CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-Continued. Reports Received from Dec. 30, 1916, to Apr. 27, 1917-Continued. CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-Continued. Reports Received from Dec. 30, 1916, to Apr. 27, 1917-Continued. VOL. 32 MAY 11, 1917 EPIDEMIC CEREBROSPINAL MENINGITIS. No. 19 The current prevalence of epidemic cerebrospinal meningitis in so far as data are available will be found on pages 703–704. VACCINE VIRUS. SHOULD ALWAYS BE KEPT ON ICE. Vaccine virus rapidly loses its potency unless kept cool. In many drug stores vaccine is kept in a drawer back of the counter instead of in the ice box. Under these conditions the vaccine is likely to be worthless and not to produce successful vaccination. In buying vaccine one should ascertain that it has been properly kept. It is a matter of common knowledge that biologic products should be kept in a cool place. The United States Pharmacopoeia, ninth decennial revision, specifies temperatures between 4.5° and 15° C. for diphtheria and tetanus antitoxin and vaccine virus-the three official products of this class. What is not generally appreciated is the difference between these products in this respect. The change in the antitoxins, serums, and such products as typhoid vaccine is a gradual chemical deterioration, since these contain no living matter; in the case of the antitoxins it can be demonstrated that at reasonable temperatures and within reasonable times the products are not rendered valueless, nor harmful-simply a somewhat larger amount must be used to produce a given effect. With vaccine virus we have an altogether different situation. The virus is a living thing, suspended in a medium without food for multiplication, and like most minute living things which do not enter the spore state, death rapidly takes place unless the life processes are retarded by refrigeration. No definite and certain limits. can be placed on the duration of the life of the vaccine virus at different. temperatures, for we know neither the number of living microorganisms of vaccinia originally present nor the minimum number necessary to produce the characteristic vaccination; both are undoubtedly variable. As the virus leaves the manufacturer's hands it is practically always potent. It is a fact, however, that as commonly cared for in drug stores the vaccine virus of commerce deteriorates rapidly. Virus of various manufacturers purchased at drug stores has been found, though within the stamped expiration date, to give less than YOUR PATRIOTIC DUTY-BUY A 1917 LIBERTY BOND. 50 per cent of "takes"; but when obtained direct from the manufacturer, "takes" were nearly 100 per cent. Vaccine virus at pharmacies is often kept in the cellar or in the soda fountain cooler, and the temperature of these places, both winter and summer, has been found to be in the neighborhood of 15° C. (59° F.) or higher. This is by no means satisfactory. Ice-box temperature is not freezing temperature, but usually several degrees above freezing. Vaccine virus should be kept in a metal container in constant contact with the ice itself. If it can be kept at or below the freezing point, so much the better. There is no danger of keeping it too cold. SMALLPOX. The mild type of smallpox has been widely prevalent in the United States since 1898. The tables which follow show the number of cases reported in cities during the five weeks ended April 21, and the counties in which 10 or more cases were reported during the month of March. The disease has appeared to be universally of the mild type except in Austin, Tex., where the virulent type is present. For additional information concerning the current prevalence of smallpox see pages 707-709. Cases of smallpox reported in cities during 5 weeks ended Apr. 21, 1917. YOUR PATRIOTIC DUTY-BUY A 1917 LIBERTY BOND. Counties in which 10 or more cases of smallpox were reported during March, 1917, showing number of cases reported. UNITED STATES PUBLIC HEALTH SERVICE IN ANNUAL CONFERENCE WITH STATE AND TERRITORIAL HEALTH AUTHORITIES, WASHINGTON, APRIL 30 AND MAY 1, 1917. The fifteenth annual conference of the State and Territorial health authorities with the Public Health Service of the United States was held April 30 and May 1, 1917, in the city of Washington. This conference is held annually pursuant to an act of the Congress approved July 1, 1902. The following were among the matters brought before the conference for its consideration: The need and advisability of correlating the Federal, State, and local health authorities and agencies to effect a maximum of cooperative efficiency in times of national emergency. Reciprocal notification by State and Territorial authorities of disease carriers traveling or about to travel from one State or Territory to another. Minimum standard morbidity tables for use in annual reports of State and Territorial health authorities showing the prevalence and geographic distribution of cases of the notifiable diseases. What constitutes an epidemic or unusual prevalence of a disease. The typhus fever situation as it affects the United States and the best means of handling it. Are health authorities using all available information and known means to reduce the morbidity from pneumonia, syphilis, and tuberculosis. The sanitation of public conveyances. Interstate quarantine regulations. Intrastate quarantine regulations. YOUR PATRIOTIC DUTY-BUY A 1917 LIBERTY BOND. |