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Circular Issued by the State Board of Health of Kentucky.

To the Health Officials, Physicians and People of Kentucky: Although smallpox has been stamped out over and over again in nearly every county in Kentucky within the last five years, this board has official information that the disease has again appeared in several widely-separated sections. It is also prevalent in adjoining States, and everywhere manifests a tendency to break over official control and assume an epidemic form. Since January, 1898, smallpox has prevailed, more or less extensiveiy, in every county in this State, with a total of 25,026 cases and 396 deaths, and costing in cash from our county and municipal treasuries as gathered from official reports, the immense sum of $596,714.69, and an estimated loss from interference with business and travel of $1,321,395. Judiciously expended, this would be much more than enough to keep every person in Kentucky thoroughly vaccinated for a generation, so that the existence of anything but an imported case of smallpox would be an impossibility. In spite of this, it is estimated that over 50 per cent. of our people, and in many counties and country districts over 90 per cent., have never been vaccinated. An imported case, and especially a mild and easily-overlooked one, who can go around freely all the time, or after the eruption appears and the fever subsides, and visit his friends and kin, is like a spark in tinder, and such a case usually means an epidemic, which spreads by a repetition of these conditions, often skipping to distant communities and counties. Usually the disease has been mild in form, but in Christian, Fulton, and some other counties and sections, it has been very severe, as it has in Indiana, Ohio and Massachusetts, where the death rate has been high. It is a loathsome disease at best, and at any time the mildest cases may communicate it in the severe form. As we are likely to have disastrous and expensive epidemics until vaccination is systematically and thoroughly done, this board feels it to be a duty to again warn our officials and people that active steps should be taken at once, and in an intelligent and comprehensive way, to guard against the disease. Fortunately, the method of prevention is as safe and certain in its action as it is cheap and easy to obtain. Vaccination and re-vaccination, properly done with reliable virus, is a certain preventive, and is free from danger. This is the conclusion of the scientific world after large experience and full investigation, and may be confidently relied upon.

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