• TABLE OF CONTENTS
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 Front Cover
 Title Page
 Letter of transmittal to the...
 Letter of transmittal to the president...
 Table of Contents
 Laboratory, report
 Communicable diseases, report
 Tuberculosis, report
 Sanitation, report
 Public health nursing, report
 Works progress administration nurses,...
 Dental health, report
 County health work, report
 Auditing, report
 Malaria research, report
 Drug inspection, report
 Library, report
 Custodian, report
 Multigraphing, report
 Vital statistics, report
 Addenda






Title: Annual report - State Board of Health, State of Florida
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Permanent Link: http://ufdc.ufl.edu/AM00000243/00007
 Material Information
Title: Annual report - State Board of Health, State of Florida
Series Title: Publication - Florida. State Board of Health
Physical Description: v. : ill., ports. ; 23-29 cm.
Language: English
Creator: Florida -- State Board of Health
Florida -- State Board of Health
Publisher: State Board of Health.
Place of Publication: Jacksonville Fla
Frequency: annual
regular
 Subjects
Subject: Public health -- Periodicals -- Florida   ( lcsh )
Genre: government publication (state, provincial, terriorial, dependent)   ( marcgt )
 Notes
Dates or Sequential Designation: Ceased in 1968.
Numbering Peculiarities: Report year for 1893/94 ends Mar. 31; for 189<7>-1968, Dec. 31.
Numbering Peculiarities: Reports for 1923-32 combined in one issue.
General Note: Reports for 1910-<17> issued as its Publication.
 Record Information
Bibliographic ID: AM00000243
Volume ID: VID00007
Source Institution: Florida A&M University (FAMU)
Holding Location: Florida A&M University (FAMU)
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 01569394
lccn - 07039608
 Related Items
Succeeded by: Annual report - Division of Health, Department of Health and Rehabilitative Services, State of Florida

Table of Contents
    Front Cover
        Front Cover
    Title Page
        Title Page
    Letter of transmittal to the governer
        Page i
    Letter of transmittal to the president of the state board of health
        Page ii
    Table of Contents
        Page iii
    Laboratory, report
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
    Communicable diseases, report
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
        Page 25
    Tuberculosis, report
        Page 26
        Page 27
        Page 28
    Sanitation, report
        Page 29
        Page 30
        Page 31
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
        Page 46
        Page 47
    Public health nursing, report
        Page 48
        Page 49
        Page 50
        Page 51
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
        Page 59
        Page 60
        Page 61
        Page 62
        Page 63
        Page 64
        Page 65
        Page 66
        Page 67
    Works progress administration nurses, report
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
    Dental health, report
        Page 73
        Page 74
        Page 75
        Page 76
    County health work, report
        Page 77
        Page 78
        Page 79
        Broward county
            Page 80
            Page 81
            Page 82
        Escambia county
            Page 83
            Page 84
            Page 85
            Page 86
            Page 87
            Page 88
        Franklin, Gulf, Liberty, & Calhoun county
            Page 89
            Page 90
        Gadsden county
            Page 91
            Page 92
        Hillsborough county
            Page 93
        Jackson county
            Page 94
            Page 95
            Page 96
            Page 97
            Page 98
            Page 99
            Page 100
            Page 101
            Page 102
        Leon county
            Page 103
            Page 104
            Page 105
        Monroe county
            Page 106
            Page 107
            Page 108
            Page 109
        Pinellas county
            Page 110
            Page 111
            Page 112
            Page 113
            Page 114
            Page 115
            Page 116
        Taylor county
            Page 117
            Page 118
            Page 119
    Auditing, report
        Page 120
        Page 121
        Page 122
        Page 123
        Page 124
        Page 125
        Page 126
        Page 127
        Page 128
        Page 129
        Page 130
        Page 131
        Page 132
        Page 133
        Page 134
        Page 135
        Page 136
        Page 137
        Page 138
        Page 139
        Page 140
        Page 141
    Malaria research, report
        Page 142
        Page 143
        Page 144
        Page 145
        Page 146
        Page 147
        Page 148
        Page 149
        Page 150
        Page 151
    Drug inspection, report
        Page 152
    Library, report
        Page 153
    Custodian, report
        Page 154
        Page 155
        Page 156
        Page 157
    Multigraphing, report
        Page 158
    Vital statistics, report
        Page 159
        Page 160
        Page 161
        Page 162
        Page 163
        Page 164
        Page 165
        Page 166
        Page 167
        Page 168
        Page 169
        Page 170
        Page 171
        Page 172
        Page 173
        Page 174
        Page 175
    Addenda
        Page A
        Page A 1
        Page A 2
        Page A 3
        Page A 4
        Page A 5
        Page A 6
        Page A 7
        Page A 8
        Page A 9
        Page A 10
        Page A 11
Full Text


FLORIDA STATE

FLORIDA STATE


BOARD OF HEALTH


THIRTY-SEVENTH

ANNUAL REPORT

FOR THE YEAR ENDING DECEMBER 31, 1936




















JACKSONVILLE
FLORIDA STATE BOARD OF HEALTH
1937









FLORIDA STATE BOARD OF HEALTH


















THIRTY-SEVENTH

ANNUAL REPORT

FOR THE YEAR ENDING DECEMBER 31, 1936










ADMINISTRATION OFFICES

JACKSONVILLE

LABORATORIES
JACKSONVILLE
TAMPA
PENSACOLA
MIAMI
TALLAHASSEE






JACKSONVILLE
FLORIDA STATE BOARD OF HEALTH
1937

















January 1, 1937




His Excellency, Fred P. Cone
Governor of Florida
Tallahassee, Florida

Sir:

I beg to hand you herewith a report of the
State Borrd of Health for the period of January 1,
1936 to December 31, 1936, inclusive.

Respectfully submitted,



Florida State Board of Health
N. A. Baltzell, M.D., President











Hon. N. A. Baltzell, M.D.,
President, State Board of Health



My dear Doctor Baltzell:-

I herewith submit the annual report of the State
Board of Health for the year 1936. The work of each Bureau is
reported separately and in detail, and I respectfully call th3se
to your attention.

The year has been principally distinguished as in
all States, by the addition of Social Security funds to the regular
budget. Through the use of these funds, we have been able to estab-
lish several new End much needed services, nauely a Division of
Tuberculosis Control, v Bureau of Dental Ioalth, a Bureau of Local
and County Health work, a Bureau of Maternal and Child Health, and a
Bureau of Public Health Educntion.

Particular emphasis has been laid on the establish-
ment of local health wor'. During 1936, eight full-time county health
units were formed. Fin-acial assistance for these units came front
Federal, State, rnd County funds.

Through two l0TA grants and a special grant from the
State Legislature, two additions to the headquarters of the Board in
Jacksonville were made possible. The first addition which will pro-
vide needed space for the Central Laboratory, and also an auditorium
or meeting room for the use of public health, medical end dental meet-
ings, will be completed early in 1937. The second addition, whicn will
house* the Bureau of Vital Statistics, for rany years occupying rented
quarters in a downtown building, will be completed during 1937 or early
in 1938.

The program of the State Board of Health is larger and
more adequate to the necds of Florida than has been possible for a
.number of years, due to the assistance from the Federal Government. We
look forward to a continuous expansion of public health work, with the
ideal of local hcrith service available to crcry section of Florida.

Respectfully submitted,



W.A. IdPhaul,M.D.
State Health Officer









III


TABLX Of CONTENTS
Page

Letter of tranmittal to the Governor . . I
Letter of transmittal to the President of the State Board of Health II
Table of contents * * * III


Laboratory, report .9 .
Communicable Diseases, report .
Tuberculosis, report . .
Sanitation, report. . .
Public Health Nursing, report ....
Works Progress Administration Nurses,
Dental Health, report . .
County Health Work, report .
Broward County.. . .
Escambia County .....
Franklin, Gulf, Liberty, & Calhoun
Gadsden County . . ..
Hillsborough County . .
Jackson County . ....
Leon County . ...
Monroe County . .
Pinellas County . .
Taylor County . . .
Auditing, report . .
Malaria Research, report ...
Drug Inspection, report . .
Library, report o . ..
Custodian, report . .. .
Multigraphing, report o ...
Vital Statistics, report . .


* *

. .
* *
* *


report
* ,
* 9 .


* *
County
* *
. *
* *
. *
* *


* *
* *



* *
* *
* .
* .


. 1
. 19
. 26
. 29
. 48
. 68
. 73
. 77
. 80
* 83
. 89
. 91
* 93
S94
.103
.106
.110
,117
.120
.142
.152
.153
.154
.158
.159



t
































-1-


January 1st, 1937.


Dr. W. A. McPhaul
State Health Officer
State Board of Health
Jacksonville, Florida.

Sir:

I have the honor to submit herewith the report of the
activities of the Bureau of Laboratories for the year, 1936.

The first table shows the gross amount of work done in
the central laboratory and the various branches. Separate tables are
given showing the kind and the number of examinations of ecch made in
each of the laboratories. The last table shows the distribution of the
Biologicals. These tables are self-explanatory and no comments will be
made.

During the year we have added sane much needed equipment.
This included five Binocular Microscopes with Inclined Eyopieces and
five Microscope Illuminators, providing the most modern optical equipment
obtainable.

I wish to take this opportunity to express our appreciation
and thanks to you for your efforts in securing an addition to the
building for the use of the Bureau of Laboratories. When completed,
this will relieve the congestion which has existed for a number of years
and will make it possible for us to carry on our work in a much more
satisfactory manner.

Respectfully submitted,


Pearl Griffith
Assistant Director of Laboratories.





















TABLE I

j!,AINATIONS MADE IN THE LABORATORIES DURING THE YEAR 1936


LABORATORY EXAMIIIATIONS

DIAGINSTIC MIILK AiND WATER TOTAL

CENTRAL:
Jacksonville, Fla. 166,257 3503 169,560

BRANCHES:
Tampa, Florida. G1,996 5280 67,276


Pensacola, Fla. 16,366 2025 18,591


Miami, Florida. 54,211 7565 61,776


Tallahassee, Fla. 11,009 1906 12,815


509,859 19,979


TOTAL


529,818





1936
CENTRAL LABORATORY
Jacksonville, Florida,
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
AlIMAL PARASITES
HOOKWORM: Pos. 744 691 725 757 542 383 377 413 423 928 1070 668
Neg. 1523 2324 2099 1953 1396 1057 1156 1193 1424 2092 2674 1681
Unsat. 25 44 51 44 31 3 7 12 1 27 132 57
ASCARIS 27 37 58 21 33 33 23 13 15 35 18 31
OYXURIS 32 18 20 10 11 5 4 3 2 18 19 11
STRONGYLOIDES 4 6 2 4 3 3 1 1 2 1 1 5
TAPEWORM 10 5 9 4 2 2 5 4 1 5 3 4
TRICHIURIS 25 17 6 5 15 19 4 1 11 3 2
THROAT CULTURES
DIPHTHERIA:Pos 32 11 12 5 11 3 2 1 8 62 39 39
Neg 843 623 735 540 552 377 255 300 479 835 653 661
Unsat 1


VINCENT ANGINA
Pos.
Neg.


S STREPTOCOCCUS


2
23 22


2
17 5


Grand
Total Total

7721
20572
434
344
153
33
54
108 29419


225
6853
1

240
686


46
11 14 213


Pos, 78 44 21 46 61 116 147 151 146 197 96 69
Neg. 1150 752 818 1765 1205 1248 1309 1591 1466 1151 764 769
Unsat. 3 1 1 1


AGGLUTINATION TESTS
TYPHOID: Pos.
Neg.
Partial
Unsat.
PARA TYPHOID A:
Neg.
PARA TYPHOID B:
Pos.
Neg.
WEIL FELIX:Pos.
Neg.
Partial


2 1 2 5 8 1 1 1 1 1
635 599 697 850 1049 1247 1294 1623 1477 1328 857 745
3 1 1 1 2 1 3 4
1 4 1 1


113 113


113 113
14 8
95 98
4 7


82 101 139 180 210 243 202 151

1
82 101 139 180 210 242 202 151
10 4 8 5 15 23 11 3
69 96 130 175 193 212 187 147
3 1 1 2 8 4 1


86 112


86 112
2 6
84 106


7079


926


259


1172
13988
6 15166

23
12401
16
7 12447


1732

1
1731
109
1592
31


1732


1732


1732


MALARIA:


oNeg.
Neg.


I












BRUC~LIA ABORTUS
Pos.
Neg.
Unsat.
TULAREMIA:Neg.
SPOTTED FEVER:Neg.
TYPHOID CULTURES
Blood: Neg.
Stool & Urine:
Neg.
TUBERCULOSIS
Microscopic:
Pos.
Neg.
Unsat.
Animal Inoculations
Bronchial


1936
CENTRAL LABORATORY-cont.
Jacksonville, Florida
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec


3 4:
90 61
1
36 31


4 3 3 2 2 4 2
96 110 128 124 127 142 102
1 I 3 1
54 58 44 63 37 61 33
1 1


Grand
Total Total


38
1234
11
507
5


1283
507
5


1 1 1 4 2


11 17 17 19 C 34 26 50 62 73 6 6 327


39 37 32 29 40 72 46 38 38 33 24 22
303 264 295 261 279 324 264 250 195 184 247 250
1 2 1
4 8 3 8 11 5 & 1 8 8 9


Spirochaetosis
Pos. 13 8 5 5 11 10 14 9 11 5 5 9
Neg. 329 293 322 286 308 386 296 279 222 212 268 264
0PHTHL'JIi.:Pos 1 1 2 1 2 2 1 1 1
Neg 12 12 15 20 17 1i 17 14 14 15 13 9
Unsat 1 2
GONORRHDEA:Pos 248 214 236 270 264 293 V64 261 246 295 188 250
Neg 793 826 885 816 89d 774 905 1016 877 1000 853 838
Unsat 3 6 3 2 6 1 2 1 1 1 4


SYPHILIS
Kahnt



RABIES
Dog:


Pos. 490 467 606 564 683 663 681 863 796 637 645 573
Neg. 5222 4390 4477 4265 4467 4566 5170 4752 5113 5343 4536 2685
Partial 297 300 361 304 239 266 "11 237 218 296 305 283
Unsat. 293 210 308 250 306 538 595 604 395 310 171 172


Pos.
Neg.
Unsat.


450
3116
4
79


105
3465
12
174
3
3029
10479
30

7668
56986
3317
4152


338




3570
79



3570


189


13538




72123


69
115
10






1936
CENTRAL LABORATORY-cont.
Jacksonville, Florida
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total


RAI IES
Cat:

U]
Calf:
Cow:

Hog:
Horse:
Mouse: U
Mule:
Rabbit:
A Rat:
SSquirrel:
LEPROSY:
IMILK:
ICE CREAM:
MISCELLANEOUS:


Pos.
Neg.
nsat.
PosB
Pos.
Neg.
Neg.
Neg.
nsat.
Neg.
Neg.
Neg.
Neg.
Neg.


1 4


1 3
2 2 2 3 1 2


3
1 1


1 1


1 1


274 269 273 281 281 295 276 283 294 269


267 238


21 15 23 10 25 25 33 37 21 26 55 29


14060 13112 13636 13955 13487 13618 14324 15059 14837 16133 14401 12938 169560 169560


Grand
Total


3
4
3300
3
320


239
4
3300
320
320


TCT;AL







1936
TAMPA LABORATORY
Tampa, Florida
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
ANIMAL PARASITES -
HOOKWORM: Pos. 475 372 219 169 190 226 270 82 51 158 74 128
Neg. 1623 1543 1939 1560 1440 951 721 336 379 698 424 369


Unsat.


1


ASCARIS 75 64 148 111
OXYURIS 15 11 12 10
STRONGYLOIDES 5 6 2
TAPEWORM 5 6 3 2
TRICHIURIS 58 44 197 136
THROAT CULTURES
DIPHTHERIA:Pos. 9 12 14
Neg. 134 354 195 102
Unsat.


VINCENT


o STREPTOC


MALARIA:



AGGLUTINATIC
TYPHOID:


ANGINA
Pos.
Neg.
'OCCUS
Pos.
Neg.


25 27
74 51


16
2


1
79

11
1
1
191


16 14 4 22 8
7 3 11 3
9 2 1 1 1
1
21 19 10 21 9


3 3
64 122


50 26
69 128


7 9 55 42 31
88 176 700 288 267


Grand
Total Total

2414
11983


2
592
89
34
22
786

191
2567
1

454
707


15922



2759


1161


4 1


Pos. 16 10 11 20 27 48 55 38 38 40 23 9
Neg. 212 176 241 257 274 327 364 305 294 280 165 160
Unsat. 1
)N TESTS
Pos. 4 3 7 3 3 4 1 1 2 1 1 1
Neg. 200 169 214 232 273 328 332 314 287 233 146 135
Partial 13 8 22 16 35 21 26 11 24 9 12 7


Unsat.
PARA TYPHOID A
Negs
PARA TYPHOID B
Neg.
WEIL FELIX:Pos.
Neg.
Partial
BRUCELLA ABORTUS
Pos.


335
3055
1


3391


31
2864
204
1 3100


3 4 4 4 11 7 7 10 9 4 4 1


3 4
1
6 7


4 4 11 7
3
12 5 15 10
1


1 2






1936
TAMPA LABORATORY-cont.
Tampa, Florida.
Jan Feb Mar Apr May June July Aug


BRUCELLA ABORTUS
Neg.
Unsat.
TULAREMIA:Neg.
SPOTTED FEVER:
Neg.
TYPUOID CULTURES
Blood: Neg.
Stool&Urine:
Pos.
Neg.
Unsat.
TUBERCULOSIS


Microscopic:
Pos. 59
I Negb 134
OPHTH[MIlA:
Pos,
Neg. 12
Unsat.
GONORRHOEA;
Pos. 76
Neg. 288
Unsat.
SYPHILIS
Kahn : Pos* 171
Neg. 2568
Partial 230
Unsat. 75


RABIES
Dog:


Cat:
WATER:
MILK:


Pos.
Neg.
Unsat.
Neg.


