• TABLE OF CONTENTS
HIDE
 Front Cover
 Title Page
 Letter of transmittal
 Members of the Florida state board...
 Official staff of the Florida state...
 County health officers
 Organizational chart of the Florida...
 Table of Contents
 The diamond jubilee
 Highlights for 1949
 State board of health and the state...
 Cooperating agencies
 Bureau of finance and accounts
 Vital statistics
 Division of health information
 Bureau of preventable diseases
 Bureau of laboratories
 Bureau of sanitary engineering
 Bureau of local health service
 Field technical staff
 Field training center
 Bureau of maternal and child...
 Bureau of dental health
 Bureau of tuberculosis control
 Nutrition investigation and...
 Division of diabetes control
 Bureau of narcotics
 Typhus epidemiological studies...






Title: Annual report - State Board of Health, State of Florida
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Permanent Link: http://ufdc.ufl.edu/AM00000243/00020
 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: VID00020
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
        Letter
        Letter 2
    Members of the Florida state board of health
        Members
    Official staff of the Florida state board of health
        Directors
    County health officers
        County health officers
    Organizational chart of the Florida state board of health
        Florida State Board of Health chart
    Table of Contents
        Table of Contents 1
        Table of Contents 2
    The diamond jubilee
        Page 1
        Page 2
    Highlights for 1949
        Page 3
        Page 4
        Page 5
        Page 6
    State board of health and the state health officer
        Page 7
        Page 8
        Page 9
    Cooperating agencies
        Page 10
        Page 11
    Bureau of finance and accounts
        Page 12
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
    Vital statistics
        Page 24
        Page 25
        Page 26
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
    Division of health information
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
    Bureau of preventable diseases
        Page 43
        Page 44
        Page 45
        Page 46
        Page 47
        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
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
    Bureau of laboratories
        Page 73
        Page 74
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
        Page 82
        Page 83
        Page 84
        Page 85
    Bureau of sanitary engineering
        Page 86
        Page 87
        Page 88
        Page 89
        Page 90
        Page 91
        Page 92
        Page 93
        Page 94
        Page 95
        Page 96
        Page 97
        Page 98
        Page 99
        Page 100
        Page 101
        Page 102
        Page 103
        Page 104
        Page 105
        Page 106
        Page 107
        Page 108
        Page 109
        Page 110
        Page 111
        Page 112
        Page 113
        Page 114
        Page 115
        Page 116
        Page 117
    Bureau of local health service
        Page 118
        Page 119
        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
        Page 142
        Page 143
        Page 144
        Page 145
        Page 146
        Page 147
        Page 148
        Page 149
        Page 150
        Page 151
        Page 152
        Page 153
        Page 154
        Page 155
    Field technical staff
        Page 156
        Page 157
        Page 158
        Page 159
        Page 160
        Page 161
        Page 162
        Page 163
        Page 164
    Field training center
        Page 165
        Page 166
        Page 167
    Bureau of maternal and child health
        Page 168
        Page 169
        Page 170
        Page 171
        Page 172
        Page 173
        Page 174
        Page 175
        Page 176
        Page 177
        Page 178
        Page 179
        Page 180
        Page 181
        Page 182
        Page 183
    Bureau of dental health
        Page 184
        Page 185
        Page 186
    Bureau of tuberculosis control
        Page 187
        Page 188
        Page 189
        Page 190
        Page 191
        Page 192
        Page 193
        Page 194
        Page 195
        Page 196
        Page 197
        Page 198
        Page 199
        Page 200
        Page 201
        Page 202
        Page 203
        Page 204
        Page 205
        Page 206
        Page 207
        Page 208
        Page 209
        Page 210
        Page 211
        Page 212
    Nutrition investigation and services
        Page 213
        Page 214
        Page 215
        Page 216
        Page 217
        Page 218
        Page 219
        Page 220
        Page 221
        Page 222
    Division of diabetes control
        Page 223
        Page 224
        Page 225
        Page 226
    Bureau of narcotics
        Page 227
        Page 228
    Typhus epidemiological studies in Florida
        Page 229
        Page 230
        Page 231
        Page 232
        Page 233
        Page 234
        Page 235
        Page 236
        Page 237
        Page 238
        Page 239
        Page 240
        Page 241
        Page 242
        Page 243
Full Text

14






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ANNUAL REPORT

1949


FLORIDA

STATE BOARD OF HEALTH









-~4


N'


STATE BOARD OF HEALTH





1949







The following statistical reports will be published separately:
SUPPLEMENTAL I FLORIDA VITAL STATISTICS, 194S
SUPPLEMENTAL II FLORIDA MORBIDITY STATISTICS, 1949



WILSON T. SOWDER, M.D.
STATE HEALTH OFFICER
JACKSONVILLE, FLORIDA


K`
















C .Z


The Honorable HERBERT L. BRYANS, M.D., President
Florida State Board of Health
Pensacola, Florida

Dear Ir. Bryans:

I herewith submit the fiftieth annual report of the
Florida State Board of Health for the year ending December
31, 1949.

Sincerely yours,

WILSON T. SOWDER, M.D.
State Health Officer


September 1, 1950
Jacksonville, Florida




















His Excellency, FULLER WARREN
Governor of Florida
Tallahassee, Florida


SIR: .

I beg to hand you herewith a report of the Florida State
Board of Health for the period January 1, 1949 to December
31, 1949, inclusive.

Respectfully submitted,

HERBERT L. BRYANS, M.D.
President

September 1, 1950
Pensacola, Florida






















Members of the
FLORIDA STATE BOARD OF HEALTH


HERBERT L. BRYANS, M. D., President
Pensacola


EDWARD L. FLYNN, D. D. S.
Tampa


ROBERT B. McIVER, M. D.
Jacksonville


T. M. CUMBIE, Ph. G.
Quincy


MARK F. BOYD, M. D.
Tallahassee












OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH
State Health Officer................................Wilson T. Sowder, M. D., M. P. H.
Assistant to State Health Officer............Knox E. Miller, M. D.

DIRECTORS

Bureau of Local Health Service..............eorge A. Dame, M. D.
Division of Public Health Nursing......Ruth E. Mettinger, R. N.
Bureau of Dental Health..........................Floyd H. DeCamp, D. D. S.
Bureau of Preventable Diseases..............Roger F. Sondag, M. D.
Division of Venereal Disease Control....
Division of Industrial Hygiene..............John M. McDonald, M. D.
Division of Cancer Control.................
Florida Rapid Treatment Center....... Frank M. Faget, M. D.
Bureau of Tuberculosis Control................Clarence M. Sharp, M. D.
Bureau of Laboratories........... ......Albert V. Hardy, M. D., Dr. P. H.
Miami Regional Laboratory.......... Nathan J. Schneider
Tampa Regional Laboratory................... D. Venters
Tallahassee Regional Laboratory............Robert A. Graves
Pensacola Regional Laboratory............Addie V. Hamilton
Orlando Regional Laboratory................Max T. Trainer
Bureau of Maternal and Child Health....Frances E. M. Read, M. D.
Division of Mental Health.................
Bureau of Sanitary Engineering............David B. Lee, M. S., Eng.
Division of Entomology.......................John A. Mulrennan
Bureau of Vital Statistics......................Everett H. Williams, Jr.
Bureau of Finance and Accounts............Fred B. Ragland
Personnel Supervisor..............................Paul T. Baker
Purchasing Agent..................................G. W ilson Baltzell
Bureau of Narcotics..................................Marshall H. Doss
Division of Nutrition Investigations
and Services.................-..... .....-....Walter Wilkins, M. D., Ph. D.
Division of Health Information................Elizabeth Reed, R. N.
Field Technical Staff.................................L. L. Parks, M. D., M. P. H.
Division of Diabetes Control................. Malcolm J. Ford, Sr. Surgeon,
U. S. P. H. S.











