Division will study any individual situation upon request and will make recommendations for the establishment of proper health conditions. The prevention of venereal diseases, smallpox and typhoid fever are specialized fields of health work which should also receive attention in any industrial health program. The industrial phase of the venereal disease problem is receiving special attention from the Department's new Bureau of Venereal Diseases. Heavy losses in working time will be wiped out by effective measures for venereal disease prevention in any industrial establishment in the State. The Bureau of Venereal Diseases has prepared comprehensive plans for industrial co-operation and will be glad to take up the matter with any employer who is interested. Smallpox and typhoid fever are so easily prevented that they should demand no extended discussion. It should be sufficient to recommend to every employer that he require of his workmen the same protection against these diseases that is required in the army: vaccination against smallpox and inoculation against typhoid fever. The plant whose workmen are not thus protected is constantly in danger of a complete collapse due to the outbreak of an epidemic of one of these diseases. The State Department of Health is not asking any employer to take up health work among his employees purely for the benefit of the employees and the public. It knows, and can produce evidence to convince any employer, that industrial health work will produce a profit in dollars and cents by increasing the number of days' work done in a year. Health Council Member Goes to Italy With Red Cross From time to time in these columns the departures of various members of the staff of the State Department of Health to enter military and other war service have been noted. This month, however, brings the first occasion for extending good wishes to a member of the Public Health Council as he dons the uniform. Dr. W. I. Jones, who has been ably representing the dental profession of the State in the Council, since its creation with the reorganization of the State Department of Health a year ago, has entered Red Cross service and has left for Italy with the tuberculosis mission, of which Dr. Robert G. Paterson, head of the Department's tuberculosis. work, is also a member. Dr. Jones is one of Ohio's most progressive and public-spirited dentists. Deserved recognition of his standing was given by Governor Cox in appointing him to the Public Health Council. His service in the Council has fully justified the honor thus conferred upon him, and gives assurance that he will render valuable service in Italy. Existing System of Antitoxin To make clear to physicians, health officials and druggists of the State the new system now in operation for distribution of diphtheria antitoxin in Ohio, an explanation of this plan is here presented. The chief points of difference from the former system are that prices are now lower than before for general distribution, that the same prices apply to purchases for indigents as to purchases for other persons and that any druggist, instead of only those who are laboratory distributors for the State Department of Health, may now carry a stock of antitoxin. Antitoxin is being distributed under a new contract with the H. K. Mulford Company, manufacturing chemists, Philadelphia, who will sell antitoxin outright to any druggist who wishes to carry a supply on hand. Every druggist will be solicited by the Mulford salesmen and given an opportunity to participate in the plan. The distributing stations, to which antitoxin stocks have heretofore been limited, in most cases number only one to the community. The new price schedule is as follows: 1,000 units, 75 cents; 5,000 units, $3; 10,000 units, $5. This is lower than the former rate for general distribution, but is higher than the rate formerly quoted for indigent cases supplied at public expense. By regulations of the State Department of Health, no antitoxin other than that manufactured by the Mulford Company may be sold in Ohio. The Department takes no part in the distribution of the antitoxin, this being left entirely to the manufacturer. Instructions for Control of Influenza The Public Health Council of the State Department of Health, at a meeting October 10, adopted the following "Instructions of the State Department of Health to Local Health Authorities for the Prevention and Control of Influenza": The seriousness of the epidemic of influenza in the Eastern States and the possibility of equally serious conditions in Ohio if immediate steps are not taken to prevent and control the introduction and spread of the disease in this state leads the State Department of He: th to give these instructions to local health authorities. The fatalities that have resulted from this epidemic are a sufficient justification for any reasonable measures of control that can be exercised, and the State Department of Health hereby calls upon all citizens of the state to lend every possible aid and support to the health authorities by observing all regulations that have for their purpose the control of this disease. Furthermore, in the East, there has been serious interference with all activities, including those directly connected with the prosecution of the war. Ohio has a large share in the production of war materials and this work must continue with the least interruption and delay possible. Influenza is communicated directly from person to person and this occurs most often when people are crowded together indoors. To prevent this condition, the State Department of Health hereby directs the following procedure: 1. When an outbreak of influenza occurs in a community, the Board of Health or health officer or person performing the duties of a board of health, shall immediately close moving picture shows, theatres, schools, churches, lodges and other places of public assemblage, and shall prohibit congregating or loitering in saloons, stores, pool or billiard rooms and other places. 2. All public funerals shall be prohibited in any community during the presence of influenza. 3. During the prevalence of influenza, all street cars, factories, offices, dining-rooms and other rooms or places which must be occupied should be given the greatest amount of ventilation possible. 4. All measures for the prevention and control of communicable diseases depend on prompt information as to the existence and location of cases. For this reason the State Department of Health has declared that cases of influenza shall be immediately reported to the local health officer by the physician in attendance, or where a physician is not called, by the head of the family or person owning or maintaining the premises. 