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Breathitt County Board of Health: Dr. B. D. Cox, Jr., Dr. W. G. Daily Dr. C. H. Williams, Dr. J. P. Boggs.

Jackson, Ky., July 16, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 3 outbreaksof smallpox in this county, in the following districts or precincts: Jackson, Cane Creek and Frazee, with a total of 30 cases and no deaths. Three hospitals or pest houses were provided near these precincts, and the following was our method of management: Isolation and vaccination of all who had been exposed. Some of our cases were severe.

The disease was brought to this county from Tennessee; it was very promptly recognized, after few had been exposed. I estimate that 500 vaccinations have been done in the county since the first cases occurred, that 200 had been previously vaccinated, out of a total population of 14,756, leaving 14,256, or practically all outside of town of Jackson now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been SHOO. The estimated, cost to the county in loss of trade and interference of business bar been about $10,000.

Our chief difficulties in stamping out the disease were: That the people did not fear the disease and that they would not be vaccinated.. The fiscal court supported our efforts cheerfully.

Very respectfully,

B. D. COX, M. D., Secretary.

Bvllitt County Board of Heauh: Dr. S. W. Bates, Dr. Geo. W. Kirk,.

Dr. F. A. Barnett, C. E. McCormack, Esq., W. T. Lee, Esq.

Lebanon Junction, Ky., September 3, 1901. To the State Board of Health:

Gentlemen: Within the last four years we have had-4 outbreaks of smallpox in this county, in the following districts or precincts: Shepherdsville and Lebanon Junction, with a total of 94 cases and 1 death. One hospital or pest house was provided near Shepherdsville, and the following was our method of management: We have used the flag assoon as known to be smallpox, disinfected and fumigated and burned all bedding and clothing we were justified in doing. ,We were in quarantine by your Board in 1900 for what you considered lax management.

The disease was brought to this county from Louisville and Corbin; it was not recognized until many had been exposed. I estimate that 200 vaccinations have been done in the county since the first cases, occurred, that 100 had been previously vaccinated, out of a total population of 9,000, leaving 97 per cent, now unprotected.

The total cost of management to the county, including hospital. physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $1,100. The estimated cost to the county in loss of trade and interference of business has been $5,000.

Our chief difficulties in stamping out the disease were: From the fact that several doctors discredited the fact that it was smallpox, and some people seemed to think the doctors wanted to make something out of it. I have estimated above, but did not give any cost as to the last cases, but think it will cost us $300 at least; but now when we have it, the people are willing to give us full credit and I am satisfied none of us were careful enough at first. Very respectfully,

F. A. BARNETT, M. D., Chairman.

Butler County Board -of Health: P. E. James, J. H. Austin, W. A. Helm, E. A. Cherry.

Morgantown, Ky., July 22, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 3 outbreaks of smallpox in this county, in the following districts or precincts: Morgantown and Banock, with a total of 55 cases and no deaths. One pesthouse was provided near Morgantown, Ky., and the following was our method of management: So far as practicable all cases were taken to the pest house as soon as one could be provided. In the recent outbreak near the Ohio county line, the cases were treated at their homes and managed under great difficulties.

The disease was brought to this county from Louisville, Frankfort, and Indiana; it was promptly recognized, after several had been exposed. I estimate that 500 vaccinations have been done in the county since the first cases occurred, that few had been previously vaccinated, out of a total population of 15,000, leaving practically all now unprotected, except the 500 above mentioned.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $3,000. The estimated cost to the county in loss of trade and interference of business has been $20,000.

Our chief difficulties in stamping out the disease were: The laity did not believe it to be smallpox. Some would call it "Cuban itch," or "hog measles," but we had some very severe cases which did not look like the so-called measles and itch, and then people became somewhat alarmed and most of them obeyed the county board's orders. Others never did obey a single order. Very respectfully,

E. A. CHERRY, M. D., Secretary.

Jireckenridge County Board of Health: A. M. Kincheloe, M. D., A. A. Simons, M. D., R. T. Dempster, M. D.

Cloverport, Ky., July 30, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 4 outbreaks -of smallpox in this county, in the following districts or precincts: McDaniels, Irvington and Cloverport, with a total of 82 cases and 2 deaths. No hospital or pesthouse was provided near, and the following was our method of management: Quarantine in houses where cases were; medical service furnished. No special treatment instituted. Guards took charge of provisions and clothing. All old clothing and bedding burned and new furnished, every room disinfected and whitewashed. Every person given an antiseptic bath before discharging.

The disease was brought to this county from Owensboro, it was recognized, after many had been exposed. I estimate that 120, vaccinations have been done in the county since the first cases occurred, that some had been previously vaccinated, out of a total population of 20,534, leaving at large — per cent, now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc. for all the cases which have occurred in the time named has been $1,000. The estimated -cost to the county in loss of trade and interference of business has been $2,500.

