OPERATIONS OF THE SANITARY DISTRICT OF THE GREAT LAKES. As mentioned in the annual report for 1915, the laboratory of the Sanitary District of the Great Lakes was established at the United States Marine Hospital, Chicago, Ill., on March 1, 1915, with the following personnel: Surg. J. O. Cobb, medical officer in charge; Asst. Surg. C. L. Williams; Sanitary Engineer H. P. Letton; and one attendant. As the work of the laboratory increased an additional attendant was employed. The personnel remained unchanged until December 1, 1915, when Asst. Surg. C. L. Williams was ordered to New Orleans, and Asst. Surg. R. R. Spencer was detailed in his place. The clerical work of the district greatly increasing, an acting clerk was appointed February 17, 1916. Conditions aboard. lake vessels were ascertained to be such as to require immediate attention, and the efforts of the district force were concentrated on this branch of the work during the greater part of the fiscal year. About the 15th of June, 1915, intensive collection of water samples from lake vessels was inaugurated, and this was kept up during the major portion of the operating season. At the same time sanitary surveys were made of nearly every passenger vessel operating on the Great Lakes, as well as a number of freighters. The results of the bacteriological examinations and the sanitary surveys soon showed that it is impossible for Great Lake vessels to obtain a water supply directly from the lake which will, without treatment, at all times conform to the Treasury Department standard. Much attention was given, therefore, to a study of the methods of water purification in current use aboard lake vessels. Representative boats were selected for intensive studies, these investigations demonstrating that the methods adopted were wholly inapplicable for the purpose contemplated. An investigation was then commenced of all methods of water purification capable of adaptation for use on lake vessels. This study was carried on in much detail, and a report describing the conditions aboard vessels, as well as the possible remedies, was published. On March 10, 1916, a circular letter was addressed to all common carriers obtaining drinking water supplies from the Great Lakes stating that every vessel would be required to install some form of water-purification apparatus which would be automatic in action, proof against carelessness, indifference, or forgetfulness, as well as dependable in every stress of weather. Three methods of treatment were approved, namely, distillation, disinfection by heat from a steam jet, and disinfection by ultra-violet rays. Pursuant to this order many of the carriers have taken steps toward the installation of one of the approved forms of apparatus. Owing to the difficulty of installing apparatus of this character during the operating season, the order as yet has not been strictly enforced, but by the beginning of the coming season every lake vessel deriving its supply from the water over which it is navigated must be provided with proper water-purification equipment. In addition to the investigations on lake vessels, some attention was paid to steamers operating in interstate traffic on the Illinois River. This river receives all the sewage of the city of Chicago and is turbid a great deal of the time; hence the obtaining of a safe water supply on river vessels requires somewhat different treatment than on lake vessels. In connection with the inspections of vessels not touching at Chicago it was necessary to ship samples of drinking water used to the laboratory for examination. Inasmuch as such shipments require that the samples be kept at a low temperature, the question of an efficient shipping case arose. All the available data regarding this matter were collected and a shipping case used on the Ohio River investigation was tried out. This case failed to solve the problem, and, after more or less experimentation, a galvanized-iron case insulated with pressed cork was designed. This shipping case will hold eight 4-ounce sample bottles and a sufficient quantity of ice to maintain the water at a temperature below 10° C. for 48 hours. The case is inexpensive and durable. There being considerable question as to the value of the examination of shipped samples, a large number of experiments were performed to determine the viability of bacillus coli under such conditions. This data will be presented in the form of a report at a later date. Before taking up the study of drinking water supplied passengers aboard trains operating in interstate traffic a comprehensive plan for carrying on the work was prepared. A map covering the entire sanitary district, having a scale of 8 miles to the inch, was obtained, and on this has been shown, by means of colored tacks, the location and status, as far as has been determined, of every source of water supply used by railroads for supplying passengers. From this map a perspective view of the water-supply situation in the entire district can be obtained. Sanitary surveys of watersheds and the collection and examination of samples have already been commenced. Inspections have been made of every railroad terminal in Chicago, special attention being paid to the methods of handling train water. These inspections have indicated that there is a vital necessity for the standardization of methods of handling drinking water for trains. A number of investigations were made by the laboratory staff in accordance with Bureau orders. On September 17, 1915, Asst. Surg. C. L. Williams reported the findings of an investigation of an epidemic of typhoid fever aboard naval reserve vessels of the Great Lakes, following the maneuvers of that year. Sanitary Engineer H. P. Letton investigated and submitted reports of the sanitary quality of the water supplies at the Vermillion Lake Indian School, the Wahpeton Indian School, and the Holland Pier Head Light Station. Many conferences have been held with various manufacturers of water-purification apparatus. In several instances where it seemed probable that the equipment would meet the necessary requirements it was temporarily installed at the laboratory and thoroughly tested to determine its availability for use on vessels. A number of transportation companies have sought conferences regarding the installation of water-treatment equipment, and in several instances have submitted specifications of the apparatus which they proposed to install, to determine whether or not it would meet with the Government requirements. Various railway officials have similarly had consultations concerning their water supplies and the methods of handling water on their roads, and a number of letters have also been received from these authorities requesting that sanitary surveys be made of their water supplies. In conjunction with the above-described activities there is tabulated below in detail the analytical work of the laboratory for the fiscal year. Water samples examined: Total samples from boats engaged in interstate traffic_ Total