Sept Oct Nov Dec Total


2 2 1 10 12 13 13 5 11 12 10 2


1
1 4 5


5 4


3 1


1 1


9 4 7


9 3
1


17 49 57 15 61 17 39
71 135 148 117 160 124 151


2 1
9 17 24 4
1 1


61 56 52 76 61 77 85
243 256 310 324 329 346 371
2 1 2

105 109 109 140 163 172 118
1927 1859 1439 1643 1664 1820 1655
169 155 136 115 108 113 129
60 47 58 74 94 77 103


7 4


1
31 82 47 43 79 54 167 58
328 344 324 404 326 356 374 349


5 11 13 36 15
1


9 45
84 142


1
6 35


11 123
2


13 46
72 143


4
25 14 20


90 95
334 371
1 2

131 198
1035 2589
122 141
88 114


83 72
233 316


148 175
2-45 2347
159 160
100 98


4 6 1 2 5
1 1


57 641
290 348


49 37
306 270


427
1481

10
176
2

884
3721
11

1739
25791
1737
988

1
50
2
1
768
4019


Grand
Total


133



1908


188


4616




28255


34
768
4019











Jan Feb
ICE CREAM: 55 71
MISCELLANEOUS: 8 13


1936
TAMPA LABORATORY-cc
Tampa, Floridi
Mar Apr May June July
31 67 32 39 38
6 11 7 18 6


Aug Sept Oct Nov Dec
32 34 32 31 31
1 6 4 14 4


7026 6064 6461 5609 5741 5370 5497 4433 4537 6573 4993 4972


67276 67276


TOTAL


Total
493
98


Grand
Total
495
98






1936
PENSACOLA LABORATORY


Veaat ^ nl


V1l- 4


Jan Feb Mar Apr May June July
Jan Feb Mar Apr May June July


ANIMAL PARASITES
HOKWORM: Pos.
Neg.
Unsat.
ASCARIS
OXYUtRIS
STRONGYLOIDES
TAPEWORM
TRICHIURIS
THROAT CULTURES
DIPHTHERIA:Pos.
Neg.
VINCENT ANGINA
Poe.
Neg.
SSTREPTOCOCCUS
I -


57
131


UJ JLM


110 135 109
158 170 170


4 6 4
3


1
15 14


3 2
1 1
25
5 3


La Grand
Aug Sept Oct Nov Dec Total Total


77 95
174 99
2

3
5


1
15 19


148
381
2
9
1
1
4
3

2
26

5
28


150
248
8
1
2
13



7
52

13
19


1133
1885
15
58
12
10
38
22


20
19 269


351
351


3171


289


463


MALARIA:


AGGLUTINATION
TYPHOID:

P(


ros.

Pos.
Neg.
TESTS
Poo.
Neg.
partial


Un sat.
PARA TYPHOID A:
Neg.
Partial
Unsat.
PARA TYPHOID B:
Pos.
Neg.
Partial
Unsat.
Weil Felix: Pos.
Neg.
Partial


7 2 2


20 12
1


20 12
1


2 1 3


23
118


91
3


1
24 30


24 31 32 78 92
2


20 13 21 31 32 74
3 4

2
19 13 24 31 32 73
4


1
91
2

1
88
7


55 31
2
1


42
112


94
8


99
3



96
6

4
95
5


38
109

3
84
6
2

93
2
2


85
10
2
2
85
&


84
124

2
112
10


117
2


1
112
6

4
110
7


279
855

7
659
33
3

685
11
3

2
656
358
3
15
654
31


1134




702



699




699







1936
PENSACOLA LABORATORY-cont.
Pensacola, Florida.
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total


WEIL FELIX:
Unsat.
TYIHOID CULTURES
Blood: Neg.
Stool&Urine:
Neg.
TUBERCULOSIS
Microscopic:
Pos,
Neg.
OPHTHALMIA: Pos.
Neg.
Unsat.
GONORRHOEA: Pos.
SNeg.
i Unsat.
SYPHILIS
Kahn: Pos.
Neg.
Partial
Unsat.
RABIES


Pos.
Neg.
Pos.
Neg.


Rabbit: Neg.
RATER:
ILK:
ICE CREAM:
ISCELLAN'EOUS:


2 2 1


53 38


1 3


35 27 21 26 31 38 25 52 33 33 26
149 153 221 166 179 163 178 197 178 162 143


33 27 57 74 71 68 62 67 75 41 39
319 246 268 325 438 325 399 381 523 440 366
38 19 41 34 42 29 45 49 57 55 40
4 4 6 7 6 20 21 31 38 18 5


1 1
1 1
3 5 6 5 2 37 25 27 17 12 14
25 158 175 232 225 175 125 146 193 209 132
4 2 1 6
1 2 2 9 4 1 4 1 3 6


Grand
Total


5 705


2 94


40
301
5
24


26 37
159 204
1

32 64
214 424
44 4S
4 16


2
2
2 155
62 1857
13
2 35


1 2422

r6
4
13
4 5547


1008 948 1136 1272 1570 1723 1782 1883 1954 2373 1714 1028 18391


Dog:

Cat:


11
155
1857
13
35

18391


TOTAL





1936
MIAMI LABORATORY
Miami, Florida
Jan Feb Mar Apr May June July


ANIMAL PARASITES
HOOKWORM: Pos.
Neg.
Unsat.
ASCARIS
OXYURIS
STRONGYLOIDES
TAPEWORM
THROAT CULTURES
DIPHiHERIA:Pos.
Neg.
Unsat.
VINCENT ANGINA:
Pos.
Neg.
Unsat.
0 STREPTOCOCCUS:
I Pos.
Neg.
Unsat.
MALARIA:
Pos.
Neg.
Unsat.
AGGLUTINATION TESTS
TYPHOID: Neg.
Partial
Unsat.
PARA TYPHOID A:
Neg.
Unsat.
PARA TYPHOID B:
Pos.
Neg.
Partial
Unsat.
WEIL FELIX:Pos.


11 17 24 15
184 111 149 134 149
6 12 2 14 4
1 2
1
2 1
1 1

10 8 5 1 1
855 526 329 232 162
7 2 3 6 4


9 11
103 100
11 1
5


1
55 62


Grand
Aug Sept Oct Nov Dec Total Total


9 23 10 18
115 152 117 145
14 8 6 3


3 3
435 2094
1 1


151
1544
83
10
3
5
3


20 16 69
380 584 5799
3 3 32


35 31 44
111 101 121
15 15 14


4
9 7


3
3 26


3
33 32 34


1
6 5 2 5


25 47
2


47 47
1


1 5


24 38
1


325
907
168

9
78
2

10
437
8


1799



5900



1400



89



455


52 50 45 46 56 44 56 45 63 63 43 60 623
4 3 1 8
1 1 1 1 4 635

52 50 49 46 56 44 56 45 63 63 46 61 631
1 1 1 1 4 635


2
52 50 49 46 56 44 54


1
44 63 63 46 60


3
627


1 1


635


1 1 1








MIAMI LABORATORY-cont.
Miami, Florida. Grand
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total Total


BRUCELLA ABORTUS:
Unsat.
TYPHOID CULTURES
Stool&Urine:
Neg.
Unsat.
TUBERCULOSIS
Microscopic:
Pos.
Neg.
Unsat,
OFHTHAIdLA: Pos.
Neg,
GONORRHEA: Pos.
Neg.
Unsat.


2 4


5 1 1


37 10 15 5
1


20 6 22 10
1


12 28 16 55
3


3 7
58 29
2 1


4 1 3
41 33 53 57 28 23 26 25 28 28 23 26
274 223 205 222 200 206 208 169 192 284 261 349
7 6 2 4 12 12 1 4 5 8 2 3


16


236
5


71
551
7
1
8
391
2793
66


16



241




629

9


3250


SYPHILIS
Kahn: Pos, 330 198 292 205 215 158 217 194 189 282 336 445 3061
Neg. 4031 2637 2531 1699 1793 1760 1538 1514 2279 2778 2757 4600 29917
- Partial 186 140 149 127 95 102 85 109 107 133 151 198 1582
Unsat. 173 143 51 52 94 55 88 52 98 79 73 104 1062 35622


Catt N
Rat: N
IEPROSY:
IATER:
SILK:
ICE CREAM:
I ISCELLANEOUS:


1 1


2
176 200 226
624 512 409
17 13 14
139 177 132


1 1 3


1 8 6 2
190 148 186 206 234 303 177 188 187
456 529 435 356 467 352 311 298 243
13 13 13 13 14 12 12 18
161 159 216 207 191 124 242 197 283


19
2421
4992
152
2228


14
19
2421
4992
152
2228


7617 5426 5064 4067 4106 3643 3561 3545 4687 7105 5224 7731 61776 61776


RABIES
Dog:


Pos.
Neg,
Unsat.


eg,
eg.


TOTAL






1936
TALLAIASSEE IJJ3OPITORY
Tallahassee, i'lorida
Jan Feb Mar Apr May June July Aug Sept


Grand
Oct Nov Dec Total Total


A IMAL PARASITES
HOOKWORM: Pos.
Neg.
Unsat.
ASCARIS
OXYURIS
TAPEWORM
THROAT CULTURES
DIPHTHERIA:Pos.
Neg,
Unsat.
VINCENT ANGINA:
Pos.
Neg.
STREPTOCOCCUS
H( Poa.
Neg.
MiLARIA: Pos.
Neg.
Unsat.
AGGLUTINATION TESTS
TYPHOID Pos.
Neg.
Partial
Unsat.
PARA TYPHOID A:
Neg.
PARA TITHOID B:
Neg,
WEIL FELIX: Pos.
Neg.
Partial
BRUCELLA ABORTUS:
Pos.
Neg.


440
547
8
3
2
1


6 14 6 7 11 4 22 9 7 16 78
2


6 2
11 8
124 103


2
10 15


16
24


9
13
147


40 27 20 14


3 9 18
14 45 73
198 244 325
1

1
26 58 41
1 1
1 1


50
18 52 91 28
135 305 252 163


45 255
2


45
359

2
99
371
2213
2


2
41. 21 19 12 343
2
1 3


31 7 5 4 7 9 12 9 23 6 9 5 127


7 5 4 7 9 12 9
1
20 8 10 10 29 24 16


6 9 5 127
4
11 13 5 212


4 220


1 1


1001


264


404


101


2586




350

127

127








1936
TALLAHASSEE LBORATORY-cont.
Tallahassee, Florida. Grand
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total Total


TUBERCULOSIS
Microscopic:
Pos.
Neg.
OPHTHALMIA: Neg.
GONORRHOEA: Pos.
Neg.
Unsat.
SYPHILIS
Kahn: Pos.
SNeg.
/ Partial
Unsat.
hILK:
ICE CREAM:
lISCELLANED US:


5
30 31 15


24 31
94 103


6 20 29
2
6 24 20
51 115 101


35
3 218 253
4 4
.8 259
i8 870
1 1130


66 71 101 106 105 111 110 41 91 107 81 54
258 186 255 292 347 346 344 118 290 317 256 179
2 2 4 2 1 3 2 2 4 2
4 7 8 11 15 24 13 3 12 18 6 4
140 90 102 117 173 269 333 116 206 171 86


5 8 10 3 6 5 5


10 3 3


1044
3188
24
125
1803
3
58


4381
1803
3
58


915 837 904 900 1132 1478 1616 612 1344 1290 1138 649 12815 12815


IOTAL












TABLE III

BIOLOGICS DISTRIBUTED DURING 1936


I

JANUARY

FEBRUARY

IARCH

.PRIL

liAY

JUNE

JULY

AUGUST

SEPTEMBER

OCTOBER

NOVEMBER

DECEMBER


DIPHTHERIA
ANTITOXIN
10000 5000
units units

62 29

54 25

45 13

60 18

45 16

3 5

42 37

38 7

68 48

104 55

110 58

34 7


TYPHOID
SCHICK TOXDID VACCINE

3690 593 264

1200 586 3440

7000 1260 2912

810 950 4212

3260 1540 2584

690 305 1992

2050 4495 4850

1440 1075 3688

4070 2175 5240

5330 2100 2877

3510 2550 1306

1870 935 1264


VACCINE
VIRUS

484

1203

975

1731

1845

517

850

1724

1580

1970

1661

930


ANTI-
RABIC
VIRUS

33

38

19

65

28

28

16

29

31

30

61

48


PURIFIED PROTEIN DERIVATIVE TUBERCULIN
100 test pkgs. 10 test pkgs.
1st str. 2nd str. 1st str. 2nd str.


18564 34629 15470 426


TOTAL 663 318 34920


18 15 65 70






-16-


January 1st, 1937.



Dr. W. A. McPhaul
State Health Officer
State Board of Health
Jacksonville, Florida.

Sir:

I have the honor to submit herewith a report of the work done
during the year 1936. This department is called on by every Bureau of the
State Board of Health to help them with various kinds of work and with the
organization of new departments and the noted increase in work in every Bureau
the amount of work in this department has increased. Tho addition to the
State Board of Health building when completed and the remodeling of the main
building will make it possible for the various departments to handle the work
with much less effort.

GENERAL ROUTINE FOR PREPARING SPECIMEN CONTAIERS
FOR DISTRIBUTION THROUGHOUr THE STATE

Kahn containers; tubes cleaned and sterilized; corked and
placed in double containers with data blank for sase.

Diphtheria containers; swabs rolled, sterilized and placed in
tubes which have been sterilized; corked with cotton plugs r.nd placed in double
containers with data blank.

Hookworm and Sputum containers; bottles labeled, disinfectant
added, corked, and placed in double containers 'ith data blank.

Malaria, Typhoid and Gonorrhea containers; glass slides cleaned,
polished and sterilized, placed in containers with data blank.

All material returned with spociimno for examination are cleaned,
sterilized and placed in mailing containers, labeled, packed and wrapped in
various amounts for shipments. Specimen containers are shipped to every city
and town in Florida.

SPECIMEN CONTAINER PACKED AND WRAPPED FOR MAILIm
AND DISTRIBUTED DURING 1936
January 10688 Ihy 7164 September 11981
February 11154 June 3065 October 15566
March 8249 July 8418 November 12318

April 8090 August 9057 December 8803


TOTAL FOR THE YEAR: 117523





-17-


-2-

BIOLOGICALS PACKED, WRAPPED FCO MAILING
AND DISTRIBUTED DURING 1936

Diphtheria Antitoxin 981 Packages
Schick 34920 "
Toxoid 18564 "
Typhoid Vaccine 34629
Vaccine Virus 15470 "
Antirabic Virus 426 "
Tuberculin Tests 336 "

PRESS
2212 pieces of Express shipped
2333 received


BUREAU OF LABORATORIES
Each laboratory test made requires the use of from one to ten
pieces of glassware which must be washed and sterilized before using.

72,123 Kahn tests wore made in the laboratory during the year
1936. Each test required 5 tubes and 2 pipettes, a total of 350,615 tubes and
142,246 pipettes.

Throat specimens for Diphtheria also requires the une of tubes.
8005 of these tests were made, using one tube for the swabs and one tube of
media, or a total of 16010 tubes.

3303 tests of milk were made. Each sample requires the use of
ten pieces of glassware. This meant the preparation of 33030 pieces of glass-
ware for this work.

Typhoid and other agglutination tests require both slides and
tubos. 19,438 of these tests were made and 15,166 malaria tests were made each
reqturing tho use of one or more slides. Many other examinations were made all
requiring slides and tubes.

239 animals were examined for Rabies. The heads of.these animals
were all opened and prepared for examination by this department.

All media used in the laboratory and Sanitation Department and for
the four branch laboratories is made in this department and part of the specimen
containers for use by the branch laboratories are assembled here and shipped to
them for distribution in their territory.

BUREAU (F SANITATION
In connection with service given the Bureau of Sanitation, it may
be said that the Expross shipments of standard water sample cases, as well as
parcel-post wrapping and mailing of the small water bottle boxes is an important
part of this department's work.






-18--


-3-

BUREAU OF SANITATICN-Cont.

Glassware and media necessary in conducting all water and oyster
examinations are prepared by this office. Lactose Broth, Agar, E.M.B. Agar,
and dilution water are made by this office. All glassware is cleaned, steri-
lized, stored and delivered to that Bureau upon request.

A single sample of water requires eleven pieces of glassware
during process of examination and when it is realized that 4728 samples of water
were received during the year, unpacked and delivered to the Bureau of
Sanitation, and glassware to handle the tests were sterilized and sent to the
Bureau, it will be seen that 52,008 pieces of glassware were necessary for such
tests and this office is responsible for the preparation of same.

During the quarterly sample months February, May, August and
November, considerable time is required to care for sample boxes received by
Express and arrangement for their repacking with bottles fcr shipment the
following day.

Media and glassware necessary for 85 oyster samples examined were
prepared.

This department helpr3 to make it possible for the Laboratory and
Sanitation department tc make examinations on specimens anC reports promptly.
A delay in material or media would mean a delay in examination. Sterilizaticn
of Laboratory material plays a very important part in making laboratory tests.

This department is responsible for cleaning and minor repairs to
the building, care of grounds and Guinea Pigs, responsible for Express, Freight
and mail, in-coming and out-going, keeping records on all shipments and on
material that is r-eceived for the State Board of Heclth so bills can be checked
by Auditor's office.

Respectfully submitted,


Frank M. Whiddon
Technician & Custodian.





-19-


ANNUAL REPORT
OF THE
BUREAU OP EPIEMIOLOGY
A. B. MoCreary, M. DI Acting Director



In August 1936 an investigation was made by Dr. John Phair, of an epidemic
of typhus fever in Taylor County at Perry.

During the month of August, Mr. B. E. Holsendorf, of the United States
Public Health Service, speaf two weeks in Florida investigating rat
harborage c.nd stressing the value of ratproofing. He surveyed conditions
in Jacksonville, Tal lhanssee, Pensacola, Tampa, Marianna, Quincy and other
points where typhus fever had occurred.

During the month of September 1956, Dr. J. S. Spdto, acting as a special
representative of the Bureau of Epidemiology, investigated an epidemic of
poliomyelitis in Brevard and Volusia counties. He found by c thorough
check that there vere approximately fourteen cases of poliomyclitis within
that area and that only three or four had been previously reported to
the department.

As the area covered by the district health officer is so vast it is obvious
that it would be impossible for him to investigte every case of communicable
disease in the area even if it was reported, however, investigartions have
shown that reporting in counties without full time health service is indeed
very lax.

During this period the Morbidity Report was changed listing the counties
and cities with full tine health service separate from those without full
time health service. The reporting efficiency of those counties with full
time health service contrasted with the counties without full time health
service is indeed as interesting comparison and leads one to believe that
reports from counties without full time service are hardly -rrth while.
A copy of one of the morbidity reports is reproduced.

It has long been recognized that the disease rate apparently increases for
the first few months after the health unit is installed. It would indeed
be a false impression for anyone to think that there vas actually more
disease in such a county, the truth being that the diseases are simply
reported, located, recognized and an effort at control instituted. The
counties not having full time health units as a rule are woefully lax in
reporting. It is very difficult to get a true picture of existing
conditions. The great majority of the diseases listed on the morbidity
report from these counties have been taken from the lr-bcr.tory report, then
of course, there is no record.

The usual history following the inauguration of full time health service has
been a marked increase in disease at first, due entirely to more accurate
reporting, followed later by a reduction in disease incidence due to
proper control measures.








The county health unit is in a position to collect
the diseases within the boundaries of that county.
of cvory State Health Departmont is dependent upon
local health organizations


information regarding
The reporting efficiency
the efficiency of the


One issue of the weekly morbidity report showed that 422 cases of a
communicable disease were reported from counties having lull time health
service h ile only 88 were reported by counties not having full time
heal th service.