COUNTY HEALTH OFFICERS
(As of December 31, 1949)

Alachua................................................. Frank M. Hall, M. D., M. P. H.
Baker Nassau..........................................John W. McClane, M. D.
Bay.................................. ........................ Franklin H. Reeder, M. D., M. P. H.
Bradford Clay Union...............................A. Y. Covington, M. D., M. P. H.
Brevard Osceola...........................................James H. Wells, M. D.
Broward............................................................ Paul W. Hughes, M. D., M. P. H.
Calhoun Gadsden Liberty.......................Edward C. Love, Jr., M. D.
Charlotte DeSoto Hardee---.......................John C. McGuire, M. D.
Citrus Pasco Sumter...............................R. N. Nelson, M. D.
Columbia Hamilton Gilchrist.................Joseph C. Weeks, M. D.
Dade............................................................... T. E. Cato, M D., M P. H .
Dixie Suwannee Lafayette.....................E. H. John, M. D.
Duval......................................................... Thomas E. Morgan, M. D., M. P. H.
Escambia Santa Rosa.................................John C. McSween, M. D.
Flagler Putnam............................................Joseph L. Brizard, M. D.
Franklin Gulf Wakulla...........................Terry Bird, M. D., M. P. H.
Glades Highlands Hendry.....................G. L. Beaumont, M. D.
Hillsborough ..........................................Frank V. Chappell, M. D., M. P. H.
Holmes Okaloosa Walton.......................Walter T. Colbert, M. D.
Indian River Martin Okeechobee
St. Lucie...................................................... J. Ross Hague, M. D.
Jackson Washington..................................Robert G. Head, M. D.
Jefferson...................................................G. A. Dickinson, M. D.
Lake............................................................. James B. Hall, M. D., M. P. H.
Leon........................... ........................... Joseph M. Bistowish, M. D.,
M. P. H.
Levy..........................---------- ............ Laurier E. Hackett, M. D.
Madison Taylor...........................................James L. Wardlaw, M. D.
Manatee Sarasota..................................... William L. Wright, M. D.
Marion....-------.................. .-.............. Luther A. Brendle, M. D.
Monroe.......................... ..........................William J. Peeples, M. D.
Orange...........................-- ...........................----Leland H. Dame, M. D.
Palm Beach-...................................-...... Clarence R. Rogero, Jr., M. D.,
(Acting)
Pinellas...................................................... T. Paul Haney M. D., M. P. H.,
Dr. P. H.
Polk.......................... ..............................Edwin G. Riley, M. D. Ph. D.
Seminole ..................................................Frank L. Quillman, M. D.
Volusia............................................................R. D. Higgins, M. D., M. P. H.






FLORIDA STATE BOARD OF HEALTH

I GOVERNOR OF FLORIDA j
FIVE BOARD MEMBERS
I
STATE HEALTH OFFICER.
______i.


I I ,
DIVISION DIVISION
IALTnH I OAILTLS
INFORfATION CONTROL


DIVISION FIELD
or TECHNICAL
NUTRITION STAFF


DIVISION DIVISION DIVISION RAPID
INDUSTRIAL CANCER vEtRAL -TREATMENT
E C DISEASE
HtYGIENE CONTROL. I COrOL CENTER











TABLE OF CONTENTS

The Diamond Jubilee -....-..........-.. -------------------- 1

Previews .......----------------------.. --------- 3

State Board of Health and the State Health Officer ..-----..... 7

Cooperating Agencies -......-.-----------....----.-........ ------- 10

Finance and Accounts (including Personnel and
Purchasing ....................-------------------... 12

Vital Statistics ....------...... ---........ .----------------. 24

Health Information (including Library and Food
Handlers' School) -...-......-...-....-------------------. 33

Preventable Diseases (including Venereal Disease, Cancer,
Industrial Hygiene and Veterinary Diseases) ------. 43

The Laboratory Services .-..........-..........---------------- 73

Sanitary Engineering (including Entomology) ...----........... 86

Local Health Services (including Public Health Nursing)... 118

Field Technical Staff ....-......-- ........---------------...... 156

Field Training Center ........---..........-------------- 165

Maternal and Child Health (including Heart Disease
and Mental Hygiene) .......-......-----............-.... -------- 168

Dental Hygiene .....-- .............---------.-----..-. ..------------184

Tuberculosis Control .--.....-.......--- ...-....-----------------187

Nutrition --.........---.....-------- --------------213

Diabetes ..--...-....-....---------------------....... 223

Narcotics ..................------------......-------- ..........--- 227

Appendix --------......----------.. ...............--- 229



























Edited By
KNOX E. MILLER, M.D.













THE DIAMOND JUBILEE


Sixty years ago (1889) the State Board of Health was
created. The report which follows for the year 1949 will out-
line the stage to which the Board has evolved in the meantime,
but a look at the picture as it existed in 1889 will serve to
heighten the contrast between then and now.
Situated as it is in close proximity to the Carribean islands
where yellow fever was rampant, Florida was particularly vul-
nerable to this disease at that time. Periodic visitations were
not only an imminent menace, but were actually experienced
with disconcerting frequence. The demand for a state health
agency was, therefore, the outgrowth of this experience. As
we now know, however, the efforts of the newly created Board
to meet the emergencies of those times were almost wholly
futile from the standpoint of actual control of the disease,
though it did serve a good purpose as a morale builder and as
a preventive of hysteria and panic. How could a Board, ever
so earnest and diligent, successfully combat yellow fever and
the other major pestilential diseases such as cholera, typhoid
fever, malaria, diphtheria and tuberculosis, when the causes
of these diseases were not even known to medical science?
The one exception was smallpox, for which vaccination was
known to be effective for prevention, though the actual cause
was not known, and even to this day has not been demonstrated.
An attempt to contrast death rates in Florida for 1889 with
those of the present day is fraught with extreme difficulties
for the reason that there was no systematic and official re-
cording of births and deaths at that time. Birth and death
registration in Florida was first required by law in 1899. Some
scattered reports resulted but effective registration began in
1917 after the passage of the model Vital Statistics law of
1915. Registration for deaths did not become acceptable to
the Bureau of the Census until 1919, and for births until 1924.
The most conservative estimates however prior to 1900 would
furnish an astounding contrast between then and now. But
to avoid uncertainty, the official figures for 1917 are cited:








Death Rates Per
1,000 Population
1917 1949
All Causes --..----....---. 13.1 9.5
Tuberculosis .....................
Syphilis ...................----
Typhoid ..-... --.................
Diphtheria ........-..........
Whooping Cough ..~...--
Measles -.....---..--...-..
Malaria .......---.
Dysentery ----.......-.....


Death Rates Per
1,000 Population
1917 1949


118.9
22.6
24.2
10.1
5.4
18.6
29.9
29.4


25.4
7.4
0.2
0.4
0.2
0.3
0.3
0.9


The improvements in maternal and infant mortality have
likewise been phenomenal. In 1917 there were 11.6 maternal
deaths for every 1,000 live birth, whereas the ratio was 1.8
per 1,000 in 1949; and the infant death rate has dropped from
105.9 per 1,000 live births in 1917 to 33.6 in 1949. It is the
saving of life in infancy that has been the greatest factor in
the lengthening the average life span from 53 years in 1917
to 67 in 1949.








HIGHLIGHTS FOR 1949


The report for 1948 recorded many significant advances in
disease prevention, lowered mortality rates, and higher birth
rates. During 1949 these lines have not only been held, but in
most instances further advances have been scored. A preview
of some of the highlights of the forthcoming report for 1949
will indicate some of the trends.
Preventable Diseases-From the morbidity standpoint special
significance is attached to the reduction of diphtheria to 102
cases as compared to 314 during the previous year, and to 73
cases of typhoid and paratyphoid as compared with 112 in
1948, since these are the best indices of direct public health at-
tack. On the other hand, the apparent increase of certain
other diseases, such as tuberculosis, which advanced from 4,853
reported cases in 1948 to 6,467 in 1949 reflect commendable
work because these figures indicate that a more thorough effort
is being focused upon the discovery of cases.
With the exception of cancer and the cardio-vascular diseases,
death rates have shown a definite downward trend, which, per-
centagewise, in many instances has been marked. Special stress
has been placed upon the reduction of infant and maternal
deaths, and while reductions have been achieved in each of
these, the rates are still considerably above the national averages.
Local Health Services-During 1949 one more county, Martin,
came into the full time health service program, and similar ar-
rangements are in progress for St. Johns County, leaving only
Collier, Lee and Hernando Counties unorganized.
During the year 1949 the terms of the Hill-Burton act have
been liberalized so as to make possible much larger grants to
local health units for construction of health centers. During
1950 a concerted drive will be made for adequate housing of
local health units through the assistance of Hill-Burton funds.
Tuberculosis Control-Approximately 346,125 small x-ray
chest films were made, and 30,000 large films, which were
largely instrumental in the discovery of 3,347 cases. Facilities
for handling the case load are in the process of completion
through the addition of 425 beds in the new sanatorium at
Lantana by the Tuberculosis Board.








Venereal Disease Control-Reported cases of both syphilis
and gonorrhea decreased during 1949 as follows:
Gonorrhea Syphilis
1948 18,088 14,823
1949 14,605 12,304
It is believed that these decreases represent an actual rather
than an apparent decline in these diseases. During the year
approximately 7,000 persons were admitted to treatment in the
Rapid Treatment Center.
Cancer Control-Applications for State aid to Cancer cases
were approved for 1,052 patients.
Heart Diseases-Efforts toward control initiated in 1949
remained throughout the year entirely upon an educational
basis, beamed primarily at the medical profession, except for
the cardiac survey of school children in Pensacola in cooperation
with the Navy.
Diabetes Control continued in Jacksonville on a demonstra-
tion basis, but has taken firmer root state wide through an
increase of funds provided for the purchase and distribution
of insulin, from $20,000 to $60,000 per year. The appropriating
act also provided for a broadening of the educational phases
into a state wide program. In the past 3 years 140 new cases
of diabetes were discovered in Jacksonville.
Sanitary Engineering-The usual high level of performance
was recorded by the Bureau of Sanitary Engineering as wit-
nessed by the beginning of 39 new water treatment plants,
and 36 sewage disposal plants, costing a total of $18,795,840.
Plans for new water plants and/or systems or extensions
were approved for 62 localities, while 18 were disapproved.
Eight industrial waste treatment projects were initiated. Thirty-
two stream pollution surveys were conducted in 27 counties,
with six surveys in progress at the close of the year.
Laboratory Services-The number of examinations conduct-
ed during the year continued on the upgrade, with more than
2,000,000 tests as compared with 1,930,248 in 1948. The sit-
uation as regards inadequate quarters for both the central and
branch laboratories has not been relieved, and suggests the
urgent need for full utilization of Federal funds available
through the Hill-Burton act for aid in hospital and laboratory
construction.








