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SCARLET FEVER, MEASLES, DIPHTHERIA, AND TUBERCULOSIS.

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Cases and Deaths Reported by Cities for Week Ended Oct. 18, 1913.

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Over 500,000 inhabitants:

Baltimore, Md.
Boston, Mass..
Chicago, Ill....
Philadelphia, Pa.
Pittsburgh, Pa.

St. Louis, Mo.
From 300,000 to 500,000 inhabit-
ants:
Buffalo, N. Y...
Cincinnati, Ohio.
Los Angeles, Cal.
Milwaukee, Wis.
Newark, NJ
New Orleans, La.
San Francisco, Cal.

Washington, D.C.
From 200,000 to 300,000 inhabit-
ants:

Jersey City, NJ
Providence, R.I.

Seattle, Wash.
From 100,000 to 200,000 inhabit-
ants:

Bridgeport, Conn..
Cambridge, Mass.
Columbus, Ohio.
Dayton, Ohio.
Fall River, Mass.
Grand Rapids, Mich.
Lowell, Mass.
Nashville, Tenn.
Oakland, Cal..
Richmond, Va.
Spokane, Wash.
Toledo, Ohio..

Worcester, Mass.
From 50,000 to 100,000 inhabit-
ants:

Altoona, Pa. Bayonne, N.J. Brocktop, Mass. Camden, V.J. Erie, Pa. Evansville, Ind. Harrisburg, Pa..

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52, 127 55,515 56,878

4,538 66,525 69, 647 64,186

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SCARLET FEVER, MEASLES, DIPHTHERIA, AND TUBERCULOSIS_Contd.

Cases and Deaths Reported by Cities for Week Ended Oct. 18, 1913—Continued.

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From 50,000 to 100,000 inhabit-
ants-Continued.
Hartlord, Conn..
Hoboken, NJ.
Johnstown, Pa..
Kansas City, Kans.
Laurence, Mass.
Lynn, Mass.
Manchester, N. H.
New Bedford, Mass.
Pawtucket, R.I..
Reading, Pa..
Saginaw. Mich
St. Joseph, Mo.
South Bend, Ind.
Springfield, t.
Springfield, Mass.
Trenton, N.J.
Wilkes-Barre, Pa..

Yonkers, N. Y.
From 25,000 to 50,000 inhabitants:

Atlantic City, N.J..
Auburn. N. Y.
Aurora, m...
Austin, Tex..
Binghamton, N, Y..
Brookline. Mass.
Chattanooga, Tenn..
Chelsea, Mass.
Chicopee, Mass..
Danville, ill..
East Orange, N. J..
Elmira, N. Y.
Everett, Mass.
Fitshhurg Mass..
Haverhill, Mass.
Knorville, Tenn.
La Crosse, Wis.
Lan aster, Pa.
Lexington, Ky.
Lynchbure, Va.
Malden, Mass.
Newcastle, Pa.
Newport, Ky.
Newton, Mass.
Niagara Falls, N. Y
Norristown, Pa..
Oranre, N. J..
Pasolena, Cal.
Pittsfield, Mass.
Portsmouth, Va..
Rarine, Wis.
Roanoke, Va..
Rockford, IlI..
Barramento, Cal.
San Diego, Cal.
South Omaha, Nebr.
Superior, Wis...
Taunton, Mass.
Waltham, Mass.
West Hoboken, N.J..
Wheeling, W. Va.
Wilmington, N. C...
York, Pa..

Zanesville, Ohio.
Less than 25,000 inhabitants:

Alameda, Cal
Ann Arbor, Mich.
Beaver Falls, Pa..
Bennington, vt.
Biddeford, Me.
Braddock, Pa.
Cambridge, Ohio..
Clinton, Mass.

98,915
70,324
55, 482
82,331
85, 892
89,336
70.063
96,652
51, 622
96,071
50,510
77,403
53,684
51,678
88, 926
96.815
67,105
79, 803
46,150
34, 668
29,807
29,860
48, 443
27,792
44,604
32, 452
25, 401
27,871
34,371
37, 176
33, 484
37,826
44, 115
36.346
30, 417
47,227
35,099
29, 494
44,404
36.280
30. 309
39,806
30, 445
27.875
29,630
30.291
32, 121
33. 190
38.002
34,874
45.401
44,696
39,578
26, 259
40.384
34,259
27.834
35, 403
41.641
25, 748
44, 750
28,026

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23,383
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8, 698
17,079
19, 357
11,327
13,075

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SCARLET FEVER, MEASLES, DIPHTHERIA, AND TUBERCULOSIS-Contd

Cases and Deaths Reported by Cities for Week Ended Oct. 18, 1913– Continued.

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Less than 25,000 inhabitants
Continued.