Number of cases
State


Typhoid

Typhus

Malaria

Smallpox

Measles

Scarlet Fever

Diphthoria

Influenza

Poliomyelitis

Encephalitis

Tuberculosis

Syphilis

Gonorrhea

Pollagra

Undulant

Tularemia





Neoarsphenamino

Insulin


Yeast


1932

266

42

318

33

217

235

735

335

8

1

591

4063

713

60

2

2


-21-

of certain communicable diseases reported to the
Board of Health, 1932-1936, Inclusive
I


1933

183

54

1011

1

:.048

203

452

1267

7

2

661

4833

616

73

6

1


1934

129

35

1106

3

8115

190

491

65

16

5

603

5198

702

151

8

1


1935

169

27

813

14

1176

273

426

632

16

2

523

4339

1207

74

68

2


1936

93

55

869



30?

29)

301

587

4'



627

3237

1146

35

16


6150 Ampules

2100 Vials

600 two pound packages






-22-


Bolow is tho record of a Florida county for three years, it is needless to
state this county did not have full time cooperative health service.


CASES REPORTED


Diphtheria

2

0

5


Tuberculosis Malaria

1 4


Cancer Pellagra

0 9

0 0

0 0


DEAIS REPORTED FOR SAME PERIOD


1934

1935

1936


YEAR


1934

1935

1936


Typhoid

4

0

0




-23-
FLORIDA STATE BOARD OF HEALTH
BUREAU OF EPIDEMIOLOGY
JACKS NVILLE

MORBIDDTY IEP(RT FOPR fE W'EEK ENDING MAY 15, 1937


0 TE AV 0 0F T S
r1 *5 0 4 a a
0 ,hi a0 04 0 W
"4 o o .0 0 ,0 -


COUNTIES AND CITIES HAVING FULL TIME HEALTH SERVICE


ALtCHUA
Ga nc svillc
EAKER
BRP.DFORD
BREVARD
CHARLOTTE
CITRUS
CIAY
COLLIER
COLUMBIA

DESOTO
DIXIE.
DUVAL
FL&GLER
GILCHRIST
GRADES
HAMILTON
HARDEE


COUNTIES LND CITIES NOT HAVING FULL TIME HEAkLTH SERVICE


1








2


2 5


S--I 1J-








0 -24- 5 4
0 4 0
o to

SO O ae I*
.: iS oM *




RENDRY i [ '
Sp HERNAN D O a v nC o
14 0 0 .4 0 4 4) h r- 0 .'
W r4 0 CS F 4 44 0 0
( 6O CA -

HENDRY

HOMES
INDIAN RIVER __ ------
JEFFERSON _..
IAFAYETTE
LAKE
LEE 1L-
Ft. Myers I -
LEVY
o -- i .. -
MADISON _.----
MANATEE
MARION -f I. --i -
MARTIN -
NASSAU j.. ---- --
OKALOOSA-
E COBEE
r lano nt
OSCEOLA -- -- -- -
PAUL BEACHi
PASCO -----
POLK ------
PUTN AM t --.

ST. LUCIE
ST. -J S----- -' --i .
SANTA ROSA
ARASOTA -
SEMIINOLE -- -- --, -
aAsoUTER
.. .. I- --- _- --__
SUTi. --NEE j t----. --- --

yOLUSIA _,-_-_. g-- -r-4- "
Daytona Beach -
WILTON-
WASHINGTO::
The increased reportinG efficiency of the counties and cities
with full time health service is obvious, whilc the great open spaces
opposite many of the others indicate a lraxity in reporting. That there
exists as much, if not more, disease in the counties reporting none can
hardly be doubted. No health department cnn control disease without a
knowledge of thon .'nd vh ere it exists.

********* ** ******** ****

The County Helth Unit is in position to collect information
regarding the existence of disease within the boundaries of that county.
The reporting efficiency of every state health deurirtment is largely
dependent upon the efficiency of the city and county health organization.
If all reports from full time health depr.rtments were compiled with the
total amount of disease according to population for the combined area








-25-


computed per one hundred thousand population, then the application of
these figures as a yardstick in communities without full time health
service the results would be at least nearer the correct figure than
the present schone. This has its fl-ws as disease incidence is greatly
decreased in full time departments which have been operating for a period
of years.

In counties without full time service computation of disease
from the death certificates, especially for malaria, typhoid, and
tuberculosis would present a more accurate picture than the present
method. In counties without full time service the laboratory specimens
are relied upon as the only worthwhile index for the amount of hookworm
disease.

IS IT WORTIWILE TO CONSIDER THE COUNTIES WITHOUT FULL TIME
SERVICE IN A MORBIDITY REPORT ANYWHERE?




A. B. UcCreary, M. D.
Collaborating Epidemiologist
U. S. Public Health Service







-26-


Dr. W. A. McPhaul
State Health Officer
State Board of Health
Jacksonville, Florida

Dear Doctor TcPhaul:

I herewith attach the annual report of the
Division of Tuberculosis, covering the period from October
1l36 to January 1937.

Respectfully submitted,



A. J. Lorie, .D., '.A.C.P.
Director, Division of Tuberculosis


AJL:ga






-27-
Division of Tuberculosis
A. J. Logie, 1.D., Director




The manifest need for an official body to deal with the great problem
of the prevention and control of tuberculosis was a deciding factor in the crea-
tion of the Division of Tuberculosis. This department became active in October
1936.

The activities of this department were directed towards establishing
a systematic and centralized intensification of efforts to reduce the tuberculo-
sis mortality and morbidityr rates and prevent the continued spread of the disease.
This department formulated a state-wide program which was approved by the State
Medical Association, state educational authorities, State Radiologioal Society,
and the State roard of Health.

An extensive publicity campaign was undertaken for the purpose of ac-
quainting the lay person, professional groups, and interested organizations with
the need and value of the program.

The feature of the program which was especially stressed consisted of
a school program for finding cases of tuberculosis among children in the later
teen age and for tracing the source of the infection in the family. In addition
to this feature, opportunity was afforded each county to include in this invest-
igation its indigent contacts and suspected cases

The essential aim of the program is to assist the local physician in
arriving at an early diagnosis of the disease by the use of modern facilities,
that is, the tuberculin test and X-ray Field Unit. This serves a manifold pur-
pose, two of which are of groat importance:

1. Finding the case at such an early stage when the chances for
spread of the disease are at a minimum.

2. Arriving at an early diagnosis, which increases the infected
individual's chance for permanent cure of his condition.

Investigation of the school and contact groups is to be done by moans
of the tuberculin test and the X-ray of all positive reactors. The program con-
siders the counties as separate entities and is to be inaugurated into a county
upon the invitation of the local medical society.

This program brings the family physician who is named by the family
of the child or contact directly into the control program. All the reports of
our findings will be sent to him. The family physician will keep the possible
case under observation and will examine the othcr members of the family in an
endeavor to trace the source of the infection.

Pamphlets were sent to the schools, health officers, nurses, interested
organizations and physicians throughout the State. Lectures and addresses were
given to various groups. Records of the results of the program will be filed and
illustrated by graphs and maps.












The activities of the Division of Tuberculosis from October to
January 1936 wcrc those of introducing the anti-tuberculosis program into
the State. Fourteen counties have already bcn scheduled for the program
inauguration. Special equipment for the X-rays has been ordered. The pro-
gram will be initiated into the State within the next few months.



Summary of Activities


Interviews ard Conferences 12

Public Addresses 10

Newspaper Articles 14

Schools Visited 7

Chest Clinics Developed 1

Clinics Attended 7

Persons Examined (physical) 8

Tuberculosis Cases Investigated 21

Cases Isolated 1

Tuberculin Tcsts 20

Pncumnthorax Clinics Developed 1

Addresses to County Medical Societies 15

Counties Inviting Program 8


Lectures to Nurses and Physicians






-29-


BUREAU OF SANITATION
Fred A. Safay, Director

-INTOIXCTIC(--

The purpose of the Bureau of Sanitation is to assist cities, towns
and individuals in matters pertaining to sanitation which are non-medical
in character. Work of the Bureau is concerned mainly with certain dis-
eases which may be prevented through proper control of sanitary environ-
ment.

Activities of the Bureau have steadily increased from year to year
with increased population and, as new industries bringing with than
additional sanitary problems, have appeared.

PERSONNEL

Personnel of the Bureau at the beginning of the year consisted of a
Director, Assistant Director, Secretary and five District Sanitary Officers.
To effectively handle the work in the State, it has been divided into five
districts by the Bureau and a Sanitary Officer assigned to each of the five
districts. This procedure continued for several years but during the early
part of 1936 in an effort to centralize the work, the original districts
of the Bureau were changed by an executive order and areas or districts of
the central organization of the Board designated as State Districts and
the District Sanitary Officers of the Bureau working out of these Districts.
This procedure was followed throughout the year.

In addition to the regular personnel of the Bureau, Special Supervisors
and Inspectors made available through Federal funds, were detailed to the
Bureau and operated under its supervision. Following is listed additional
personnel made available during the year:

On January 23, Mr. George F. Catlett, was appointed Assistant State
Director on Malaria and Mosquito Control Community Sanitation, with U.S.
Public Health Service, also to act as Sanitary Engineer for the State
Board of Health. Under this position all activities of a strictly engin-
eering nature were handled by Mr. Catlett and his activities along those
lines will form a part of this report.

During the period from April first to July first five Special In-
spectors were engaged on special school inspections.

On June first, Doctor A. H. Williamson was appointed State Dairy
Supervisor by the Board, and, working out of this office, Doctor Williamson
began his duties concerning the passage and enforcement of the Standard
Milk Ordinance of the U. S. Public Health Service which in 1932 was adopt-
ed as a model by the Board. The work of Doctor Williamson will be shown
under Dairy Sanitation as presented in this report.






-30-


On August first, C. L. Richardson was given the newly created position
of Crab Meat Inspector by the Board and following a six weeks course of
training and observation with representatives of the U. S3 Department of
Agriculture in field work took up his duties to enforce State Board of
Health Rule No. 105-A, re crabmeat plant sanitation.

On September 21, District Sanitary Officer David B. Lee of the West
Florida District left the department to enter Harvard University for
special training and to receive his degree in Sanitary Engineering. His
place was filled by one of the Special Inspectors.

During September, two Special Sanitary Officers, Goodwin and Irwin,
were assigned to the Bureau and detailed to tourist carp inspection work.

December first, a special inspector was assigned to School Inspection
work.

ACTIVITIES

The work of this Division comprises such a varied field of activities
that any attempt to cover them for a twelve month period in u detailed
manner would be exceedingly difficult. Tiorefore, following the precedent
set by former Directors of the Bureau, this report for the yoar 1936 will
be divided into several sections each covering a specific phase of the
work. Th- function of the Bureau is to render helpful assistance to in-
dividuals, communities rnd counties in the solution of their sanitary
engineering problems. In this report the following general outline will
be used in presenting the subjects considered:

1. Water Supply, Public and Private.
2. Sei.orae end Sewage Disposal.
3. Lbsquito and Malaria Control (non-medical)
4. VWaste (other than sewage) disposal.
5. Dairy Sanitation.
3. Rabies Control.
7. Disaster Relief.
8. Shellfish Producing Areas.
9. Sanitation of
a. Schools
b. Swimming Pools
c. Canneries
d. Oyster packing establishments.
e. Public Fairs
f. Tourist and other Camps
g. Public Institutions Child Caring Homes.
h. State Institutions
i. Crabmeat packing plants.
10. Special reports and investigations.

WATER SUPPLIES -
Public Supplies

In Florida, by virtue of State Statute, the State Board of Health is
the governmental agency having control of and supervision over all public






-31-


water supplies and the division of the Board delegated to carry out
this statute is the Bureau of Sanitation.

Every citizen should have at his disposal a hygenically safe water
supply for domestic consumption. The necessity for a safe water supply
from a public health standpoint makes it imperative ample supervision
over the public supplies be provided to insure their safety. Realizing
this the Bureau endeavors at all times to keep an ever-watchful eye on
the sanitary quality of all water supplies in the State.

Initially pure well water supplies are often contaminated by im-'
proper storage in leaky or uncovered reservoirs, uncovered standpipes,
leoky mains, by-passes, dual or cross-connections, etc. Those and many
other problems are those with which the Bureau personnel is confronted.
Supervision of the treated surface supplies is likewise necessary to
insure proper protection of the source, plant operation and handling
of the treated water. The use of surface water from lakes, rivers,
and shallow wells is becoming more end more prevalent as increased draft
upon the deep wells have rendered them unfit for use because of water
shortage and objectionable chemical quality.

In connection with water works supervision, the Bureau:

1. Arranges for collection end submission to the Laboratory
of samples from all public water supplies, and the
bccteriologicrl examination of same.

2. Reviews and p~ssos upon plans for new or improvement to
old water works plants.

3. Mrkos regular routine inspection of all plants, follow-up
investigations necessary when samples submitted give poor
results, advise re sterilization of new water mains, etc.

Continuing the water plant improvement work made possible with
assistance of Federal funds during 1954-35, the work during 1936 pro-
gressed in a very satisfactory manner. In accord with P.W.A. ruling,
as wll as State Board of Health requirement, plans and specifications
of all of these projects were submitted to the Bureau for review and
approval. The cooperation of the State P.W.A. office and the local
city engineers in this matter was greatly appreciated. All plans sub-
mitted were reviewed and at the close of the year work was in progress
at the following places:

Arcadia Hollywood Panama City
Belle Glade Jecksonville Beach Pinellas County
Clearwator Lakeland Community supply.
Daytona Beach Livu Oak Punta Gorda
Dunnellon Miami St. Augustine
Ft. Lauderdale Moore Havan Sarasota
Ft. Wyers Opa Locka Trenton
Hialeah Orlando Valparaiso
Voro Beach






-32-


Private Water Supplies

The most desirable water for home use is that furnished by a public
water supply plant, since such supplies are under close observation at'
all times both by local plant operators and Bureau personnel. However,
there are many homes in the State where it is not possible to procure
water from a city or community supply. At these homes it is necessary
to secure water for drinking and domestic purposes from privately owned
and operated supplies and it is with those supplies that the Bureau is
also vitally concerned. Protection of existing supplies, selection and
installation of new supplies and examination of samples of all water
used for drinking are points on which the Bureru furnishes infori-ition
and assistance. To help those interested in sLcuring safe wwarCr supplies
the Bureau offers to rll citizens data descriptive of approved types of
wells, pumping equipment and advice concerning proper protucticn of sur-
face supplies shallc.w wells, springs, dug wells and cisterns. The
District Sanitary Officers nrke personal investigations at homes to
render ad-ice on the proper type of supply or means whereoy existing
supplies iay be protected against chance contamination. W?-en necessary
water sample collections arc, made by personnel of the Bureau.

Bottled Water

The annual consumption r-d sale of bottled water in Floride is quite
extensive and is almost wholly dependent upon the belief in the purity
end wholesomeness of the water offered in such form. Realizing this,
and in an effort to potoct tha industry itself, the Bureau promulgated
Rul. No. 26 which wes passed by the Board. The Rule governs the mand-
facture, importation and bottling of water for sale in the State, It
further r-quires that pll bottlers of water shall secure a permit from
the State Board of Herlth before placing their product on the market and
provides for the revocation of such permits where deosud advisable.

Previous to granting a poemit for the sale of bottled wat.tr the
bottler rist furnish complotc and satisfactory detai'.od inlfiation
under :ath- pertaining to his bottling establishment ~md water. Inspection
is made of the plant and source of supply by a representative of this
Bureau and plans and specifications for proper layout of the plant are
furnished as well as instructions concerning bottling procedure. In
considering permits for bottled water plants particular attention is
paid to: (1) method cf washing, cleaning end storilizction of bottles,
(2) use of washing powders or sterilizing agents, (3) facilities for
bashing, (4) filling apparatus, (5) filters or strainers where used,
(6) cleanliness and neatness of establishmentt and employees, (7)
manner in which corks and caps are kept, (8) method of draining bottles,
(9) protection from dirt and dust, (10) protection of cap and cork.

This regulation also provides for the control of bottled water im-
ported into the State and through the cooperation of other State Health
Departments we are furnished with copies of their inspections of those
plants. Samples of water as prepared for sale on the market and shipped
into the State are submitted for the regular bacteriological examinations.







-33-


During the year there were 55 permitted bottled water plants operating
in the State under Bureau supervision while five imported bottled waters
were shipped in for sale on the Florida market.

Certification To The Treasury Department

Certification of water to the U. S. Public Health Service is an im-
portant Bureau function. This service necessitates investigations
relative to water supplies used for drinking and culinary purposes on
interstate carriers trains, vessels, airplanes.

In connection with this work water supplies at the following points
were certified to the Treasury Department in Washington for use on canon
carriers during 1936: (where not especially designated the public supply
is indicated)


Baldwin (Railway)
Buena Vista
Crestview
Dunnl lon
Ft. Lauderdale
Ft. Pierce
Ft. Myers
Geinesville
Haines City
High Springs
Jacksonville
Jacksonville (4 Private)
Key West (Private)
Leesburg
L-keland
Live Oak
Miami


New Smyrna
Orlando
Okeechobee
Palatka
Port Tampa (Railway)
Port St.Joe (Railway)
Port Everglades
Panama City
Pensacola
Perry
Palmdale
Starko
Sanford
St. Petersburg
St. Petersburg (Railway)
Sebring
Srrasota


St .Auustine
frllahassee
Titusville
Tampa
Tampa (Railway)
Tampa (Private)
Tavares
Trilby (Railway)
West Palm Beach
Wildwood
River Junction
Madison
Shipley
Quincy
Vrro Beach


1936 was the 9th consecutive year that Florida, through its Bureau of
Sanitation, has been reported 100% on common carrier water supply certi-
fication by the Government.

WATER LABORATORY

Since the'creation of the Bureau as a division of the State Board of
Health in 1916, the water laboratory has been operated by the Bureau.
Water samples are submitted by individuals and municipalities for bacteri-
ological examination and the results are reported directly to those sub-
mitting the samples. Routine Laboratory procedure is satisfactory when
samples examined indicate a water of good sanitary quality, but when
laboratory tests question the quality of water it becomes necessary to
have the physical surroundings of the water supply investigated and co-
ordinated with the findings of the laboratory. It is for this reason that
the Bureau operates the laboratory handling water samples, thus giving one
department complete control over the matter of water supply quality. In










some instances, it is also necessary to make routine chemical determinations
to assist individuals and communities when improvements to their supplies
are being considered. Such tests include determination to indicate tastes,
odors, color, salinity, iron, etc., which are not indicated in the bacteri-
ological examination. Together with the regular bacteriological examinations,
tests are also made to determine chlorine residual and pH index of certain
waters.

To maintain proper control of the sanitary quality of all public water
supplies in the State it is necessary to have records showing the quality
of water furnished by the supplies at all times. The regular examination
of samples from all public water supplies is therefore desirable and, to
secure such control, Rule No. 97 of the State Board of Health was passed
by the Board. This rule requires the owners or operators of all public
supplies to submit samples of water for regular bacteriological examination
at the periods designated by the Bureau. The rule further provides that
each public water plant in the State shall submit these samples in a
standard, official type, water sample case of approved design, the case to
be the property of the plant. The sterile bottles in which samples are
submitted are furnished free of charge by the State Beard of Health. At
the present time 192 supplies in the State are operating under the regu-
lation end thus are under the close supervision of the Bureau at all times.

