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Of the fifteen exposed who had not been vaccinated, five took the disease and none died.

The population of this county is ten or twelve thousand. At the time of our last report 50 per cent. had been vaccinated. Since that time it is estimated that 5 per cent. have procured vaccination, leaving 45 per cent. still unprotected after nearly eight years of smallpox almost constantly in some section of the State.

We have no eruptive hospital.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $50 per case.

The chief difficulties in stamping out the disease have been caused by the people refusing to be vaccinated.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, one-third of the deaths in the county; typhoid fever, one hundred and fifty cases and 10 per cent. deaths; diphtheria, twenty cases and 10 per cent. deaths; scarlet fever, fifty cases and 5 per cent. deaths; cholera infantum, two hundred cases and 10 per cent. deaths; dysentery, one hundred and fifty cases and 5 per cent. deaths, and yellow fever no cases. The total loss to the county for the two years from diseases which might be prevented was $10,000, as against $27,000 for State taxes. The county health officer is paid a salary of $75, and all the other members serve gratuitously.

The following additional facts will be of interest in connection with this report: Our physicians rarely ever report cases to county health officer.

Very respectfully,

N. L. ROGERS, M. D., Secretary.

Barren County Board of Health.

Glasgow, Ky., August 31, 1905.

To the State Board of Health:

Since our last published report one year ago there has been one outbreak of smallpox in this county in the Glasgow district, with a total of seventy-five cases and no deaths.

The first case came from Louisville, and many persons had been exposed to the disease before its character was recognized and reported so that we could take steps to bring it under control. Of those exposed, half had been properly vaccinated; of these, none contracted the disease, and none died. Of the one hundred exposed who had not been vaccinated, seventy-five took the disease and none died.

The population of this county is 34,000. At the time of our last report 15,000 had been vaccinated. Since that time it is estimated that 2,000 have procured vaccination, leaving 50 per cent. still unprotected after nearly eight years of smallpox almost constantly in some section of the State.

We have one eruptive hospital, located four miles from Glasgow, with a capacity of fifty patients. Our method of managing the disease was local quarantine at the patient's home when safe, and confinement in the eruptive hospital when necessary to protect others.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $500. The estimated cost in loss of trade and interference with business has been nothing.

The chief difficulties in stamping out the disease have been the obstinate and persistent contention by many persons and some physicians that the disease was not smallpox, but some harmless eruption, that was not to be dreaded.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, ten cases and eight deaths; typhoid fever, thirty cases and two deaths; scarlet fever, four cases and no deaths; dysentery, six cases and one death. The average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of time and incidental expenses, is estimated to be $75, making a total loss to the county for the two years from diseases which might be prevented, of $4,250, as against $40,000 paid for county, and $36,000 for State taxes. The county health officer is paid no salary, and all of the other members serve gratuitously.

The following additional facts will be of interest in connection with this report: The use of humanized virus has been found far more satisfactory in every way than the points or tubes furnished the board from any source yet, and we would advise its use wherever possible. We have had no smallpox in the last twelve months.

Very respectfully,

R. E. GARNETT, M. D., Secretary.

Bath County Board of Health.

To the State Board of Health:

Owingsville, Ky., August 31, 1905.

Since our last published report two years ago there have been three outbreaks of smallpox in this county in the Sharpsburg, Owings. ville and Preston districts, with a total of thirty cases and no deaths.

The first case was contracted from the clothing of a man from eastern Kentucky, and twelve persons had been exposed to the disease before its character was recognized and reported so that we could take steps to bring it under control. Of those exposed, none had been properly vaccinated; of these, six contracted the disease, and none died.

The population of this county is 16,000. At the time of our last report 4,500 had been vaccinated. Since that time it is estimated that 500 have procured vaccination, leaving 70 per cent. still unprotected after nearly eight years of smallpox almost constantly in some section of the State.

We have an eruptive hospital located three miles from Owingsville. Our method of managing the disease was as follows: The recent outbreaks of smallpox within the county have been principally confined to country homes. By isolating both patients and suspects and en. forcing vaccination, we have succeeded very well in suppressing the disease.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $500. The estimated cost in loss of trade and interference with business has been $200.

