LIST OF LOCALITIES, GIVING NUMBER OF TREATED PERSONS FROM An analysis of the 542 treated cases is given in tables "C" and "D." Tables "C" and "D" are based upon the classification used at the Pasteur Institute in Paris, but present certain modifications: Class I includes persons bitten or otherwise infected by animals proved to have had rabies. Class II includes persons bitten or otherwise infected by animals in which a diagnosis of rabies was based upon clinical grounds. Class III includes persons bitten or otherwise possibly infected by animals suspected of having rabies. Under "Bitten" and "Otherwise Infected" all three classes are re-divided into those frankly bitten and those in whom the atrium of infection was *Resident of Minnesota. caused in some other way than by the teeth of the offending animal. Each of these divisions is sub-divided into three groups according to the location of the injury-upon head, hands, or other parts of the body. *One case reported in the previous biennial report developed rabies four days following the completion of treatment. Note 1 to Table C-Treatment was discontinued in two persons belonging to Class III because the offending dog in each case was traced and found to be normal. One person belonging to Class II and one belonging to Class III, the dog in each case being dead, failed to return after the first day. Note 2 to Table C--The examinations of 91 animals infecting 206 persons were made in other laboratories as follows: Fifty-six in the City Board of Health Laboratory, Minneapolis, thirty-three in the City Board of Health Laboratory, St. Paul, one in the Laboratory of the State Live Stock Sanitary Board, University Farm, St. Anthony Park, St. Paul, and one in the South Dakota State College of Agriculture and Mechanic Arts, Brookings, S. D. Table C shows that 274 persons were bitten or otherwise infected by animals proven through laboratory examination to have had rabies. The diagnosis in most instances is based upon the finding of Negri bodies but in ten animals in which Negri bodies were not demonstrated a positive diagnosis was made through the inoculation of laboratory animals. There were 48 persons bitten or otherwise infected by animals in which a clinical diagnosis of rabies was made. Fifty-nine persons were bitten or possibly infected by dogs suspected of having rabies. In nine of these persons, belonging to class III., treatment was unnecessarily given since through the inoculation of rabbits the offending dog was proven not to have had rabies. In thirty-one persons the offending dog was not traced and in sixteen the dog was killed but not sent for examination. TABLE D-CASES TREATED DURING YEAR 1913 Note 1 to Table D-Treatment was discontinued in two persons belonging to Class III because the offending dog was traced and found to be normal. Two persons, one belonging to Class I and one to Class II failed to return after the first day of treatment. Note 2 to Table D-The examinations of 25 animals infecting 51 persons belonging to Class I were made in other laboratories as follows: Thirteen in the City Board of Health Laboratory, St. Paul, eleven in the City Board of Health Laboratory, Minneapolis, and one in the Laboratory of the State Live Stock Sanitary Board, University Farm, St. Anthony Park, St. Paul. Table D shows that 86 persons treated were bitten or otherwise infected by animals in which a laboratory diagnosis of rabies was made. Twenty-three persons were bitten or infected by animals in which rabies was diagnosed upon clinical grounds. Fifty-two persons were bitten or possibly infected by animals merely suspected of having rabies. In twentyseven persons, belonging to class III., the preventive treatment was unnecessarily given since the results of animal inoculations proved that the offending animal did not have rabies. In eight persons the dog was not traced and in seventeen the offending animal though killed was not sent for examination. Two deaths from rabies in those treated during this period have occurred. Treat Case 1102, J. S., age 24, St. Paul, was bitten by his own rabid dog (diagnosis by St. Paul City Board of Health Laboratory), on each of three days, April 11, 12 and 13, receiving sixteen or more punctured wounds of the right hand, and was registered for treatment on April 15. ment was concluded on May 5. Mr. S. remained well until about July 9, when symptoms of rabies appeared. Dr. A. of St. Paul attended the case and diagnosed rabies. Death occurred July 11. No autopsy could be obtained. Case 1157, W. D., age 7, son of James D., Empire township, was bitten by a stray rabid (Negri bodies found by this laboratory) dog on July 19, 1913. The wounds upon the face were severe in character. The left upper eye-lid was cut at edge, the lower lid torn across tear duct (three stitches had been put into this skin wound by attending physician, Dr. D. of Farmington). The serous surface of lower lid was also torn to the extent of inch. There was also one long scratch (2 inches) at edge of hair over forehead and three or four punctures or abrasions over the forehead. There was one deep punctured wound, size of dime, on back of left arm and seven other punctures and scratches nearby. Treatment was begun on July 23 and completed on Aug. 12, the "intense" schedule being used. The boy remained well until the morning of September 1, when he vomited. On the evening of September 1 Dr. J. A. S. of Farmington was called. At this time there were spasms of the muscles of the throat. On September 2 the child could drink with difficulty but by night drinking was impossible. The eyes were dilated, restlessness marked. Death took place at 7 a. m., September 3. No autopsy could be obtained. Besides the treated persons, 294 others applied for advice but were not treated. An analysis of all applicants by months is given below. MINNESOTA STATE BOARD OF HEALTH. Regulations Concerning Rabies. Regulation 1100: When any person has been attacked by an animal suspected of being, or known to be rabid, or, where an attack occurs in a community in which rabies is known or supposed to exist, the facts shall be immediately reported by the physician in attendance or the health officer by telegram, telephone, or personally, to the Pasteur Institute, State Board of Health, University Campus, Minneapolis, in order that the advisability of the said person receiving the Pasteur preventive treatment for rabies may be determined. In addition Regulation 301 directs that these cases shall also be reported in writing; and Regulation 314 directs that the body of one dead of rabies shall be prepared for burial by a licensed embalmer only. In Minnesota, rabies among animals is under the jurisdiction of the State Live Stock Sanitary Board. See chapter 541, Laws of 1913, entitled: "An Act to Provide for the Suppression and Elimination of Rabies; Conferring Power and Authority on Certain Health Officers to Determine the Fact of the Existence of Rabies in any Town, City or Village, Together with Authority to such Health Officers to Make Proclamation of the Fact of the Existence of Rabies Therein, and by Said Proclamation to Thereafter, for a Specified Period of Time, Prohibit Dogs From Being at Large Unless Muzzled and Providing Penalties for Violation Thereof." CIRCULAR ON RABIES To Supplement Regulation 1100 of the Minnesota State Board of Health Cause and Transmission-The cause of rabies is an infectious agent usually spoken of as the virus of rabies, the exact nature of which is not definitely known. The virus of rabies is present in the saliva, in the central nervous system, in the peripheral nerves, in numerous glands, including the salivary and lacteal and elsewhere in the body of the rabid animal. The virus of rabies has been shown to be present in the saliva of the dog a few days (four to six), before the first symptoms of rabies are observed. Rabies is practically always transmitted from animal to animal, and from animal to man through biting, but if the saliva of the rabid animal is brought in contact with an open wound of whatever origin, infection may *No attempt is here made to give a complete setting forth of rabies in any of its phases. Most of the statements may be found in almost any treatise on this disease. We have given briefly some of the more striking facts concerning rabies, hoping that they may prove useful as a ready reference. |