The foregoing paragraphs have referred only to examinations of samples
from supplies furnishing water to the public; however, that is only a part
of the work handled by the laboratory. Analyses are made free of charge
on all samples of water from individual supplies if the water is collected
and submitted in the sterile bottles furnished by the department. Con-
tainers with sterile bottles are submitted to individuals in the State upon
receipt of request. The collection of a water simple for bacteriological
examination is a delicate task and extreme care must be exercised.

All analyses made by the 3ureau water laboratory are carried on in
accord with Standard Methods of the Joint Committce on Standards of the
American Public Health Association and the American Water Works Association.

During 1936, 4,728 samples were examined in the water laboratory, as
shown on the attached sheet.

In addition to the examination of water to be used for drinking -
samples of raterr from swimming pools and bathing places are examined in
connection with investigations to determine the fitness of the water for
use. Samples are also examined of waters over oyster beds during studies
concerning approved areas for the taking of shellfish.









BACTERIOLOGICAL E~AMLIATIONS OF WATER AS CONDUCTED BY LABORATORY OF THE BUREAU OF SANITATION
FLORIDA STATE BOARD OF HEALTH 1936 -


Good Doubt BAD Good Doubt Bad Good Doubt Bed Good Doubt Bab" Good Doubt -Ba
fl ul ful f ul ful
Deep -
Wells 1831 124 290 69 115 8 6 445
Wells
Shallow 319 26 1 535 252 34 89 4 4 -1264
Wells

Springs 22 42 1 20 18 1 177 36 317

Dug
Wells 11 1 16 34 24 86

Surface
Treated 335 66 6 4 2 16 9 438
Surface- -
Untreated 48 38 18 6 2 11 18 6 147

Cisterns 2 r 5 3 -- I10

Unknown 12 9 2 23


TOTAL


2568


882 191


383


-I


4728


-


Number samples


examined during 1936 -


4728


GOOD Indicates low bacterial Count, no presumptive evidence of contamination 48 hours incubation.
DOUBTFUL Indicates presui.pt ive evidence of con t~m nation (exceedinLg 5% gas ferm entation in 48 hours in
three or less 10 cubic centimeter portions or in the one and one-tenth cubic centimeter portions, but no
confirmation on Uosin Methylsre Blue Ager).
BAD Indicates high count and presumptive evidence in four or more 10 cubic centimeter portions, in one
or one tenth cubic centimeter portions with positive B-Coli determination on Eosin Methylen3 Blue Agar.


I urM"rrt. WWWrr WWYAb


l j m


I


PUBLIr, StrI~T5~I`-~S~~) PIWP~I~ ~7TPPT.~R9
PUBLIr, Stry~LIli~S PIWPI'I~ ~ITPPT.~li~S


rFr'TT.'T)7 v'n'


'PI~T~T.T~ rld9T)T~R






-36-


SEWAGE DISPOSAL

Every home, individual, concern, institution or municipality should
be provided with adequate, properly installed means of sewage disposal, and
to this end the Bureau offers assistance and guidance to those interested.

First, considering municipal sewage disposal systems as in the case
of public water supplies, the Bureau advises with city officials, con-
sulting engineers and those in authority concerning proper installation
to handle the population to be served and advises on the matter of ultimate
disposal. Plans for new extensions or improvements to existing systems
are submitted to the Bureau for review and approval. With PWA assistance
improvements were made on savoral municipal systems during the year.
Work being carried on nt the following points:

Extensions end Improvemonts

Fort Lauderdale
Hollywood
River Junction
T:llahassee

New Plants

Lcosburg
Milton
Port St. Joe

In creas not accessible to city sewers it is necessary to provide
other meaas of sewagc disposal and where iator under pressure is available,
septic tank installations with flush type toilet fixtures ere recommended.
Plans of proper type s-ptic tl:nks as proposed by the Buroau cra furnished
for individual home installation as well as for schools, tourist camps and
boarding houses where central sewor systems are not possible. These plans
are drawn in accord with standard practice and as outlined in State Board
of Health Rule 100.

For rural a.ras where it is impossible to use septic tank disposal,
sanitary, fly-proof privies of a design approved by the State Board of
Health must be installed.

Through Community Sanitation Projects under the Federal Government,
during the last few years many new privy installations have been mado at
homes throughout the State. As a part of community cleanup campaigns and
in connection with property inspections the Bureau personnel has been
instrumental in getting sanitary privies installed.

Printed literature concerning approved type of privies and septic
tanks are distributed by the Bureau through the mails and by the field
force.






-37-


DAIR SANITATION

Arthur H. Williamson, D. V. M.,
State Dairy Supervisor

Assumed duties with the State Board of Health on June first, 1936,
After having the -6licies of the Board outlined by Doctor McPhaul, pro-
ceeded to Tallahassee with Doctor Kennedy and Doctor McPhaul for a con-
ference with Honorable Nathan Mayo, Commissioner of Agriculture, and his
corps of Inspectors. At this conference we came to some definite under-
standing about field inspections in the State by the two agencies, viz.,
the State Board of Health and the State Dopartment of Agriculture. It
was agreed that the Stote Board of Health would work only with organized
Health Departments within the State, and at the invitation of the Health
Officer in the particular locality. That we would confine our activities
to advising and assisting, in other ways, these Health Officers upon
their request for service in matters pe-taining to milk control, We
agreed further never to give a Grade or issue a permit to any dairyman
within the State. These policies have been strictly adhered to. In no
case have we over gone into rng territory except upon invitation of the
Health Officer and the Health Officer in every instance has been the one
to give the Grades and issue the permits. The Department of Agj-iculture
has given us aid wherever and whenever possible and has shown us every
courtesy and consideration. Realizing from the first that ialk control
authority is vested in the State Department of Agriculture we have been
very careful not to recommend, or permit if possible, anything that is
contrary to the rules and regulations of the State Department of Agri-
culture.

The first three weeks of June 1936 were spent in making contacts
and in getting acquainted with Health Officers and Official families of
those cities which had already adopted the Public Health Service i.lk
Ordinance, which the State Board of Health is promoting in the State. Of
the thirty three cities which, at that time, had adopted the ordinance,
Miami and Coral Gables were the first to call on us for service. Co(m
ploto surveys were made on these sheds and reports sent to Wrshington,
to the Office of Milk Investigationswhere ratings are compu-c'd by the
Government and then returned to the State Board of Health which in
turn transmits them to the local Health Officers. Doctor MacDonell of
Miami and Dr. Kitchen of Coral Gables were well pleased with the service
ronlered and the results obtained and so expressed themselves.

Requests for service from the Milk Division of the State Board of
Health were few at first, but after it became generally know that the
State Board of Health had added to its personnel and was again in
position to render assistance in the matters of milk control the re-
quests for service became frequn -and from every section of the State.
We have been able, so far, to take care of these requests but they are
now taxing the ability of one Supervisor. If this work progresses in
the next twelve months as it has progressed in the last six months the
services of an additional Supervisor will be needed to adequately serve
the State.






-38-


Contacts with all cities which had adopted the Public Health Service
Milk Ordinance were made as fast as possible. It was soon ascertained
that the depression had had its effect upon the Milk Control programs
of the State as it had effected other projects and industries of the
State. The physical equipment of the dairies had become dilapidated through-
out the depression years and enforcement had become lax because of economic
conditions. Business and industry was now definitely on the up-grade, how-
ever, and we felt that the dairymen were able to make reasonable expenditures,
at this time, which would help put them back on a Grade "A" basis in the
shortest period of time. It would be eminently unfair to infer that all
dairies had "slipped* for this is not the case by any means but it is true
that the great majority had. This improvement program was engineered by
local Health officers and their assistants with the State Board cf Health
lending assistrnc whtenover and wherever possible. Pre-rating surveys were
made by the State Board in the various cities to give tbh Health Officers
an unembellished picture of the actual situation on their milk shed, and at
the same time point out to the inspectors und to the individual dairymen the
"Rough" spots in their progrwas which needed "ironing out".

The stabilizing effect of the Milk Control Board on milk prices through-
out the State put the dairyren in a position to adopt our suggestions regard-
ing the improver'ont of their physical equipment, the enlargement of their
"skeleton force" perscnncl and the inauguration of up-to-dato methods, etc.,
that go to nake up a well rounded program. The State Livestock Sanitary
authority with its Brngi, Mstitis and tuberculosis cradicetion program
had a large, though indirect, effect on the milk sanitation program of
the State cooperating with the Federal Governomnt, Dr. Knapp and his men
contributed nany men rnd much noney to eradicate economic and Health
hazards of the dairymen end consuming public.

Official Surveys w.re made in every instance on all sheds where re-
quests wre made by toh local Health Officers for such service end no
surveys were iode, not even on Public Health Service Milk Ordinmnc
sheds, without en invitation from the prop-r authority. We have en-
deavored, in every instance, to suit our progren to the wishes and needs
of the local Health Control officials throughout the State. No deviation
has been or will be made from this policy,

Due to the aoovo mentioned policy of the State Board, and to several
other factors, not all of the towns which originally adopted the Public
Health. Service Milk Ordinance received official ratings from Washington
in 1936. The principal reasons, among the many being that sone of the towns
which were supposed to be operating under the Public Health Service Milk
Ordinance originally has changed their ordinances and are now operating
under Department of Agriculture rules and regulations and are of course
advised, instructed and controlled by that Department. Others havo not,
because of short tenure of office by the Health Officer and other good
reasons thought it advisable at this time to make official surveys but
have elected to have unofficial surveys made with the idea of appraising
the situation "as is" and of having official surveys made later. This is
a logical and reasonable procedure and is endorsed by the State Board of
Health.







-39-


Out of the sheds officially surveyed two Florida cities were
able to meet the high standard sot for satisfactory milk supplies by the
U. S. Public Health Service viz. 90 percent, and above rating on surveys
based on the U. S. Public Health Service Milk Ordinance and Code of
all raw and pasteurized milk. Several cities including Perry, Fort
Lauderdale, Marianna and Pompano have recently adopted the new Ordinance
and others which had adopted it but had never enforced it have tighten-
ed control and from evidence now in hand we believe there will be a
representative list of Florida cities in the next publication of the U. So
Public Health Service which lists only those cities and towns in the
U.S.A. with a 90 percent or above rating on both raw and pasteurized milk.

The foregoing must not be taken to mean that those cities in Florida
not on this list, have unsatisfactory milk supplies. As a matter of fact
we know that several of our larger cities rnd some of the smaller ones
even though they are operating under different ordinances, from the one
we are promoting in the State, have excellent milk supplies. Some of
those cities would no doubt get a high rating end would receive pub-
licity accordingly. Not, however, until requests come from the local
Health Officers to the State Board of Health for a survey can official
surveys be made, for the U. S. Public Health Service works only
through the State Board of Health and the State Board of Health only
through the local Health Officers. Very recently several such requests
have come in to the State Board. The surreys have been made and the
reports forwarded to Washington. In due time the ratings will be made and
sent out of Washington to the local Health Officers through the State
Board of Health. If these ratings are sufficiently high they will be
published in the next official list.

The State Board of Health milk program is being well received through-
out the State as far as we are able to ascertain. We base this statement
on thu repeated and additional calls for service front all sections of
the State. Whils we work principally with those cities operating under
our owi Ordinance we do not by any means confine our activities to
those alone. Any city, regardless of size or what ordinance they
operate under, is entitled to and receives any service which we are able
to render, upon request front local Health officials. Only through this
means end any other which enables us to render a real service to the
Health officials of this State will we increase the prestige of the
State Board of Health and enlarge our field for service.







-40-


RABIES CONTROL -

Assisting cities, towns and rural areas to control rabid animals
the District Sanitary Officers of the Bureau are ever on the alert to
use their influence to have the local governing bodies enact an ordi-
nance to control rabid as well as healthy dogs. In rural areas the
Sanitary Officer takes charge of the situation when a rabid dog is
reported and through assistance and advice endeavors to have the animal
in question confined for a period of observation. Twelve community
rabid dog investigations were made during the year while sanitary
officers answered many cells to individual homes.

SCHOOL SANITATION -

As previously mentioned school surveys were made by the Bureau
and during the year information pertaining to water supply and sewage
disposal secured. This data was compiled in the office and copies
sent to the office of the State Superintendent of Public Instruction
and the Secretary iof the State Planning Board.

This survey vws not completed at the end of the year, but on
December first,-a single sanitary inspector'Was assigned to continue
the work started in April.

The work of the district sanitary officers continued as in the
past and through their efforts School Trustees made improvements to
water supplies and sewage disposal at public schools.

The bulletin relative to School Sanitation is freely distributed
by this office.

CANNERIES -

A marked increase in the number of improvements to existing
canneries in the State was noted during the late spring and early fall
of 1936. Several of the old plants that had been in use for some time
were replaced by nore modern, up-to-date establishments.

One of the problems of greatest concern to corrunities in con-
nection with the operation of a canning plant is the disposal of waste
therefrom. During February the Director in company with G. F. Catlett,
Sanitary Engineer nmde an inspection of citrus canning plants operated
in Polk County, in an effort to study this disposal problem further.

The Bureau and others interested at the close of the year were work-
ing out a plan whereby nuisance created by the wastes at these plants
will be eliminated.




-41-


SHELLFISH SANITATION -

Continuing work on Shell Fish Sanitation the Bureau personnel con-
ducted water pollution surveys in the following areas during 1936:

Spring Creek, Crystal River
Apalachicola, Indian River County
(Ft. Pierce to Vero Beach).

The Spring Creek survey was made to determine whether or not the water
in the creek and in the area producing oysters was being contaminated by
sewage disposal. A series of sample collection stations were established
and samples of the creek water examined over a period of several days.
The results of the tests, together with findings of the physical survey
indicated that the Spring Creek area was free from contamination of a
fecal nature and was therefore suitable for the taking of oysters.

Typhoid fever cases in the Ocala section threw suspicion upon the
oysters from Crystal River and upon request of local physicians an in-
vestigation was made. This study made in cooperation with Dr. John Pheir,
Epidemiologist of the Diagnostic Laboratories clearly proved that oysters
were not responsible for the several cases of typhoid fever in and around
Ocala. Factors brought out by the survey were:

1. Location of oyster beds and freedom fran contaminating
influences. This determined by sanitary survey of the
area and examination of samples of wrter from over the
beds.

2. Handling of the oysters in our certified oyster houses -
proper methods employed as to handling of the product end
general sanitation of the house, workers and equipment.

3. Constant supervision of the houses and regular inspections
by representative of this department.

4. Regular examination of oysters as shucked by shuckers in
these places.

5. Previous examination of shuckers for health certificates
as food handlers.

6. That if oysters from these Crystal River oyster houses
were transmitting typhoid fever, then there would have
been many More cases and at other points in the State to
which these oysters aro shipped. Those oysters are
shipped to all points in central and interior towns in
the State and the reports of typhoid do not tend to
indicate that cases developed following the use of such
oysters.

During September in an effort to dotormine the amount of sewage
pollution in the Indian River from Fort Pierce to Varo Beach the Bureau
began pollution study in that area. Collection stations were established
and a physical survey of the area node.






-42-


The results of this investigation are shown in the following
recommendations and conclusions:

1. That a continued study of this area be made over an
extended period to further determine the pollution
lines in this vicinity for future development of
oyster industry in this section.

2. That an open area be established for taking of
oysters as follows: Area to be bounded on the
south by a line from Indrio to Garfield point
along stations 7-8-9 and on the north from Oslo
16 to 18 east side of River.

3. That said closed area be properly posted with
signs to notify the public against the taking
of oysters from points within the area.

4. That the Cdnservation'Department be notified of
this closed area-in order that they may have
their local Inspectors patrol same and that any
leases in closed areas be cancelled and no fur-
ther grant for oyster cultivation be made in the
restricted zone,

In an effort to curb the sale of bootleg oysters the Bureau had
printed for distribution, cards bearing the following:

CERTIFIED OYSTERS
SOLD HERE
,* 4

CO-OPERATING WITH THE STATE BOARD OF HEALTH, U. S. PUBLIC
HEALTH SERVICE, COUNTY AND CITY HEA~L' DEPARTMENTS

In the interest of public health and for the privilege
of displaying this sign, furnished by the State Board
of Health, we agree

To buy or sell no oysters except those from Certified
oyster shuckers, re-shippers, or repackers, delivered
In original containers bearing the Certificate Number
issued by the proper authority in the State of origin.

We further agree to prevent, to the fullest extent of our
ability, the further use in the shellfish industry of all
oyster containers which may come within our possession.

This sign is the property of and may be removed by a
representative of the State Board of Health, for the
violation of either of the above provisions.





-43-


The cards were furnished managers of all chain grocery stores as well
as all privately owned places selling oysters. A sheet entitled "Notice
to Retail Oyster Dealers*, and concerning the handling of the product was
also published by the Bureau. Local city governments assisted the Bureau
in this matter*

During the year, in addition to the control of the certified houses,
the District Sanitary Officers spent time in preventing as far as possible
the sale of oysters from closed areas and places without permits from the
Board.

88 shell and shucked stock oyster houses were operating under State
Board of Health certificates at the end of the year.

CRAB MEAT

On August first the position of Crub Eeat Inspector was created and
C. L. Richardson appointed a representative of the Buravu unier that title.
Following a six weeks training course with Federal Representatives in the
States of Virginia, New York and New Jersey Mr, Richardson returned to
Florida and entered upon his duties. Rule 105-A as regards Crabmeat sani-
tation was the guide for all work undertaken. Mr. Richardson took up the
work begun by the District Sanitary Officers in 1935 and at the close of
the year 26 permitted crabmoat plants were operating in the State under
the direct supervision of the Bureau.

During April a laboratory survey of moat put out by the certified
houses in the State was uade by the U. S. Food and Drug Administration
working out of the Bureau laboratory. This work had a direct bearing
upon improvements which had been recommended to plant operators.

SWIMMING POOLS

Medical and Sanitary sciences have proven that bathing places (pools,
springs, lakes, beaches, etc.,) are frequently the means of conveyance of
infectious diseases and other painful physical disturbances. Swimming
pools improperly cared for have been the source of eye, nose, throat and
ear infections and bathers who have conducted themselves improperly have
frequently become infected.

Because of these facts and in order that control measures might be
instituted to protect the bathers, the State Board of Health in 1919
sponsored a bill which was passed by the legislature. That statute,
known as Chapter 7825, Laws of Florida,. No. 43, is:

"AN ACT PROVIDING for the Sanitation, Healthfulness and Cleanliness
of Swimming Pools, Public Bath Houses, Swimming and Bathing Places;
Regulating and Granting and Revocation of Permits Therefor from the
State Board of Health, Providing for the Inspection of Such Places;
declaring Places and Things in Violation of This Act to be
Nuisances, Dangerous to Health and Providing for the Abatement of
the Same, making Violations of This Act Misdemeanors; and Providing
for the Punishment of the Same".






