December was exceptionally dry and cold. Thus meteorological conditions tended to exaggerate the symptoms of danger of contact of soldiers and thus to facilitate the spread of measles. 12. CAMP LEWIS, WASH. Camp Lewis is situated at American Lake, approximately 13 miles south of Tacoma, a city of about 110,000 inhabitants. The soil is porous, absorbing all surface drainage. The water is supplied from great springs, of which the largest has a capacity of 3,500,000 gallons. Two wells have a pumping capacity of 1,140,000 gallons together. The water is of excellent quality. The sewage passes by gravity into Nisqually Bay, a branch of Puget Sound. The The western part of Washington has an equable climate. lowest temperature for December was 28° F. There was a rainfall that month of 15.3 inches, above double the average, and practically no snow fell. There was only one clear day. The "constant cold rains" aggravated certain throat inflammations. To Camp Lewis were called from civil life the following contingents: Polygon of weekly strength of Camp Lewis measured by scale on the left. [Increments are indicated by dotted rectangles of which the unit, 1,000 men, is represented by the smal 7 14 21 28 5 12 19 26 2 9 16 23 30 7 14 21 28 Nov. CAMP LEWIS Dec. CHART NO. 21. These men came from Washington, Oregon, Idaho, Montana. Wyoming, Utah, Nevada, and California. This area includes such cities as Seattle (340,000), Spokane (145,000), Tacoma (110,000). Portland (275,000), Butte City (145,000), Salt Lake City (115,000), Ogden (35,000), Los Angeles (480,000), San Francisco (460,000), Oakland (200,000), Sacramento (65,000), Berkeley (55,000), and San Diego (53,000), besides numerous smaller cities, especially in California. Taken as a whole, the territory from which Camp Lewis draws is 51 per cent urban or about the same as Camp Custer. The strength of the camp at different dates is shown in Chart 21. Owing to huge increments of the latter half of September and early October the population mounted quickly to nearly 40,000 by October 15, and then slowly fell to 35,000 by the end of the year. The colored troops numbered about 500 during October, November, and December. The leading diseases at Camp Lewis are shown in Table 29. 1 Figures in parentheses indicate number of colored troops in venereal diseases only. The most striking feature of this table is the great number of cases of German measles (1,063 in December). In respect to the frequency of this disease the camp stands in a class by itself. Typical measles, on the other hand, was relatively infrequent. Camp Lewis had also the largest number of new admissions for gonorrhea of any camp (among the recruits of October). This exceptional rate for venereal disease was not maintained in later months. The division surgeon reports: "Arriving men showed a large percentage (2.73 per cent) of venereal disease, and it was decided to place all in camp hospital, the milder cases being sent to duty soon but continued under treatment.' This undoubtedly accounts for the large number of venereal cases admitted to sick report in October and November. It is to be recalled also that the population was drawn largely from mining regions. This camp was also visited by a small epidemic of scarlet fever, with no deaths reported. The division surgeon reports that nose and throat cases were so numerous that, while waiting in the outpatient clinic of the base hospital, patients with sore throats, beginning scarlet fever, were seated next to the patients with sore throat, beginning measles and other infectious diseases. Cross infections occurred, and it was thereupon ordered that all but emergency nose and throat cases should be treated at regimental infirmaries. Up to that time about 300 operations on hypertrophied tonsils alone had been performed. Pneumonia.-As draft men arrived in successive contingents. efforts were made to secure floor and air space as ordered from Washington. Thus the incidence of pneumonia was undoubtedly controlled, since every other draft man promptly caught cold, particularly those coming to a cold, wet climate from warm, dry States. First cases of pneumonia were almost exclusively from dry, warm climates. The mortality rate remained low, although laboratory personnel were too fully engaged to attempt to divide pneumonia cases into groups. Nevertheless, No. 1 serum was occasionally used. 13. CAMP JACKSON, S. C. This camp is situated about 5 miles from Columbia, S. C., the State capital, a city of about 30,000 inhabitants. The terrain is sandy and rolling, draining both to the southeast and northwest. A large swamp adjoining the western boundary of the camp and covering about 300 acres is traversed by Gill Creek. Another swamp on the camp site proper forms the headwaters of Wild Cat Creek. This had to be drained. Construction of the camp was begun on June 15, 1917, at which time the whole camp site was covered with woods and cotton fields. During the months of July and August, 1917, the contractor used between 7,000 and 10,000 men daily building barracks and clearing land. The weather at Jackson was abnormally cool during September to December, 1917, and fell to 8° F. on December 30. The temperature fell to freezing during 21 days of the month. The autumn was dry. A snowfall of 2 inches occurred on the 12th of December. Water is obtained from the city of Columbia. As the water supply came from a contaminated source and the filter beds were not functioning properly, it was chlorinated. A permanent sewage disposal plant was built, of which the effluent discharged into a small creek. To Camp Jackson were called from civil life the following contingents: Sept. 5-10.. Oct. 3-8.. Oct. 27-Nov. 1.. Total..... Men The men came from North Carolina, South Carolina, and Florida, whose combined quota amounted to 32,380. This territory comprises in North Carolina, 7 cities of over 10,000 inhabitants (largest, Char lotte, 40,000); in South Carolina, 5 cities of over 10,000 inhabitants (largest, Charleston, 60,000); in Florida, 4 cities of over 10,000 inhab itants (largest, Jacksonville, about 70,000). The territory drawn from is only about 17.5 per cent urban. Indeed this camp shows the smallest percentage of inhabitants from cities of any of the National Army cantonments. Polygon of weekly strength of Camp Jackson measured by scale on the left. [Increments are indicated by dotted rectangles of which the unit, 1,000 men, is represented by the small rectangle above the polygon.] 