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room must be carefully prepared by sealing all cracks and closing holes in the chimneys. If formalin is used, a pint to 1,000 cubic feet is not too much. If sulphur, five pounds to the same space, and in either case leave the room closed for eighteen hours.
Sunlight and pure air are always in order, both through the time uf sickness and afterwards, and a plentiful supply should be furnished. They will kill the germs of disease; but the process is not rapid, and should be used to supplement the other, not to replace it.
If these suggestions are carried out, all cases promptly reported, complete isolation of the sick and attendants, vaccination of those exposed, thorough cleaning of the convalescent patient, destruction of all discharges, bits of food, clothes, etc., used about the patient, screening of the room, and disinfection of house and contents, the present epidemic can be quickly subdued.
TYPHOID IN ROCKLIN.
At the request of the Board of Health of Rocklin, the Secretary of the State Board of Health visited that place on June 1st, for the purpose of determining the cause of the typhoid fever epidemic which existed there, and if found, have it abated.
Rocklin is a small town of 1,000 inhabitants, the principal industrial industries being the railroad shops and granite quarries. The location is healthful and the water supply is from the mountains, the water being conducted in an open ditch to within about five miles of town, when it enters a closed pipe from a very small reservoir. Some of the railroad men bring water from the mountains on the engine for the use of their families.
The first case appeared in December, 1905, and was soon followed by another in the same family. The second case might easily have been of secondary infection. There were no further cases until April, 1906, when a number of cases occurred in rapid succession, until on June 1st there had been nineteen cases.
Loomis, a town of two or three hundred inhabitants, farther up the road and having the same water supply, had four cases of typhoid, which were no doubt traceable to the same cause, and are considered as part of the same epidemic.
The cases were all typhoid, and there is no dispute as to diagnosis. Two deaths occurred out of the twenty-three cases. The cases were scattered in all parts of the town, and in only three houses was there more than one case in a house. In one there were three, and in two houses two cases each, leaving fifteen different points of infection, and in no case were the houses in close proximity, making it probable that the disease spread from one to the other. There was no common supply of milk, many keeping their own cows, so that milk as a cause was quickly eliminated, as was the vegetable supply, for a like reason.
It seemed reasonable to suppose that the water supply was at fault, and this was strengthened by the fact that the families of railroad men who brought water from the mountains were not affected, and that Loomis, using the same water supply, had several cases of typhoid. It seemed so probable that the water was at fault that an investigation of it was undertaken by a member from the State and one from the local Board of Health. A sample from the reservoir had already been
sent to the State hygienic laboratory for analysis, but the report had not been received.
The reservoir was visited first. It was but a few yards across, and located close beside the wagon road and probably but one hundred or two hundred feet from the main line of railroad. It was entirely unprotected, even by a fence, which would keep boys or animals from bathing in it. This, of itself, might be the cause; but we determined to look further. The open ditch which brings the water to the reservoir runs through a farming district and is subject to the wash from many fields, orchards, and, no doubt, corrals. The capstone was reached, however, when at Penryn we found a China and Jap town situated in a small hollow, with gently sloping sides, but with quite a steep descent. The houses were built on either side and directly across the hollow which received all the drainage from them. Across the lower end of this hollow ran the water ditch into which discharged quite a stream of water, the drainage from the hollow.
It seemed useless to hunt further for a cause, for while other sources of pollution might be found, here was enough to condemn the supply. The result of the examination of the water at the laboratory, received soon after the inspection, confirmed our belief that the water was polluted, colon bacilli being plentifully found.
Owing to the reticent nature of the Orientals and their fear of being disturbed in their mode of life, it is very difficult to get from them any history of previous sickness. This makes it impossible to trace the disease to a former case, but as the Japanese are quite subject to typhoid, in this State, at least, it is more than probable that some one of them was sick with it in that camp, or came there while convalescing.
To summarize : (a) We have two adjoining towns, having the same water supply, afflicted with a sudden epidemic of typhoid, where one in fifty of the inhabitants was sick, and a death-rate of ten per cent.
(b) But four of the cases could possibly have been secondary. (c) Milk and other food supplies, as a cause, were eliminated. (d) All the cases used the town water supply.
(e) A bacteriological examination of the water showed colon bacilli, and plenty of pollution was found by examining the ditch.
There had been an attempt to keep the ditch free from pollution by building a flume over it for the drainage of the hollow to pass through. This, however, was ineffective, and the company was notified to at once take steps to conduct the water over the drainage. This they promptly did, and that source of danger has been shut out. The inud in the reservoir may be still infected, and when stirred up by any means may yet cause trouble.
MARTIN REGENSBURGER, M.D., President,
F. K. AINSWORTH, M.D.
San Francisco San Francisco A. C. HART, M.D.
Sacramento WALLACE A. BRIGGS, M.D., Vice-President,
0. STANSBURY, M.D..
STATE BUREAU OF VITAL STATISTICS. N. K. FOSTER, M.D., State Registrar..Sacramento | GEORGE D. LESLIE, Statistician..-.. Sacramento
STATE HYGIENIC LABORATORY. ARCHIBALD R. WARD, D.V.M., Director....
University of California, Berkeley
VITAL STATISTICS FOR JUNE.