-44-


This Act places the control of bathing places directly under the
supervision of the State Board of Health. Florida was the second State
in the Union to have such an Act passed, and today bathing place sani-
tation has assumed the proportions of a major public health problem.

In accord with provisions of the above Act, Rule No. 42 of the
Florida State Board of Health was drawn by the Bureau and passed by
the Board. Under this Rule all public swimming pools'and bathing
beaches are subject to inspection by Bureau personnel, and as required
by law, plans for all pools must be approved by the Board before con-
struction work starts and all pool operators must request and receive
a permit before attempting to operate a pool* Permits are issued for
operation of swimming pools when requirements specified in Rule 42
have been complied with. Therefore, if it is found that any public
swiniing pool in the State does not have a permit issued by the State
Board of Health it is an indication that the pool does not meet
requirements of the Board or is operated in violation to State law.

70 permitted swimming pools wore operating in the State during
1936.

TOURIST CAi SANITATION -

This phase of the work has increased greatly with the number of trailer
cars visiting the State from the north. This mode of travel coupled with
the regular tourist car travel patronizing our established tourist camps
brings up the problem of sanitation as regards additional camping space and
provisions for disposal of wastes from these trailers.

In all fairness to users of trailer cars nnd to the resident population
of the State, trailers cannot be permitted to camp discriminately on vacant
lots, beaches or highways without sanitary facilities. This matter is
clearly taken care of by State Statute and State Board of Health regu-
lations pertaining thereto and under this legislation the Bureau conducts
its program relative to Tourist Camps and Trailers.

During the 1935-36 season to the end of 1936 there were operating in
the State 313 Tourist Camps with permits issued by this Bureau.

Two special inspectors were engaged on routine tourist camp in-
spections during the early spring- death leaving the Bureau with only one
inspector in August.

Summer camps operated by Boy and Girl Scout Camps, Y.M.C.A. and
church societies were subject to regular inspections by the Bureau. The
matter of sewage disposal water supply and proper handling and storage
of foods are points considered.






-45-


MOSQUITO CONTROL -

The principal work on Mosquito Control during the year was carried on
under the County projects cooperating with the U, S. Public Health Service.
The Service furnished Supervisors for these projects and they were under
the direct supervision of the Sanitary Engineer.

At a called meeting of the State Chamber of Commerce held at Tampa
on March 5, 1936, and attended by interested parties from all parts of the
State, a general discussion of the mosquito problem was heard. The
Director of the Bureau made a motion that a committee be appointed to
fonrmlate a state-wide plan for mosquito control and eradication and report
at the next meeting. This motion carried and members of the committee were
Dr. T. S. Kennedy, G. F. Catlett and Dr. W. V. King, with Dr. W. A. McPhaul,
State Health Officer.

Upon decision of the Committee an attempt was made to secure the co-
operation of the CCC ccaps and through then obtain labor for necessary
work on mosquito control projects in selected areas of the State.

Though the committee received favorable replies from the Regional
and State Forestry Service and nuch correspondence was prepared on the
matter in an effort to secure favorable action from officials in Washington
to the end of the year little progress had been made on this matter.

FLORIDA ANTI-D)SQUITO ASSOCIATION -

Following a period of inactivity extending from the 1932 annual meet-
ing in Clearwater on March 14, and 15, the Florida Anti Mosquito Association
by unanimous vote of the Officers and Executive Board, hold a one day session
at Orlando on May first, 1956.

A roll call of members indicated an attendance of 56, which represented
sections of the State from Penana City to Miami. No specific, set program
was arranged for this meeting it being deemed advisable to throw the session
open for general discussion concerning ways and means whereby the Associa-
tion could be of assistance to cities and towns in solving their mosquito
control problems.

In the absence of President Alex MacWillian, First Vice President J*.N
Hornbaker, presided, assisted by Doctor T. H. D. Griffitts who called the
meeting to order and asked for a report from the Association's Secretary
Miss Lena W. Starck. In this report the last annual meeting of the
Association was referred to and the cause for postponement of the 1933
meeting explained and at the sane time the Executive Board's reason for
the called meeting, was given.

Those present representing different areas of the State were called
upon for a short address end among them the following appeared:







-46-


Major M. .J Mackler. Assistant City Health Officer, Tampa,
Ford Thompson, Health Officer, Tallahassee,
K. J. Boyd, District Manager, Florida Power Corp., Tallahassee,
Claude Strickland, Supt. Pinellas Coo Anti Mosquito District,
Fred He Stutz, Director, Broward and Dade Co. Anti-Mosqaito District,
Dr. Wm. W. McKibben, Miami,
W. B. Shaffer, Director, Indian River Co.Mosquito Control District,
W. I. Fee, Ft. Pierce.

DRAINAGE WELLS -

Under Chapter 6443, Acts 1913, the State Board of Health is given
jurisdiction over drainage well installations. During 1936, 32 requests
were received for the sinking of these wells and following necessary study
and investigations of the area in question 29 permits for drainage wells
were issued by the Bureau at the following places: tMisai Beach, Miami,
Cocoanut Grove, Fort Lauderdele, Fulford, Orlando, Hollywood, Tallahassee,
Greensboro, Winter Haven, Coral Gables, west.

These wells were installed to take care of excess surface water, waste
water fran air conditioning plants, condenser water, swimming pool overflow
end excess waste water at laundries.

STORM RELIEF -

On June 16, District Sanitary Officer Macready, upon advice that a
stom accompanied by heavy rains had visited Lee County and the Fort Myers
area, proceeded to that point and though the flooded area was found
extensive and conditions serious the situation was not considered alarming.
The greatest problem was the matter of safe drinking water since the en-
tire area and well supplies were flooded. The territory in the vicinity
of Bonita Springs, Alva and LaBelle was included in this survey. The
Director and District Sanitary Officors Broughman and Safay also visited
the area. Through personal contacts, printed posted notices and in-
structions, people were advised against danger of drinking flood water or
water subject to flood water. Instructions were given that all drink-
ing water should be boiled or treated with hypochlorite.

District Sanitary Officer Macready attended meetings of the South Florida
Red Cross Safety Committee on Disaster Preparedness during the year, held in
West Palm Bonch.

INSPECTION OF INSTITUTIONS AND BOARDING HOMES -

Cooperating with the State Board of Social Welfare, the Bureau con-
ducted annual inspections of 79 boarding hones and 50 nurseries in the
State.


The inspection form as prepared by the Bureau covered.






-47-


I Premises
II Buildings
III Water Supply
IV Sewerage and Sewage Disposal
V Sleeping Quarters
VI Kitchen
VII Dining Boom
VIII RPcroation center (indoors and out) Comfort.
IX Food Milk Supply.

These forms were filled out in triplicate and copies fumishod the
State Board of Social Welfare.

SPECIAL INVESTIGATIONS -

In connection with the establishment of a resort area, a survey
of the waters of Hillsborough Bay, Tampa, was conducted by District Sanitary
Officers Fred A. Safay and Russell Broughman.

A series of collection stations were established in Hillsborough Bay
from Catfish Point to Station 15, west of Broad Creek end samples there-
from indicated that the waters near the channel and in deeper parts of
the area were free from contamination.

Stations 1 2 3, located on the shore line between above named
points were found to be in waters grossly polluted by evidence of sewage
contamination as indicated by confirmatory test.

The survey revealed a long sand-bar or flat projecting out for some
distance from Gadsen Point and that this sand-bar prevented much con-
tamination from entering the area under consideration for Beach project.
Proposed plans for this development contemplate extending the shore
line at least 1000 feet for bathing purposes and the results of stations
10-11-12-13-14 and 15 on both incoming and outgoing tides indicated water
free from evidence of serious contamination.

This preliminary survey indicated that the area at the point of
Beach Development was free from contamination of a serious nature but
it was the opinion of the investigators that further study should be
made of the area over a longer period of time.





-48-


STATE BOARD OF HEALTH

Bureau of Public Health Nursing

ANNUAL REPORT 1936


Personnel

Miss Ruth E. Mettinger, Director
Miss Jule O. Graves, State Supervisor of Midwives
Miss Lalla Mary Goggans, State Mobile Field N urse
Miss Clio McLaughlin, State Tuberculosis Field Nurse
Miss Johanna L. Sogaard, District Supervisor of Nurses
Miss Vandilla Strickland, District Supervisor of Nurses
Mrs. Mary W. Matthews, District Supervisor of Nurses
Mrs. Mary Hitchcock, District Supervisor of Nurses
Miss Cynthia May Mabbette, District Supervisor of Nurses
Nurse Ethel Mae Jones, State Midwife Teacher
Miss Annie Laurie Dcwey, Secretary
Miss Anne M. King, Clerk

WPA STATE SUPERVISORS

Mrs. Lydia C. Holzscheiter Headquarters New Port Richey
Miss Margaret A. Hoxsey Madison
Mrs..Inez M. Nelson Orlando

Narrative Report

Through Social Security Funds, the Bureau of Publie
Health Nursing has been able to employ additional nurses which,
of course, has increased the activities of the Department.

MIDWIFE WORK:

Miss Joyce Ely, Midwife Supervisor, resigned her
position the first of the year; and was succeeded by Miss Jule 0.
Graves, who brought to the position ten years experience in mid-
wifery.






-49-


Upon the recommendation of Dr. B. McCord, Consultant to the
Children's Bureau, a change in midwife institute plans was made
and small one-day institutes were held in every county in the
state in place of the larger institutes previously conducted.
1151 midwives have been licensed and registered, and sixty-five
one-day institutes held, with 875 in attendance. Also, sixty
classes for nurses were held with an attendance of 208.

The Midwife Manual was revised, simplified consider-
ably so that the midwives could better understand the policies of
the State Board of Health. The county nurses were asked to con-
duct monthly midwife meetings between Miss Graves' visits. A
manual was prepared for the nurses as a guide in conducting these
one-day classes. Model midwife bags have been supplied to the
District and State Supervisors, and County Health Units. The
equipment for these bags was made by the WPA sewing rooms.

A colored midwife teacher was employed for county re-
check on the midwives who were not licensed or following the pol-
icies of the State Board of Health. She remained in the counties
from two to three weeks, observing deliveries and postpartum care,
holding meetings and learning if the midwife has actually had a
physical examination, including Wasserman. She has accomplished
a great deal and has enabled this Bureau to have a more accurate
record of the midwives, and has assisted in the reduction of the
maternal death rate by observing more closely the midwives who
were not conducting their work properly.

Through the Welfare Department, we have been able to
place many of the midwives, too old to practice, on Old Age
Assistance.

COUNTY HEALTH UNITS:

Much time has been spent by this department in assist-
ing with the development of County Health Units. Miss Lalia Mary
Goggans, was employed as State Mobile Unit Nurse, and remained in
the county units from three to four Weeks. She assisted in -he
establishment of the nursing service, outlining a generalized pro-
gram and observing the teaching methods used by the nurse when
visiting the home, observing classes, and assisting in organizing
Public Health Nursing Councils. At the completion of her visit,
she submitted to this Department, Health Officer and County Health
Unit, a recommendation as to the program which the nurses should
follow.

TUBERCULOSIS:

We have been fortunate in securing Miss Clio McLaughlin
for the tuberculosis division, who has specialized in this phase
of public health nursing for many years. She has conducted an






-50.


educational program, instructing the unit and county nurses in the
prevention of tuberculosis and the care of the patient. She has
visited many schools and explained the importance of the tuberculin
test, and created among the pupils a desire to take the tuberculin
test. Six weeks was spent in Escambia County assisting the County
Health Officer in putting over the tuberculosis program in the
schools.

REFRESHER COURSES:

Cooperating with the Florida State Nurses' Association,
this Bureau conducted ten one-day institutes on Maternity and
Pediatrics, emphasizing the nursing technique in this program.
The Director of the Bureau of Maternal and ChildHealth and the
Director of the Bureau of Public Health Nursing gave these lectures,
accompanied by moving pictures.

The Short Course for registered nurses was repeated
this year, at the University of Florida in Gainesville. Tho course
was arranged and conducted by the Extension Division of the
University, State Board of Examiners for Nurses and the Bureau of
Public Health Nursing. Miss Myrtle Hodgkins, Teaching Supervisor
of Medical Nursing, School of Nursing, University of Minneapolis,
Minnesota, and Miss Elizabeth Garridon, Educational Director from
George Peabody College, Nashville, Tennessee, were the instructors.
There were one hundred nurses in attendance.

At the invitation of the Director of this Bureau, Mrs.
Charlotte Heilman, Assistant Director of Public Health Nursing and
Home Hygiene and Care of the Sick of the American National Red
Cross, Washington, D. C., conducted six two-day institutes on -
"Methods of Teaching ", applying it to the course of Home Hygiene
and Care of the Sick. All arrangements for those classes were made
through the Bureau of Public Health Nursing.

Realizing the importance of subscribing and using the
nurses' official magazine, "The American Journal of Nursing",
arrangements were made for Miss Dora M. Cornolison, Field
Representative of the American Nurses' Association, to talk to
thirteen groups of nurses in various sections of the state,
explaining'how this magazine can be used to the best advantage of
the nurses, patient and the community.

Two one-day staff conferences fbr the district nurses
of the State Board of Health were conducted, each nurse partic-
ipating in the program.

At the request and expense of the American National
Red Cross, the Director of this Bureau spent one week in Washing-
ton during the month of September, attending the conference held
for the Nursing Field Representatives for the Eastern Area. The
main subject under discussion was "Disaster Relief".










The Director of the Bureau, who is also President of
the Florida State Nurses' Association, attended the Biennial
Convention of the three National organizations, viz- American
Nurses' Association, National League of Nursing Education, and the
National Organization for Public Health Nursing. The convention
was held in Los Angeles, California, with approximately 11,000
nurses in attendance, representing every state in the union and
several foreign countries.

The State Advisory nurses, and Director of Courses,
held a special meeting during the Biennial. Miss Olivia Petersen,
Director of the Division of Public Health Nursing, State Board of
Health, Minnesota, presided. Each state gave a report of the
Nursing Activities under the Social Security Program.

A second Advisory and Director of Courses meeting was
held in New Orleans in November. The Director of this Bureau
arranged the program and presided.

At the expense of the American Nurses' Association,
the Director attended a Committee Meeting in New York to study
"Placement Service and Vocational Guidance". Every section of
the United States was represented.

Nineteen nurses wore given stipends. The qualifica-
tion for students emphasized an aptitude for public health nursing
and proper educational background. With the exception of four,
all of these nurses had previously boon employed on FERA for a
period of two years.

PUBLIC HEALTH NURSING COUNCILS:

Public Health Nursing Councils have been organized in
practically every county and have continued to support the Nursing
Service. Through-their infinite knowledge of this Service, they
have been able to act as an educational media between the nurse
and the public as a whole; and have stimulated the community to
assume a civic responsibility, and give support to the Nursing
service. These Councils have sponsored Loan Closets, and through
the financial assistance of the Local Chapters of the Red Cross,
the necessary articles such as hospital accessories, wheel chairs,
bed linens, etc., have been purchased. The WPA sewing rooms have
cooperated in making obstetrical packs under nursing instruction.
Layettes, sheets, pillow cases, gowns, etc. have also been made.

MAY DAY:

The Director of the Bureau served as State May-Day
Chairman, and through the county nurses and Public Health Nursing
Councils, each county selected a May Day Chairman. Upon the
receipt of the names of the County Chairmen, suggestions for
plays, window displays, parades and the May Day Program wore sent
to the Chairmen.







-52-


May Day and Mothers' Day were celebrated in prac-
tically every county in the state. Immunization was stressed
this year the same as last. In many counties this activity was
combined with the Summer Round-Up sponsored by the P.T*A,

The President's Proclamation was sent to each county,
with the request that it be published in the local newspapers.

At the completion of those programs, a compiled county
report was made, and a copy sent to the Children's Bureau,
Washington, D. C.

EXHIBITS:

Through experience, we have found that health can be
taught much better through visual education; and the nurses who
attempt to impart knowledge through speaking only, is neglecting
a valuable tool.

Through WPA funds, we have employed one who has been
trained in preparing exhibits. As a result, we now have fifty-one
exhibits demonstrating prenatal care, sanitation, infant care,
venereal disease control and tuberculosis. These exhibits have
been loaned for fairs, to county nurses for window displays, and
the Short Courses held at the University of Florida, Gainesville.

W.P.A.:

The Bureau of Public Health Nursing has continued to
supervise the relief nursing program, which was re-opened Feb-
ruary lst under WPA. The project was cut considerable, due to
the reduced appropriation from Washington.

One hundred and fifty nurses were employed, and were
placed in counties where there was the greatest need. They contin-
ued to conduct a generalized public health nursing program. It
has been difficult for the county nurses to continue their work,
due to the small salary. Through the efforts of the District
Supervisors, twenty-nine counties have supplemented the salary and
travel of those nurses, and have promised to continue the program
if and when WPA funds are discontinued.

The Homo Hygiene Classes which the WPA nurses have
taught in the sewing romas, school and to ccumunity groups have
been invaluable. Classes have not been confined to the women,
but also included men. It has improved their personal outlook,
awakened interest in self help, and stimulated community thought
upon subjects of better environment. The nurses have received






-53-


excellent cooperation from the sewing roams, which has evidenced
their appreciation of this service.

The teaching program of health has assisted greatly in
the Work Centres; and, in many instance, the women in'these con-
tres have requested extra lessons in Health Education, following
the receipt of certificates in Home Hygiene and First Aid Classos.
Because of this request, we have had to plan an outline of advanced
health work for those groups.

Through the WPA'Nursery Schools, many immunization
clinics have been organized, and toxoid given by the District
Health Officer. The county nurses are working very diligently in
trying to get defects of the preschool children corrected before
they enter school.

The WPA nurses have tried also to arrange an effec-
tive immunization program in the schools for the District Health
Officer.

Through Social Security Funds, the State Board of
Health was able to absorb many of the WPA nurses, including five
of the District Supervisors.

The WPA Nursing Service has been of real educational
value to the counties, as through this Service, we have been able
to create health consciousness, and assist in establishing County
Health Units.












