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fatality rate in typhoid fever is NOTES OF PROGRESS IN considered to be about 10 percent,

SANITARY ENGINEERING rather than the 50 percent figure

IN OHIO MUNICIPALITIES which these rates would indicate

Zanesville's new water plant, for Cincinnati.

by which the city's Muskingum

River supply will be replaced by We Wonder Also !

well water, is expected to begin If this had been tuberculosis, operations about May 15. The imwhat would have happened? provement consists of twenty wells

That is the headline which the and an entire new pumping station. division of tuberculosis suggests should be placed on the following Filtration of Cleveland's water item from an Akron paper :

supply, by means of the new West When John Smith of 808 S. Main

Side filtration plant, erected at a street appeared in Police Court Monday cost of $3.500,000, began in March. morning to answer to a charge of gam- Fifty · million gallons of filtered bling, his face

mass of red blotches.

water per day were supplied at "What's the matter with you?" asked

first - enough to supply half the Judge l'aughan.

city — and this quantity "The Lord only knows," replied doubled by the latter part of April, Smith. Vaughan sent a hurry call for Dr. R.

permitting almost city-wide disW. E. Cole, city epidemiologist.

tribution. The maximum capacity "He has a well-developed case of of the plant is estimated at 150 to smallpox," said Cole.

160 millions of gallons. The city's Immediately there was a scattering in

maximum daily consumption is 135 the courtroom. Spectators who had been enjoying the

millions. Monday morning grist, fought to get through the door at once into the lobby. They went down the stairs three steps

Twelve new wells being drilled at a time,

to increase Canton's water supply “See that every prisoner who came in were due to reach completion May contact with this man is vaccinated," Vaughan ordered.

1. Preliminary work is being done “Also see that all bailiffs and jail attendants are vacci

in Canton toward the construction nated. Order the entire place fumi- of a trunk sewer, for which imgated." Sixty men

provement a bond issue of $290,were in the city prison when Smith was brought in Sunday

000 has been authorized. morning. He was released several hours later on bond.

A new sewage disposal plant has Before his appearance Monday, a

This score of prisoners had been arraigned

been completed in Xenia. and released.

plant is of modern design and will An effort will be made immediately to

produce a highly purified effluent. round them all up and see that they are The plant was installed to correct vaccinated.

the pollution of Shawnee Creek, Judge Vaughan was the first to be vaccinated.

which has been in a foul condition Smith was taken to the pesthouse.

for a number of years.

A low-turned gas jet or burner may, through changing pressure or a loose key, change into a raging fire menace while you sleep.

Infection in the family, coupled with poor housing conditions, is the principal cause of the spread of tuberculosis.

PUBLIC HEALTH NOTES FROM OVER THE STATE

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The annual meeting of the Ohio Plans for the construction of a State Medical Association, to have contagious disease hospital, to cost been held in Columbus May 13, 14 $5,000 to $6,000, are being conand 15, has been postponed until sidered in Lorain. October 1, 2 and 3.

The Ohio Supreme Court has Akron's health authorities cun

upheld a $35,000 hospital bond isducted a school survey last month, sue of Circleville, to which objeclooking into the general surround

tion was made on the ground that ings of buildings and grounds, council had not given official nosanitary conveniences, water sup- tice that the question was to be ply, ventilating systems, lighting of

submitted at an election. rooms and arrangement of blackboards and charts.

At a conference of tuberculosis Toledo's restricted district has

hospital superintendents in Colum

bus, March 14, these officers were been wiped out of existence by an

elected for the ensuing year: order from Mayor Schreiber, issued as a wartime health measure

Chairman, Dr. S. A. Douglass, Mt.

Vernon; vice chairman, Mrs. at the request of the Federal authorities. The order set May I as

Aloysia Lawin, Columbus; secrethe date by which the district must

tary, H. J. Southmayd, State De

partment of Health, Columbus. cease to exist.

Meetings of the conference are to Leaving her home while it was

be held every two months. under quarantine for scarlet fever cost a Dayton woman $20 and

Two thousand dollars for the costs last month. Judge Budroe

support of the Ravenna Visiting assessed the fine after the offender Nurse Association during the comhad entered a plea of guilty.

ing year was raised in a campaign

the week of March 18. For refusing to clean the floors, walls and utensils in his bakeshop. The Hamilton Anti-Tuberculosis when ordered by the sanitary League has elected the following police to do so, a Lorain baker officers: President. Dr. A. C. Carwas fined $10.

ney; vice president, John Conbory; secretary-treasurer,

Mrs. E. S. One hundred thousand persons

Griffis. living or working in Cincinnati have been vaccinated since Decem- The Mississippi Valley Conferber 1, 1917, according to city ence on Tuberculosis will meet in health authorities, who based their Columbus during the latter part of estimates upon physicians' reports. September. The Ohio Society for Many industrial concerns in Cin- the Prevention of Tuberculosis cinnati have required their em- will meet at the same time and ployees to be vaccinated.

place.