A new virus related to that of poliomyelitis was isolated
from five patients in Florida.
Food Sanitation-Through food handlers schools 8,489 per-
sons completed the course and received certificates. The pro-
gram is well received and is proving to be exceedingly popular.
Sanitation Visits made by local sanitarians for supervision of
food handling, and other sanitary services totaled 301,570.
Entomology-State responsibility for mosquito control was
recognized in an appropriation of $350,000 conditioned upon
available funds. Due to the lowered incidence of malaria, the
State Board of Health was notified by the Public Health
Service that after the close of the fiscal year, June 30, 1950,
no more money would be allowed to Florida for mosquito control.
Dental Health-A full time director was employed during
the year. Demonstration of topical application of fluorides
for the prevention of dental caries was carried out in 8 coun-
ties, and 5,263 elementary school children were given complete
sodium fluoride treatment. Six counties maintained full time
dental service, which accounted for 37,492 examinations, and
23,488 dental corrections.
Public Health Veterinary Service-Cases of rabies dropped
from 332 in 1948 to 60 in 1949. There were no human cases.
The brucellosis control program among dairy cattle was vig-
orously pursued.
Maternal and Child Health and Mental Hygiene-Maternal
mortality survey committees, initiated in Dade County in 1948
were extended to Duval, Palm Beach, and Orange Counties in
1949. It is estimated that 13 more such committees are needed
to give an adequate coverage of the State.
Work in the interest of premature infants has been a major
activity. Approximately 200 incubators are owned by insti-
tutions, and 72 owned by the State Board of Health are loaned
to the counties. The Board also owns and makes available
to counties 32 specially equipped carriers for transporting
premature infants.
The hearing program in the schools has received special
attention from the Board through the use of funds from the
Federal Children's Bureau for demonstration purposes. In
addition to the audiometers previously supplied to local health








units, six group audiometers were purchased in 1949. A
Florida student has been awarded a three year fellowship
in audiology and speech at Johns Hopkins School of Public
Health, after which she will return to Florida as a special con-
sultant to the State Board of Health in these fields.
Mental health is becoming increasingly popular. During
1949 the facilities of the six clinics in Bartow, Miami, Orlando,
St. Petersburg, Tallahassee, and Tampa were extended so as
to take care of 800 additional patients. Postgraduate institutes
in Mississippi and Jacksonville afforded training in mental
health to 63 doctors and nurses in public health and institu-
tional service.
Public Health Nursing exemplifies the most intimate con-
tacts with persons and their home life. It is a program of
service exclusively, since it enforces no laws or regulations.
The number of nurses employed in County Health Depart-
ments in 1949 was 278, of whom 23 are in a supervisory
capacity. City health departments, the Crippled Children's
Commission, insurance companies, and private agencies ac-
counted for 105 additional public health nurses.
State nursing consultants made a total of 210 visits to local
health departments for giving advice and guidance. Service
visits made by County health department nurses alone ran
well beyond 300,000.








THE STATE BOARD OF HEALTH


The State Board of Health is probably taken too much for
granted. A brief explanation of its organization and functions
is therefore believed to serve a useful purpose.
In accordance with Florida law, all of the responsibility for
safeguarding and advancing the health of the people of Florida
is placed upon the State Board of Health. The Board consists
of five members who are appointed by the Governor and hold
offices at his pleasure. Two of these are required to be doctors
of medicine, one a dentist, one a pharmacist, and one a "dis-
creet citizen." At the present time the "discreet citizen" is
a doctor of medicine, so that there are three physician mem-
bers instead of the minimum requirement of two.
The members of the Board serve without compensation.
This being the case, it is obvious that they can not undertake
the detailed management of the multiplicity of technical pro-
cedures that constitute the activities for which the Board is
responsible. The only answer to this problem is the em-
ployment of a technically skilled administrator to carry out
their over-all plans and policies. In practice, therefore, the
Board is essentially a policy making group, determining the
nature and scope of work to be done, the grouping of ac-
tivities into Bureaus, Divisions, and sections, recommending
new legislation, endorsing legislative budgets, maintaining
liaison with the State Medical Society, public relations, etc.
The administrator, legally designated as the State Health
Officer, is recommended by the Board and appointed by the
Governor. All other employees of the Board are appointed by
the Board upon recommendation of the State Health Officer
and compliance with the Merit System requirements.
Other functions of the Board include the fixing of salaries
and promotion schedules, and the adoption of rules and regu-
lations pertaining to health matters, which may amplify but
not conflict with State Statutes. It is the Board, also, which
is the final authority for dismissing employees for cause.

Office of the State Health Officer
Here also the duties of the State Health Officer are likely
to be submerged in the reports of the service branches. The








State Health Officer is not only responsible to the Board for
the efficient operation of all its service units, but has many
duties which he alone can perform.
His first duty, of course, is that of administering the en-
tire program laid out by the Board. He must select suitable
persons for specific jobs, and supervise their work to insure
maximum efficiency. To this end he must be a master co-
ordinator, to see that each activity is stressed in accordance
with its relative importance in comparison with others.
Just as the Board delegates authority to him, the State
Health Officer in turn must delegate responsibilities to the
chiefs of the various subdivisions, bureaus, divisions, and
sections.
Within the framework of the Board's policies, the State
Health Officer initiates rules and regulations for adoption by
the Board. Likewise, new legislation is initiated and pre-
pared for the Board's approval. While the State Health Of-
ficer is restrained from "lobbying" for the passage of legis-
lation, he must nevertheless marshall all legitimate interest
in favor of needed laws. During the last session of the legis-
lature he was instrumental in securing the passage of a re-
vised Vital Statistics Law (see Vital Statistics Report), and
a law requiring forcible hospitalization, if necessary, to infec-
tious cases of tuberculosis. Two other laws carrying ap-
propriations were enacted. The law relative to diabetes con-
trol was expanded to provide for a State-wide program and
the appropriation for insulin was increased from $20,000 to
$60,000 per year. To aid Mosquito Control districts an ap-
propriation of $350,000 was made, provided funds were avail-
able in this amount. Actually, the money released for Mosquito
Control purposes during 1949 was $5,000.
Proposed laws which failed to secure legislative approval
included a bill for rabies control, and a bill for the creation
of sanitary districts.
Large grants of Federal funds for aiding general health
administration and many specialized activities, are made an-
nually to the State Board of Health. Allocation of these funds
to local units and accounting for their expenditure in ac-
cordance with specifications is a duty which falls upon the State
Health Officer. In addition to the annual accounting for such








funds, the State Health Officer must submit a plan of expendi-
tures, together with budgets, for the succeeding year.
The demands upon the time of the State Health Officer
for attendance at health conferences, local, state, and national,
are enormous. Roughly speaking, half of his time would be
spent in this way if he responded to all requests.
Another time consuming duty is in connection with State
Boards, Commissions, and Committees. By law he is a member
of the following: Florida Milk Commission, Florida Children's
Commission, State Board of Funeral Directors, and the Hospi-
tal Advisory Council.
By request of the Governor or otherwise, he is a member
of the following: State Council of Civil Defense; Health Com-
mittee of the Department of Education; State Resource-Use
Education Committee; and the Florida Highway Safety Coordi-
nating Committee.
The office of the State Health Officer sometimes resembles
a complaint bureau. Every citizen who has an unresolved
complaint which even remotely involves health, has the right
of appeal to the State Health Officer, and many of them ex-
ercise this right. It is also a favorite practice for State and
Federal legislators to pass on to the State Health Officer all
health grievances received by them from their constituents
within the State. Unfortunately, not all of these are health
complaints, but commonly include all sorts of welfare problems.
Finally, the State Health Officer is the expert consultant to
the Board on all technical matters pertaining to health. His
advice and guidance is essential to the soundness of many of
the Board's decisions.
From the foregoing it should be clear that to keep abreast
of all of these duties and responsibilities, the State Health
Officer would have to be a superman. This problem has
been solved, in part at least, by the employment in September
1949 of an Assistant to share these obligations with the State
Health Officer. Through their combined efforts the load is
distributed equitably and with satisfying results.









