.6
7
6.7
40.9
4
26.7
29.2
3
11.4
26.2
4
22.7
1
8.3
7.5
3
24.8
2
11.0
8.5
3
16.5
17.0
2
25.3
22.0
1
12.7
11.0
13.5
1
13.5
16.0
4.5
5
2
26.6
9.0
19.0
4
29.4
1
28.8
7.3
1
7.3
3
30.5
2
20.4
1
9.6
2
20.8
1
19.2
18.2
1
19.2
12
27.3
34.5
6
18.2
5.7
6
69.4
1
9.1
11.7
27.3
11.7
16.7
16.7
27.8
8.8
12.4
3
8.8
12.4
2
35.7
9.5
51.8
20.7
16.7
7
13.2
40.1
13.2
1
16.9
6.1
3
18.2
3
39.6
1
13.2
3
19.7
12.3
5
4
24.6
16.4
1
19.8
9.8
2
19.8
4
35.4
15.2
3
9.8
23.9
4
3.8
39.2
23.9
1
13.2
9.2
1
13.2
18.3
3
16.5
23.0
2
16.5
15.3
3
28.3
11
20.0
18.8
15
10
15.0
17.1
3
10.9
16.6
5
2
27.3
11.1
3
15.4
34.7
1
3
9.1
21.0
1
15.4
11.6
1
18.2
7.0
9.1
18.9
12.8
2
8.8
1<1.4
2
27.3
18.9
2
18.3
8.6
7.2
1
51.7
7.2
2
11.0
17.4
6
14.1
22.2
6
4
22.0
41.7
4
43.9
64.5
21.1
3.7
22.0
39.0
11.0
3
42.8
1
47.3
5.5
1
2
6.8
10.9
13
23.3
17.4
18
12
19.1
16.1
Information and Statistics
407
TABLE XVII (continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM
HOMICIDE AND DIABETES MELLITUS IN EACH COUNTY IN
GEORGIA: 1938 AND 1947
*HOMICIDE
DIABETES MELLITUS
COUNTY OF RESIDENCE
NUMBER
RATE PER 100,000
RATE PER 100,000
POPULATION
NUMBER
POPULATION
1947
Rockdale
1
Schley
2
Screven
4
Seminole
Spalding
4
Stephens ------------------ 1
Stewart
1
Sumter
2
Talbot
Taliaferro
1
Tattnall
2
Taylor
1
Telfair ---
2
Terrell --------
1
Thomas ..........................
5
Tift
1
Toombs
5
Towns
1
Treutlen
Troup
Turner
Twiggs
Union
1
Upson
2
Walker
1
Walton
I
Ware
Wanen
2
Washington
2
Wayne
1
Webster -------------------------- 1
Wheeler
1
White
Whitfield
Wilcox
Wilkes
Wilkinson
6
Worth
2
Residents of Georgia. death occurring in other states
1938
1 1
3 8 .,. ;f 5 6 2 4 8 2 4
5 3 3 8 2 4 2
2 2
5 8
1947
13.5 15.5 23.5
14.0 7.1
10.2 8.1
20.4 13.3 10.8 15.9
5.8 13.7
4.9 31.3 23.3
12.9 23.5
14.3 8.3 3.2 4.9
21.3 9.1 7.6
25.0 15.4
6.7 19.8
62.5 10.1
1938 1947 1938
1
17.7
2
4.3
2
29.3
2
7
2
24.6
1
28.5
3
4
29.6
1
52.9
1
12.3
1
21.0
2
23.1
6
11.7
<l
20.9
1
24.5
1
2
15.3
11
6
15.8
10.5
1
2<1.0
5
I
10.4
3
3
13.0
1
2
28.5
5
4
16.3
1
3
15.2
1
2
14.5
1
1
2
2
8.5
2
1
13.8
1
5
I
43.6
1
2
34.1
3
1
4
1947
13.5 45.5 11.8
7.0
12.1
6.7 10.8
7.9 11.7 16.5 19.5
23.3 16.7 23.7
11.1
20.8 9.5 4.9
17.0 10.6
4.5 7.6
33.3 6.7
38.5 10.4 15.1
1938
13.8
12.9
29.3 15.1
8.2 14.3 20.9 30.2 41.'1
8.8
31.4 2.9
11.7 20.9 40.0 24.5 15.3
13.7 4.8 10.4 8.6 14.3
24.4 7.6 7.2
37.0
4.3 6.9 6.0 17.4 4.3
NOTE: These figures exclude nonresidents of Georgia and include residents of Georgia with death occurring in other states.
Rates based on the estimated population as of July 1, 1938 and 1947.
*ofDceoautnhtsy
from homicide of residence.
are
allocated
to
county
where
homicide
occurred
instead