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TABLE OF CONTENTS

PAGE

EDITORIALS - Suinmer Months Make Up the Typhoid Season — Typhoid

Is Easily and Immediately Preventable — Typhoid Wastes Millions

Needed for Liberty Bonds - California's Record in Lowering Typhoid

Rate - What a State Must Do to Prevent Typhoid Fever — Carrier

Danger Is Best Avoided By Vaccination — Figures Show That Typhoid

Is Not Properly Reported -- Protect Vacationists for Sake of Com-

munity -- "Community Health Is a Purchasable Commodity" — Baby

Needs Protection Against Summer Diarrhea....

186

Typhoid Fever in Ohio: Some Statistical Observations. By Sara KERR.... 193

Water Purification as a Factor in the Elimination of Urban Typhoid fever.

By W. H. Dittoe....

200

Steubenville's Survey

205

The Health Officer's Responsibility in the Prevention of Typhoid Fever. By

JAMES E. BAUMAN..

206

Prevention of Typhoid Fever in Small Towns and Villages. By Allen W.

FREEMAN, M. D........

208

Typhoid Prevention on Farms.

210

The Laboratory and Typhoid Fever. By R. V. Story.

212

Whooping Cough Strikes Heavily.

215

Lima Regulates Barber Shops.....

215

Typhoid fever as a Contagious Disease..

216

Four of Five Largest Ohio Cities Have Typhoid Death Rates Under 10 Per

100,000 for 1917....

217

Baby Death Total Little Reduced in February.

218

Public Health Nursing Service — Report for March, 1918.

219

DEPARTMENTAL REPORTS BY DIVISIONS (APRIL, 1918) –

Division of Communicable Diseases

221

Division of Public Health Education and Tuberculosis.

225

Division of Sanitary Engineering

227

Division of Industrial Hygiene

228

Division of Laboratories

229

Division of Plumbing Inspection

230

Hawaii Now Included in Registration Area.

230

HEALTH OFFICERS' ROUNDTABLE – Enforce Whooping Cough

. Quarantine - Quarantine Violator Fined - Civilian Health Is Topic

- Hogs Ruled Out of Kenton Blames Dust for Death Increase

Wouldn't Force Vaccination, So....

Public Health Notes From Over the State.

232

The Ohio Public Health Journal

Vol. IX

MAY, 1918

No. 5

EDITORIALS

Summer Months Make Up The "typhoid season” has arrived. The the "Typhoid Season" record of past years shows that the

typhoid curve begins to rise in May or June, reaches its highest point in September and then falls off to its low mark in December or January.

Whether this year will see the curve go to as high a point as last depends upon the work which health officials do in the next three months. There can be no delay if we are again to succeed in lowering our typhoid death total. Every health official in the state should feel it a personal duty to improve the situation within his own district.

Look up the record of your district for the past few years. Note how large a share of the death total has usually been crowded into the summer months. Then resolve to make the figures tell a different story for 1918.

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Typhoid Is Easily and Typhoid fever is easily preventable, and Immediately Preventable to a large extent immediately preventable.

In the case of no other disease can direct evidence of results achieved by preventive campaigns be so readily collected.

The typhoid problem is fundamentally a simple one. All that is needed to stamp out the disease is to prevent human food and drink from being contaminated by human filth. An abnormally high typhoid rate in a community can be attributed only to neglect of simple sanitary precautions.

The methods of typhoid prevention in both cities and rural communities are discussed elsewhere in this magazine. Stated in a general way, typhoid can be prevented by provision of pure water, proper disposal of sewage, elimination of flies, and regulation of food supplies especially milk – so as to guard against contamination of these products by typhoid carriers.

Any health officer can do something toward making improvements along these lines. Every time an insanitary toilet is put out of existence - every time the use of a polluted water supply is prevented — every time a campaign for reducing flies and screening against them is instituted - every time, in short, an obstacle is put in the path of the typhoid germ toward the human mouth, the typhoid death rate receives a severe blow.

Typhoid, we repeat, is easily preventable. Any health official who is so inclined can prevent his share. And he will not have to wait long for results. Results will appear at .once in the form of a decreased typhoid death rate.

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Typhoid Wastes Millions Five million dollars wasted every year! Needed for Liberty Bonds That is what Ohio's present typhoid

fever situation means, judged from an economic standpoint. Think how little of this money would be needed to stamp out most of the typhoid! Or think what this amount would do if invested in Liberty Bonds !

Yet we continue to throw our yearly five millions away, merely. because we are too careless to direct it into proper channels of expenditure.

The five million dollars is the approximate amount arrived at in a careful statistical study of the situation, taking into account the incidence of the disease in various age-groups, the estimated value of the human lives lost at these different ages, the loss of time from productive employment and the cost of treatment.

With an average of about seven hundred deaths per year in the state, it is estimated that the case total must reach at least seven or eight thousand, fatalities being estimated at from one-fifteenth to one-tenth of the cases. The money loss represented by the deaths has been put at three millions per year and that represented by both deaths and nonfatal cases at five millions.

When there are as many other uses for five million dollars a year as there are at present, with war needs mounting higher every day, typhoid prevention becomes a vital issue. Deliberate waste of money is to be condemned at any time, but just now it is a crime against the national well-being.

Every typhoid case that is prevented means an average saving of seven hundred dollars. Every typhoid death that is prevented means an average saving of more than four thousand dollars.

"Prevent typhoid and help finance the war!" should be Ohio's slogan during the present summer.

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