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The work done so far has led to the conclusion that mere exclusion from school without quarantine does not insure the necessary isolation of the germ cases. Consequently, the following letter will be sent to the parents of children harboring diphtheria bacilli: Mrs. DEAR MADAM: An examination has been made of the throat of
and it has been found that there are diphtheria germs present. This does not necessarily mean that he will have diphtheria, but it does mean that..he has been exposed to the disease and may give it to other children. Although the germs may never show in the throat except by bacteriological examination, yet he is a menace to other children.
Your children are therefore quarantined. This means that they are not to be allowed to leave, nor are other children to enter, the premises while this quarantine lasts. The quarantine will be maintained until the throats of your children are free from the germs. They will be visited from time to time at your home to determine when this is the case, and notice will be sent you when the quarantine may be removed. Its duration will undoubtedly be shortened if you will consult a physician and have proper treatment.
Diphtheria is spread by children using in common such things as cups, spoons, pencils, and the like; sucking the same toys; coughing in each other's faces; kissing; or by any of the various ways in which the germs in the throat and saliva may be transferred.
G. R. REINHARDT,
It is quite too early in the work to speak of results, but certain lessons may be drawn.
The termination of quarantine in diphtheria ought always to be made dependent upon a bacteriological examination. The widespread existence of diphtheria in the form of a mild inflammation without the presence of a membrane is not recognized by the average physician in his practice. A bacteriological examination alone can make it sure. During a diphtheria epidemic any sore throat in child or adult should justify making such an examination.
The fact that the laboratory is conveniently near to the epidemic has greatly facilitated the work; still there is no reason why the laboratory should not do similar work for other towns. Cultures should be taken by local health authorities and sent in by express with only a slight loss of time. In Minnesota, where the laboratory staff is adequate, a representative of the laboratory goes to the epidemic equipped to do the work. This can not be done here at present, but the laboratory is open for the use of all health officers, and if they will avail themselves of it they will be able to take a positive stand early where otherwise they would be in doubt.
PURE FOOD. The National Pure Food Law, which went into effect January 1, 1907, has only a limited power to prevent the use of impure and adulterated food in this or any other state, as it simply prohibits the importation of impure food into the State. All that was here at the time the law took effect and all that can be manufactured within the State is not reached by that law. Consumers must not think that because of this law they will not be served with adulterated foods and drugs, for they will be, and possibly for a time to a greater extent, unless they watch out for themselves.
Foods brought in now must come up to the standard of purity, but that already here or manufactured within the State may be grossly adulterated. The only way to meet this is by a California Pure Food and Drug Law. It is encouraging to see that the Legislature which is now in session has taken the matter up seriously, and has before it a most excellent Pure Food and Drug bill. This bill is directly in accord with the national law, using the same definitions and having practically the same requirements.
As the Governor has always stood for pure food there are high hopes that we will soon, in a great degree, be relieved of that disgrace to our civilization, impure food. The slow poisoning by foods preserved with dangerous chemicals, together with the impure and adulterated stuff that is often sold, is responsible for innumerable deaths.
We can not, as a State, afford for any consideration to become the dumping-ground for other states, nor allow our manufacturers to serve the people with anything but what is pure. Not only the health and life of our children are at stake, but our reputation as a State. Let it once be known that California products are pure and wholesome, and exactly what they are represented to be, and an impetus will be given to trade that will far more than offset any damage that can be done.
TYPHOID FEVER. There has been a material falling off in the number of deaths from typhoid fever during the past month, and also in the number of cases reported. This is due in the cities to the general cleaning up and in the suppression of flies, and in the country to the rainfall which has cleaned out the streams and reservoirs, and diluted the water, which, in many places, is polluted, thus lessening the chances of infection.
Typhoid fever should be a rare disease, instead of standing sixth or seventh in the list of causes. It is a filth disease, the germs being carried only in the discharges from the body, and we have simply to destroy them. This is impossible in all cases, for they linger long after the patient is out from under the care of the doctor; but much can be done in that way. Flies, water, and personal contact are the chief means of distribution, and these can be largely controlled.
“The Life of Germs in Water.-It is well-known that water is a carrier of infection, and indeed that pure spring water may carry organisms of disease. The question as to how long the organisms of disease may live and retain their virulence has been the subject of considerable controversy. The general tendencies of opinions hitherto made have been that though they may live for a time in clean
water, they will multiply little, if at all, and tend to die out rapidly. The short life of disease-producing bacteria in water is supposed to be due to unfavorable environments, such as the competition of hardier water-bacteria and the absence of proper nutriment. Recently these conclusions have been challenged. It is stated that water is an excellent medium for many pathogenic micro-organisms, and that in the long run they survive the supposedly more hardy water-bacteria. It has also been stated that disease organisms live longer in pure than in dirty water; therefore, pure drinking water, once infected, is more dangerous than foul water. Some experimenters have demonstrated that typhoid bacillus would live in ordinary drinking water for over a year.
Sterilized water has been demonstrated to be a good culture medium for the anthrax bacillus, as well as for the typhoid bacillus. The practical significance of these demonstrations is that a community which has suffered from an epidemic of typhoid fever, due to infection of the water supply, can not rely upon the short life of bacteria to free it from danger, and these experiments may also explain recurrences of epidemics of typhoid fever after supposedly sanitary reforms of water supplies.”—Exchange.
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, O. STANSBURY, M.D.
...Chico Sacramento | W. LE MOYNE WILLS, 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 JANUARY.