Our chief difficulties in stamping out the disease were: A prevailing doubt as to the genuineness of the disease caused by one or two physicians spreading a report that it was impetigo contageosa which made authorities lukewarm in their efforts to lend a hand in stamping it out. Also our county court is slow to pay physicians for services. At last May term one physician sued county for services. Physicians are therefore slow to do their duty.

Very respectfully,

A. A. SIMONS, M. D., Sec'y.

Caldwell County Board of Health: Dr. P. R. Shelby, Dr. J. A. H. Miller, Dr. W. R. Clement, Dr. R. W. Ogilvie, Dr. J. D. Mott.

Princeton, Ky., August 23, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 2 outbreaks -of smallpox in this county, in the following districts or precincts: Princeton and Fredonia Districts, with a total of 39 cases and 1 death. The pest house was provided near Princeton, Ky., within 2% miles, and the following was our method of management: During the epidemic -of two years ago we isolated every case at pest house as soon as disI ^covered, and disinfected (by fumigation) every infected house or thing; the recent epidemic in Fredonia district was managed by house isolation and disinfection; the one death occurred in the last epidemic, it being a confluent case.

The disease was brought to this county from Metropolis, 11l., by a negro; it was recognized, after several had been exposed. I estimate that 3,000 vaccinations have been done in the county since the first cases occurred, that 4,000 had been previously vaccinated, out of a total population of 15,000, leaving 9,000 now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $1,000. The estimated cost to the county in loss of trade and interference of business h t~i been $15,000.

Our chief difficulties in stamping out the disease were: Reports that it was only Cuban itch, chickenpox, or anything except smallpox, and the disinclination of people to be vaccinated and tardiness of the authorities in enforcing vaccination and other means of combatting the disease. Very respectfully,

JOS. A. H. MILLER, M. D., Chairman.

Calloway County Board of Health: Wm. M. Mason, M. D., C. 0. Gingles, M. D., E. T. Dunaway, M. D., Will Mason, Jr., M. D.

Murray, Ky., July 16, 1901.

To the State Board of Health:

Gentlemen: Within the last four years we have had 2 outbreaks of smallpox in this county, in the following districts or precincts: Murray and Hazel, with a total of 128 cases and 5 deaths. A tent hospital or pest house was provided near Murray, and the following was our method of management: Had everybody in and around Murray vaccinated and placed in quarantine all who had been exposed, and kept them 20 days. We had an apartment of detention for those who had been exposed to cases in the pustular stage. After getting well, wehad them thoroughly washed in soap and antiseptic solution and a change of clothing before being released.

The disease was brought to this county from Paris, Tenn.; it was recognized after 30 or 50 had been exposed. I estimate that 5,00Oj vaccinations had been done in the county since the first cases occurred, that 5,000 had been previously vaccinated, out of a total population, of 18,500, leaving 8,500 now unprotected.

. The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $5,000. The estimated cost to the county in loss of trade and interference of business has been $35,000.

Our chief difficulties in stamping out the disease were: To get the people and authorities to realize the seriousness of the disease. Many thought it was not smallpox, but after a death or so, the court ordered an eruptive hospital, and gave the physician in charge permission to employ nurses and proper supplies. The disease was then brought tinder prompt control.

Very respectfully,

W. H. MASON, M. D., Secretary.

Campbell County Board of Health: C. B. Schoolfield, M. D., J. F. Houston, M. D., Wm. A. Young, M. D.

Dayton, Ky., October 1, 190L

To the State Board of Health:

Gentlemen: Within the last four years we have had 7 outbreaks -of smallpox in this county, in the following districts or precincts: Hayfield or Brut, Highland, Alexandria and John's Hill, with a total of 41 cases and 1 death. No hospital or pest house was provided and the following was our method of management: Patients were quarantined at once by placing guards sufficient to prevent exit or entrance. See that they have necessary medical attention and are provided with provisions. After recovery, used disinfectants (usually formaldehyde) and burned all that could not be disinfected.

The disease was brought to this county from Greenup county, Ky., Covington, Ky., and Cincinnati, Ohio; it was not promptly recognized, and many had been exposed. I estimate that — vaccinations have been done in the county since the first cases occurred, that — had been previously vaccinated, out of a total population of 54,000, leaving — per cent, now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $1,608. The estimated cost to the county in loss of trade and interference of business has been $10,000.

Our chief difficulties in stamping out the disease were: Lack of co-operation of the fiscal court and refusal on their part to pay legitimate expenses for quarantine and provisions.

Very respectfully,

WM. A. YOUNG, M. D., Secretary.

Newport City Board of Health: Dr. Chas. J. Kehm, City Health Officer.

Newport, Ky., August 6, 1901.

To the State Board of Health:

Gentlemen: Within the last two years we have had 2 outbreaks -of smallpox in this city, with a total of 51 cases and no deaths. No hos

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