Number

Number

Number

Number

Number

Number


-54-

ANNUAL REPORT OF DISTRICT SUPERVISORS OF NURSES


counties visited* 670 Number of visits to cou

communities visited 1956 Number of visits to coz

nurses employed: White 757 C6lored : 185

nurses transferred: White 14 Colored 2.

talks given during the year: 12

Public Health Councils attended: 109

PERSONAL INTERVIEWS

interviews with Relief Directors, Relief Administrators,
Case Aides, etc.: 2066

interviews with nurses (not employed): White 388

interviews with doctors (not public health)White 567

interviews with health officers: 280

interviews with interested individuals: White 6008

interviews with state staff: 1267

MIDWIFE WORK


Colored

Colored


Colored 260


Number of visits to midwives

Number of midwives practicing without registration:

Number of midwife investigations:

Number of classes and demonstrations held: 22

Attendance:

Number of One-day midwife institutes holds 54

Attendance:

Number of midwives examined:


White

White

White



White


White

White


13

16

185


Colored

Colored

Colored


2 Colored 47


Colored 279

Colored 77


ties: 1802

miunities:2875


Number of


Number

Number

Number

Number

Number






-55-


ANNUAL REPORT OF NURSES EMPLOYED BY OFFICIAL & VOLUNTEER AGENCIES


Total No. cases under
care at beginning of
month-
Intake
a. New
b. Re-admitted
Total under care
during month
No. carried cases
visited
Total under care
visited
Dismissed
Carried over


Health
Supervision
W C


1977
1069
724
345


327
290
200
90


Maternity
W C


334
162
147
15


Morbidity
W C W


422
379
312
67


3046 617 496 112 801


524 132 192


799
2956
1090


53 269


224 207
380 173
237 323


417
398
503


135
81
71
10


Total


2733
1610
1183
427


C


541
404
303
101


216 4343 945

69 985 254


89 1423
99 2427
117 1916


366
532
413


HOME VISITS
Total No. homes
Total No. homes


visited first time
re-visited


Total No. visits to homes
Total No. visits to cases

HEALTH SUPERVISION
Infants to 1 year
Pre-school (1 to 6 yrs)
School children
Adults

MATERNITY
PronaTa.T
Delivery
Post Partum
Newborn

MORBIDITY
Non-oommunicable diseases
Infants to 1 year
Pre-school (1 to 6 yrs)
School children
Adults
Communicable diseases
(Exclusive of tuberculosis)
Infants to 1 year
Pre-school (1 to 6 yrs)
School children
Adults


White
-83T
1132
2973
2553


738
903
2493
621


750
53
275
162



293
637
596
502


20
77
312
127


Colored
165
218
509
498


200
334
431
904


229
24
24
34



80
178
159
392


1
0
27
30






-56-


TUBERCULOSIS White Colored
No* of positive cases visited 86 196
No. of suspects visited 30 0
No. of contacts visited and listed 57 11

VISITS IN BEHALF OF-
Health supervision 852 54
Maternity 399 53
Morbidity 556 45
Visits for special activities 1072 79
Non-effectual visits- not seen 46 9
not found 36 11

HEALTH SUPERVISION
Infants to 1 year 223 78
Pre-school (1 to 6 yrs) 730 174
School children 1630 466
Adults 2444 444

MATERNITY
Ante-partum 91 34
Post-partum 21 16

CLINICS OR CONFERENCES GROUP
Infants No. of clinics 2 0
New attendance 4 0
Returned attendance 5 0
Pre-school No. of clinics 30 11
New attendance 257 11
Returned attendance 0 0
Prenatal No. of clinics 7 0
New attendance 122 121
Returned attendance 403 476
Orthopedic No. of clinics 6 4
New attendance 74 26
Returned attendance 53 3
Dental No. of clinics 198 0
Now attendance 17 0
Returned attendance 7 0
Treatment attendance 7 0
Toxoid Pro-school- No. of clinics 1 0
Attendance 45 0
Vision No. of clinics 0
New attendance 5 0
Tuberculosis New attendance 146 176
Returned 104 420
School children No. of clinics 10 3
Attendance 211 99
Tonsil and Adenoids No of clinics 3 5
Attendance 7 10






-57-

CLINICS OR CONFERENCE GROUP (cont'd.) White Colored
Venereal and Medical No. of clinics -
New attendance 102 116
Returned attendance 730 1078
Nursery school No. of clinics 27 0
General No. of clinics 137 10
New attendance 175 13
Returned attendance 131 11
Office interviews 78 .7

No. of individuals referred for
medical examination 3053 246
N o. of cases hospitalized 488 85
No. of adults securing corrections 249 82

HOOKWORM CONTROL
No. of containers distributed 3045 18
No. of containers collected 3797 127
No. of treatments given 796 2
No. of families with open or no toilets 597 33

I1UNIZAT ION
No. of clinics held for vaccination
against smallpox 270 41
No. vaccinated 851 946
No. of Schick tests- positive 325 0
No. of Schick tests- negative 771 0
No. of clinics held for the Admin-
istration of Toxoid, TAT 605 89
No. receiving treatment 355 30
No. clinics held for the admin-
istration of typhoid vaccine 80 6
No. completing 3 treatments 658 84

CONFERENCES INDIVIDUAL
Health Officers 170 29
Other physicians 894 104
Teachcrs 2141 791
Social Service Workers 396 11
District Supervisor of Nurses 54 0
Other nurses 170 2
Interested individuals 5484 67
Parents consultation 23 0

SUPERVISION OF MDIWIVES
No. of home visits to midwives 49 78
No. of conferences with midwives 48 154
No. of investigations of midwives 7 19
No. of demonstrations, classes or
institutes held 7 18
Attendance 19 95
No. of bags inspected complete 12 129
incomplete 4 27
No. of Wassermans taken 1 7






-58-


EDUCATIONAL ACTIVITY COMMUNITY White Colored
No. of talks by nurse 78 5
Group meetings lo5 12
Attendance 203 0-
School children 1074 17
Attendance 655 0
Teachers 5 0
Attendance 59 0
Parents' meetings in school 18 0
Attendance 379 0
Institutes attended 3 0
Home Hygiene classes 196 0
Attendance 814 0
First Aid classes 9 0
Attendance 120 0
Board of Directors 18 0
Boy Scout meetings 12 0
Attendance 12 0
General 23 1
Attendance 9 0
Class room talks 102 0

BIRTH REGISTRATION
Registrars visited 14 0
Unreported births discovered 27 1

HEALTH CENTERS
Health Plays 2 0
Beautification show 1 0

NURSERY SCHOOLS
No. of children inspected 296 0
No. of children with one or more
symptoms of defects 60 0
No. of cases referred to doctor 65 0
No. of inspections -
Infant and Pre-school 25 0
Corrections on infant and Pre-school 18 0

ACTIVITIES IN SCHOOL
No. of schools visited 1109 272
No. of schools given assistance 230 26
No. of individual inspections
by nurse 22653 1461
No. of routine examinations
by doctor 5849 150
No. of children with one or more
symptoms of defects 1575 0
No. of special examinations 317 1






-59-


INDICATIONS OFt White Colored
Enlarged glands 598 45
Skin disease 685 20
Scalp disease 49 6
Hookworm 454 35
Defect Orthopedic 59 2
Eye trouble 799 115
Defective vision R 211 0
L 152 0
Defective hearing R 59 0
L 20 0
Diseased gums 66 0
Defective teeth 4560 98
Adenoid symptoms 1076 0
Abnormal throat 887 113
Abnormal weight 1269 0
Nervous symptoms 45 0
General 1609 0

CORRECTIONSt
Enlarged glands 106 5
Skin disease 291 13
Scalp disease 208 1
Hookworm 135 0
Defect orthopedic 13 4
Eye trouble 192 2
Defective vision R 40 0
L 17 0
Defective hearing R 9 0
-L 4 0
Diseased gums 21 0
Defective teeth 832 1
Adenoid and tonsils 261 5
Abnormal throat 59 4
Abnormal weight 8 0
Nervous symptoms 2 0
General 185 0
Apendectcay 1 0
Glasses 9 0





Page 59 should precede page 68

Page 72 should continue on page 59


Page 67 should precede page 73





-60-


CLASSES


Total No. classes
brought forward from
preceding month-
Total No. new classes
organized during
month-
High School
Sewing room
Mattress Factory
P.T.A.
Nursery School Mothers
W.P.A.
Teachers
Highway Department
General


FIRST AID REPORT


TYPE OF GROUP
Adults Scool
W C W C


ENROLLMENT
Adults School
W C W C


244 40 81 19 2483 4637 1195 309


320
670
35
82
57
228
86
182
155


559
0
0
0
19
O
0
O
19


ENROLLMENT . .* 4298 48(
* *** ** ** ** ** ***** *

TYPE OF GROUP
Adults
W C


Total No. lessons taught
during month-
High School
Sewing Room
Mattress Factory
P.T.A.
Nursery School Mothers
W.P.A.
Highway Department
General

Total No. of hours taught
Total No. classes completed
during month-
High School
Sewing Room
Mattress Factory
P.T.A.
Nursery School Mothers
Highway Department
W.P.A.
General


161
493
49
77
69
149
37
126


1472


19
133
19
18
48
26
82
20


277


)8 1592 444


P
School
W C


323
37
0
2
10
0
0
11

370


129
0
0
0
2
1
0
0

153


315
0
0
0
0
0
0
0


110
10
0
0
0
0
7
0
8






-61-


TYPE OF GROUP


Adults
W -C


School
W C


Approximate date other
classes will be completed
High School


Sewing Room

Mattress Factory
P.T.A.
Nursery School Mothers
W.P.A.

Highway Department

Total number of students
receiving certificates


Nov
Apr
Aug
Dec
Oct
Oct
Jan
Aug
Apr
Aug


Feb
Jun

Nov

Nov
Oct

Jul


Nov Mar
Apr

Sept Mar



Jun ug
Jun Aug


Oct
Jan
Jun
Jan


Feb
Apr

Apr


Feb
Jun


Jan Mar


- -


Aug -


628 63


Mar


0 0






-62-


HOME HYGIENE AND CARE OF THE SICK REPORT


CLASSES TYPE OF GROUP ENROLLMENT
Adults School Adults School
W C W C W C W C
Total number classes
brought forward from
preceding month- 659 295 151 56 8975 4185 2290 505

Total number new classes
organized during month
High School 23 11 43 1 249 0 606 0
Sewing room 175 36 0 3 2716 604 0 15
Mattress Factory 13 3 0 0 372 60 0 0
P.T.A. 24 11 0 0 141 183 0 0
Nursery School
Mothers 14 6 0 0 231 64 0 18
W.P.A. 0 0 0 0 20 0 0 0
General 81 10 0 0 380 112 16 0

ENROLLMENT ... . . . 12484 5188 2912 538
** ** ** ** ** ** * * * **

TYPE OF GROUP
Adults School
W C W C
Total number lessons
taught during month
High school 335 178 715 183
Sewing room 1876 433 4 10
Mattress Factory 161 42 0 1
P.T.A. 127 95 1 21
Nursery School
Mothers 239 148 2 4
W.P.A. 7 0 0 0
General 116 702 15 32

Total number of hours
taught 4081 1673 868 298
Total number classes
completed during mo.
High School 74 23 66 26
Sewing Room 975 339 0 0
Mattress Factory 43 11 0 0
P.T.A. 40 55 0 0
Nursery School
Mothers 110 44 8 0
W.P.A. 0 0 0 0
General 201 113 3 2





-63-
TYPE OF GROUP
School
-


Approximate date other
classes will be
completed.
High school Jan Jun
Nov Dec
Sewing room Jun May
Jul Oct
Mattress Factory Jan Jun
Jul Oct
P.T.A. Jan Feb
Nursery School
Mothers Jan Jul
Others Jan'

Total number of students
receiving cortifi-
cates 1048


Jan Jun
Nov
Jan Sept
Nov
May Jun

Mar

Mar
Jul Aug
Oct


Jan Dec

Sept Dec







Mar


507 283


MATTRESS FACTORY REPORT


Number of visits to factory . .

Number of inspections made . .

Number of cases referred to physicians

Number of cases referred to visiting nurse


* 0 0 5

* S 0 *

* 0 0 6

* S S


SEWING ROOM REPORT


Number of visit to sewing room . .

Number of inspections made ....... .

Number of cases referred to physicians . .

Number of cases referred to visiting nurse . .

Number of individual conferences with workers . .

Number of Routine inspections *. ..... ...


Adults
W- c


Aug

Jun






Apr
Apr


68


297

3656

227

67


645

5436

238

176

59

1011







-64-


REPORT OF NURSERY SCHOOLS


Number of Nursery Schools in County *

Number of visits to Nursery Schools

Number of children inspected .

Number examined by doctors .

Number excluded *


w
W 448


. . 1924

S. .. 8896

S. . 1302

* .. 666


Number of clinics:

Number of home visits:

Number of corrections:

Number of immunizations:


C

63

372

6006

150

168


White

White

White

White


69

2147

472

692


Colored

Colored

Colored

Colored


11

380

40

268


*

*







-65-
MIDWIFERY

1 9- 6


Number of midwives

Number of midwives

Number of midwives

Class A
Class B
Class C

Number of midwives

Number of midwives

Number of midwives

Number of midwives

Number of midwives

Number of midwivcs

Number of midwives


licensed and registered

registered

licensed





notified not to practice

having physical examination

with positive syphilis

resigned

licensed revoked

decuasod

with positive hookworm


W

123

52

71

10
9
52

2

16

1

1

0

0

2


C

1058

444

614

1
32
581

6

56

12

9

0

9

15


Total

1181

496

685

11
41
633

8

72

13

10

0

9

17






-66-


LITERATURE AND SUPPLIES SENT OUT

Children's Bureau Booklets


Infant Care * * *
Prenatal Care * * *
The Child from 1 to 6 . .
Height & Weight Charts. . .
Are you Training your Child to be Happy?.


For Nurses


Notices to Perents or Guardians .
Hookworm Specimen Reports (Positive) *
Eookworm Spocimun Reports (Negative).
Request for Iookworm Treatment *
Maternity Lotter Request Slips *.
Nurses' Inspection School Cards *. *
Physical Inspection Records *. .


48546
5532
6012
1566
3846
9500
34980


For Doctors


Notice to Parents or Guardians .. ..
Physical Inspection Records . .


*0 0
* C 0


For Teachers


Physical Examination Blanks . . .
Teachers Examination Cards .* .. *


State Board of Health Pamphlets


Hookworm Pamphlets .. ...
Malaria . . . . .
Tuberculosis ... . ......
Mosquito Control .. .
What to doWhen ..... ,. .
Sanitary Privy .. . ... .....
Filthy Fly .. . . .
Dengue Fever Pamphlets ...... .
Why Births Should be Registered *
Collateral Reading .. . . .
Diet for Constipation ... . .
Establishment of Toilet Habits .* .
Summer Time Fly Time . . *
Influenza . . . .

Midwife Supplies


9


* 0
. C
. C
C C
* .
. C
. C
C S
. C
C
* .
C C
AC.


Midwife Monthly Report Cards . . ...
Bag Inspection Sheets .. .. .. .... .
Bag Inspection Sheets . . ..
Cord Dressing Pattern .
Mask Pattern .* ..
Instructions for Midwife Equipment* .* .
Attendants Other Than Midwives or Doctors *


1238
597
477
162
5


700
2700


341
10


783
256
364
434
560
664
418
72
501
23
67
239
150
10


3724
1986
1483
413
215
699
193






-67-

'Midwife Supplies


Midwife Investigation Cards . . .
Persons Practicing without Midwife Registration .


Doctors' Report Cards . . .
Personal Data Cards for New fidwives .
Book of Birth Certificates ... .
Requisition for Midwife Supplios .
Midwife Laws . . ....
Layette Instruction Shoots ..* .* -,
Promise Cards . . *
Midwifo Manuals . . ..
Physical Examination Blanks . .
Notice to Attend Midwife Mooting .
Midwife Summary Shoots ...
Joint Pledge Blanks . . .
Application for License . . .
Application for Certificate of Registration .
Silver Nitrate (Ampuls) . . .
Outline of Midwife Progran &
Demonstration of Midwife Classes .
Midwife Creed and Prayer .
Midwife Songs . . .


*.5


* 5


* .


* .
. .
* .


Maternity Letters


Prenatal Letters . ..
Postnatal Letters . .
Dental Letter No, 1 .


Diet Charts
Diet Charts
Diet Charts
Diet Charts


No. 1
No. 2
No. 3
No. 4


376
130
115
114


Respectfully ubmittcd,


Ruth E. Mottingor, RM-Director
Division of Public Health Nursing


194
279
365
538
199
227
74
572
148
459
.949
2541
80
906
804
96
10972

16
20
20


1166
780
41





-68-


ANNUAL REPORT FIL. WORKS PROGRESS ADMINISTRATION NURSES


Health
Supervision
W C


Maternity
W C


Morbidity
W C


Total No. eoses under
care at beginning
of month
Intake
a. New
b. Re-admitted
Total under care
during month
No. carried cases
visited
Total under care
visited
Dismissed
Carried over


33654
10623
7676
2947


7852
3793
2569
1224


44277 11645

13255 5073


21436
18198
26079


8110
3250
8395


9141
3395
3102
293


3967
2200
1270
930


12536 6167


6067

9148
1285
11251


2814

3665
1411
4756


HOME VISITS
Total No. homes visited first time
Total No. homes Re-visited
Total No. visits to homes
Total No. visits to cases

HEALTH SUPERVISION
Infants to 1 year
Pre-school (1 to 6 yrs.)
School children
Adults


MATERNITY
Prenatal
Delivery
Post Partum
Newborn


MORBIDITY
Non-comunicable diseases
Infants to 1 year
Pre-school (1 to 6 yrs.)
School children
Adults
Communicable Diseases
(Exclusive of Tuberculosis)
Infants to 1 year
Pre-school (1 to 6 yrs..)
School children
Adults


11837
6953
5873
1080


4360
4522
4152
370


54632
20971
16651
4320


16179
10515
7991
2524


18790 8882 75603 26694

8138 4000 27460 11887


14293
7117
11673

White
1T"55-
24797
40346
58402


5137
7317
7468
7143


7344
446
1046
3145


1475
2219
3613
6851


470
958
1832
1794


8063
3988
4894


44877
26600
49003


17838
8649
18045


Colored
6157
13127
20605
30024


2076
2091
4356
2572


68
171
1796
1494



634
826
1523
3148


126
366
1541
1292


Total






-69-


TUBERCULOSIS White Colored
No. of positive cases visited "0.. 648
No. of suspects visited 790 466
No. contacts visited and listed 1469 845

VISITS IN BEHALF OF
Health Supervision 10676 4238
Maternity 3701 1493
Morbidity 6211 5801
Visits for special activities 6124 1223
Non-effectual visits- not seen 2119 449
not found 928 313

HEALTH SUPERVISION
InfanirL to 1 year 2367 803
Pre-school (1 to 6 yrs.) 1707 469
School children 4949 644
Adults 5440 1111

MATERNITY
Ante-partum 925 284
Post-partum 528 128

CLINICS OR CONFERENCES GROUP
Infant No. of clinics 212 183
New attendance 661 308
Returned attendance 1862 450
Pre-school No. of clinics 279 165
New attendance 1032 562
Returned attendance 1170 422
Prenatal No. of clinics 154 154
New attendance 727 555
Returned attendance 1001 1143
Orthopedic No. of clinics 108 8
New attendance 140 19
Returned attendance 85 20
Dental No. of clinics 112 9
New attendance 1787 22
Returned attendance 72 1
Treatment attendance 203 2
Well baby conference Clinics 69 279
Tuberculosis Clinics 608 82
Typhoid Immunization clinics 1216 164
Venereal Disease clinics 878 3800
General attendance 3637 4607

No. of individuals referred for
medical examination 8371 5505
No. of cases hospitalized 1270 314
No. of adults securing corrections 1228 3993