Summary.—For January there were reported 1,771 living births; 2,475 deaths, exclusive of stillbirths; and 1,754 marriages. Estimated by the Census Bureau method with slight modifications, the population of California in 1907 is 2,001,193. For this population the preceding figures give annual rates per 1,000 inhabitants, as follows: Births, 10.4; deaths, 14.6; and marriages, 10.3.
Marriages are reported only by counties, the numbers being highest for Los Angeles, 380; San Francisco, 310; and Alameda, 243. There were also over 50 marriages in each of the following counties: Fresno, Marin, Orange, Sacramento, San Diego, and Santa Clara.
Births are reported separately for cities having freeholders' charters, the totals being greatest for Los Angeles, 325; San Francisco, 313; and Oakland, 163. There were over 20 births in each of the following cities as well: Berkeley, Fresno, Pasadena, Sacramento, San Diego, and San José.
Deaths are shown for all incorporated cities, whether with charters or not, the numbers being highest for San Francisco, 593; Los Angeles, 383; and Oakland, 203. There were also 20 or more deaths in each of the following cities: Alameda, Berkeley, Fresno, Pasadena, Redlands, Riverside, Sacramento, San Bernardino, San Diego, San José, Santa Cruz, Santa Rosa, and Stockton.
The deaths were distributed by geographic divisions, as follows: Northern California--coast counties, 130; interior counties, 102; total, 232. Central California-San Francisco, 593; other bay counties, 365; coast counties, 171; interior counties, 375; total, 1,504. Southern California-Los Angeles, 511; other counties, 228; total, 739. State total, 2,475.
Causes of Death.—There were 407 deaths, or 15.6 per cent of all reported for January, from pneumonia and other diseases of the respiratory system, and 390, or 15.8 per cent, from tuberculosis of the lungs and other organs. The proportions for pneumonia and tuberculosis were each higher than in the preceding month. Third in order, as before, are diseases of the circulatory system, heart disease, etc., causing 352 deaths, or 14.2 per cent of all.
Typhoid fever, as usual, was the most fatal epidemic disease, causing 46 deaths against 20 for diphtheria and croup, 15 for measles, 13 for influenza, and 25 for various other epidemic diseases. However, the per cent of all deaths due to typhoid fever was only 1.9 for January, against 3.5 for December, 4.5 for November, and 4.4 for October.
Detailed figures on causes of death in California appear in the table below, which shows the number of deaths due to certain principal causes in January, as well as the proportion from each cause per 1,000 total deaths for both January and December:
CALIFORNIA PUBLIC HEALTH ASSOCIATION. The annual meeting of the California Public Health Association will be held at Del Monte, Monterey, Monday, April 15th, at 2:00 P. M., the day preceding the meeting of the State Medical Society.
"Child's Work in the Public Schools” will be the main question for discussion. Other subjects will be brought out by the “question box," and plenty of time given for discussion. The effect of the public school, either for good or bad, is a vital question to the State. It is not everything that the child becomes greatly learned. Education is good, but if secured at the expense of health it is a poor bargain. It is entirely possible to get the one and retain the other, but are we doing it at present? If you think not, come to the meeting and tell us about it. If you think we are, still come and show those who think otherwise the error of their views. It is a question of such broad interest and one on which any
one can talk, as it is not scientific, that the meeting should be well attended
There will be a paper on Formation of Springs and a Stretch of the Underground Waters,” which will be of exceptional interest. Disease is often water-borne, and the idea is prevalent that all water from the earth is pure. This phase of the question will be discussed.
The California Public Health Association doors are open to all. No dues are charged, and every one who is interested in the public health is welcome. The program will be published next month.
DR. J. F. KENNEDY. It is with regret we note the retirement of Dr. J. F. Kennedy from the position of Secretary of the Iowa State Board of Health, and editor of the Iowa Health Bulletin. He had held the secretaryship for twentytwo years, and had edited the Bulletin since its start, twenty years ago. In keeping him in these responsible positions so long the State exercised good judgment, and in return he honored and greatly aided the State. Scholarly, earnest and able, and always a gentleman, the California Bulletin feels a sense of personal loss in his retirement.
While Dr. Kennedy may not be, as in the past, one of the active leaders in the cause of sanitation, we are sure that his interest in the cause will not lessen, and that not only his State, but the others, may receive occasional feasts from his storehouse of knowledge.
PURE FOOD. It seems probable that the Legislature which is now in session will enact a Pure Food and also a Pure Drug law. Indeed, these bills have already passed the Senate. The features of the bills are exactly those of the National law, the definitions, requirements, and standards being copied from it. While the National bill may not be all that could be wished, it is a far step in advance, and by following it we will have the advantage, in the enforcement of the State law, of decisions rendered in the National.
It would be a great misfortune to the State if the Legislature should not enact some stringent laws on these subjects. The National law deals only with interstate commerce, and leaves the State to take care of its own food affairs. It simply says no other State shall send you adulterated or impure food. Shall we, as a State, have less interest in ourselves than the United States has in us? We hope not.
The State law should be, as the bills before the Legislature are, as near as possible in conformity with National law. Two years' experience will show defects, and it will be easy to remedy them then. If the Legislature should adjourn without action, the people of the State will be served more than in the past with a poor quality of food, oftentimes preserved with injurious chemicals, and sometimes with a very material decrease in weight or measure, and with drugs that are responsible in no small degree for the increased population of our State institutions. The members of the Legislature owe it to their constituents to enact these laws which will protect them from the grasping avarice of unprincipled manufacturers.
DIPHTHERIA. “LODI (San Joaquin County), February 12.—The case of the Edwards children, living in West Lodi, and supposed by some physicians to have diphtheria, is being seriously considered. The Edwards children, five