Pulaski County Board of Health: Dr. G. M. Reddish, Dr. J. W. F. Parker, Dr. A. W. Crim, James L. Waddle, Esq.

To the State Board of Health:

Somerset, Ky., July 31, 1901.

Gentlemen: Within the last four years we have had 2 outbreaks of smallpox in this county, including the city of Somerset, in the following districts or precincts: Fairbush and Somerset, with a total of 65 cases and 3 deaths. One hospital or pest house was provided near Somerset, and the following was our method of management: Isolaation of all cases not treated in hospital, a strict quarantine established at each house when the disease prevailed. The hospital was provided with a resident physician and nurses, good beds and wholesome food were provided by city council and county court.

The disease was brought to this county from Russell county, Ky.; it was not promptly recognized until after a large number had been exposed. I estimate that 4,000 vaccinations have been done in the county since the first cases occurred; that 2,000 had been previously vaccinated, out of a total population of 16,000, leaving 10,000, or 66 per cent. unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $8,000. The estimated cost to the county in loss of trade and interference of business has been $25,000.

Our chief difficulties in stamping out the disease were: Getting assistance of county court; the aversion of the laity in submitting to vaccination; the fact that some physicians would not concur in the

Robertson County Board of Health: Dr. J. B. Wood, Dr. W. H. Anderson, Dr. Riley Wells, Hon. W. J. Osborne.

To the State Board of Health:

Mt. Olivet, Ky., July 21, 1901.

Gentlemen: Within the past four years we have had an outbreak of smallpox in this county in our town, Mt. Olivet, with a total of 40 cases and no deaths. No hospital or pest house was provided near our town, and the following was our method of management: Each and every case was kept at their home, isolated from the public. Almost all so affected were exposed almost simultaneously, and in consequence of being provided with neither hospital nor pest house, those exposed were kept in confinement until the disease was soon under control.

The disease was brought to this county from Pendleton county;

it was recognized after these had been exposed. I estimate that about 100 vaccinations have been done in the county since the first cases occurred, that 25 per cent. hod been previously vaccinated, out of a total population of 4,900, leaving about 75 per cent. now unprotected. The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been about $200. The estimated cost to the county in loss of trade and interference of business has been $500, or thereabout.

Our chief difficulties in stamping out the disease were: Keeping patients confined to their homes, and indifference and ignorance on the subject of vaccination.

Very respectfully,

J. B. WOOD, M. D., Chairman.

Rockcastle County Board of Health: Dr. Percy Benton, Dr. John S. Cooper, Dr. A. G. Lovell.

To the State Board of Health:

Mt. Vernon, Ky., July 30, 1901.

Gentlemen: Within the last four years we have had 3 outbreaks of smallpox in this county, in the following districts or precincts: Brodhead and Livingston, Wildie and Climax, with a total of 12 cases and no deaths. No hospital or pest house was provided, and the following was our method of management: The cases were treated in their own homes, and a physician superintended the fumigations in each instance before the patients were turned loose.

The disease was brought to this county from Lebanon Junction, Richmond and Nem123456 Mines, Tenn.; it was each time promptly recognized after few had been exposed. I estimate that 250 vaccinations have been done in the county since the first cases occurred, that 100 had been previously vaccinated, out of a total population of 13,000, leaving about 12,500 now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $654. The estimated cost to the county in loss of trade and interference of business has been small.

Our chief difficulty in stamping out the disease was: Maintaining quarantine against Jackson county, when the disease was running loose there. We had no trouble in managing our own cases.

Very respectfully,

A. G. LOVELL, M. D., Secretary.

Rowan County Board of Health: Dr. Jere Wilson, Dr. B. C. Wilson, Dr. F. M. Carter, Hon. W. A. Young.

To the State Board of Health:

Morehead, Ky., July, 1901.

Gentlemen: Within the last four years we have had 2 outbreaks of smallpox in the county, both in Morehead precinct, with a total of 40 cases and 1 death. One pest house was provided near Morehead, and the following was our method of management: Isolation of patient, strict local quarantine and vaccination of all suspects. The disease was brought to this county first from Pinhook, Morgan county, Ky., and second by a traveling show; it was recognized after several had been exposed. I estimate that 250 vaccinations have been done in the county since the first cases occurred; that 2,000 had been previously vaccinated, out of a total population of 8,200, leaving 6,000 now unprotected in the county.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $1,600. The estimated cost to the county in loss of trade and interference of business has been considerable, but I am unable to make an estimate.

Our chief difficulties in stamping out the disease were: The resistance to vaccination and refusal of county authorities to co-operate with the health officer. We labored against both wind and weather, but kept the disease from spreading.