COOPERATING AGENCIES

Though the State of Florida is far ahead of most of the
States in its dependence upon its own resources, it is indebted
in no small measure to assistance from other sources. In the
main, this assistance is in the form of financial allotments,
but personnel assignments are also of vital significance, as il-
lustrated by the fact that the State Health Officer himself
is an officer of the United States Public Health Service on loan
to the State of Florida at the request of the Governor. Other
members of the Staff on assignment from the Public Health
Service include one doctor, one dentist, two dental hygienists,
two nurses, one nutritionist, five technicians, three admini-
strative and seven clerical workers and sixteen laborers.
Financial Allotments
1. U. S. Public Health Service for
a. General Health Administration .....................----------. $175,235
b. Tuberculosis Control .--...--...---.............------.--..--. 189,597
c. Venereal Disease Control ..---...-......----........-------.--.-- 423,647
(includes Rapid Treatment Center facilities)
d. Cancer Control ...---.......-........-----------......-.. 42,340
e. Mental HIygiene --...--......-------... .----.....------... 64,849
f. Heart Disease Control ...---~.......-.........-------------.. *17,330
g. Industrial Hygiene .....------....... ..---------------. 15,607
h. Water Pollution Survey --...---................ .-------- *7,600
Sub Total -------............. -----------------.....$936,205
2. U. S. Children Bureau
Maternal and Child Health ...--...-..........-.------------... 210,280
Sub Total ............ ................... ------- ------------210,280
3, Commonwealth Fund for Assistance in Supporting
the Field Training Staff and Field Training Center 36,630
4. Pulp Industry for research in disposal of pulpwaste 7,500
5. Phosphate Industry for research in disposal of
phosphate wastes ......,--......-..............----------------- 32,500
6. Rockefeller Fund for Typhus Survey ...---...--....-..---.. 11,970
Sub Total .----..--......-...-.......-- ........----------------. $88,600
Total .-....------....-...-----..------------- -- $1,235,085
"To him that hath shall be given" is a truism which is
exemplified by the experience of the State Board of Health.
It has been recognized in health circles generally that the








Florida State Board of Health makes the best of its oppor-
tunities. For this reason, Florida is a favorite proving ground
for health research projects. This circumstance is reflected
in the cooperative enterprise listed above.
*Heart Disease control, $17,330, and Water Pollution survey,
$7,600 represents six month allotments for period July 1, 1949-
December 31, 1949, and as such are not included in Table I
of the Financial Report.








BUREAU OF FINANCE AND ACCOUNTS

Fred B. Ragland, Director

The Bureau of Finance and Accounts has the responsibility
of all fiscal, personnel, purchasing and property control matters.

The Bureau is a service organization, handling the business
management of the Board. Every effort is made to handle ef-
ficiently and expeditiously to the best interests of all Bureaus,
Divisions, and County Health Units the payment of salaries,
travel expenses, and other obligations; the personnel actions
such as recruitment, employment, termination, reclassification,
salary changes, leave records, efficiency reports and training
records; the purchasing by good business methods; and the
control of property.
Fiscal Section
The financial transactions of the State Board of Health for
the fiscal year ended June 30, 1949, as reflected by the records
of the Bureau are presented in the condensed tables that fol-
low. A detailed financial report for the fiscal year ended
June 30, 1949, has been prepared and distributed to the Gov-
ernor, members of the Governor's Cabinet, members of the
Board of Health and all Bureaus, Divisions and County Health
Units of the State Board of Health.
A brief summary of the financial operations of the State
Board of Health for the fiscal year ended June 30, 1949, has
been distributed widely in pamphlet form. Copies are still
available upon request.

In addition to the funds disbursed as indicated in the fol-
lowing condensed tables, the State Board of Health was fur-
nished supplies and materials and the services of a number
of persons, the cost of which was borne directly by the U. S.
Public Health Service, other State Departments and various
local units of government within the State. The value of
these services amounted to $551,639.56 and were mainly to aid
the Venereal Disease, Tuberculosis, and Malaria and Typhus
Control Programs.
During the year, the Fiscal Section processed approximately
20,000 vouchers for payment from 88 State Board of Health








Funds. In liquidating all obligations of the Board, approxi-
mately 41,000 warrants to payees were handled.
Fiscal operation followed a budget plan of 101 departmental
budgets. These budgets were frequently revised to meet chang-
ing situations. The majority of the revisions related to County
Health Unit budgets primarily because the fiscal year of the
County differs from the fiscal year of the State. At the time
County Health Unit budgets were initially prepared, it was
not known exactly what local funds would be available in each
instance. It was, therefore, necessary to revise a number of
the County Health Unit budgets during the year after the
availability of funds from County sources was determined.






OFFICE OF THE PERSONNEL SUPERVISOR

Paul T. Baker, Personnel Supervisor

During the calendar year 1949 continued steps were taken
in establishing more firmly the Merit System of personnel
administration in the State Board of Health. Leave records
were developed and maintained and periodic efficiency re-
ports were obtained and recorded.
Records of in-service training of employees were maintained
and the application of regulations governing such training was
assured. All employees at State Headquarters were encour-
aged by the Personnel Supervisor to discuss their employment
problems, if any, with him. At the prescribed times for con-
sideration by the State Board, of salary increases, full infor-
mation concerning each employee was made available to the
Board in order that all employees might be treated equitably.
Careful check was made to insure that all appointments and
terminations were made in accordance with the rules adopted
by the State Board of Health.
The payrolls for all employees were prepared in the Per-
sonnel office and forwarded to the State Comptroller for








payment. All matters pertaining to the retirement plan were
handled promptly.
During the year 1949 one new County Health Department
was organized. At the end of the year 63 of Florida's 67
Counties were organized and operating under the Merit
System.
On December 31, 1948, there were 1,185 State employees
and 31 Federal employees. On December 31, 1949 there were
1,216 State employees and 36 Federal employees.
During the year there were 350 employment and 319 ter-
minations among State employees.
On December 31, 1949, the Merit System status of employees
of the Board was as follows:
Permanent and Probational .........-------__...------------. 886
Provisional ...-.........-....-------------------. 102
Temporary ...---..............------------------ 1
Emergency -----------------.........---......... 6
War Duration -----------------.......................... 0
Exempt and Part-time -.........--.....- --...-............. 221

Total .............. --------.-.............-- ........ 1,216
During the year specifications were adopted for 5 new classes;
specifications were revised for 19 classes and 2 classes were
abolished.








PURCHASING AND PROPERTY


G. Wilson Baltzell, Purchasing Agent
During 1949, the section received 1,684 requisitions from
various departments and 3,387 purchase orders in the amount
of $399,989.23 were issued. The number of requisitions and
purchase orders for the year were less in each instance than the
preceding year mainly for two reasons: First, for a portion of
the year office supplies were requisitioned monthly through a
temporary central purchasing system in Tallahassee which was
ordered by the Governor under his executive authority; second,
there was a curtailment of funds for the period July-September
due to insufficient tax monies to meet State appropriations
in full.
It is interesting to note here that during the 1949 Legisla-
tive Session the matter of central purchasing was strongly
favored by the State administration. While this matter was
being debated, various editorials appeared in the newspapers
of Florida. There is cause for pride in one editorial of the
Miami Herald under date of April 10, 1949, in which it was
cited that various items of office supplies were purchased by
various State agencies for amounts which differed considerably.
For instance, letterheads were purchased by various agencies
for $2.50 per thousand (State Board of Health price) to as
high as $5.55 per thousand; onion skin copies from $2.41 per
thousand (State Board of Health price) to $6.50 per thousand;
No. 10 envelopes from $2.93 per thousand (State Board of
Health price) to $7.50 per thousand. In each instance in
which the State Board of Health was specifically mentioned,
its price was the lowest.
During the year, a new tracer system was put into effect.
This procedure is designed to insure that all purchase orders
issued are acted upon promptly in order that goods or ma-
terials might be received, inspected, and invoiced so that the
vendor may be paid with the least possible delay.
One of the functions of the Purchasing and Property Sec-
tion is the processing of automobile accident and liability
claims. The State Board of Health carries insurance coverage
on the automobile fleet for public liability, property damage and
comprehensive. The Board acts as self-insuror insofar as col-









lision damage is concerned. During the year the insurance
companies settled liability and property damage claims against
the State Board of Health in the amount of $897.00 and one
comprehensive claim in the amount of $50.00.
Since the Board acts as self-insuror for collision coverage,
it might be stated that $702 was spent for collision repairs
to units of the fleet. However, $242.00 was reimbursed to
the State Board of Health by individuals and firms who ad-
mitted liability, leaving a net of $460.00, cost to the State
Board of Health for collision damages, whereas the actual
cost of insurance of this type would have cost the Board some-
thing over $2,000.00.
Fire insurance on buildings and contents is carried by the
State through the office of the State Fire Insurance Commis-
sioner. During the year, there was one fire at the Rapid
Treatment Center Hospital at Melbourne in which the kitchen
and mess hall were destroyed. This building and equipment
was replaced out of the proceeds from claim made to the
State Insurance Commission.

