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course may be due not only to the lack of care at the onset of the disease, but also to the increase in virulence that the organisms acquire by transmission from one host to another of different races.

No specific remedy for the above situation seems to be at hand. Education of seamen as to the danger present in this region and to the value of proper and early prophylactic measures are essential. Many of our cases give a history of having been infected on one or more previous occasions, and so the lesson learned from the first infection seems to be of little value.

DEATH RATES IN A GROUP OF INSURED PERSONS. COMPARISON OF DEATH RATES FOR PRINCIPAL CAUSES, MARCH AND APRIL, 1923, AND

APRIL AND YEAR, 1922. The accompanying table is taken from the Statistical Bulletin of the Metropolitan Life Insurance Co. for May, 1923, and presents the mortality experience of the industrial department of the company for the months of March and April, 1923, and April and year, 1922. The rates are based on a strength of approximately 14,500,000 insured persons.

The gross death rate for April (10.1 per 1,000) in this group of persons shows a seasonal decline from the rate for March (12 per 1,000), but was slightly higher than the rate for April of 1922 (9.7 per 1,000). The largest declines from rates for the previous month are shown for influenza, tuberculosis, pneumonia and other respiratory diseases, and organic diseases of the heart. High death rates still obtained for measles and whooping cough. The widespread prevalence of measles gives that disease a prominent place in the morbidity record so far this year. Death rates (annual basis) for principal causes of death per 100,000 lives er posed, Varch and April, 1923, and April and year, 1922.

Death rate per 100,000 lives exposed.

Cause of death.

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DEATHS DURING WEEK ENDED JUNE 16, 1923.

Summary of information received by telegraph from industrial insurance companies for

week ended June 16, 1923, and corresponding week of 1922. (From the Weekly Health Index, June 19, 1923, issued by the Bureau of the Census, Department of Commerce.)

Week ended Corresponding

June 16, 1923. week, 1922. Policies in force...

49, 178, 986 50, 058, 107 Number of death claims..

9, 632

8, 289 Death claims per 1,000 policies in force, annual rate...

10.2

8.6 Deaths from all causes in certain large cities of the United States during the week ended

June 16, 1923, infant mortality, annual death rate, and comparison with corresponding week of 1922. (From the Weekly Health Index, June 19, 1923, issued by the Bureau of the Census, Department of Commerce.)

City.

Week ended

Annual
Deaths under

Infant
June 16, 1923. death

1 year.

morrate per

tality 1,00),

rate, corre

Week Corre- Week Total Death sponding ended sponding ended deaths. rate. week, June 16, week, June 16,

1922. 1923. 1922. 1923.2

6,298

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148

Total..

11.3
11.4
805

762 Akron, Ohio.

27 6. 8

7.5
3

5

36 Albany, N. Y..

22 9.8 12.6

2

4

44 Atlanta, Ga..

82 19. 2

13, 7
14

11 Baltimore, Md.

193
13.0 13.5 27

26

79 Birmingham, Ala

68 18.1 16.4

7

9 Boston, Mass.

187 12.7 14.0 27

19

77 Bridgeport, Conn.

26 9. 4

11.3
2

4

28 Buffalo, N. Y.

113
11.0
10.7 24

19

101 Cambridge, Mass.

29 13. 6

13. 6
5

89 Camden, N.J..

21 8.8

13.7
1

17 Chicago, Ill.

582 10.5 10.3 69

85 Cincinnati, Ohio.

115 14.8

12.5
15

99 Cleveland, Ohio 3.

8.7
10. 2
21
25

58 Columnbus, Ohio..

57 11. 4 13.0

5

52 Dallas, Tex.

39 11.5

11.2

10 Dayton, Ohio.

34
10.7
10.3
5

1

82 Denver, Colo.

76 14.6 13. 8

8

6 Des Moines, Iowa.

33 12. 2

2 Detroit, Mich

233 12. 2

9.4
43
30

S6 Duluth, Minn.

17 8.3

0 Erie, Pa..

22 10. 2

5.7
2

4

41 Fall River, Mass.

30 12.9 10.8

9

3

128 Flint, Mich.

24 10.6

6

119 Fort Worth, Tex.

31 11.2 11.4

8

3 Grand Rapids, Mich.

9.6
8.0
3

3

47 Houston, Tex.

29 9.8 15. 3

4

1 Indianapolis, Ind.

13, 2
10.7 13

10

100 Jacksonville, Fla.

36 18.8 18.7

3

1 Kansas City, Kans.

24 10.8
8.7

2

46 Kansas City, Mo

81 12.0
15. 0

10 Los Angeles, Calif..

180 14.1 15.8 25

20

94 Louisville, Ky..

63 12. 7 11.0

6

97 Lowell, Mass.

33
15.0
6. 4

5

35 Memphis, Tenn.

38 11.7

22. 4
5

5 Milwaukee, Wis.

104
11. 2

83
13
12

65 Minneapolis, Minn.

68 8.7

9.8
6

7

33 Nashville, Tenn. 3.

12.5
11.7

7 New Bedford, Mass.

26 10.4
11.0

8

47 New Haven, Conn..

29 8.7
8.3

65 New Orleans, La.

126 16.2 17.9 New York, N. Y.