5. Because of the possibility of the introduction of influenza into every health district in the state, local authorities should not await the appearance of the disease before preparing to combat it. The board of health should meet and adopt suitable regulations that can be put into immediate effect as soon as the disease appears. Such regulations shall contain the instructions above outlined and such additional measures as are necessary to meet local conditions. 6. In every community in which influenza has appeared, the board of health, or health officer, or person performing the duties of the board of health shall immediately put into effect the above instructions and continue the same in full force and effect as long as the emergency shall continue. 7. The health officer shall immediately notify the State Commissioner of Health by telegram or telephone of the appearance of influenza in his community and shall keep him informed as to the progress of the disease. 8. The State Department of Health has the assurance of the United States Public Health Service and the American Red Cross that assistance by furnishing medical and nursing service and supplies, will be given to local communities if conditions become so serious that the local authorities and the State Department of Health are unable to cope with the situation. "Spanish Influenza"-"Three-Day Fever" -"The Flu"* What is Spanish Influenza? Is it something new? Does it come from Spain? The disease now occurring in this country and called "Spanish Influenza" resembles a very contagious kind of "cold" accompanied by fever, pains in the head, eyes, ears, back or other parts of the body, and a feeling of severe sickness. In most of the cases the symptoms disappear after three or four days, the patient then rapidly recovering; some of the patients, however, develop pneumonia, or inflammation of the ear, or meningitis, and many of these complicated cases die. Whether this socalled "Spanish" influenza is identical with the epidemics of influenza of earlier years is not yet known. Epidemics of influenza have visited this country since 1647. It is interesting to know that this first epidemic was brought here from Valencia, Spain. Since that time. there have been numerous epidemics of the disease. In 1889 and 1890 an epidemic of influenza, starting somewhere in the Orient, spread first to Russia, and thence over practically the entire civilized world. Three years later there was another flare-up of the disease. Both times the epidemic spread widely over the United States. Although the present epidemic is called "Spanish influenza," there is no reason to believe that it originated in Spain. Some writers who have studied the question believe that the epidemic came from the Orient and they call attention to the fact that the Germans mention the disease as occurring along the eastern front in the summer and fall of 1917. How can "Spanish influenza" be recognized? There is as yet no certain way in which a single case of "Spanish influenza" can be recognized; on the other hand, recognition is easy where there is a group of cases. In contrast to the outbreaks of ordinary coughs and colds, which usually occur in the cold months, epidemics of influenza may occur at any season of the year; thus the present epidemic raged most intensely in Europe in May, June, and July. Moreover, in the case of ordinary colds, the general symptoms (fever, pain, depression) are by no means as severe or as sudden in their onset as they are in influenza. Finally, ordinary colds do not spread through the community so rapidly or so extensively as does influenza. In most cases a person taken sick with influenza feels sick rather suddenly. He feels weak, has pains in the eyes, ears, head or back, and may be sore all over. Many patients feel dizzy, some vomit. Most of the patients complain of feeling chilly, and with. this comes a fever in which the temperature rises to 100 to 104. * Reprinted from Supplement No. 34 to the Public Health Reports (United States Public Health Service). In most cases the pulse remains relatively slow. In appearance one is struck by the fact that the patient looks sick. His eyes and the inner side of his eyelids may be slightly "bloodshot," or "congested," as the doctors say. There may be running from the nose, or there may be some cough. These signs of a cold may not be marked; nevertheless the patient looks and feels very sick. In addition to the appearance and the symptoms as already described, examination of the patient's blood may aid the physician in recognizing "Spanish influenza,' for it has been found that in this disease the number of white corpuscles shows little or no increase above the normal. It is possible that the laboratory investigations now being made through the National Research Council and the United States Hygienic Laboratory will furnish a more certain way in which individual cases of this disease can be recognized. What is the course of the dis ease? Do people die of it? Ordinarily, the fever lasts from three to four days and the patient recovers. But while the proportion of deaths in the present epidemic has generally been low, in some places the outbreak has been severe and deaths have been numerous. When death occurs it is usually the result of a complication. What causes the disease and how is it spread? Bacteriologists who have studied influenza epidemics in the past have found in many of the cases a very small rod-shaped germ called, after its discoverer, Pfeiffer's bacillus. In other cases of apparently the same kind of disease there were found pneumococci, the germs of lobar pneumonia. Still others have been caused by streptococci, and by other germs with long names. No matter what particular kind of germ causes the epidemic, it is now believed that influenza is always spread from person to person, the germs being carried with the air along with the very small droplets of mucus, expelled by coughing or sneezing, forceful talking, and the like by one who already has the germs of the disease. They may also be carried about in the air in the form of dust coming from dried mucus, from coughing and sneezing, or from careless people who spit on the floor and on the sidewalk. As in most other catching diseases, a person who has only a mild attack of the disease himself may give a very severe attack to others. What should be done by those who catch the disease? It is very important that every person who becomes sick with influenza should go home at once and go to bed. This will help keep away dangerous complications and will, at the same time, keep the patient from scattering the disease far and wide. It is highly desirable that no one be allowed to sleep in the same room with the patient. In fact, no one but the nurse should be allowed in the room. If there is cough and sputum or running of the eyes and nose, care should be taken that all such discharges are collected on bits of gauze or rag or paper napkins and burned. If the patient complains of fever and headache, he should be given water to drink, a cold com |