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Expense incurred by reason of inmates at pest-house insurance and repairs on property, new furniture, vaccina tions

Total cost of management from July 24, 1904 to October 1, 1905.....

1,343 69

$2,153 69

The county is now free of smallpox and has been since June 29, 1905.

Because of the interest to all parties concerned to suppress each outbreak as soon as it occurred, and to prevent the spread of each epidemic, the expense to the county, under the present management has been greatly reduced.

At the suggestion of the board of health, we desire to make the foliowing recommendations to the fiscal court.

1. As a means of further economy and to secure better services for the amount of expenditures, we would like to suggest that the keeper of the pest-house be elected for a term of years, and be placed on a salary basis, similar to the plan now being successfully used at the county pocr-house.

2. That a four or six room house for suspects alone be provided, the present building being inadequate even during the past year.

We respectfully request the consideration of the court to these recommendations, as well as the foregoing report.

SILAS GRIFFIN,

Secretary Henderson County Board of Health.

Henry County Board of Health.

New Castle, 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 Eminence, with a total of two cases and no deaths.

Do not know where the first case came from, but thirty 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, twenty had been properly vaccinated, of these none contracted the disease. Of the ten exposed who had not been vaccinated none took the disease.

The population of this county is 20,000. At the time of our last report three-fourths had been vaccinated. Since that time it is estimated that one-eighth have procured vaccination, leaving one-eighth 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 to isolate them in the place we found them, have the house guarded and then thoroughly fumigate the house.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine has been $178. 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: Consumption, fifty cases and twenty-five deaths; typhoid fever, seventy-five cases and ten deaths; diphtheria, two cases and one death; scarlet fever, twenty cases and no deaths, and dysentery, 100 cases and twenty 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 $100, making a total loss to the county for the two years from diseases which might be prevented of $23,700, as against about $26,000 paid for county, and $22,000 for State taxes. The county health officer is paid a salary of $375, and all of the other members serve gratuitously.

Very respectfully,

JOHN P. NUTTALL, Jr., M. D., Secretary.

Hickman County Board of Health.

November 25, 1905.

To the State Board of Health:

Since our last published report two years ago there have been two outbreaks of small pox in this county, in the Clinton, Columbus and Spring Hill districts or precincts, with a total of fifty-eight cases and no deaths.

The first cases came from Dyersburg, Tenn., and Missouri, and

thirty 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 twenty-seven had been properly vaccinated, of these none contracted the disease. Of the fifty-three exposed who had not been vaccinated fifty-three took the disease and none died.

The population of this county is 13,000. At the time of our last report 8,000 had been vaccinated. Since that time it is estimated that 250 have procured vaccination, leaving 30 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 $1,500. The estimated cost in loss of trade and interference with business has been $500.

The chief difficulties in stamping out the disease have been indifference on the part of the people, and the great difficulty of successfully quarantining negroes who will mix and mingle in spite of quarantine.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, twenty cases and twenty deaths; typhoid fever, fifty cases and six deaths; diphtheria, ten cases and no deaths; scarlet fever, forty cases and five deaths; cholera infantum, twelve cases and three deaths, and dysentery, fifty cases and five deaths. The average cost to the 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 $10,000, as against $32,000 for State taxes.

The fiscal court and county board of health work in harmony and pay the health officer for services rendered.

Very respectfully,

J. L. SCARBOROUGH, M. D., Secretary.

Hopkins County Board of Health.

(No report received.)

Jackson County Board of Health.

To the State Board of Health:

August 19, 1905.

As nearly as can be ascertained, other cases of preventable diseases have occurred during the two years as follows: Consumption, fifty case and fifty deaths; typhoid fever, 100 cases and ten deaths; cholera infantum, 100 cases and fifteen deaths, and dysentery, fifty cases and five deaths.

Very respectfully,

W. T. AMYX, M. D., Secretary.

Jefferson County Board of Health.

Louisville, 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 Fourth Magisterial district, with a total of fifty-three cases and eight deaths.

The first case came from Louisville, and 100 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 fifty-two exposed who had not been vaccinated fifty-two took the disease and eight died.

The population of this county outside of Louisville is 50,000. At the time of our last report 33 per cent. had been vaccinated. Since that time it is estimated that 75 per cent. 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 one eruptive hospital, located three miles from Louisville, with a capacity of 200 patients. Our method of managing the disease was in every case to remove at once, as soon as a diagnosis was made, to the eruptive hospital, vaccinated and unvaccinated, all exposed, cremate all bedding and clothing, fumigate the house and inspect the family every day.

The total cost of managing the disease for the two years, including hospital, physicians, vaccination, guards, nurses, food and medicine has been $5,300. The estimated cost in loss of trade and interference with business has been $1,000.

The chief difficulties in stamping out the disease have been inability to get all the people vaccinated.

The county health officer is paid a yearly salary of $1,200, and all of the other members serve gratuitously.

The following additional facts will be of interest in connection with this report: Have spread 60 barrels crude oil for mosquito nuisance; have served 200 nuisance notices; had nine dairymen indicted for selling milk from cows fed on still slop. Miss Rosa Stonestreet deserves much credit for getting all the county school children vaccinated without expense to the county.

Very respectfully,

B. W. SMOCK, M. D., Secretary.

Louisville, Ky., January 5, 1905.

The Jefferson County Board of Health met in Judge Gregory's office on the above date. There were present Judge Gregory, Drs. T. H. Baker and B. W. Smock. Doctors Griffiths and Allen were absent. The meeting was called to order by the secretary on motion of Judge Gregory. Dr. Baker was elected to preside. The report of the health officer for the year was made, as follows:

Summary of work done by the county health officer for the year 1904: Served 157 nuisance notices; vaccinated 109 children in school; adults, 64, those exposed; total, 173; had reported and sent to the eruptive hospital for treatment fifty-seven cases of smallpox, with seven deaths; had reported and placarded twenty-seven cases of scarlet fever, with five deaths; had reported and placarded fourteen cases, with two deaths; had spread thirty barrels of crude oil for the mosquito nuisance; recommended a sewer for Oakdale; had slaughtered thirty milk cows at Lakeland, after they responded to the anti-tuberculine test.

There being no other business, the meeting adjourned to meet at 3:30 p. m., February 7, 1905.

B. W. SMOCK, M. D., Secretary.

Louisville, Ky., November 27, 1905.

Dr. J. N. McCormack, Secretary State Board of Health, Bowling Green, Ky.

My Dear Doctor: I have the honor to report to you a summary of the work done by me as health officer of Jefferson county, from November, 1904, to December, 1905, to-wit:

I received reports of forty-three cases of diphtheria and twentyone cases of scarlet fever, all of which were confined to the Fourth Magisterial District. All of these cases were placarded for from twelve to twenty-one days, and after recovery or death of child the houses were thoroughly fumigated with formaldehyde. It is grati fying to report in this connection that our county doctors are alive to the great value of the early administration of antitoxine in diph

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