Coffeyville, Kans..
Columbus, Ind.
Concord, N. H
Cumberland, Ma.
Dunkirk, N. Y.
Galesburg, Ill.
Gloucester, Mass.
Hannibal, Mo.
Harrison, N.J.
Kearny, N. J.
La Fayette, Ind
Marinette, Wis.
Massillon, Ohio.
Medford, Mass.
Melrose, Mass.
Moline, m.
Montclair, N. J..
Morristown, N. J.
Nanticoke, Pa...
Newbury port, Mass.
North Adams, Mass.
Northampton, Mass.
Plainfield, N.')
Pottstown, Pa.
Rutland, Vt.
Saratoga Springs, N. Y
South Bethlehem, Pa.
Steelton, Pa...
Wilkinsburg, Pa.
Wohurn, Mais

12,687

8, 813 21, 497 21.839 17,221 22.089 24,398 18,341 14, 498 18.659 20,081 14,610 13, 879 23, 150 15, 715 24. 199 21,550 12,507 18, 877 14,949 22.019 19, 431 20.550 15.599 13,546 12.693 19,973 14.246 18, 924 15,309

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IN INSULAR POSSESSIONS.

HAWAII.

Examination of Rats and Mongoose.

Rats and mongoose have been examined in Hawaii as follows: Honolulu, week ended October 11, 1913, 458; Hilo, week ended September 27, 1913, 10,858; week ended October 4, 1913, 2,790. No plague-infected animal was found.

PHILIPPINE ISLANDS.

Cholera- Cholera Carriers-Manila.

During the week ended September 20, 1913, 3 cases of cholera with 1 death were notified at Manila.

On September 14, 1913, a case of cholera was found in the person of a Filipino carpenter who worked with a large group of men at the corner of Calles Padre Faura and Taft, and who lived on Calle Nueva, near Calle San Andres, both of which addresses are in the residential section of the city and a number of miles from the last case, which occurred at Caloocan. (See Public Health Reports, Oct. 10, 1913, p. 2093.) No connection could be traced between the cases, nor have

any cases of cholera occurred in the group of men among whom the carpenter worked. Seven persons who were supposed to be contacts at his house were examined, and two vibrio carriers were found, the organism being identical with that of Koch with the exception that it failed to agglutinate with cholera serum.

On September 16 a case occurred in the person of an American who lived in Pasay under native conditions. Pasay is several miles from where the above case occurred. This man was an employee of the Quartermaster's Department of the Army and was alleged to have been a sufferer from nephritis. He died on September 17. The autopsy revealed the typical findings of cholera and in addition a nephritis which may have been present before cholera was contracted. The laboratory findings were positive. Five contacts were examined and all of them were negative for cholera organisms and vibrios.

The third case was in an African-Filipino child that applied at the Philippine General Hospital for treatment for dysentery. On stool examinations being made, Koch's vibrios were found. The case was removed to the San Lazaro Cholera Hospital. Two contacts examined were found negative for cholera organisms and vibrios.

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During the week ended September 27, 1913, 3 cases of cholera with 1 death were notified in Manila. The disease occurred in widely separated sections of the city.

Plague-Plague Rats-Manila.

During the week ended September 27, 1913, a fatal case of plague occurred in Manila in the person of an American, editor of the Manila Daily Bulletin. In view of the completeness with which the origin of the infection in this case was traced, and its significance, the following details may be of interest:

On September 6 a plague rat was found in the block adjacent to that in which the offices of the Manila Daily Bulletin are located. On September 19 the editor was admitted to a local general hospital. On September 20 a preliminary diagnosis of plague was made and he was immediately transferred to the San Lazaro Plague Hospital, where he died on September 22. In carrying out the routine insecticidal measures in the offices of the Manila Daily Bulletin a mummified rat was found in the desk of the late editor. There were also a number of live fleas, one of which was identified as Pulex cheopis. Microscopical slides prepared from the ground-up flea showed bipolar staining organisms similar to those of plague. The rat was also ground up, and inoculations made from it into healthy laboratory rats produced in them typical cases of plague, which terminated fatally. A culture made from one of the buboes of the patient and inoculated into a guinea pig resulted in a positive case of plague, which also terminated fatally.

The facts that the mummified rat found in the desk must have been dead for a period of at least two weeks and that live fleas which contained plague bacilli were associated with it furnish strong proof that plague might be introduced into a country without either the importation of human or rat cases of plague and that fleas might be alone concerned. In this instance the possibility remains, however, that the fleas might have been carried into the desk by plague rats which either died elsewhere or subsequently recovered.

On the first floor of the building in which the offices of the Daily Bulletin are located are a large grocery warehouse and a restaurant, and in the cleaning up which followed 4 dead rats were found in these premises. The cause of death in these rats could not be definitely ascertained.

It is interesting to note, however, that on September 20 a Chinaman employed in the warehouse died, and that the attending physician certified the cause of death as pulmonary tuberculosis after an illness of four months. Subsequently it was learned that the Chinaman had been ill only one day. The body was ordered exhumed by the bureau of health on September 22, and it was definitely ascertained that

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