samples from ultra-violet ray apparatus (3 types) Experimental samples-testing longevity of B. coli and reliability of 1; 081 324 635 114 263 50 35 2, 502 Total water samples-- In the analysis of these samples the routine procedure as laid down by the Treasury Department standard and the "Standard Methods of Water Analysis " of the American Public Health Association were closely followed. Cultures from Indian schools examined for the presence of bacillus diphtheria: Positive___ Negative Total 26 104 130 Specimens of sputum from Indian schools examined for the presence of tubercle bacilli : Positive_ Negative Total Blood specimens from Indian schools for the presence of malarial . organisms: Positive_. Negative Total Positive_. Negative Specimens of blood from Indian schools for Widal test: Total Wassermann tests since December 1, 1915, for United States Marine Hospital: Positive_ Negative Total Total miscellaneous tests_ RECAPITULATION. Number of water samples tested- Number of miscellaneous tests____ Grand total 9 17 26 1 0 1 1 4 32 36 194 2, 502 194 2,696 OPERATIONS OF THE SANITARY DISTRICT OF PACIFIC. The interstate sanitary officer of this district made a survey of the extensive watersheds of the company supplying water to the city of San Francisco, at which point many railroad and steamship companies take on water for use of passengers in interstate travel. A survey of a part of the watershed of the company supplying water to the east bay cities was also made, but detailed reports of these investigations have not yet been prepared. A survey of the water supply for the Panama-Pacific International Exposition was made and reported upon during the year. The interstate sanitary laboratory for this district comprised during the first five months of the year a part of the service exhibit at the Panama-Pacific International Exposition. When the exposition closed the laboratory equipment was removed and installed in part of the Federal laboratory in San Francisco, where the work has since been conducted. On account of the officer in charge having been detailed to other duty in connection with the prevention of the introduction of typhus fever during several months of the present fiscal year, sanitary surveys of the remaining watersheds in the district were not made. Water is taken by common carriers at 124 different places in this district, and during the coming fiscal year a survey of each of these separate sources of supply is contemplated. Letters have been written to each common carrier, and the local address of those responsible for furnishing water at each source has been obtained for use when the local surveys are undertaken. During the year 29 samples of water were examined and certificates issued when required. All of the samples examined were found to comply with the bacteriological standard promulgated by the Secretary of the Treasury October 21, 1914. OPERATIONS OF THE SANITARY DISTRICT OF THE NORTH PACIFIC. By direction of the Surgeon General the work of examining water supplies used by common carriers in the State of Washington was undertaken in November, 1915. Samples were secured from practically every supply used by common carriers engaged in interstate traffic and the railroads concerned were furnished with certificates conforming to the findings obtained. In addition to this sanitary surveys were made of nearly all the watersheds serving as a source of such supplies. Upon recommendation of this office the water supplies at the following places were condemned for use by common carriers engaged in interstate traffic, and the railroads concerned were immediately notified by the Surgeon General to discontinue furnishing water from these sources: Fallbridge, Wash., used by the Spokane, Portland & Seattle Rail way. Cheney, Wash., from springs used by the Northern Pacific Rail way. Republic, Wash., from a well and a creek used by the Great Northern Railway. In addition to this work numerous typhoid and smallpox vaccinations have been performed as a measure toward the prevention of the interstate spread of these diseases. OPERATIONS OF THE SANITARY DISTRICT OF THE GULF. The work of the sanitary district of the Gulf during the past year has been exclusively confined to the examination of the water supplies of vessels leaving the port of New Orleans. Inasmuch as this was the first year of operation of the district it was decided that a survey should be made of water supplies of ships leaving the port, both domestic and foreign, in order to obtain a clear conception of existing conditions. Since the Louisiana State Board of Health through its president, Collaborating Epidemiologist Oscar Dowling, had informed the Public Health Service of its work in examining water supplies on railroad trains entering Louisiana, it was decided that the laboratory of the district should defer its own operations on the railroad phase of the subject pending developments. The results of analyses of water supplies of vessels entering New Orleans during the year were as follows: Vessels from which supplies were obtained_. Number of samples confirmed_ Number of samples nonconfirmed. Number of samples badly polluted... Probability of contamination in handling Number of supplies untreated__. Number of supplies treated_. Filtered. Distilled Other methods ----- 186 397 211 186 25 75 143 43 31 6 6 In general it may be said that while many of the water samples did not conform to the Treasury Department standard only 6.5 per cent of the supplies showed a high degree of pollution. The supplies were derived from varied sources, water from South American, European, and Central American ports being examined. A great many of the vessels leaving New Orleans take water from the city supply sufficient to last until their return, and the lines plying between New Orleans and New York as a rule take only New Orleans and New York City water. A number of tests of New Orleans city water were made, only a few of which showed colon bacilli present, while in practically all the counts on agar plates were quite low. Inspections have been made of most of the ships regularly entering the port of New Orleans, and it was found that on the larger vessels the methods of handling the water supply, as well as their other sanitary conditions, were good. On many of the smaller vessels, however, the water for drinking purposes was often found in coolers which were filled by use of buckets from a hand pump leading from the fresh-water tank. The men designated to take care of them were frequently careless and resulting severe contamination in handling was not unusual. A great deal of time has been spent in adequately equipping the laboratory for the work intended. Several alterations in the laboratory have recently been completed and the installation of a large amount of apparatus has made it possible for the work to be conducted hereafter on an extensive scale. The sanitary district of the Gulf is well situated for purposes of sanitary control of interstate operations. The progress within its |