Buildings and Grounds
The Superintendent of Buildings and Grounds together with
his personnel maintained the Central Office building during the
year efficiently and economically. In addition, the maintenance
staff was able to build a number of cabinets and educational
displays at considerable savings over outside contractors'
prices. During the year, several of the offices were improved
by better lighting facilities, the most significant case being
the Library. The new lighting fixtures in the Library now
afford sufficient light for the reading tables as well as ref-
erence shelves.
There is still a lack of sufficient office space for the Cen-
tral Office administration. In addition to the main building,
the Board leases two buildings at the St. Johns Shipyard, of-
fices at the corner of Clay and Adams Streets and offices in
the Central Truck Lines Building on Pearl Street. During
the year, the Board leased space in the Caldwell Building in
Tallahassee which will serve as office space for the Regional
Narcotics Inspector, the Regional Sanitary Engineer, and other
Regional personnel. Also during the year the branch labora-
tory at Orlando formally began operations in buildings remod-








eled from Army surplus buildings which the Board was able
to secure from the War Assets Administration. Also in this
location, in addition to the Laboratory, is a Regional Office
for the Division of Entomology and the Bureau of Sanitary
Engineering.
Duplicating Department
New Public Health programs such as Diabetes, Heart Disease
and Mental Health have increased the emphasis on Health In-
formation materials, resulting in the Duplicating Department
being called upon to turn out more pamphlets and literature
than ever before. Also, a heavy demand has been made by the
Bureau of Local Health Service, since all of their forms are
being renumbered, and County Health Unit monthly activity
reports revised. As to be expected, there was a sizeable in-
crease in forms for the Bureau of Laboratories and Vital
Statistics.









TABLE 1
STATEMENT OF AVAILABLE FUNDS AND CASH OBLIGATIONS FOR THE FISCAL YEAR ENDED
JUNE 30, 1949
State Appro-
priations and Local Health Public Children's
TOTAL Authorized Fees Unit Funds Health Service Bureau Other


AVAILABLE FUNDS:
Cash Balance-July 1, 1948 ...
Receipts:
State Appropriations ...............
Fees Authorized by Law .......
From Local Agencies for
Local Health Units .............
Federal Grants-in-Aid ...........
Private Contributions .............
Total Available Funds .............
0 % of Total
Adjustment to Reflect Transfer
Adjusted Total Available Funds
% of Total
CASH OBLIGATIONS:
Total Operating and Non-
Operating Disbursements
(See Tables II & III)
Unencumbered Funds -
Returnable to State Treasury
and/or Contributors
Encumbrances
Total Cash Obligations
% of Total


.$ 790,271.84
. 1,715,791.51
66,136.73
. 1,462,287.45
1.121.556.66


$ 253,369.97
1,715,791.51
66,136.73


$ 299,234.41 $ 144,770.23


1,462,287.45


$ 84,762.00 $ 8,135.23


911,275.74 210,280.92


S 48,600.37 48,600.37
.$5,204,644.56 $2,035,298.21 $1,761,521.86 $1,056,045.97 $295,042.92 $56,735.60
100% 39% 34% 20% 6% 1%
rs 744,040.00 $ 744,040.00
$5,204,644.56 $1,291,258.21 $2,505,561.86 $1,056,045.97 $295,042.92 $56,735.60
100% 25% 48% 20% 6% 1%



$4,598,092.73 $1,133,874.69 $2,165,853.16 $ 966,768.60 $282,272.23 $49,324.05

147,086.36 138,414.27 3,741.72 4.698.82 231.55
82.282.58 17,669.25 57,803.30 6,810.03
$4.827.461.67 $1.289,958.21 $2.165,853.16 $1,028,313.62 $293,781.08 $49,555.60
100% 27% 45% 21% 6% 1%


UNENCUMBERED FUNDS
AVAILABLE FOR EXPENDI-
TURE IN FISCAL YEAR 1950 $ 377,182.89


$ 1,300.00 .. $ 339,708.70 $ 27,732.35 $ 1,261.84 $ 7,180.00


$ 27,732.35 $ 1,261.84 $ 7,180.00


$ 1,300.00 .. $ 339,708.70









TABLE II


STATEMENT OF OPERATING AND NON-OPERATING EXPENSES BY
OBJECT FOR THE FISCAL YEAR ENDED JUNE 30, 1949

OPERATING EXPENSE AMOUNT
Salaries ---------------------..........................................$2,896,461.23
Other Personal Services (includes fees for clinical
services and for Vital Statistics Registrars and
Cancer services -....-......---. ------------.--. 251,307.67
Travel Expenses, including subsistence and lodging 494,737.21
Communications -----....--......-..-...........----- ------ ----- 71,344.49
Supplies and Materials ...-........................--------------. 313,840.33
Printing, Binding and Publicity .........--------..........-... 26,109.35
Repairs, Maintenance and Alterations -------.. ------ 43,633.28
Rents ---------------...................-----------------------.. 32,266.33
Miscellaneous Payments ..............................------------- 23,569.04
Outside Laundering and Cleaning ---.....- ---............... -7,700.55
Legal Expenses .............-- ........--------------............ 2,883.24
Freight, Express, Drayage ............-.............------------ 6,329.89
Insurance and Bonds ...............................--------------. 14,962.52
Drugs and Biologicals .. ...----------..---........-----. 97,480.02
Hospital and Convalescent Care .----- ...--......-----........ 35,115.52
Merit System -----.... --.......--..--................. ---------- 12,438.14
Emergency Maternal and Infant Care for Eligible
Servicemen's Families ..........------........-...... ....----- 7,777.98

TOTAL OPERATING EXPENSES ..------....-..-....$4,337,956.79

CAPITAL EXPENSE AMOUNT
Equipment -.....--...............................-------------- $ 175,224.58
Building Construction and Real Property ..--------. 46,048.90

Total Capital Expense ..............................------------ 221,273.48

TOTAL OPERATING AND CAPITAL EXPENSE $4,559,230.27
NON OPERATING DISBURSEMENTS
Transfers from Fee Account and Special Revenue
Account Balances to State General Revenue
Fund .-....---..--......-- -----........................... $ 38,862.46

Total Non-Operating Disbursements .........-...... 38,862.46
TOTAL DISBURSEMENTS ...----..........................---- $4,598,092.73










TABLE III

STATEMENT OF OPERATING AND CAPITAL EXPENSES
BY PUBLIC HEALTH PROGRAM ACTIVITY FOR THE

FISCAL YEAR ENDED JUNE 30, 1949


ACTIVITY
Health Services to Mothers, Infants, Preschool and School
Children .............................. .......... ........ ......----
Statewide Venereal Disease Control, Diagnosis and Re-
ferral of Infectious V. D. Patients to the Rapid Treat-
ment Center and Operation of Rapid Treatment Center
Sewage and Waste Disposal, Water Supply and Treat-
ment, and General Public Health Engineering and
Sanitation Operations ...................... ..............
Statewide Tuberculosis Control, X-Ray Surveys and Fol-
low-up Work ................- ... ....--.............
Statewide Mosquito, Pest Control, and Structural Pest
Control Law Enforcement ......................... ..........
Statewide Cancer Control Program .................................-
Vital Statistics Records and Reports ...............................
Public Health Training Program .................. ..........
Mental Health Program ......................- ...........
Narcotic, Drug, Medical Practice Law Enforcement ........
Purchase of Insulin and Diabetic Education ...................
Nutrition Investigations and Services .................................
Statewide Dental Health Program ................... ......
Industrial Hygiene Program .................... -........- ..
Merit System Operation ......... .................. .......
General Health Program, Education and Administration ....
TOTAL OPERATING AND CAPITAL EXPENSES ..


AMOUNT


$1,030,037.86



765,501.17


498,628.11

459,648.92

294,758.29
242,027.63
123,359.22
92,087.84
65,738.61
58,181.19
34,225.87
29,316.94
25,834.11
19,284.38
12,438.14
808,161.99
$4,559,230.27


NOTE:
The total operating expenses are summarized herewith as to Public
Health program activity on an estimated basis since formal cost
accounting by program is not maintained. The amounts designated
have been determined after careful review of activity reports of
County Health Units, various departments, and other fiscal data
maintained in the Bureau of Finance and Accounts.








DISTRIBUTION OF PERSONNEL AT MAIN


Z 1 1 1


TABLE 4
OFFICE, BRANCH LABORATORIES AND RAPID TREATMENT
DECEMBER 31. 1949


1 1


CENTER


2 2 14


Nurses 2 1 3 6 12
Dentists 2 2
Sanitation Personnel:
Graduate Engineers 1 20 21
Others 3 1 1 5
Lab. Personnel (Tech.) 15 1 2 7 2 2 1 2 9 2 43
Health Educators 1 4 3 1 9
Nutritionists 1 1
Medical Social Workers
Clerical-Adminis.-Fiscal 3 9 1 2 2 3 11 7 6 3 3 2 1 3 3 2 1 2 4 1 3 2 9 3 9 42 4 141
Part Time 1 2 1 1 2 1 8
Exempt 3 29 9 2 6 2 2 5 1 1 7 28 95
Others 5 4 3 4 2 10 1 1 1 3 3 2 1 10 3 5 58
Federal Employees 1 7 26 2 36
TOTAL 8 60 3 12 34 9 11 7 18 14 4 6 3 19 13 6 5 6 3 5 4 8 8 5 34 7 20 22 45 47 445


