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TOTAL NUMBER OF DEATHS IN EACH COUNTY IN THE STATE FOR

THE YEARS 1916 AND 1917, FROM ALL CAUSES, AND THE VARI-
OUS DISEASES, WITH RATES PER 1,000 POPULATION-Concluded.

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NOTHER serious typhoid closed in addition to these. The

fever epidemic, due to the fifteen cases had occurred since

importation of a case of ty- March 6, in three groups about one phoid into a community devoid of month apart: March 6 to March necessary sanitary safeguards, has 22, April 28 to May 7 and June 5 been investigated by the State De- to June 15. None of the cases had partment of Health. The outbreak

been reported to the State Departoccurred at Connorville, an unin- 'ment of Health, the call for invescorporated community of about 250 tigation having been brought about inhabitants in Jefferson County. by the superintendent of a hospital Conditions were similar in many at Martins Ferry, whose wards respects to those prevailing in the were being crowded with typhoid epidemic at Coitsville, Mahoning patients. County, investigation of which was The first case, appearing on reported in the June Ohio PUBLIC March 6, was in a man whose ocHEALTH JOURNAL.

cupation of drayman caused him A representative of the Depart- to travel over the country and ment went to Connorville July 2, drink water from many sources. after information of the outbreak The second and third cases folhad been transmitted to the De- lowed in his household March 22, partment by the health officer of The fourth case (April 28) and Warren Township, in which the the fifth case (May 1) were in a hamlet is located. Ten cases of man and wife residing at a distance typhoid fever had been reported to from the first three cases, but inthe health officer, it was learned, directly connected with them by hut five unreported cases were dis- marriage. Other cases also were scattered here and there over the in the control of the first three community. Family relationships cases, according to the investigator and an intimate degree of contact, who reported upon the epidemic. however, were established in ten Recommendations made for the of the cases; of the remaining five prevention of further typhoid outcases, two were children in a house- breaks in Connorville included: hold which purchased milk from Disinfection of all wells and abanthe family first affected, two others donment of the spring, anti-typhoid were children who had been in inoculation of residents, improveclose contact with children num- ment of wells by grading of surbered among the first ten cases and rounding ground to carry surface the fifth was an older brother of water away from the well and by one of these latter two children. installing concrete curbs and tight Contact is therefore established as concrete covers to keep out surface the probable source of infection in contamination, reconstruction of all twelve of the fourteen cases which privies so as to provide water-tight followed the first case, and either vaults with flyproof superstrucmilk infection or contact in the tures and covered seats, screening remaining two

cases — children of doors and windows of all who were in the habit of playing houses, allowing of no person to be with the other children in the com- connected with the handling or dismunity.

tribution of milk or other raw food Lack of sanitary precautions supply until he has complied with with regard to wells and privies the other recommendations stated. makes these probable additional sources of typhoid infection also. The water supply of the com

REPORT PUBLISHED

ON SICKNESS SURVEY munity comes from wells and from a spring, all of which were found A sickness survey conducted in to contain B. coli, indicating human connection with the Framingham contamination. None of the cases (Mass.) health demonstration could under the circumstances be showed 6.2 percent of the populadefinitely traced to water supply, tion of the town to be suffering but it is almost certain that some from some illness, according to of these wells, after the epidemic their own knowledge. This figure had prevailed for some time, were covered all minor illnesses as well capable of transmitting the disease. as more serious ones. Those whose Carelessness in looking after pa- illness was serious enough to make tients, evidenced by the prevailing them unable to work amounted to lack of cleanliness among the resi- 3.3 percent of the population, or dents, and the presence of leaching 54. I percent of all those reporting privy vaults close to wells and illness. usually on higher ground than the The survey has been reported in well, made the spread of the dis- full in Monograph No. 2, recently ease certain after one case was in- published by the Community Health troduced.

Station, Framington. A later pubThe two later periods of the lication will report the results of epidemic, including twelve of the medical examinations in the town. fifteen cases and two deaths, would affording a basis for comparisons almost certainly have been avoided between the amounts of recognized had proper precautions been taken sickness and existing sickness.

Baby-Saving in Ohio During the Earlier

Half of 1918

D

in that year.

is 2,255.

URING the first three months activities, when as a matter of fact

of Children's Year 663 a certain amount of these savings

babies were saved in Ohio, is due to the fact that the average basing comparisons with 1916 on monthly mortality is normally conthe average three months' period siderably higher than the actual

The state's three totals for May and June. The months' quota is 1,128 — 465 in truth of this statement is evident excess of the actual saving. Deaths in the fact that May and June come of children under five years old after the period of high pneumonia during these three months totaled mortality and before the period in 3,174; for the average three which the toll of diarrhea and enmonths' period of 1916 the total teritis rises. The fact that no dewas 3,837

tailed statistics on infant mortality During the six months from by months in Ohio are available, January i to July 1, 1918, a sav

however, makes it necessary to ing of 683 was attained, by com- base computations of savings on parison with the average

six average figures. months of 1916. The quota as

Since the Children's Year quotas signed to be saved in six months were apportioned, on the basis of under the Children's Year program

the 1916 mortality in the various Children's Year did not counties and cities, the 1917 infant formally open until April 1, the an- mortality figures have been comniversary of America's entrance piled by the State Bureau of Vital into the war.

