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The first case came from Louisville, Ky., and several 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, 50 per cent. had been properly vaccinated, of these one contracted the disease, and none died. Of the 50 per cent. exposed who had not been vaccinated, 20 per cent. took the disease and none died.

We have one eruptive hospital, located four miles from Elizabethtown, with a capacity for eight to ten patients. Our method of managing the disease was vaccination and isolation.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $2,475. The estimated cost in loss of trade and interference with business has been large.

ΤΙ chief dit ulties in stamping out the disease have been opposition to vaccination.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, many cases and many deaths; typhoid fever, 400 cases and 10 per cent. deaths; diphtheria, thirty cases; cholera infantum, many cases; dysentery, many 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. The county health officer is paid a yearly salary of $300, and all of the other members serve gratuitiously. Each doctor who treats a case of smallpox is paid $5 and mileage for a reasonable number of visits, and the fiscal court relies on the chairman and health officer of the county board of health to pass judgment on the justice of the claim of each doctor. We have so fair an understanding between court and doctor that it is now seldom that a claim is not paid in full.

Very respectfully,

C. Z. AUD, M. D., Secretary.

Harrison County Board of Health.

Cynthiana, Ky., August 31, 1905. To the State Board of Health:

Since our last published report two years ago there have been three outbreaks of smallpox in this county, with a total of thirteen cases and no deaths.

The first case came from Covington, Ky., and an unknown number of 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 the number exposed who had not been vaccinated twelve The population of this county is 18,000. At the time of our last reSince that time it is estimated

89 took the disease, but none died. port unknown had been vaccinated. that 100 have procured vaccination, leaving unknown 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 and one-half miles from Cynthiana, with a capacity of forty patients. Our method of managing the disease was where satisfactory quarantine was possible patient kept at home, otherwise sent to pest-house.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been less than $100. The estimated cost in loss of trade and interference with business has been small.

The chief difficulties in stamping out the disease have been unwillingness to vaccinate.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, 200 cases and eighty-five deaths; typhoid fever, 200 cases and twentyfive deaths; diphtheria, forty-five cases and six deaths; scarlet fever, ninety cases and three deaths, cholera infantum, seventy cases and twenty deaths, and dysentery, eighty-seven cases and twelve deaths. T'he average cost to our people for managing and treating a case of any of these diseases, including medical attention, nursing, loss of t.me and incidental expenses, is estimated to be $100, making a total loss to the county for the two years, from diseases which might be prevented, of $69,200, as against $70,478,15 paid for county, and $70,478.15 (two years) for State taxes. The county health officer is paid a salary os $200, and all the other members serve gratuitously.

This report is estimated. The figures in latter part of report based upon reports from less than one-third of the physicians in the county.

Very respectfully,
MARSHALL MCDOWELL, M. D., Secretary.

Harlan County Board of Health.

Harlan, Ky., August 31, 1905. To the State Board of Health:

Since our last published report two years ago there have been three outbreaks of smallpox in this county in the Bend of River, Turtle Creek and Town districts or precincts, with a total of 130 cases and no deaths.

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The first case came from Covington, Ky. jail, and 100 or more persons had been exposed to the disease before its character was recog. nized and reported so that we could take steps to bring it under control. Of the 130 exposed who had not been vaccinated all took the disease, but none died.

The population of this county is 8,000 to 9,000. At the time of our last report none had been vaccinated. Since that time it is estimated chat 150 have procured vaccination, leaving 99 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 quarantine them in their own homes, with sufficient guard to keep down improper intercourse.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $1,325. The estimated cost in loss of trade and interference with business has been $2,000.

The chief difficulties in stamping out the disease have been the people don't believe it is smallpox. Especially the justices of the coun. ty, or a majority of them.

The following additional facts will be of interest in connection with this report: The majority of the people don't believe it is smallpox and same refuses to be vaccinated. It would be quite a job to force vaccination in this region of country.

Very respectfully,

W. T. NOLEN, M. D., Secretary.
N. S. HOWARD.
G. P. BAILEY, M. D.

Hart County Board of Health.

Horse Cave, Ky., August 31, 1905. To the State Board of Health:

Since our last published report two years ago there have been out'breaks of sinallpox in this county, in the Foroleing, Camner, Hardyville and Monroe districts or precincts, with a total of 240 cases and no deaths.

The first case came from Indiana, 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 none had been properly vaccinated, of these many contracted the disease, but none died.

At the time of our last report over half had been

vaccinated. Since that time it is estimated that three-fourths have procured vaccination,

pox almost constantly in some section of the State.

We have no eruptive hospital.

There is about 25 per cent. of our population unprotected and as there is such a war on vaccination in Indiana and Virginia and Ohio it will be a hard pull for us to force it further.

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 large.

The chief difficulties in stamping out the disease have been from some of our doctors and our county judge and county attorney, who feel that they have no right.

The following additional facts will be of interest in connection with this report: We have no statistics in regard to any of the infectious diseases except smallpox. We have had during the last year and up to this time quite a number of typhoid fever cases with several deaths. We have had a few cases of diphtheria, about ten, as I best can get it. Otherwise we are all 0. K.

Very respectfully,

T. H. GARVIN, M. D., Chairman.

Henderson County Board of Health.

Henderson, Ky., August 31, 1905. To the State Board of Health:

Since our last published report two years ago, there have been five outbreaks of smallpox in this county in the Zion, Geneva, Henderson, Corydon and Oak Grove districts or precincts, with a total of sixty-three cases and one death.

The first case came from Madisonville, Ky., and sixty-three 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 one had been properly vaccinated, of these none contracied the disease. Of the sixty-three exposed who had not been vaccinated, sixty-three took the disease and one died.

The population of this county is 34,000 (about). At the time of our last report forty-five had been vaccinated. Since that time it is estimated that 2,000 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 one eruptive hospital, located two and one-half miles from Henderson, Ky., with a capacity of forty patients. Our method of managing the disease was: The health officer was on salary and under contract to treat all indigent persons with smallpox. Developed cases, with suspects were sent to pest-house, except in extreme cases. In some few instances cases were quarantined at home, with a general vaccination in the neighborhood.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine, has been $2,153.69. The estimated cost in loss of trade and interference with business has been very small.

The chief difficulties in stamping out the disease have been, first, mildness with the accompanying doubt in minds of public as to genu. ineness of disease; disposition to conceal and refusal to obey quaran. tine regulations, with the tangled and vague laws relating to the subject.

The county health officer is paid a salary of $600, and all of the other members serve gratuitously.

This report covers the time from July 25, 1904 to October 1, 1905.

Have no data for estimation of per cent. of unvaccinated or of the other diseases enumerated.

Very respectfully,

SILAS GRIFFIN, M. D., Secretary.

Henderson, Ky., October 3, 1905. The State Board of Health of Kentucky:

As health oficer of Henderson county, I beg leave to submit the following report, from June 24, 1904 to October 1, 1905: During this time we have had seven separate and distinct outbreaks of smallpos in various parts of the county, viz.: Henderson, Zion, Geneva and Club House, Oak Grove, Corydon, Audubon, Griffith's and Sechrist's Saw Mill.

The infection in the first two cases reported, which developed within a few days of each other, came from Madisonville and Hopkinsville. Below we give a summary of the work accomplished:

Number. Cases smallpox treated in and out pest-house.

63 Deaths

1 Suspects quarantined at pest-house.

91 Dismissed from quarantine....

154

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