' fPhysicians





-- -- -


K1









TABLE 5
DISTRIBUTION OF PERSONNEL IN COUNTY HEALTH DEPARTMENTS AND
TRAINING CENTERS-DECEMBER 31, 1949


Sa .
A .S B a n 5 a o 0
1 1I I 1 -" 1 h l
(a)(b) (c) (d) (e)(f) (g) (h) (i)
Physicians 2 11 11 15 5 1 2 11 1 1' 4 11
Nurses 9 1 4 3 3 9 1 1 1 3 2 54 1 1 10 8 1 5 1 2 111 2 23 2 2 3 1 2
Dentists 1 1 1
Sanitation Personnel:
Graduate Engineers 1 1
Others 1 1 2 1- 2 4 1 1 1 2 27 1 1 6 5 12 11 1 1 2 12 1 1 1 1
Laboratory Personnel
(Technical) 1
Health Educators
Nutritionists
Medical Social Workers
Clerical-Administrative-
Fiscal 41 2 1 1 3 1 1 1 1 28 115 5 1 3 1 11 1 1 1 22 1 1 11
Part Time 3 1 1 1 1 1 12 1 2 2 1 1 1 1 9 2 1 1
Exempt 1 1 3 5 3 6
Others 1 1 6 3 4 1 11 1 1
TOTAL 21 412 7 717 3 2 3 6 7138 3 4 32 29 1 512 2 3 3 3 4 2 7 89 5 6 7 5 3


(a) Also serves Clay and Union Counties. (d) One also serves Santa Rosa County.
(b) Also serves Osceola County. (e) Also serves Gulf and Wakulla Counties.
(c) Also serves Gilchrist and Hamilton Counties. (f) Also serves Calhoun and Liberty Counties


(g) Also serves Charlotte and DeSoto Counties.
(h) Also serves Glades and Hendry Counties.
(i) Also serves Washington County.








TABLE 5
DISTRIBUTION OF PERSONNEL IN COUNTY HEALTH DEPARTMENTS AND
TRAINING CENTERS (Con't.)-DECEMBER 31, 1949








Physicians 1 1 1 1 1 1 1 1 1 2 2 1 1 1 1 1 1 1 1 46
Nurses 6 5 2 1 1 4 4 1 3 3 2 1 13 2 8 1 16 7 2 2 6 3 2 1 3 1 1 10 2 1 2 1 275
Dentists 1 1 5
Sanitation Personnel:

Others 3 3 1 1 23 1 11 41 12 6 2 12 1 2 1 1 114 1 1 144
Laboratory Personnel
(Technical) 1 1 3
Health Educators 1 1 2
Nutritionists
Medical Social Workers
Clerical-Administrative-
Fiscal 2 3 1 2221221 5 1 551 14 4 1 1 2 1 1 1 1 1 1 2 1 2 1 157
Part Time 4 1 1 1 6 6 2 2 1 2 1 1 1 71
Exempt 4 3 1 5 6 1 10 49
Others 1 1 1 2 1 2 11 3 1 2 1 1 3 49
TOTAL 12 21 5 1 6 9 13 2 12 8 5 2 32 4 26 3 58 23 6 6 11 8 7 5 7 4 3 28 3 5 5 15 807


(j) Also serves Taylor County.
(k) Also serves Sarasota County.
(1) Also serves Baker County.


(m) Also serves Flagler County. (p) Also serves Dixie and Lafayette Counties.
(n) Also serves Indian River Martin and Okeechobee. (q) Also serves Holmes and Okaloosa Counties.
(o) also serves Citrus and Pasco Counties.








BUREAU OF VITAL STATISTICS


-Everett H. Williams, Jr., Director

This report contains a brief summary of the statistical data
tabulated for the year 1949 and covers the activities of the
Bureau of Vital Statistics. The 1949 annual statistical report
will be published separately as a supplement to this report and
will contain more detailed statistical data regarding births,
stillbirths, deaths, marriages, and divorces. Previous issues
of these annual statistical reports may be obtained upon re-
quest to the Bureau of Vital Statistics.
Population
The population estimate for the State of Florida as of July
1, 1949 is 2,661,000, divided as follows: (1) 2,076,000 white,
and (2) 585,000 colored.
Births
There were 61,642 resident births for Florida during 1949
and the rate was 23.2 per thousand population. This rate was
slightly lower than the rate of 23.3 for the previous year.
The white birth rate was 21.4 and the colored rate was 29.5
per thousand population. Table 6 shows the number of resi-
dent births and birth rates for this state for the period of
1931-1949.
Deaths
In 1949, there were 25,317 deaths among residents of this state
and the death rate was 9.5 per thousand population. This is
lower than the death rate for the previous year. The white
death rate was 8.8 and was 27% lower than the colored rate
of 12.1 per thousand population. Table A shows the trend of
resident death rates in Florida for the years 1931-1949.
Heart disease continued to be the leading cause of death
and accounted for 32% of all deaths. Other leading causes of
death were cancer, vascular lesions affecting central nervous
system, and accidents. It is very interesting to note that the
three leading causes of death are the so-called old-age diseases.
Since the average length of life is gradually increasing, one
can also expect the percentage of persons in the older age groups
to increase. Deaths and death rates for the abridged list of fifty
causes are shown in Table 7.








Marriages and Divorces
There were 22,039 marriages performed in Florida during
the year 1949. This represents a two per cent increase over
the preceding year. Divorces decreased one per cent as 17,631
were granted during the year. The ratio of marriages to
divorces was 1.25 as compared to 1.21 for 1948 and 1.16 for 1947.
Activities
A notable improvement in the vital statistics registration sys-
tem was brought about by the passage of an amendment to
the state vital statistics law by the 1949 State Legislature.
This amendment classified birth records as confidential and
restricts the issuance of certified photostatic copies to certain
individuals who were deemed to have proper interest in the
records. This will result in the protection of individuals from
unnecessary disclosure of illegitimacy, adoption, or any other
information of a personal nature on their birth record which
might prove embarrassing. This amendment further provided
for the issuance of a Birth Registration Card for most cer-
tification purposes. It is an attractive wallet-sized card en-
cased in plastic containing only the name, date and place
of birth, and birth certificate number. It can be issued to
any applicant and is sufficient to prove age and citizenship,
the purpose for which most birth certificates are needed. Dur-
ing the last 41/2 months of the year 5,407 birth cards were issued.
The new revised birth, stillbirth, and death certificates rec-
ommended by the National Office of Vital Statistics were placed
in use during the year. Stillbirths which were previously regis-
tered as both a birth and a death are now registered on a sep-
arate stillbirth certificate. Causes of death were classified ac-
cording to the new International List of Causes by Death
adopted by the World Health Organization in 1948.
There were 1,255 adoptive birth certificates placed on file
during 1949 as compared to 1,126 for the previous year. There
were also 2,499 delayed birth certificates registered. 1,173
of these delayed birth certificates were filed with the various
County Judges and forwarded by them to this office. 71,482
requests were received for searching the records and 63,776
certifications were issued. The total amount of fees received
during the year was $54,408.25.










TABLE 6

RESIDENT BIRTHS AND DEATHS WITH RATES
(Per 1,000 Population) FLORIDA, 1931-1949

Birth Death
Years Population Births Deaths
Rate Rate

1949 2,661,000 61,642 23.2 25,317 9.5
1948 2,563,800 59,685 23.3 24,505 9.6
1947 2,466,600 60,201 24.4 24,150 9.8
1946 2,369,400 54,347 22.9 22,750 9.6
1945 2,272,200 48,839 21.4 22,594 9.9
1944 2,196,195 49,186 22.4 23,251 10.6
1943 2,125,935 46,763 22.0 23,213 10.9
1942 2,055,675 40,675 19.8 21,144 10.3
1941 1,985,415 37,351 18.8 21,438 10.8
1940 1,915,155 33,696 17.6 21,458 11.2
1939 1,853,660 32,437 17.5 20,209 10.9
1938 1,795,322 31,101 17.3 19,949 11.1
1937 1,736,984 29,529 17.0 19,825 11.4
1936 1,678,646 28,116 16.7 20,050 11.9
1935 1,620,308 28,058 17.3 19,059 11.8
1934 1,585,596 26,722 16.9 19,518 12.3
1933 1,557,976 25,647 16.5 18,112 11.7
1932 1,530,356 27,242 17.8 17,721' 11.6
1931 1,502,736 26,789 17.8 17,291 11.5


