TRICHINIASIS.

Between December 1 and 8, 1915, 10 cases of trichiniasis, with 3 deaths, were reported in Portland, Oreg. All of the cases were in Italians who had eaten infected sausage, samples of which upon examination were found to contain large numbers of encisted larvæ.

TUBERCULOSIS.

The information which city and State health departments are securing of the prevalence of tuberculosis is improving. Cases are being reported more frequently so that the health department's information of where the sick are and the conditions under which they are living is constantly becoming more complete.

During the calendar year 1915 the highest recorded case rate in the continental United States was in New York State, where 3.2 cases were recorded for each 1,000 of the population. Hawaii had 3.5 cases reported for each 1,000 population, and Mississippi 4.2. In the latter State, however, the means of collecting the information is not sufficiently accurate to warrant comparison with other States. Many of the cases undoubtedly are reported several times.

Of the larger cities, Newark, N. J., Chicago, Ill., and Los Angeles, Cal., reported the highest number of cases in proportion to the population. Newark recorded 5.4 per 1,000 population, Chicago 5.2, and Los Angeles 5.1. It is not to be assumed that Newark and Chicago have a greater proportion of tuberculous persons than many other cities. The probable explanation is that the health departments have been especially interested in the disease and have secured the cooperation of practicing physicians in the reporting of cases. Los Angeles probably has a relatively large number of such persons, as many go there from other States in the hope of regaining their health.

a Deaths were not reported.

TYPHOID FEVER.

Typhoid fever, while one of the infections which is to be found in practically all sections of the country, is undoubtedly becoming less and less prevalent owing to the more general knowledge regarding the means by which it is spread and the improvement in municipal and individual water supplies, supervision of the handling of milk, and the screening of houses.

The highest recorded case rates in States during the calendar year 1915 were in Mississippi, Maryland, and Virginia, where rates of 3.2 per 1,000 population, 2.4, and 2, respectively, were reported. Of these States, however, the methods employed by Maryland are the only ones which are sufficiently accurate to make the results available for comparison with other States.

As indicating the excellence of the reports of cases being received, the fatality rates in Utah and the District of Columbia are of special interest. În Utah this rate was 10.5, in the District of Columbia 11.7 per 100 cases, showing practically 10 reported cases for each registered death.

Of the larger cities the highest recorded case rates were in Nashville, Tenn., Birmingham, Ala., and Toledo, Ohio, with rates of 3.6, 2.4, and 2.3, respectively, per 1,000 population.

The lowest fatality rates of the larger cities, which usually may be taken as an index of the completeness of the reported cases, were recorded in Lynn, Mass., with a rate of 4.9 per 100 cases, in Salt Lake City, Utah, with a rate of 6.7, and Hartford, Conn., with one of 8.9.

4 Deaths were not reported.

TYPHUS FEVER.

Since the demonstration that the so-called "Brills Disease," of which cases had been recognized in New York City for a number of years, was in reality typhus fever, cases have from time to time been recognized in cities throughout the country. During the past year, owing to the prevalence of typhus fever in Mexico and the increased travel back and forth across the Mexican border, a number of cases of the disease have been reported in Texas, Arizona, and New Mexico. The cases reported to the Public Health Service are shown in the appended table.

WORLD PREVALENCE OF CHOLERA, PLAGUE, TYPHUS FEVER, AND

YELLOW FEVER.

These diseases are probably much more prevalent than the reported cases would indicate. They are doubtless present in many localities in atypical or mild form and not recognized. In many localities plague is undoubtedly present continuously in rats and only periodically attacks man. Cholera may be carried over from season to season in unrecognized form. This has been shown to be true in Manila and elsewhere. The same is without question true of typhus fever. In the United States cases of typhus fever are occasionally recognized in all of the larger cities and" Brills disease" was recognized for years before its identity with typhus fever was more than suspected. Mild and atypical forms of the disease probably occur in all of the larger cities of Europe and Asia, and probably also of Africa and South America. Yellow fever occurs in endemic centers much more frequently than the reported cases would indicate. In these localities it is probably a disease of childhood and appears usually as a rather mild affection.

CHOLERA.

EUROPE.

Cholera was present in Austria-Hungary from August 7 to October 31, 1915, with 22,838 reported cases, and from January 3 to