Very respectfully,

J. WILSON, M. D., Chairman.

Russell County Board of Health: Dr. J. B. Scholl, Dr. W. G. D. Flanagan, Dr. J. S. Rowe.

"To the State Board of Health:

Jamestown, Ky., July 24, 1901.

Gentlemen: Within the last four years we have had 3 outbreaks of smallpox in this county, in the following districts or precincts, towit: Jabez, Irvin's Store and Kimble, with a total of 62 cases and 3 deaths. A hospital or pest house was provided near Jabez, and the following was our method of management: Isolation and vaccination, guards, etc. In the first outbreak we had to institute the shotgun method of quarantining on account of a majority of the people in the infected district being hostile to the usual methods. Hence the enormous cost to the county.

The disease was brought to this county in the first outbreak from Lebanon, Ky., and the second from Somerset, Ky.; it was recognized after from 50 to 75 had been exposed. I estimate that 500 vaccinations have been done in the county since the first cases occurred; that

1,000 had been previously vaccinated, out of a total population of 9,000, leaving 7,500 now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $2,119.91. The estimated cost to the county in loss of trade and interference of businesshas been $1,000.

Our chief difficulties in stamping out the disease were: A disposition on the part of a large per cent. of the people to disobey the law, and to the fact that a large per cent of our people had never been and would not be vaccinated, or otherwise advised or controlled. Very respectfully,

J. S. ROWE, M. D., Secretary.

Scott County Board of Health: Dr. John E. Pack, Dr. John A. Lewis, Dr. R. L. Carrick.

To the State Board of Health:

Georgetown, Ky., July 16, 1901.

Gentlemen: Within the last four years we have had 3 outbreaks of smallpox in this county, in the following districts or precincts: Minorsville, Sadieville and Georgetown, with a total of 160 cases and 2 deaths. A pest house was provided near Georgetown, and the following was our method of management: In the country districts infected houses and persons were kept under surveillance for the usual length of time and general vaccination enforced. Two-thirds of the houses in Sadieville were disinfected, it having a population of nearly 600.

The disease was brought to this county from Lexington, probably; it was not promutly recognized, and many had been exposed. I estimate that 2,000 vaccinations have been done in the county since the first cases occurred, that 3,000 had been previously vaccinated, out of a total population of 20,000, leaving 15,000, or 75 per cent., now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $1,400. The estimated cost to the county in loss of trade and interference of business has been $5,000.

Our chief difficulties in stamping out the disease were: Failure on part of physicians to recognize the disease, as same pronounced it "Cuban itch." The county officials were slow to give assistance to the health board at first, but finally did all that was required.

Very respectfully,

JOHN E. PACK, M. D., Chairman.

Shelby County Board of Health: Dr. R. D. Pratt, Dr. W. R. Ray, Dr. E. L. Bramanan, Dr. Curtis Austin.

To the State Board of Health:

Shelbyville, Ky., July 24, 1901.

Gentlemen: Within the last four years we have had 6 outbreaks of smallpox in this county, in the following districts or precincts: Shelbyville (2), Todd's, Finchville, and Sweet Home, with a total of 70 cases and 2 deaths. A hospital or pest house and detention house were provided near Shelbyville, and the following was our method of management: Patients were confined in pest house or guarded at home; exposed persons promptly vaccinated or re-vaccinated, and either placed in house of detention or quarantined under guard at home.

The disease was brought to this county from Louisville or Franklin county, Ky.; it was recognized after 70 had been exposed. I estimate that nearly 4,000 vaccinations have been done in the county since the first cases occurred, that 50 per cent. had been previously vaccinated, out of a total population of 18,340, leaving about 8,000 now unprotected.

The total cost of management to the county, including hospital, physicians, vaccinations, guards, nurses, food, etc., for all the cases which have occurred in the time named has been $3,300. Estimated cost to the county in loss of trade and interference of business has been nominal.

Our difficulties in stamping out the disease were practically none. The county officials and people recognized quickly the necessity of stamping out the disease and gave the glad hand to the board of health. After the first week of excitement business went on as if nothing unusual had occurred.

Very respectfully,

R. D. PRATT, M. D., Chairman.

Simpson County Board of Health: Dr. J. C. Douglass, Dr. G. W. Duncan, Dr. C. W. Neeley.

To the State Board of Health:

Franklin Ky., July 16, 1901.

Gentlemen: Within the last four years we have had 1 outbreak of smallpox in this county, in the following districts or precincts: 'Town District and Shultz, with a total of 8 cases and no deaths. A pest house was provided near County Home, 4 miles from town, and the following was our method of management: Isolation, vaccination and fumigation.

The disease was brought to this county from Nashville, Tenn.; it was promptly recognized. I estimate that 50 vaccinations have been