TABLE 7
RESIDENT DEATHS FOR ABRIDGED LIST OF 50 CAUSES WITH
DEATH RATES (Per 100,000 Population) BY COLOR, FLORIDA, 1949

CAUSE OF DEATH
(Numbers in parentheses refer to the International DEATHS DEATH RATES
List of Causes of Death) Total White Col. Total White Col.
ALL CAUSES ................ .. ......__...... ....25,317 18,241 7,076 9.9* 9.3* 12.0*
Tuberculosis of respiratory system (001-008) .-. 643 295 348 25.2 15.1 59.2
Tuberculosis, other forms (010.019) ._.- -- .... 34 11 23 1.3 0.6 3.9
Syphilis and its sequelae (020-029) -.. -.. 198 96 102 7.8 4.9 17.3
Typhoid fever (040) ......-...-... --. ... 5 2 3 0.2 0.1 0.5
Dysentery, all forms (045.048) -.___-- ... 23 12 11 0.9 0.6 1.9
Scarlet fever and streptococcal sore throat (050, 051) 11 5 6 0.4 0.3 1.0
Diphtheria (055) ...._..... .. ...... ............. .. ... .~.... 10 8 2 0.4 0.4 0.3
Whooping cough (056) ...... .-..........- 6 2 4 0.2 0.1 0.7
Meningococcal infections (057) .... ......... 13 6 7 0.5 0.3 1.2
Acute poliomyelitis (080) ....... .... 13 11 2 0.5 0.6 0.3
Acute infectious encephalitis (082) .... ... 8 7 1 0.3 0.4 0.2
Smallpox (084) .0....... .. -........ 0 0 0 -
Measles (085) _...... ...... ... -....---...- ..--... 8 7 1 0.3 0.4 0.2
Rabies (094) ..........- -...... ......---- .--- 0 00 0 -
Typhus and other rickettsial diseases (100.108) .... 3 2 1 0.1 0.1 0.2
Malaria (110-117) ........ .....------------ ... 8 3 5 0.3 0.2 0.9












TABLE 7 (Continued)


RESIDENT DEATHS FOR ABRIDGED LIST OF 50 CAUSES WITH

DEATH RATES (Per 100,000 Population) BY COLOR, FLORIDA, 1949


CAUSE OF DEATH
(Numbers in parentheses refer to the International DEATHS DEATH RATES
List of Causes of Death) Total White Col. Total White Col.

All other diseases classified as infective and parasitic
(030.039, 041-044, 049, 052-054, 058-074, 081, 083,
086-093, 095, 096, 120-138) ............ ....... 123 61 62 4.8 3.1 10.5
Malignant neoplasms, including neoplasms of lym-
phatic and haematopoietic tissues (140-205) 3,230 2,665 565 126.8 136.0 96.1
Benign and unsuspected neoplasms (210-239) ._ 106 62 44 4.2 3.2 7.5
Diabetes mellitus (260) .... ..... 350 270 80 13.7 13.8 13.6
Anemias (290-293) .............. 84 56 28 3.3 2.9 4.8
Vascular lesions affecting central nervous system
(330-334) ............ .. .. ...... ...... .. 2,773 1,844 929 108.9 94.1 158.0
Nonmeningococcal meningitis (340) .......... 55 28 27 2.2 1.4 4.6
Rheumatic fever (400-402) .-.. ...........-.. .... 32 19 13 1.3 1.0 2.2
Chronic rheumatic heart disease (410.416) -... 313 244 69 12.3 12.5 11.7
Arteriosclerotic & degenerative heart disease
(420.422) ................. ... 5,840 4,953 887 229.2 252.8 150.9
Other diseases of heart (430-434) ___ 669 484 185 26.3 24.7 31.5
Hypertension with heart disease (440-434) _... 1,387 901 486 54.4 46.0 82.7
Hypertension without mention of heart (444-447) 259 174 85 10.2 8.9 14.5
Influenza (480-483) ........... .. 124 44 80 4.9 2.2 13.6
Pneumonia (490-493) .... ... .- -- 573 326 247 22.5 16.6 42.0
Bronchitis (500-502) ....- .. ... 45 33 12 1.8 1.7 2.0
Ulcer of stomach and duodenum (540, 541) ..... 136 103 33 5.3 5.3 5.6
Appendicitis (550-553) ..... ..... 67 36 31 2.6 1.8 5.3
Intestinal obstruction and hernia (560, 561, 570) ... 180 116 61 7.1 7.9 10.9
Gastritis, duodenitis, enteritis & colitis, except
diarrhea of the newborn (543, 571, 572) ............ 156 77 79 6.1 3.9 13.4
Cirrhosis of liver (581) ..__ .-. ..- ... -......... ..... 263 226 37 10.3 11.5 6.3
Nephritis & nephrosis (590-594) .................. .. 618 356 262 24.3 18.2 44.6
Hyperplasia of prostate (610) ...... ...... ......... 131 83 48 5.1 4.2 8.2
Complications of pregnancy, childbirth and the puer-
perium (640-652, 670-689) ............. ..... ........ 108 46 62 4.2 2.3 10.5
Congenital malformations (750-759) .............. 286 231 55 11.2 11.8 9.4
Birth injuries, postnatal asphyxia & atelectasis
(760-762) ......... ...... ... .... 433 303 130 17.0 15.5 22.1
Infection of the newborn (763-768) ...-........... 66 26 40 2.6 1.3 6.8
Other diseases peculiar to early infancy, and im-
maturity unqualified (769-776) _.................... 757 451 306 29.7 23.0 52.6
Senility without mention of psychosis, ill-defined and
unknown causes (780-795) .... ................... 936 475 461 36.7 24.2 78.4
All other diseases (Residual) ............. ......... 1,893 1,416 477 74.3 72.3 81.1
Motor vehicle accidents (810-835) .......... 662 501 161 26.0 25.6 27.4
All other accidents (800-802, 840-965) .. ..... 1,005 734 271 39.5 37.5 46.1
Suicide and self-inflicted injury (970.979) ................. 351 333 18 13.8 17.0 3.1
Homicide (980-985) .... .. .. --... -. 323 97 226 12.7 4.9 38.4
*Total deaths per 1,000 population.















TABLE 8


PROVISIONAL TOTALS FOR RESIDENT DEATHS BY IMPORTANT

CAUSES, BY COLOR, FLORIDA, JANUARY-DECEMBER, 1949
CAUSE OF DEATH DEATHS I Rate per 100,000 pop.
(Numbers in parentheses refer to the International D S e per 100000 pop.
List of causes of death) Total White Colored Total White Colored
ALL CAUSES _.._ ...-__ ..-..... ...... ............ 25,058 18,051 7,007 9.8* 9.2* 11.9*
Tuberculosis of respiratory system (001-008) .......... 638 288 350 25.0 14.7 59.5
Tuberculosis, other forms (010-019) .......... 34 11 23 1.3 0.6 3.9
Syphilis and its sequelae (020-029) ....-..-...-- 192 93 99 7.5 4.7 16.8
Typhoid fever (040) ............. __ 5 2 3 0.2 0.1 0.5
Dysentery, all forms (045-048) .......... .................... 21 11 10 0.8 0.6 1.7
Scarlet fever and streptococcal sore threat (050,051) 11 5 6 0.4 0.3 1.0
Diphtheria (055) ---..- ...._ ... ....... 10 8 2 0.4 0.4 0.3
Whooping cough (056) .................. ...... 6 '2 4 0.2 0.1 0.7
Meningococcal infections (057) ...................... 11 6 5 0.4 0.3 0.9
Acute poliomyelitis (080) ......... ............_ 1t 12 2 0.5 0.6 0.3
Acute infectious encephalitis (082) _...._.. ... 9 7 2 0.4 0.4 0.3
Smallpox (084) ................ ............ ... ..........- 0 0 0 -
Measles (085) ...._.. ....-.................. ... 9 7 2 0.4 0.4 0.3
Rabies (094) _......................... ........ .... 0 0 0 -
Typhus and other rickettsial diseases (100-108) .. 3 2 1 0.1 0.1 0.2
Malaria (110-117) _.. _. ----......... ..... .. 6 1 5 0.2 0.1 0.9
All other diseases classified as infective and parasitic
(030 to 138 with exception of above causes) 110 58 52 4.3 3.0 8.8
Malignant neoplasms, including neoplasms of lymphatic
and haematopoietic tissues (140-205) .................. 3,160 2,609 551 124.0 133.1 93.7
Benign and unspecified neoplasms (210-239) ... 127 79 48 5.0 4.0 8.2
Diabetes mellitus (260) ................................. 350 270 80 13.7 13.8 13.6
Anemias (290-293) 8t 56 28 3.3 2.9 4.8
Vascular lesions affecting central nervous system
(330-331) .--.-...... ................... 2,747 1,826 921 107.8 93.2 156.7
Nonmeningococcal meningitis (340) ......_____ 53 28 25 2.1 1.4 4.3
Rheumatic fever (400-402) ......... .........__ 43 30 13 1.7 1.5 2.2
Chronic rheumatic heart disease (410-416) .......... 302 233 69 11.9 11.9 11.7
Arteriosclerotic & degenerative heart disease
(420-422) ..... ----...------ ............................... 5,775 4,879 896 226.7 219.0 152.4
Other diseases of heart (430.434) ................... 695 513 182 27.3 26.2 31.0
Hypertension with heart disease (440.443) .... 1,355 884 471 53.2 45.1 80.1
Hypertension without mention of heart (444-447) .. 233 167 86 9.9 8.5 14.6
Influenza (480-483) ................................... 122 44 78 4.8 2.2 13.3
Pneumonia (490.493) ._.-.._......... ..................._ 591 340 254 23.3 17.4 43.2
Bronchitis (500-502) ....... ...........-.... ... 47 34 13 1.8 1.7 2.2
Ulcer of stomach and duodenum (540, 541) __ 133 100 33 5.2 5.1 5.6
Appendicitis (550-553) _.......-_.._. 67 35 32 2.6 1.8 5.4
Intestinal obstruction and hernia (560, 561, 570) 183 118 65 7.2 6.0 11.1
Gastritis, duodenitis, enteritis & colitis, except
diarrhea of the newborn (543, 571, 572) ___ 154 73 81 6.0 3.7 13.8
Cirrhosis of liver (581) .....................-_- .. 257 220 37 10.1 11.2 6.3
Nephritis & nephrosis (590-594) ........... ...
Hyperplasia of prostate (610) ...................... 127 80 47 5.0 4.1 8.0
Complications of pregnancy, childbirth and the
puerperium (640-652, 670-689) ....... _.. 104 45 59 1.7** 1.0** 3.4**
Congenital malformations (750-759) ...278 226 52 10.9 11.5 8.8
Birth injuries, postnatal asphyxia & atelectasis
(760-762) ......... ................... ....... 422 296 126 16.6 15.1 21.4
Infection of the newborn (763-768) ._..-...___ 54 19 35 2.1 1.0 6.0
Other diseases peculiar to early infancy, and
immaturity unqualified (769-776) 7__ 59 460 299 29.8 23.5 50.9
Senility without mention of psychosis, ill-defined
and unknown causes (780.795) 928 482 446 36.4 24.6 75.9
All other diseases (Residual) .....~........__ ......- 1,885 1,399 486 74.0 71.4 82.7
Motor vehicle accidents (810.835) ..__...._.- 638 480 158 25.0 24.5 26.9
All other accidents (800-802, 840-965) ......- 1,014 737 277 39.8 37.6 47.1
Suicide and self-inflicted injury (970-979) _... 345 328 17 13.5 16.7 2.9
Homicide (980-985) ._ ................__. .. 5- 307 96 211 12.1 4.9 35.9
Infant mortality (deaths under one year of age) ....2,066 1,220 846 33.4** 27.4** 48.9**