The chief difficulties in stamping out the disease have been that our statutes admit of too much conflict between our health boards and fiscal courts. The prerogatives of each should be more clearly defined.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, 300 cases and 80 deaths; typhoid fever, 400 cases and 25 deaths; diphtheria, 50 cases and 12 deaths; scarlet fever, 25 cases and 3 deaths; cholera infantum, 300 cases and 20 deaths; dysentery, 100 cases and 5 deaths. The average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of time and incidental expenses, is estimated to be $25, making a total loss to the county for the two years from diseases which might be prevented, of $32,595, as against $48,000 paid for county, and $48,000 for State taxes. The county health officer does not receive an annual salary, but is paid for services actually done, which has amounted to about $300 in the last two years.

Very respectfully,

A. W. WALDEN, M. D., Secretary.

Bell County Board of Health.

To the State Board of Health:

Middlesboro, Ky., August 31, 1905.

Since our last published report two years ago there has been one outbreak of smallpox in this county, in the Middlesboro district, with a total of 30 cases and 1 death.

The first case came from Tennessee, and no person had been exposed to the disease before its character was recognized and reported so that we could take steps to bring it under control.

The population of this county is 14,000. At the time of our last report 60 per cent. had been vaccinated. Since that time it is estimated that 20 per cent. have procured vaccination, leaving 20 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

The county has no eruptive hospital; they simply isolate and guard each case as they find it and vaccinate all exposed.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $4,000.

The chief difficulty in stamping out the disease has been no pesthouse, a question of what city and county should do.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, 14 cases and 9 deaths; typhoid fever, 25 cases and no deaths; diphtheria, 5 cases and 2 deaths; scarlet fever, 7 cases and 1 death; cholera infantum, 24 cases and 7 deaths; dysentery, 40 cases and 2 deaths, and yellow fever, no cases. The county health officer is paid no salary, and all of the other members serve gratuitously.

The following additional facts will be of interest in connection with this report: It is hard to get an accurate report. Both county and city isolate and guard all smallpox cases and vaccinate all exposed. All other contagious diseases are treated accordingly.

Very respectfully,

L. L. ROBERTSON, M. D., Secretary.

Boone County Board of Health,

Burlington, Ky., August 31, 1905.

Since our last published report two years ago there have been two outbreaks of smallpox in this county in the Burlington and Bellevue district, with a total of 20 cases and no deaths.

The first case came from Ludlow, Ky., and 50 persons had been exposed to the disease before its character was recognized and reported so that we could take steps to bring it under control. Of those exposed, 35 had been properly vaccinated; of these, none contracted the disease. Of the 15 exposed who had not been vaccinated, all took the disease and none died.

The population of this county is 12,000. At the time of our last report 50 per cent. had been vaccinated. Since that time it is estimated that 1,000 have procured vaccination, leaving 40 per cent. still unprotected after nearly eight years of smallpox almost constantly in some section of the State.

We have an eruptive hospital, located one mile from Burlington, with a capacity for 12 patients. Our method of managing the disease was strict isolation and thorough disinfection with formaldehyde after they were well.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $225. The estimated cost in loss of trade and interference with business has been nothing.

The chief difficulties in stamping out the disease have been The county officials, the physicians, and the laity all gave me their support, and the disease was soon stamped out.

none.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, 300 cases and 75 deaths; typhoid fever, 100 cases and 8 deaths; diphtheria, 10 cases and no deaths; scarlet fever, 15 cases and no deaths; cholera infantum, 400 cases and 50 deaths; dysentery, 200 cases and 20 deaths, and yellow fever, no cases. The average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of time and incidental expenses, is estimated to be $35, making a total loss to the county for the two years from diseases which might be prevented, of $3,500, as against $12,000 paid for county, and $50,000 for State, taxes. The county health officer is paid no salary, and all of the other members serve gratuitously.

Very respectfully,

W. O. ROUSE, M. D., Secretary.

Bourbon County Board of Health.

To the State Board of Health:

Paris, Ky., August 31, 1905.

Since our last published report two years ago there has been one outbreak of smallpox in this county in the Claysville (suburb of Paris) district, with a total of 1 case and no death.

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