Summary.- For June there were reported 1,807 living births, 2,439 deaths, exclusive of stillbirths, and 2,342 marriages, as compared with 1,712 births, 2,375 deaths, and 1,739 marriages registered in May. The annual rates, based on an estimated State population of 1,882,483, are as follows: Births, 11.5 for June against 10.9 for May; deaths, 15.5 for June against 15.1 for May; and marriages, 14.9 for June against 11.1 for May. The increases in the rates for June over those for May reflect the growing completeness in the registration of vital statistics in California, though the rise in the marriage rate is due also to the fact that June is a favorite month for weddings.
As usual, tuberculosis was the leading cause of death, followed by diseases of the circulatory and nervous systems, and by pneumonia and broncho-pneumonia.
The most fatal epidemic diseases in June were typhoid fever, measles, whooping-cough, diphtheria, croup, and influenza. The mortality from typhoid fever was the same in June as in May, while the deaths from measles were less than before, and those from whooping-cough were greater in June than in the preceding month.
Causes of Death. The following table gives for the State in June the number of deaths due to certain important causes, as well as the proportion from each cause shown per 1,000 total deaths:
Proportion Cause of Death.
Number. per 1,000. ALL CAUSES
2,439 1,000.0 Typhoid fever
16.4 Malarial fever
8.2 Scarlet fever
19 Diphtheria and croup
4.1 Other epidemic diseases
10.7 Tuberculosis of lungs
133.2 Tuberculosis of other organs
56.6 Other general diseases
17.6 Other diseases of nervous system.
82.4 Diseases of circulatory system...
118.1 Pneumonia and broncho-pneumonia
63.5 Other diseases of respiratory system. .
26.2 Diarrhea and enteritis, under 2 years..
52.5 Diarrhea and enteritis, 2 years and over.
19.3 Other diseases of digestive system..
44.3 Bright's disease and nephritis
7.4 Early infancy
17.6 Other violence
80.4 All other causes
Tuberculosis, as usual, was the leading cause of death, though the per cent of all deaths caused by tuberculosis of the lungs and other organs was only 15.7 for June, against 16.4 for May. Next after tuberculosis come diseases of the circulatory system, diseases of the nervous system, and pneumonia and broncho-pneumonia, in the order named.
The principal epidemic diseases in June were: Typhoid fever, 40; measles, 20; whooping-cough, 19; diphtheria and croup, 17, and influenza, 10. The number of deaths from typhoid fever was the same in June as in May. The deaths from measles fell from 41 in May to 20 in June, while the deaths from whooping-cough rose from 10 to 19, the deaths from diphtheria and croup being not far from the same in each month, 22 for May and 17 for June.
MEETING OF STATE BOARD OF HEALTH.
The quarterly meeting of the State Board of Health was held July 6th at the State Capitol building, Sacramento. There was a general review of the work done by the Secretary, and a discussion and outlining of future work. It was decided to appeal to the United States Public Health and Marine Hospital Service to investigate the epizoötic among the squirrels, in order to ascertain if it was in any way communicable to man. A resolution was adopted congratulating the Health Commission of San Francisco on their effective work in maintaining sanitary conditions after the recent fire, and another thanking Walter Wyman, Surgeon-General United States Public Health and Marine Hospital
Service, and his officers for the help rendered the State after that catastrophe.
Perhaps the most important work done was the adoption of the following resolution, after a discussion of water pollution :
I move that the Secretary be instructed to notify again the various cities and towns, including Sacramento, which are now polluting the Sacramento river by depositing sewage either directly or indirectly in the river channel—that this is in direct violation of the State law, which it is the duty of the board to execute; and at the same time to offer his services, if desired, in indicating the best method of sewage disposal in each particular case.
The board has, for three years, been working to purify and keep pure the water supply of the State, and it is a satisfaction to report that many towns have already taken steps to destroy their sewage. Others seem not to feel the necessity of such action, and it is evident to the board that legal means must be taken in order to protect the lives of the people using the water thus polluted. This is not pleasant nor profitable to the city or town, but it is the only way left open.
REPORTS FROM HEALTH OFFICERS. Dr. E. N. Mathis, Los Angeles County, reports that “Many complaints come from mountain resorts that picnickers bathe and wash dishes and garments in mountain streams, thus contaminating the water."
We have frequently called attention in the Bulletin and elsewhere to this danger to the public health. Already one epidemic of typhoid fever in the State has been traced to this source, and no doubt many isolated cases result from a like cause. The State law and regulations against contaminating the water of streams used for domestic purposes are ample and arrests should be made for their violation.
Dr. Charles Pratt, Fallbrook, San Diego County, reports whoopingcough and measles as epidemic. There were 12,866 deaths from measles in 1900 in the United States, not a few of them the victims of the popular idea that measles is a mild disease, and devoid of danger. Many parents purposely expose their children to it, sometimes with the result of losing them. All cases of measles should be carefully isolated, and thorough disinfection practiced.
Dr. Strong, San Bernardino County, reports a smallpox case, which exposed many, but vaccination of all contacts stopped spread of disease.
Captain J. W. Howell, Napa, reports health conditions fairly good. Typhoid disappearing. The State has been an offender in the Napa Valley in allowing the sewage of the Veterans' Home at Yountville to drain into the Napa river. The efficient commandant of that institution, Dr. H. G. Burton, notified the State Board of Health of the condition, and a system of sewage destruction is being worked out.
Dr. S. Z. Peoples, Petaluma, has a few cases of smallpox on hand. They came, as is quite common, from cases of chicken pox. The doctor