the board of education of the city add the health officer to its staff, to give lectures on public health once a week in the high school and, if time will permit, in the grade schools as well. Make this course in public health a part of the regular curriculum and have the pupils pass an examination upon it, as in the case of other subjects taught. It is recommended that the health department publish a small weekly bulletin at the close of the lecture, to contain briefly the subjects which have been lectured upon. "The cooperation of the people can be obtained only after a campaign of education, which has not in the past been carried on to any great extent," says Dr. Fox. He believes that the scheme of education which will produce the best results is that which will instruct the school children on the subject of disease prevention. A compliment is paid to the system of government (city manager plan) in vogue in Springfield, in the report. "When considered with the efficiency of the officials in charge," it may be said to be one approaching the ideal," says the report. "Under this form of government there has been developed the nucleus of a health department which only requires a little financial assistance and the co-operation of the people to expand into a highly efficient organization." ** SUPPORT THE RED CROSS. The response of Ohio citizens to the appeal for support of the Red Cross has been most gratifying. There is every indication that Ohio will do more than her share of giving. Those who have contributed have just cause for feeling proud of this and may rest assured that their money will be well spent. The Red Cross, as an agency of relief and philanthropic service has international recognition. It has the President of the United States as its president. Its accounts are audited by the U. S. Treasury Department. It is the only guaranteed source of rendering aid in time of war or disaster that is recognized by the government. The efficiency of the Red Cross has been demonstrated by the service it has already rendered to stricken Belgium and to France. Thousands of our own young men will soon be in army camps, some of them, perhaps, in the trenches of France and they will need all the aid and comfort that the folks back home can give them. Hospitals will need medical supplies for caring for the sick and wounded. Furthermore we are facing the problem of caring adequately and systematically for the dependent families of soldiers and families of soldiers, which problem has been found most easily and efficiently handled through the Red Cross. Let this be our slogan: "GIVE UNTIL IT HURTS." 1909 1910 1911 1912 1913 1914 1915 SCARLET FEVER IN OHIO. Its Occurence in Various Localities, Modes of Transmission, Diagnosis, Treatment and Prevention. BY FRANK G. BOUDREAU, M. D., C. M., Director, Division of Communicable Diseases, Ohio State Board of Health. Scarlet fever is unusually prevalent this year, judging from case reports. The winter and spring months are also the season of its greatest prevalence. For several years April has been the month of greatest mortality from the disease, as Chart I will show. Hence it seems desirable at this time to discuss the subject and determine what steps should be taken to prevent its spread. While scarlet fever is not so serious a public health problem in Ohio as measles and whooping cough, it is still a problem. Compared with smallpox, scarlet fever causes thirty times as many fatalities every year in Ohio. What makes it a real public health problem, however, is the fact that within certain limits, it can be controlled. Hence, apathy or neglect in the campaign against scarlet fever stamps the health officer as ignorant of his opportunity and indifferent to the public welfare. Like a number of other communicable diseases, scarlet fever has shown an increasing tendency to occur in mild forms, so that it is apt to be overlooked, and this is one of the chief reasons for its spread. In spite of its apparent mildness, scarlet fever is the cause of many deaths and much suffering every year in Ohio. Besides this, it frequently causes grave interruption to school work, and its complications not infrequently cripple for life those who escape death. To give an accurate idea of the annual loss of lives from scarlet fever in Ohio, Table I was compiled. Table I. MORTALITY AND MORTALITY RATES FROM SCARLET FEVER IN OHIO AND THE REGISTRATION AREA FOR THE YEARS 1909-1915, INCLUSIVE. SEASONAL DISTRIBUTION Percentage of scarlet fever deaths which occur each month. For instance in January, March, May and December ten percent. of the yearly deaths occured in each month. The least number of deaths, five percent. each month, occurred in August and September. 1913 1914 1915 1916 THE OHIO PUBLIC HEALTH JOURNAL. 239 Any disease which causes an annual average loss of lives totalling more than 300 in Ohio is worthy of the serious consideration of all physicians and public health officials. It is almost impossible to estimate the number of cases represented by these deaths. Only a fraction of the total number of scarlet fever cases is reported, although the notification of this disease is becoming more complete every year, as shown in Table II. Table II. REPORTED CASES AND CASE FATALITY RATES OF SCARLET FEVER IN OHIO, 1913-1916, INCLUSIVE. This table shows either a lessening case fatality rate, or a larger proportion of the cases reported each year. It is probable that both these factors are present in varying degree. At least ten thousand cases of scarlet fever occur every year in the state of Ohio. This mans a serious expense to the families in which they occur, to the community affected, and to the schools attended by members of the afflicted families, for every case of scarlet fever means several absentees from school. This does not take into account the anxiety caused by the appearance of the disease in a family. All in all, the prevention of scarlet fever, and even stringent measures towards that end, are easily justified by the ravages of the disease. The distribution of scarlet fever by counties for the period 19091914 is shown in Table III. Rate. |