7 14 21 28 5 12 19 26 2 9 16 23 30 7 14 21 28 The strength of the camp at different dates is shown in Chart 22. From its first increment of 1,600 men in September it increased gradually, reaching a maximum of about 19,000 at the end of the year. 2,642 colored men entered the camp during October, 1,017 during November, and 2,266 during December, or a total of 6,325. The leading diseases at Camp Jackson were as follows: TABLE NO. 30.-Admissions and deaths, infectious diseases, Camp Jackson, 1917. 1 Figures in parentheses indicate number of colored troops in venereal diseases only. The most striking facts shown by this table are the great numbers of cases of measles, German measles, and mumps. The number of cases of tuberculosis was also relatively great and in December cerebrospinal meningitis had risen to the proportions of a great epidemic exceeding that experienced at any other camp. The epidemic burned itself out during the following two months. The reason for this epidemic is the nonimmunity of the rural troops. It is stated that meningitis appeared in the families of the workmen engaged in building the barracks at Camp Jackson before the troops began to assemble. Of the men who had meningitis at this camp 31 per cent died. As bearing on the epidemic of measles and meningitis in Camo Jackson the following statements are quoted from the report of the Division Surgeon: The hospital buildings were inadequate and incomplete even by the end of the year. Woolen clothing was available. but many men did not have it and were seen going about in cotton clothing in spite of freezing weather. The lack of warm clothing is probably promoting the transmission of disease by causing the men to congregate indoors and about stoves, but we did not hear complaint of suffering. The enlisted personnel of this camp seems to show an unusual amount of illiteracy, general ignorance, and ignorance of personal hygiene, all of which doubtless has aided in the propagation of disease. The enlisted personnel is, of course, mainly rural in origin and contains a relatively large proportion of men who have not had measles or mumps in childhood. In addition to those men, certain contingents have come from Camp Gordon and Camp Pike, and it appears that these were a potent factor in the introduction and spread of disease among susceptible men. Pneumonia-Here, as in other camps, the prevalence of measles has been a principa! factor in the causation of pneumonia. It is probable that considerably more than 40 per cent of all the cases of pneumonia accompanied or followed measles. The prevailing pneumonia at Camp Jackson was broncho-pneumonia, and the majority of these cases were consecutive to measles, and these were far more fatal than ordinary lobar pneumonia. The factors to be considered in the causation of pneumonia at this camp have been much the same as at other camps, with less overcrowding and less dust. Measles has been prevalent; the men did not have sufficient supply of warm clothing until recently and even now there is some deficiency. There has been trouble with the heating arrangements, and the cold set in early and was unusually severe for this climate. Hookworm infestations are widespread. Measles-The total number of cases of measles was, to December 31, 1,452. The disease gained in September but did not assume epidemic proportions until the last week of October. It reached its maximum in the week ending November 23, when 528 new cases entered the hospital. Three deaths have been attributed to measles in addition to those dying of broncho-pneumonia. Meningitis. Epidemic cerebrospinal meningitis made its appearance in this command November 15, 1917, and appeared in the person of a man coming to this camp from Camp Gordon. In November there occurred 20 cases, December 106 cases, and these two months give a total of 37 deaths from this cause. Epidemic cerebrospinal meningitis was certainly transferred to this division from Camp Pike. Little Rock, Ark., which began to send draft men here in November, 1917. Likewise cases occurred in men arriving here from Camp Gordon. In the case of men transferred from Camp Pike two men were removed from the train with fully developed cases of epidemic cerebrospinal meningitis present upon their arrival. It is certain that this infection came, at least in part, from these two sources of Camp Pike and Camp Gordon. From a study of the local situation it appears probable that the measles ward in the base hospital was a contributing factor to the spread of this disease in this camp, as in a well-recognized percentage of cases men coming from uninfected area of camp and being sent to the hospital would first develop measles at the hospital. recover from measles, and in the course of 14 to 16 days return to duty, after returning to duty develop meningitis within one to three days after their return, there being no other case of this disease in their companies. At least 24 of the early cases contracted the disease in the measles ward. 1 Vaughan and Palmer, 1918. |