Statistics. The total of deaths The monthly savings for the six

under five years of age in 1917 months

follows (the

was 15,373. In 1916 the total was monthly quota is 376):

15,349. In view of this slight dif

ference between the two years, January

42 quotas based on 1916 mortality are February

75

practically as well-adjusted to the March (97 loss)

97

situation as if they were based on April

21 May

165 the 1917 deaths. The second of June

477 the attached tables shows infant

mortality figures by counties for These figures, it must be remem

both 1916 and 1917. bered, are based on averages, and While the infant death total retherefore represent the saving as mained practically the same in greatest in the months when infant 1917 as in 1916, the rate showed a mortality is normally low and least decrease. In 1916, 298 children in the months when it is normally under five years old in every 100,high. There is danger that too 000 of the population died – in much credit for the apparently 1917, 295 per 100,000. Deaths of large savings in May and June may children under five years old in be given to the Children's Year 1916 represented 20.7 percent of

were

as

It ap

all the state's deaths -- in 1917 pected in May and June because they were 19.8 percent of the total. of the low prevalence of pneumonia To attain the goal set for Chil- and diarrhea and enteritis. dren's Year, deaths of children pears to be a fact, however, upon under five years old this year must hasty survey of the death cernot exceed 205 per 100,000 popu

tificates for June, that enteritis lation or 15 percent of the total deaths were even less numerous deaths.

this year than they ordinarily are The percent of all deaths in Ohio in June. At the same time whoopwhich were deaths of children ing cough was unusually prevalent under five is shown in the follow- and this prevalence continued ing tabulation for the past nine through July. Whooping cough is years:

a disease which is especially fatal

to babies. The chief work which 1909

23.1

needs to be done during the sum1910

24.4 1911

21.7

mer to keep the infant mortality 1912

21.6 rate low, therefore, comes under 1913

22.9 two heads: 1914

20.8

First, the enteritis rate must be 1915

19.8 1916

20.7 kept down by educating mothers 1917

19.8 in proper methods of clothing and

feeding their babies and by proIf the Children's Year goal is at- viding adequate nursing and medtained, reducing the proportion of ical care for sick babies. deaths which are of children under Second, the whooping cough five to 15 percent, the general death epidemic must be brought under rate of the state will at the same control a result which can be actime be lowered to about 13.5. complished by strict enforcement The 1916 general death rate was by local health authorities of the 14.4 and that for 1917 was 14.8. new regulations for the control of

It has been pointed out that low whooping cough which went into infant mortality rates are to be ex- effect July 1.

DEATHS OF CHILDREN UNDER FIVE YEARS OF AGE IN OHIO, BY

COUNTIES, IN FIRST SIX MONTHS OF 1918, WITH 1916 TOTALS
OF SUCH DEATHS AND BABY-SAVING QUOTAS FOR 1918 BASED
ON THOSE TOTALS.

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Total, State. | 15, 349 4,510 1,237 1,204 1,376 11,258 1,114 802 6,991

5,420

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DEATHS OF CHILDREN UNDER FIVE YEARS OF AGE IN OHIO, BY

COUNTIES, IN FIRST SIX MONTHS OF 1918, WITH 1916 TOTALS
OF SUCH DEATHS AND BABY-SAVING QUOTAS FOR 1918 BASED
ON THOSE TOTALS - Continued.

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4 265

7 3 4 5

215

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15

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59 413

42 258 28 52 177 66 38 252 70

57 2,972

87 42 58 53 68 48 609 47 57 23 68 123 1,218

78 90 30 34 53 67 35 56 87

Auglaize
Belmont
Brown
Butler
Carroll
Champaign
Clark
Clermont
Clinton
Columbiana
Coshocton
Crawford
Cuyahoga
Darke
Defiance
Delaware
Erie
Fairfield
Fayette
Franklin
Fulton
Gallia
Geauga
Greene
Guernsey
Hamilton
Hancock
Hardin
Harrison
Henry
Highland
Hocking
Holmes
Huron
Jackson
Jefferson
Knox
Lake
Lawrence
Licking
Logan
Lorain
Lucas
Madison
Mahoning
Marion
Medina
Meigs

18 120 12 75

8 16 51 20 11 75 21

17 870 25 12 17 16 20 14 180 14 17

7 20 36 355 23 26

9 10 16 20 11 17

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