-70-


HOOKWORM CONTROL White Colored
o.l of containers distributed 9232 1459
No. of containers collected 7444 1001
No. of treatments given 2676 175
No. of families with open or no
toilets 6524 2417

IMMUNIZATION
No. of clinics held for vaccina-
tion against smallpox 419 170
No. vaccinated 1758 2389
No. of Schick tests- positive 1902 68
No. of Schick tests- negative 3927 633
No. of clinics held for the
administration of Toxoid, TAT 281 176
No. receiving treatment 3474 1077
No. clinics held for the admin-
istration of typhoid vaccine 922 584
No. completing 3 treatments 4915 1595

CONFERENCES INDIVIDUAL
Health Officers 1585 74
Other physicians 5576 834
Teachers 8511 1742
Social Service Workers 5813 352
District Supervisor of Nurses 3735 100
Other nurses 6128 1043
Interested individuals 5420 5468

SUPERVISOR OF MIDWIVES
No. of home visits to midwives 663 1469
No. of conferences with midwives 230 1192
No. of investigations of midwives 168 451
No. of demonstrations, classes or
institutes held- 109 300
Attendance 549 1595
No. of bags inspected- complete 215 1367
incomplete 137 501

EDUCATIONAL ACTIVITY COMMUNITY
No. of talks by nurse 998 339
Group meetings 914 338
Attendance 5521 2128
School children 3271 1250
Attendance 9866 4065
Teachers 173 113
Attendance 978 137
Parents' meetings in school 180 26
Attendance 4112 46
Institutes attended 188 32
Home Hygiene classes 3545 941
Attendance 8800 6655
First Aid classes 897 144
Attendance 1124 1351
Others 723 53






-71-


BIRTH REGISTRATION White Colored
Registrars visited 305 30
Unreported births discovered 170 29

HEALTH CENTERS
County Fairs 23 1
Others 28 2

NURSERY SCHOOLS
No. of children inspected 2203 1629
No. of children with one or more
symptoms of defects 2550 163
No. of cases roferrod to doctor 822 175
No. of inspections-
Infcan and Pro-school 1529 24
Corrections on Infant and Pre-
school 402 10
General 228 31

ACTIVITIES IN SCHOOL
No. of schools visited 2741 783
No. of schools given assistance 2038 622
No. of individual inspections
by nurse 30280 4176
No. of routine examinations by Dr. 3104 85
Eo. of children with one or more
symptoms of defects 6791 1324
No. of special examinations 2592 974

INDICATIONS OF:
Enlarged glands 1438 236
Skin disease 4144 1366
Scalp disease 407 209
Hockworm 2136 100
Defect Orthopedic 423 78
Eye Trouble 2011 307
Defective vision R 1226 91
L 794 33
Defoctive hearing R 104 24
-L 155 161
Disease Gums 335 83
Defective teeth 7366 870
Adenoid symptoms 1568 575
Abnormal throat 4325 989
Abnormal weight 1812 298
Nervous symptoms 244 28






CORRECTIONSt
White Colored
Enlarged glands 22
Skin Disease 731 255
Scalp disease 152 75
Hookworm 399 13
Defect Orthopedic 22 10
Eye Trouble 326 67
Influenza 0 260
Typhoid Immunization 31 0
Defective hearing 2 0
Nervous symptoms 5 13
Disease gums 111 2
Defective teeth 859 55
Adenoid symptoms 118 20
Abnormal throat 171 236
Abnormal weight 7 10
General 320 409


















Page 59 should precede page 68

Page 72 should continue on page 59


Page 67 should precede page 73






-73-


July 21, 1937










Dr. VJ. A. IEc Phaul
State Health Officer
Florida State Board of Kealth
Jackconville, Florida

Dear Doctor EcPhaul:

Attached herewith report of the Bureau of Dental
Health for the period September 1, 1936 to
January 1, 1937, and which doals primarily with
organization plans for the year 1937.



Respectfully submitted,



E. C. Geiger, D. D. S.


ECG:vt





-74-


BUREAU OF DENTAL HEALTH

E. C. Geiar, D. D. S., Director




ORGANIZATION

The Bureau of Dental Health was organized in September 1936,
for the purpose of Public Dental Health Education. A cross section exam-
ination of Florida school children has reflected dental decay to the ex-
tent of 92.5 percent. There are about 250,000 elementary school children
in attendance annually in our state. In consideration of this enormous
problem an educational program was designed to reach the greatest number
of school children in order to stimulate interest, and to create a desire
for mouth health during the formative period of future Florida citizens.

The Bureau of Dental Health program was endorsed and adopted by
the Florida State Dental Society.

A. P~r3SONEL

The Bureau of Dental Health is composed of a consulting director,
director and secretary, and will cooperate with any County Health
Department, dentist or hygienist for an educational program or
similar assistance.

B. DENT..L HEALTH EDUC'.TION

a. Didactic I'ethcds for Children

1. Plans have been made to present a visual dental health
educational puppet show for school children, parents
and teachers during the winter session. The perfor-
mance depicts the four points of dental health in a
dramatic, entertaining and interesting fashion.

2. The Bureau of Dental Health plans to cooperate with
Dr. George I'ood Clapp in issuing, weekly, a written
travelogue for the purpose of mimic broadcasts by
school children in the classroom. This series of
travelogues embodies the study of geography, history
and dental health; improves diction and tends to
prevent "stage fright". Teachers value this method
of instruction because it lends vivacity to didactic
subjects and is entertaining as well as instructive.

3. A booklet entitled "The Five Little Pigs", designed
for Kindergarten, First, Socend and Third grade school
children is well illustrated and is suitable for color-
ing with crayons or wvtmr-colors. These booklets will
soon be ready for distribution in the schools. The
illustrations and rhymes are adapted to teach dental
health to young children. A similar plan is carried
out in the transposition of the lyrics of a well-
known song, "Billy Boy", to a dental health lesson.





-75-


b. Demonstrative Method

Five children are to be selected in various large
schools for a special demonstration plan. Selection
will be based on indigency, infrequency of attendance,
poor grades and repetition of a grade. The mouths re-
flecting the most severe dental conditions will in-
fluence acceptance for complete correction in order to
offer tangible proof of the necessity of dental health
with school vork and as a health measure. This work is
to be done in the school house by a field dentist using
a portable choir, foot dor.cal engine, etc. The improve-
ment of these children is to be recorded, Rnd five un-
trorted children with sir.ilcr conditions used as a con-
trol to determine the benefits of the treated rumibcr.

c. Adult Grcups

Lrntrn slide lecture programs were presented to P. T. A.
meetings, civic clubs, and similar ornE:iz-.ticns. .
forum on dental health is to be conducted at the Univer-
sity of Florida for teachers during the coming summer
session.

d. Pro-natal and post-natal letters pertaining to dental health
are being issued,

C. SCHOOL INSPECTION

Elor.entary school children, in a county in which this program
is being executed, ere inspected and, if dental defects are
found, an inspection notice is sent tc the parents recommending
a complete examination by the family dentist. The reverse side
of the inspection notice is a certificate to be signed by the
family dentist when all work is completed. This is to be return-
ed to the tec.cher and the child's nexae placed cn the dental
honcr Roll iith a gold star beside it. The clcssrocr mry be
given an av-.rd of ono-half holiday on Child Heclth Dr.y, Kay 1,
providing eo7ry child has 100% mouth health.

D. REFRESHER COURSE

Plans arc b3ing formulated for a symposium on dentistry for
children to be held in each of the districts of the Florida
State Dental Society. This is to stimulate greater interest
c.acng the dental profession in the most modern concepts of
children's dental service and preventive dentistry.

E. LIBRARY SERVICE FOR DENTISTS

An album, or library, of slides on dental health is being pre-
pared for rlntorn projection. These slides are catalogued in
series, according to the subject, and are available to members
of the dental profession for lectures before various meetings.

The Executive Council of the Florida State Dental Society, upon
the proposal of the consulting director, voted to delegate the
S- r -
S ... .. .





-76-

library of some forty dental volumes to the State Board
cf Health whore they will be cared for by a professional
librarian and readily accessible to the dental profession
by mail.

F. RESEARCH -ND INVESTIGATION

Dr P. P. lack, of the University of Florida, in coopera-
tion with the State Board of Health, is conducting a state-
wv.id survey of water supplies relative to the incidence and
concentration of Fluorine in drinking water. If this water
is consumed for a period of time by growing children it will
produce a condition of the permanent teeth called mottled
oeanml. The Bureau of Sanitation is ccllocting the water
scnplcs, and Dr. Black and his: :L-if, financed by a W. P. -.
grant for this purpose, arc making the laboro.tcry analyses.
The Bureau of Dental Health sent a questionnaire to the
dentists of the state to determine the presence of mottled
onamel in their practice. The results cf this dental survey
are correlating to an unusual degree with the laboratory
findings. One section of the state is proving endemic with
special concern in Sarasota county.

CONCLUSION

The prevalence of dentc- defects in school children of this
state is very high, and since tests prove that children with healthy
mouths -raku fcstcr prcgrcss in school, rnd the incidence of grade
repeaters reduced in direct contrast, the problem reaches cccncnic
proportions.

The annual school budget cost, per child, in an elementary
school is approximntoly .;50.00, and if a grade is repeated the annual
cost fcr the child is $l00.00. This figure might be multiplied many
times by a high percentage of grade repeaters.

Dental health is necessarily an important part of preventive
medicine, cand dental disease influences many dcgenorative diseases
slowly and surely. The Buroru of Denta.l Health is using every avail-
able method tc dissominato knowledge tc the messes, and is proving that
this phase of Public Health is an economic, social, business and health
asset.





-77-
ANMIAL REPORT
OF THE
BUREAU OF COUNTY HEALTH WORK
A& B. McCreary, M. D., Director


County Health Work in Florida is in its infancy. The first cooperative health
unit was established in Leon County in 1930 with the county and the city of
Tallahassee cooperating with the State Board. The second cooperating health
unit was Escambia organized in 1931 with the city of Pensacola and the county
of Escanbia cooperating with the State Board of Health and the Public Health
Service. The third unit established on the same basis was Jackson County
in 1935.

1936 saw quite a few units added to this list. Broward and Taylor counties
were added in March 1936. Gadsdcn County came in April 1936. Monroe County
(Key West) and Pinellas County (St. Petcrsburg) were added during June 1936.
Hillzborough County (Tampa) was organized and started functioning in October
1936. The Franklin-Gulf-Liberty-Calhoun (four county health unit) with head-
quarters in Apalachicolr was organized at the same time. The Wakulla County
Health Unit 7aas also organized at this tiio

Heretofore Florida has relied upon a loosely woven district scheme with the
State divided into five districts, each-district having a district health
officer, sanitation officer, public health nurse and clerk with headquarters
in some central point in the district. As those districts usually comprised
from twelve to fifteen counties embracing a very' ltrge area and more than
300,000 population, it is entirely obvious that such a set-up would be
inadequate to administrate health protection to this area. Consequently,
those organizations simply did what thoy could, acting in many instances
in an advisory capacity to autonomous locr.l health departments, the aforesrid
health departments in Iany instances boinr simply part time set-ups.

With this in mind fully recognizing the inability of the district orgrnizction
to serve that number of people over so vast tn area with the type of health
service which they should have, the State Board of Health end the Burcau of
County Health Work has bent its efforts in on extensive program of health
education for the expansion of County Health Work in Florida. The counties
in the Stato of Florida rre operating by rrm'ns of funds allotted from the
United States Public Health Service, the State Board of Health, the counties
and in some instances other local agencies.

The minimal personnel in the small counties consists of a medical director,
public health nurse, sanitation officer nad clerk. All of these, of course,
are full time employees of the department. As the Board of Health does not
subscribe to the policy of subsidizing physicians, nurses or other personnel
to compete with private practice.

The personnel of those units must moot certain minimal standards before they
are approved by the State Board of Health or the Public Health Service. The
health officer must be a physician licensed in the State of Florida, who has
had special training in public health administration. The nurse must be
registered in Florida and have special training in public health. The




sanitation officer must be specially trained in sanitation and matters
dealing with community problems. Mapy of the organizations in the larger
counties have greater budgets and moire personnel. One unit, Wakulla County,
is termed by this department as a modified health unit in thct it only
has a full time nurse, situation officer and clerk, while the district
health officer acts as the department head.

During the past year the director addressed numerous medical societies,
civic clubs, Parent Teachers Associations and other interested groups with
reference to the establishment of county health units, outlining in every
instance that the cooperative health unit represented the most modern
development in health protection. Numerous pamphlets on the subject were
prepared and distributed as well as newspaper articles, all designed to
acquaint the public with the facts regarding county health units and what
they were to expect from a county health unit in their county.

The response from the Medical Societies hrs been very gratifying, there
being committees appointed by the societies to work with representatives
from the health department for the organization of county health service.
The civic clubs responded and this Bureau feels that the results of the
campaign have been very gratifying.

The Mobile Health Unit has been of inestimable value in the promotion of
the work, as thorough surveys of health conditions in the various counties
resulted in the gleaning of information which could be presented to the
people cf these counties in a manner which bore fruit.







-79-


REPORT
DISTRICT HEALTH OFFICERS
FLORIDA STATE BOARD OF HEALTH
1936


ACTIVITIES TOTAL

Interviews 2,723

Conferences 191

Public Addresses 203

Newspaper Articles 55

Schools Visited 1,080

Clinics Attended 1,136

Persons Examined 5,638

Cormnunicable Diseases Investigated 443

Cases Isolated or Excluded 389

Houses Placarded 48

Smallpox Vaccinations 6,354

Typhoid Inoculations 34,004

Schick Tests 10,699

Toxoid 4,275

Hookworm Treatments 1,082

Throat Swabs 183

Other Specimens 222

Tuberculin Tests 2,622

Blood Smears 65

Pupils Examined 167





-80-


BROWARD COUNTY HEALTH DEPARTMENT

Paul G. Shell, M. D., Director

A. Administration

Meetings attended 128
Attendance at meetings 4,667
Administrative visits 369

B. Communicable Disease Control

Admission to service 245
Consultations with physicians 27

Field visits:
Diphtheria 41
Scarlet fever 128
Measles 44
Whooping cough 167
Poliomyelitis 3
Meningococcus meningitis 15
Pellagra 10
Chickenpox 115
Mumps 14

Immunizations:
Smallpox 1,628
Diphtheria 1,181
Typhoid 11
Schick tests 2,208
Hookworm treatments 6

Public lectures and talks 8
Attendance 669

C. Venereal Disease Control

Admissions to medical service 169
Cases transferred to private physiciruns 64
Clinic visits 178
Field visits 327
Number cases discontinuing treatment 1
Public lectures and talks 2
Attendance 300

D. Tuberculosis Control

Contacts 1
Suspects 3
Individuals admitted to nursing service 12
X-ray examinations 3
Physical examinations in clinics 2









D. Tuberculosis Control (Continued)


Visits to private physicians 7
Field nursing visits 138
Office nursing visits 4
Individuals tuberculin tested 5
Individuals X-rayed 3

E. Maternity Service

Cases admitted to antepartum medical service 357
Cases admitted to antepartum nursing service 400
Visits by antepartum cases to private physicians 101
Visits by antepartum cases to medical conferences 592
Field nursing visits to antepartum cases 925
Office nursing visits by antepartun casns 510
Cases attended by nurses for delivery service 1
Cases given postpartum examination by private
physicians 1
Cases admitted to postpartum nursing service 260
Nursing visits to postpartum cases 442
Midwives registered for formal instructions 12
Uidwife meetings 15
Attendance at meetings 175
Visits for midwife supervision 457
Conference regarding midwifery 1
Public lectures and talks 4
Attendance 55
Enrollment in maternity classes 74
Attendance 66

F. Infant :-nd Preschool Hygiene

Infant:
Individuals admitted to medical service 3
Individuals admitted to nursing service 272
Visits to medical conferences 166
Visits to physicians 49
Field nursing visits 922
Office nursing visits 294

Preschool:
Individuals admitted to medical service 15
Individuals admitted to nursing service 22
Visits to medical conferences 53
Visits to private physicians 72
Field nursing visits 402
Office nursing visits 16
Preschool round-up examinations 110





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G. School Hygiene

Inspections by physicians or nurses 28,144
Examinations by physicians 669
Examinations by physicians with parents present 92
Individuals admitted to nursing service 4
Field nursing visits 1,762
Office nursing visits 19
Prophylaxis by dentists or dental hygienists 1
Visits to private physicians 28
Public Lectures and talks -..- 8
Attendance 310
Athletic .d work certificates issued 48
Classroom health talks 584
Attendance 19,654

H. Adult Hygiene Examinations

Milk-handlers 100
Other food-handlers 1,122
Midwives 13
Teachers 1
Beauticinns and barbers 44
Hotels 57

I. Crippled Children Service

Individuals reported 62
Individuals examined at diagnostic clinics 78
Individuals treated 9
Individuals admitted to nursing service 52
Visits to diagnostic clinics 41
Nursing visits 188

J. Biologics Furnished to Private Physicians

Typhoid vaccine (No. cc) 100cc'
Toxoid (No. cc) 10cc'
Antitoxin for diphtheria (No. Unite) 20,000
Arsenicals (Ampules) 23
Silver Nitrate (Ampules) 216






683-


ESCAMBIA COUNTY HEALTH DEPARTMENT

W. H. Pickett, M.ID C. P. H., Director

CONTROL ACTIVITIES

All hookworm cases were visited at their homes and those
financially able to obtain treatment were referred to their own
physicians. Those who were not were offered the treatments in
their homes under the written instructions of the City and Coun-
ty Physician. The medicine was left by the nurse with the writ-
ten directions. In some instances fAmilies refused to have
their children take the treatment. In all ho;es they were ad-
vised that there is little use to take the cure unless they
build, maintain and use sanitary pit privies.

Syphilis and Gonorrhea cases were treated for the most part
by- the City and County Physician. Those who v'tir able to em-
ploy private physicians were required to do so. They were re-
stricted from handling food until open lesions wure healed or
until discnargcs failed to reveal the infection.

Malaria cases were required to remain behind screens until
recovery or until sufficient medication had resulted in a dis-
appearance of the infection from the periphery of the body and
with the understanding that treatment would be continued. An
educational campaign with a view to abating the propogation of
mosquitoes and encouraging screening of homes against mosquitoes
has been carrir.d on throughout the year. Public talks; home
visits; and news articles have resulted in fairly good results;
although much more intensive efforts must be made before rural
and suburban as well as city home owners will screen. City prem-
ises inspections have resulted in the destruction of a majority
of the breeding places on private premises. The City has been
requested to open or improve drainage of low areas where fresh
or brackish wat~q is held for sufficient length of timr to per-
mit mosquito propogation. Intensive efforts are being made in
rural areas to bring about screening of homes since the preven-
tion of mosr'uito breeding is impractical.