1,166
10.3 11.2 138

164

55 Bronx Borough.

126 7.8 10.1

4
13

14 Brooklyn Borough..

391 9.5
9,5 48

58

51 Manhattan Borough.

537 12. 4 13. 4 76

78

74 Queens Borough.

74 7.2

9.1
5
14

27 Richmond Borough...

38 15.5 16.3

5

1

91 1 Annual rate per 1,000 population.

Deaths under 1 year per 1.000 births--an annual rate based on deaths under 1 year for the week and estiniated births for 1922. Cities left blank are not in the registration area for births. 3 Deaths for week ended Friday, June 15, 1923.

47738°-233

వరాలు –ండలానిలో

Natoare

Deaths from all vuuses in rerlain large cities of the United States during the week ended

June 16, 1923, infant mortality, annun! death rate, and comparison with corresponding week of 192?. From the Weekly Health Index, June 19, 1923, issued by the Bureau of the Census, Department of Commerce. )-Continued.

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Newark, N. J...
Norfolk, Va..
Oakland, Calif.
Omaha, Neb.
Paterson, N.J.
Philadelphla, Pa..
Pittsburgh, Pa.
Portland, Oreg.
Providence, R. I
Richmond, Va
Rochester, N. Y
St. Louis, Mo...
St. Paul, Minn.
Salt Lake City, Utah
San Antonio, Texas.
San Francisco, Calif..
Seattle, Wash.
Spokane, Wash.
Springleld, Mass..
Syracuse, N. Y
Tacoma, Wash.
Toledo, Ohio.
Trenton, N. J
Utica, N. Y..
Washington, D. C..
Wilmington, Del.
Worcester, Mass..
Yonkers, N. Y
Youngston, Ohio..

16

3 10 6 6 11 10

9.9 8.2 9.6 82 12.7 11.7 13.5 10.7 13.6 17.6 10. 8 11.0 10.6 14.5 11.3 10.8

9.1 120 13.0 11.6 11.8 10.7 13.5

&6 11.0 10.2 9.0 7.3 14.6

14

11.5

9.3 12,0

7,1 13.0

9.6 13.3

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12. 2
10.4

12
3

92 23 33 15 37

10.4
0.5

1 Deaths for week ended Friday June 15, 1923.

PREVALENCE OF DISEASE.

No health department, State or local, can effectively prevent or control disease without

knowledge of when, where, and under what conditions cases are occurring.

UNITED STATES.

CURRENT STATE SUMMARIES.

These reports are preliminary, and the figures are subject to change when later returns are received by the State health officers.

Reports for Week Ended June 23, 1923.

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Diphtheria.
Measles..
Pneumonia.
Scarlet lever.
Typhoid fever.

ARKANSAS.
Chicken pox..
Diphtheria..
Hookworm disease.
Influenza.
Malaria..
Measles..
Mumps.
Pellagra
Smallpox...
Tuberculosis..
Typhoid fever..
Whooping cough.

4

CONNECTICUT. 5

Chicken pox.... 1 Diphtheria. 12 Dysentery (bacillary). 150 German measles. 83 Lethargic encephalitis.

5 Malaria... 20 Measles. 5 Mumps.. 9 Pneumonia (lobar). 8 Scarlet lever.. 30 Tetanu3...

22 32

1 10 2 2 99 9 6 61 1

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Cerebrospinal meningitis..
Dengue..
Diphtheria..
Influenza.
Leprosy.
Malaria.
Ophthalmia neonatorum.
Pneumonia.
Scarlet fever......
Smallpox....
Typhoid fever..

GEORGIA,
Chicken pox.
Diphtheria..
Dysentery (amebic).
Dysentery (bacillary).
Hookworm diseaso.
Influenza.
Malaria.
Measles...
Mumps.
Pneumonia.
Scarlet fever.
Septic sore throat.
Smallpox.
Trachoma..
Tuberculosis (pulmonary).
Typhoid fever....
Whooping cough.

Chicken pox.. Diphtheria... Cerman measles. Measles..... Mumps.. Pneumonia. Scarlet fever. Smallpox.. Tuberculosis.. Typhoid fever. Whooping cough.

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7 3 1 7 20

7 23 124

5 11 7 1 9 1 9 22 16

90 1

Diphtheria..
Influenza.
Measles...
Scarlet fever.
Smallpox..
Typhoid fever..
Whooping cough.

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ILLINOIS.

Chicken pox.. Diphtheria.. German measles. Measles.. Pneumonia.. Scarlet lover. Tuberculosis. Typhoid fever.. Whooping cough.

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MARYLAND.

1

1 116

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