Estill County Board of Health.

To the State Board of Health:

Since our last published report two years ago there have been outbreaks of smallpox in this county, in the Redlick, Irvine Station, Camp and Riddell districts or precincts, with a total of forty cases and no deaths.

The first case came from Richmond, Ky. I don't know how 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.

The population of this county is 5,000. At the time of our last report 200 had been vaccinated. Since that time it is estimated that 100 have procured vaccination, leaving 94 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

We have no eruptive hospital. Our method of managing the disease was by quarantine, by guarding, and experienced nurses.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $1,500. The estimated cost in loss of trade and interference with business has been $1,000.

The chief difficulty in stamping out the disease has been the failure to impress the people with the value of vaccination.

As nearly as can be ascertained, other cases of preventable diseases have cccurred during the two years as follows: Consumption, twenty cases and fifteen deaths; typhoid fever, one case and no death; cholera infantum, fifteen cases and eight deaths; dysentery, twentyfive cases and five 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 $30, making a total loss to the county for the two years from diseases which might be prevented of $2,440, as against $10,000 paid for State taxes.

The following additional fact will be of interest in connection with this report: The chairman and two others members of the Board of Health were allowed $50 each for managing the smallpox epidemic. Very respectfully,

G. A. EMBRY, M. D., Secretary.

Fayette County Board of Health.

Lexington, Ky., August 31, 1905.

To the State Board of Health:

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

The first case came from Cincinnati, and eight 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, three had been properly vaccinated; of these, none contracted the disease. Of the five exposed who had not been vaccinated, all took the disease and one died.

We have one eruptive hospital, located 11⁄2 miles from Lexington, with a capacity for twenty patients. Our method of managing the disease was isolation, prompt destruction of infected material (bedding), and quarantining of suspects.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $200.

The chief difficulty in stamping out the disease has been failure of attending physicians to make early diagnoses.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Diphtheria, nine cases and two deaths; scarlet fever, twenty cases and three deaths; yellow fever, one case and no death.

The following additional fact will be of interest in connection with this report: The greatest trouble this office has is in getting the physicians to report cases. I am sure that there have been more cases, but they have not been reported.

Very respectfully,

W. J. FOLEY, M. D., Secretary.

Fleming County Board of Health.

To the State Board of Health:

Flemingsburg, Ky., August 31, 1905.

Since our last published report two years ago, there have been three outbreaks of smallpox in this county, in the Grange City, Hillsboro and Plummer's Landing districts, with a total of thirteen cases and no deaths.

The first case came from Illinois, and about twenty-five 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 who had been properly vaccinated contracted the disease. Of the fifteen exposed who had not been vaccinated, ten took the disease.

The population of this county is 17,000. At the time of our last report, 13,000 had been vaccinated. Since that time it is estimated that 100 have procured vaccination, leaving 25 per cent. still unprotected, after nearly eight years of smallpox almost constantly in some section of the State.

We have no eruptive hospital. Our method of managing the disease was isolation and vaccination of those exposed.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $200.

We had no difficulty in stamping out the disease after its recognition.

The county health officer is paid a salary of $100. and all of the other members receive $25.

During the past two years we have had fewer cases and consequently fewer deaths from consumption, typhoid fever, diphtheria, scarlet fever, cholera infantum and dysentery, but having no records to refer to, can not furnish this information.

Very respectfully,

J. C. S. BRICE, M. D., Secretary.

Floyd County Board of Health.

Prestonsburg, Ky., August 31, 1905.

To the State Board of Health:

Since our last published report two years ago there has been one outbreak of smallpox in this county, in the Mouth of Mud precinct, with a total of six cases and no deaths.

The first case came from West Virginia, 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, most had been properly vaccinated. Of these, none contracted the disease.

The population of this county is about 13,000. At the time of our last report none had been vaccinated. Since that time it is estimated that half 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 no eruptive hospital. Our method of managing the discase was isolation, vaccinating all exposures, and treating cases in the usual manner.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $100. The estimated cost in loss of trade and interference with business has been nothing.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Typhoid fever, about thirty cases and four deaths; cholera infantum, about fifty cases and seven or eight deaths: dysentery, twelve cases and no 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 $50, making a total loss to the county for the two years from diseases which might be prevented of $4,600, as against $14,800 paid for State taxes. The • county health officer is paid nothing.

I am not in a position to make an exact report, as our physicians are widely scattered and fail to report their cases or keep any records.

Very respectfully,

W. W. RICHMOND, M. D., Secretary.

Franklin County Board of Health.

Frankfort, Ky., August 31, 1905.

To the State Board of Health:

Since our last published report two years ago there has been one outbreak of smallpox in this county, in the State prison, with a total of six cases and no deaths.

The first case came from Eastern Kentucky.

The population of this county is 25,000. At the time of our last report, 10,000 had been vaccinated. Since that time it is estimated that 3,000 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 no eruptive hospital. Our method of managing the disease was: The State Board of Health promptly took charge of the outbreak of smallpox in the State prison, and placed Dr. J. G. South there as its inspector. Although the institution was in splendid sanitary condition, there was a general cleaning up and disinfecting with sulphur and formaldehyde gas. All guards and civilians, in or about the prison, as well as all convicts, were vaccinated and re-vaccinated

until all had good scars. Of course all cases and suspects were at once removed to the outside (and I say outside advisedly, for they had to be taken to an old barn), and kept in strict quarantine until complete recovery and disinfection. Be it said to our shame that the capital city has not yet provided an eruptive hospital of any kind, nor has the county of Franklin or the State of Kentucky. We would be very much embarassed to handle any kind of a serious outbreak of contagious diseases.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $1,000. The estimated cost in loss of trade and interference with business has been $5,000.

The chief difficulties in stamping out the disease have been the fact that we are not provided with a pest house, and the small percentage of successful vaccinations.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Typhoid fever, seventy-five cases and six deaths; diphtheria, 100 cases and ten deaths; scarlet fever, fifty cases and three deaths.

Very respectfully,

J. GLOVER SOUTH, M. D., Secretary.

Frankfort, Ky., September 12, 1905.

Dr. J. N. McCormack, Secretary, Bowling Green, Ky.

My Dear Doctor: I want to say a few words to you about the diphtheria now existing in this county. I feel it my duty to report to you that I now consider the disease to be in epidemic form in this county; we certainly have as many as 300 cases at this time in the county alone; I can not say how many are in the city; I understand, though, from Dr. Price, city health officer, that there is not very much in the city. Diphtheria is now widely scattered throughout the county. I believe the reason for the spread has been that the country physicians, as a rule, have failed to report their cases. There has been quite a good many deaths from the disease, but, notwithstanding that fact alone, we still have some of our profession that insist the disease is not diphtheria.

I, as county health officer, am in a rather awkward position; I feel that I should be doing something towards stamping out the trouble, yet there seems little that I can do; as I said before, the disease is widely scattered throughout the county, a great many houses are infected, they nearly all have insisted on visiting, etc. It would be an enormous expense to the county now to guard each house. We have no such thing as an eruptive hospital; I must confess that I am somewhat at a loss as to what to do in the matter.