An intensive campaign was conducted during the summer to im-
prove the washing and sterilization of eating and drinking uten-
sils in all places throughout the city and county, which was
successful to the extent that the outbreak of trench mouth was
brought unaer very prompt control. Many cases of this disease
were not officially reported so that the number listed as report-
ed above does not indicate the actual number of total cases.






-84-


An intensive and extensive program of tuberculin testing was con-
ducted in all white and colored high schools throughout the city and
county following an educational course of from three to six weeks con-
ducted in class rooms. The courses of study caused the pupils and
teachers to want to take the test and dispelled all unwholesome fear
of the same. Approximately 98S of the seniors in all schools took the
tests. A brief report of the tests and results follows:

Total white students tested 700
Total positive reactors 112 or 16%

Total colored students tested 305 or 30.5%

Efforts are under way to provide X-ray for all positive re-
actors.


Scarlet fever cases were quarantined for a minimum period of
twenty-one days and longer if not thoroughly recovered. Contacts
with cases have been restricted to their own homes until seven days
have elapsed since the last contact with the case under quarantine
elsewhere.

There were four cases of typhoid fever reported during the year
and when compared with the cases reported each year during the former
five years we find quite an improvement:

1931 77 Cases
1932 65 "
1933 18 "
1934 8 "
1935 15 "
1936 4 "

The combined total of immunizations in the city and county during
the past twelve months are as follows:

Typhoid, 9047 Smallpox, 2,288 Diphtheria,l,623

These programs meant a total of throe visits to each school in
City and County-white and colored and it meant a total of twenty-
seven-thousand one-hundred forty-one typhoid vaccine injections.

Typhoid fever is very definitely a preventable disease and the
methods of prevention are listed as follows:

1. Typhoid vaccination every three years.
2. Pure water- pure food and pure milk handled by healthy people
and screened against flies.







-85-


3. Report all cr.ses to health office and immunize all contacts.
4. Proper disposal of sow.ge and screening of homes against flies.
5. Prevent consumption of contaminated sea-food.

People who live constantly in the city or county where the health
department safe-guards them against infection are reasonably safe, but
if they visit other counties where the health of the people is not pro-
tected, they may need the protection afforded by these immunizations.

Smallpox is no longer the scourge it used to be and no doubt
vaccination has been the cause.

Diphthoria is for the most part a disease of youLg children and
it is very encouraging to note that sixteen hundred and twenty-thxee
of these youngsters are now reasonably srfe fror this terrible dis-
ease.

COMLEUNICABLE DISEASE RtEPORT


Diphtheria

C~norrhea

Hookworm


Measles

Malaria


150


141


Meningitis,
Cerebro-Spinal

Scarlet Fever

Syphilis

Tuberculosis

Typhoid

Typhus Fever

Undulant

Vincent's Angina


246

7


'36

4

56

568

1

279


16

259

36

4

6

1






-86-

COMI-UICA3LE DISEASE REPORT (Continued)

'35 '36

Whooping Cough 5 7

Animal Parasites 1 52

Dengue Fever 0 0

NURSING SERVICE

A generalized nursing program was carried on during the past
year in Pensacola and throughout the County of Escambia. The City
and County were divided into districts to render the best possible
service:

1, West Pensacola District
2. E.-.t Pcnsacola District
3. Central Escambia District
4. Northern Escrnmbia District

The public health nurse working in part of Escambia County
makes Century her headquarters. She sent in daily reports and
came in to Pensacola headquarters every two weeks for general
staff meetings.

The Nursing service mnjor projects were as follows:

Maternal and Child Health Service:- While statistics show that
the maternal death rate has decreased in the past five years in Es-
cembia County, yet the infant death rate has been higher. Therefore,
a greater effort has been made to work out plans whereby the expect-
ant mother has been given better health supervision and better know-
ledge of how to care for her baby.

Vital Statistics

To find the cases early a house to house canvass was made in
the poorer districts of Pensacola during the past year. A weekly pre-
natal conference has been held at State Board of Health building by
the County Health Unit nurses. A volunteer motor corp has been bring-
ing these mothers in to the conference where general health education
program is carried on along with routine examination of blood for syp-
hilis, urine for abnormelity. The patient's blood pressure is taken
and if any abnorm ality is found the patient is persuaded to put herself
under a doctor's constant care iiaediately. The lying-in home for the
white women of Penspcola, who could not afford the regular doctor and
hospital fee, was open six and a half months during the year. One-
hundred and four babies were born there during that period, who other-
wise would have stayed at home under the care of a midwife.









Monthly meetings are held for the instruction of the midwives
who deliver about twenty percent of the babies born. They are taught
as much as possible about cleanliness and preparedness and are requir-
ed among other things to put silver nitrate in the new born babies
eyes. The sum total of this work is listed below:

Maternity Service

Cases admitted to medical service 181
(antepartum and postpartum)
Cases admitted to Nursing Service 680
(antepartum ~nd postpartum)
Visits to prenatal conference 550
Midwives classes 14

Infant Hygiene

Hone visits by nurse 1176
Individuals admitted to nursing service Z85
Individuals admitted to medical service 159
Home visits by Nurse 904

FIELD ACTIVITIES IN SCHOOL HYGIENE.

Inspection by nurses 11,803
Examinations by physicians 1,420
Field Nursing visits 3,780
Inspections by dentists 1,058
Prophylaxis by dentists 514
Exclusions from school 279
Athletic certificates issued 102
Classroom health talks 420

SANITATION DEP.FJdIlNT

A sanitary inspection campaign was conducted in rural schools
and tourist cnmps, also eating -nd drink establishments throughout
the County. An extensive clean-up campaign in the City of Pensacola,
which included an inspection of premises for mosquito breeding
places early in the spring was also conducted.

Due to the report of numerous cases of trench mouth by profess-
ional and lay persons, we conducted an intensive campaign (assisted
oy the entire City Police Department) to improve the sterilization
of eating and drinking utensils in about four-hundred lunch and drink
establishments. The cooperation by the personnel of these establish-
ments was praiseworthy and cases of the infection began to decline
rapidly.

Oyster beds in polluted areas were patrolled by state and local
inspectors throughout the early spring months.






-88-


Systematic promises inspections of rll hones, public buildings,
places of business cmd crmp sites were started, using standard forms
provided by the State Departnent of Health. These prcnises inspect-
ions will be continued and repeated routinely.

The sum total of the work of the Sanitation Departuent is listed
below:

GENERAL SANITATION

Approved individual water supplies 200
Privies restored to sanitary conditions 185
New septic tanks installed 106
Septic tanks restored to sanitary condition 65
New sewer connections 325
Field visits 10,837

Protection of Food and Milk

Food-handling Establishments registered for
supervision 350
Field visits to food-htndling establishments 4,023
Dairy farms registered for supervision 55
Field visits to dairy farms 1,108

Meat Inspection.

Inspections of slaughter houses 154
Inspection of meat handling places 279
Carcasses inspected 3,036
Carcasses condeuned(in whole or in part) 326







-89-


FRABKLIN, GULF, LIBERTY & CALHOUN COUNTY HEALTH DEPARTMENT

J. W. McMurray, M. D., Director

The counties of Franklin, Gulf, Liberty and Calhoun were or-
ganized to start active work as a unit on October 1, 1936, but Dr.
J. W. McMurray was District Health Officer working out of Marianna
office and could only act as part time Health Officer of these four
counties. The nurses from Calhoun and Liberty counties were in
training at Peabody during the months of October, November, and
December. Miss Vandilla Strickland, who was District Supervisor of
Nurses, acted as part time nurse in these counties. It was not until
January 4, 1937 that the unit became a full time health unit with a
full time personnel. Since that time the unit has been composee of
four nurses, Hiss Louise Kincaid, Franklin County, Miss Enid Mathison,
Gulf County, Hiss Karen Neilson, Calhoun County, Miss Catherine
Corbin, Liberty County, Mr. C. L. Nowlin, Sanitarian of Calhoun and
Liberty Counties, Mr. Fred Moor, Jr,, Sanitarian of Franklin and
Gulf Counties, Miss Kary Floyd, clerk in Franklin County.

Since the unit has been in operation four clerks have been added,
one for each county, which cone under the State W. P. A. Nursing
Project. Miss Catherine Palazzo, Franklin County, Mrs. Madeline
McCarthy, Gulf County, Miss Caroline Avinger, Calhoun County and Mrs.
Alvin C. Weaver, Liberty County.

The central office was assigned to Apalachicola, branch offices
have been equipped in Port St. Joe, Wewahitchka, Blountstown and
Bristol, The branch offices were mr.Lnly equipped by contributions
from cooperating bodies. Miss Lalla Mary Goggans was most helpful in
assisting in gaining these contributions.

A prenatal service was established in Apalachicola, Carrabelle,
Port St. Joe, Wewahitchka, Blountstown .nd Bristol. Dr. Center has
hold the clinics in Apalachicola, Dr. Dykes in Carrabelle, Dr. L. H.
Bartee in Port St. Joe, Dr. Meriwether in Wewahitchk., Dr. V'inley and
Dr. Gainey in Blountstown and Dr. M. Q. Burns in Bristol. Since these
clinics have been established we have handled 334 patients.

We have done physical examinations on all of the white school
children from the first through the sixth grades in all of the four
counties. This has totaled to 1512 children. Notices have been sent
to parents and since school has been closed as many corrections have
been obtained as possible.

A venereal program has been established in Apalachicola, Wewahitchka
and Blountstown. This service has increased in size. This includes
Kahn testing and the administration of neoarsphenamine. We have handled
14 patients in the Apalachicola clinics, 20 in the Wewahitchka clinics
and 60 in the Blountstown clinics.






-90-


The remainder of the program has been a general service which
includes immunization clinics, preschool clinics, tuberculosis
control and tuberculin testing, home nursing service, home hygiene
and first aid classes, hookworm surveys and follow up treatment,
crippled children's service, pellagra clinics, nursery school in-
spections, health education by talks, posters, newspaper pictures,
midwife instruction and supervision, dental education, and May Day
programs

A sanitary program has been carried out under Mr. Fred Moor, Jr.
at Apalachicola and Mr. C. L. Nowlin at Blountstown. This program
has been one of sanitary surveys, the construction of sanitary pit
privies and septic tanks, 'check-up's' have been made on positive
hookv-orm families as to the sanitation. Water supplies have been
checked and advice as to the betterment of them has been given. Our
program also included supervision of the water supply and sanitation
of the schools, inspection and supervision of dairies, inspection and
supervision of c.fes, education as to screening and drainage for
malaria prevention, educational talks, and newspaper articles.







-91-


GADSDZN COUNTY HEALTH DEPARTMENT

C, W. McDonald, M..D., Director

The Gadsden County Health Unit was organized and began activities
May 1, 1936, the personnel consisting of a Medical Director, three
Nurses, a Sanitary Officer, and a Secretary.

Some immunization work had been done in the schools of the
county in previous years by the District Health Officer of the State
Board of Health; therefore, a survey was made and activities started
in those communities where this work was most needed.

As many schools as possible were reached before they close for
the summer. At clinics and other meetings, talks were made by different
members of the organization, stressing special points and measures for
disease prevention and health protection.

General public health education h-.s been our major objective during
the year, as it was evident that public health neasurae -lere not under-
stood by many of the people and, as the organization w.s something
new, they were expecting physical, financial, and medical aid.

Preschool clinics were held in several" places in the county where
babies and preschool children were examined for defects and all who
had not been immunized were given the diphtheria and smallpox immuni-
zations. At these clinics, we had ver- good cooperation and were able
to render this service to most of the children of the county.

We also held several clinics for the different WPA workers where
the typhoid and smallpox immunizations were administered.

Malaria, hookworm, pellagra, and tuberculosis are four of the
major problem in this county and a great deal of tine was spent in
attempting to teach the people how these diseases could be prevented.

In November, conferences for indigent nmternity cases -ere or-
grnized and held in Quincy, Greensboro, Havana, and Chattohoochee.
Since that time,, these conferences have been held monthly in each
place with the exception of Chattahoochee,

Dental clinics for indigent children were started in November
and two or three have been conducted weekly since that tire. The
principals, teachers, trustees, and patrons were very cooperative and
transportation was easily secured.

Venereal disease clinics were conducted weekly and all positive
cases were urged to come in for treatment.

Classes in Home Hygiene and Care of the Sick were conducted in
six different sections of the county and were very satisfcctay. Only





-92-


two nurses were on duty during a great deal of the tine, making it
impossible to carry a large number of classes.

The following is a brief summary of the work:

Schools visited 53
Number children examined by physician 853
T.phoid immunizations 966
Smallpox vaccinations 878
Schick tests 618
Diphtheria toxoids 209
Tuberculin tests 25
Hookworm treatments 21
Dental clinics 7
Maternity clinics 3

We were fortunate in having a small community sanitation project
going at the time the Unit began. It has never been over a five man
project and most of the time only four, but over two hundred and fifty
approved type privies have been constructed since the project began a
little over a year ago. Several septic tanks have been buiL under the
supervision of this depfrtnent and a number of deep wells have been
put down. Two anopheles mosquito surveys have been made, including a
good part of the engineering, within a radius of two miles of Quincy.
This was done with the assistance of the State Board of Health.

The dairies today are fully fifty per cent ahead of what they were
a year ago, as a whole. We are indebted to Dr. Williamson to a large
degree for assisting with our dairies.

We are today cooperating with the Deputy Hotel Commissioner in
trying to raise the standards of our cafes and hotels. All cafes and
hotels are visited occasionally, and although they are considerably
ahead of what they were a short time ago, there is still room for im-
provement.

Te are pleased to have had very few complaints during the year,
and in every instance, complaints were promptly investigated. In nearly
every case, the complaint was corrected within a reasonable tine.






-93-


HILLSBOROUGH COUNTY HEALTH DEP.;TIEMNT

Joseph S. Spoto, M.D.C.P.H., Director


The Hillsborough County Health Departnent was established on
November 1, 1936. The month of November was devoted to the organi-
zation of the department. Our activities are carried on in Hillsborough
County outside of the city limits of Tampa. The county has been arbitra-
rily divided into five districts with seven Health Centers located with-
in those districts, in order that our services would be more readily
available tc the people of Hillsborough County. The centers are used
as headquarters for ihe nurses assigned to the particular district,
and to carry on the necessary medical conferences.

During the month of December we conducted a very extensive educa-
tional ca=paigv in order to acquaint the people of Eillsborough County
with our future generalized public health program with special cnphasis
on maternal and chilL hygiene. Hillsborough County has been selected as
one of the two counties where child health demonstrations will be con-
dusted. These demonstrations will show proper .uthods for feeding, pro-
tection Pgainst infection, and the teaching of health habits.





-94-


JACKSON COUNTY HEALTH DEPARTMENT

R. N. Joyner, M. D., Director

During the past five years deaths from typhoid fever and diptheria
have been reduced to a minimum. We have had three typhoid fever de-ths
during the past five years. Tuberculosis and maternal deaths have like-
wise been decreased. Malaria remains one of our most important diseases,
both from an economic standpoint and from cause of death. Syphilis is
responsible for many illnesses such as her rt disease and kidney disease
and is therefore a contributing cause of detth in many cases. An active
anti-syphilitic campaign has been started in the county and five trest-
ment clinics are held each week.

Heart disease leads all other illnesses as the cause of deaths
even in young adults. The public health endeavors to lower heart disease
deaths is directed toward the prevention and control of infections which
might damage the heart and toward periodic examinations in order to inQ
sure early diagnosis tnd treatment.

Population: (Estimated) 22,600 white, 13,400 colored, 27,238 rural
and 8,762 urban making a total of 36,000.

Our birth rate has increased steadily each year except during 1934.
This increase has not been sufficient to account for the entire increase
in our population. This fact indicates thrt we have had outside addi-
tions to our population.

COMMUNICABLE DISEASE CONTROL

The main function of a health department is the control and pre-
vention of communiccble diseases. In order for any health department to
effectively carry out this purpose the reporting of communicable diseases
by the physicians must be fairly accurate, Jackson County is quite large
and the physicians in outlying towns and communities are not in as close
touch to the health department as those who reside in Marianna. However,
the reporting of contagious diseases is prompt and reasonably accurate.

Isolation and quarantined Every communicable disease reported to
the health department is immediately visited by a nurse. If no physi-
cian has seen the c:se the Health Officer visits and makes a diagnosis.
Arrangements are then made with one of the local physicians to treat
the case. A thorough investigation of the case is made and an extensive
search is instituted for the source of infection. Regulations of the
State Board of Health are vigorously enforced. The Health Officer also
visits the local physicians in making diagnosis in questionable com-
municable diseases.

Immunization clinics: The County Health Department is located in
the City Hall, in the center of Marianna, and the Health Officer, or
nurse, is alwr.ys available to give, free of charge, to any applicant,
any immunization requested. When a case of typhoid fever is reported
anywhere in the county, arrangements are immediately mcde to hold a







-95-


typhoid immunization clinic in that area. As a result of this activity
we have had only three deaths from typhoid fever during the pest five
years and no deaths during the past two years. Dipthekia clinics are
held in conjunction with the typhoid immunization clinics and all
parents are urged to have their children given diptheria toxoid at the
age of six months.

Measless One death has been recorded from measles during the post
two years.

Rabies: Four persons were treated this year with anti-rabic virus.
No cases developed in human beings. Four dogs heads were examined. The
city of 'Arianna began an active campaign for the inoculation of all
dogs in the city.

Scarlet Fever: Two cases of scarlet fever were reported to the
Health Department. These cases were isolated and treated in conjunction
with local physicians. No deaths have occurred from scarle- fever during
the past two years.

Diptheri&: Two crses of diptherie were reported in 1936. Both of
those cases were in children who had not received diptheric toxoid.
Both c.ses died. Probably 95% of the patients treated once with diph-
theria toxoid are definitely protected for life against this disease.
The Schick test affords a means of determining whether or not immunity
has been produced.

Malaria: Malaria is the second leading cause of death in Jackson
County.W The rolling country interspersed with flat swampy lands affords
ideal breeding places for the rncpheles mosquito. The control of malaria
depends upon four factors, the destruction of breeding places by drain-
age or oiling, the treatment of all active cases; the screening of homes;
and the administration in molarial districts of prophylactic drugs. An
effort is now being made by the Health Department in cooperation with
the Board of County Commissioners to inaugurate an extensive malaria con-
trol project.

We count 300 cases of malaria for each death attributed to it. Our
28 deaths this ycer moons thct there were 8,400 cases of malaria.

Tuberculosis: For a great many years tuberculosis was the scourge
of civilization, killing more people ecch year than all other communice-
ble diseases. Today, in this county, it ranks ninth in the list of dis-
eases.causing doeth.

We do not have in this county a tuberculosis sanitorium, and are
accordingly handicapped in the treatment of this disease. The County
Health nurses visit each case of tuberculosis at least once each month
and instruct the patients in the care of themselves and the prevention
of the spread of this disease to other members of the family. As often
as possible these cases are isolated in screened rooms. Instruction is
given as to diet and the disposal of waste products. All children in
such families are given the tuberculin test end all positive reactors




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