All figures for the current year are "PROVISIONAL" Everett H. Williams, Jr.
*Rate per 1.000 population. **Rate per 1,000 live births. 2-1-50 Director













TABLE 9
MARRIAGES, DIVORCES, BIRTHS, DEATHS AND DEATHS FROM
CERTAIN CAUSES, BY COUNTIES, FLORIDA
JANUARY-DECEMBER, 1949
(Marriages and divorces are tabulated according to county of occurence. Births and deaths are
tabulated according to county of residence)


Population w
Estimate .2 4 a
1949 a


2,547,500 STATE 21,811 17,623 61,833 25,058 2,066 104 672 192 5 21 10
38,245 Alachua 313 281 1,451 414 34 5 10 6 1 0 0
6,326 Baker 37 148 187 45 3 1 2 0 0 0 0
48,000 Bay 230 111 1,216 245 34 3 9 0 1 0 0
12,400 Bradford 60 508 282 105 14 1 1 0 0 0 0
22,050 Brevard 149 432 429 227 13 '2 3 1 0 0 0
59,300 Broward 1,240 368 1,835 680 81 1 15 5 0 2 0
8,230 Calhoun 26 51 205 47 7 0 2 1 0 0 1
4,690 Charlotte 44 22 73 56 2 0 0 0 0 0 0
5,427 Citrus 57 47 145 85 3 0 3 0 0 0 0
13,000 Clay 47 152 402 96 10 0 0 1 0 1 0
4,957 Collier 50 12 141 58 7 0 1 2 0 0 0
17,350 Columbia 71 57 506 185 14 2 2 2 0 0 1
355,300 Dade 5,125 4,636 9,659 3,879 279 14 111 31 0 1 0
6,854 DeSoto 93 19 180 107 9 0 0 0 0 0 0
4,926 Dixie 10 18 118 45 7 0 1 0 0 0 0
327,600 Duval 1,744 1,188 7,764 2,771 247 7 134 25 1 3 0
131,100 Escambia _.656 655 3,368 854 104 4 23 6 0 1 2
2,652 Flagler 42 88 84 40 5 1 0 0 0 0 0
9,700 Franklin 30 23 153 51 4 2 3 2 0 1 0
25,838 Gadsden 89 79 990 299 43 3 7 3 0 0 0
3,466 Gilchrist 27 6 79 22 3 0 1 0 0 0 0
2,281 Glades 46 6 31 18 0 0 0 0 0 0 0
7,060 Gulf 28 23 156 57 7 1 1 0 0 0 0
8,731 Hamilton 37 39 284 92 7 0 5 0 0 0 0
8,585 Hardee 108 304 204 116 10 1 3 0 0 0 0
5,066 Hendry 80 23 142 49 7 0 1 1 0 0 0
5,700 Hernando 82 28 163 63 5 0 0 0 0 0 0
22,100 Highlands 142 75 328 152 13 0 3 0 0 0 0
231,100 Hillsborough 2,260 1,212 5,450 2,358 192 9 72 15 0 3 1
14,627 Holmes 41 46 355 96 9 0 2 0 0 0 0
9,190 Indian River 111 45 271 110 7 0 3 0 0 0 0
34,590 Jackson 143 83 899 282 21 2 7 6 0 0 0
11,066 Jefferson 39 11 290 125 13 1 2 1 0 0 0
3,995 Lafayette 15 2 78 35 2 0 2 0 0 0 0
28,600 Lake 210 145 849 366 29 1 9 4 0 0 1
28,700 Lee 181 109 436 243 12 2 7 2 0 1 0
38,700 Leon 228 276 1,227 322 38 4 9 0 0 0 0
9,902 Levy 71 19 288 110 9 0 4 1 0 1 0
3,193 Liberty 13 19 77 26 4 0 0 1 0 0 0
15,537 Madison 37 44 439 167 22 0 2 1 0 1 0
27,400 Manatee 299 104 668 360 13 0 7 2 0 0 0
38,500 Marion 255 171 850 437 31 5 10 2 0 0 0
6,094 Martin 79 38 151 87 5 0 2 1 0 0 0
23,200 Monroe 364 311 650 188 27 0 7 0 0 1 0
10,900 Nassau 41 18 366 121 16 1 4 2 0 0 0
18,950 Okaloosa 133 128 833 160 24 1 3 0 0 0 0
2,919 Okeechobee 36 14 86 29 4 0 0 0 0 0 0
100,500 Orange 850 217 2,501 1,023 79 6 26 6 0 0 0
11,000 Osceola 164 31 200 172 6 0 3 0 0 0 0
139,500 Palm Beach 1,078 667 2,165 1,109 95 4 22 18 1 1 1
13,729 Pasco 199 87 403 221 14 2 5 3 0 0 0
162,500 Pinellas 1,297 735 2,333 1,922 61 2 32 13 0 0 0
134,000 Polk 1,075 975 2,779 1,097 100 4 21 6 0 0 1
17,837 Putnam 117 95 566 267 31 0 8 1 0 1 0
22,900 St. Johns 195 950 552 289 23 5 9 4 0 0 0
13,800 St. Lucie .209 95 526 200 28 0 4 0 0 0 1
17,800 Santa Rosa 80 41 515 160 25 0 2 0 0 0 0
21,800 Sarasota 249 180 502 290 18 0 8 2 0 0 0
26,500 Seminole 197 211 648 262 25 2 9 3 0 0 1
10,417 Sumter 101 84 250 87 13 0 3 0 0 0 0
18,000 Suwanncee 96 57 492 173 29 2 3 2 0 0 0
10,738 Taylor 37 34 203 101 3 0 4 2 0 0 0
4,394 Union 19 21 122 53 0 1 0 0 0 0 0
62,500 Volusia 471 839 1,412 883 41 2 18 8 1 3 0
5,059 Wakulla 17 15 138 41 5 0 0 0 0 0 0
13,871 Walton 55 43 393 141 12 0 0 0 0 0 0
11,889 Washington 68 52 295 87 8 0 2 0 0 0 0

29













TABLE 10

RESIDENT DEATHS FROM CERTAIN CAUSES BY COUNTIES
FLORIDA, JANUARY-DECEMBER, 1949




COUNTIES O n; .6 02
0 AI 5 .0 = 0..... ...
1's2 ^ 11 I I | l 's 1R^


STATE
Alachua
Baker
Bay
Bradford
Brevard
Broward
Calhoun
Charlotte
Citrus
Clay
Collier
Columbia
Dade
DeSoto
Dixie
Duval
Escambia
Flagler
Franklin
Gadsden
Gilchrist
Glades
Gulf
Hamilton
Hardee
Hendry
Hernando
IIighlands
Hillsborough
Holmes
Indian River
Jackson
Jefferson
Lafayette
Lake
Lee
Leon
Levy
Liberty
Madison
Manatee
Marion
Martin
Monroe
Nassau
Okaloosa
Okeechobee
Orange
Osceola
Palm Beach
Pasco
Pinellas
Polk
Putnam
St. Johns
St. Lucie
Santa Rosa
Sarasota
Seminole
Sumter
Suwannee
Taylor
Union
Volusia
Wakulla
Walton
Washington


6 14 3 6 3,160 350 84 2,747 6,772 1,608 122
0 0 1 0 33 8 0 75 88 33 6
0 0 0 1 4 0 0 2 11 7 0
0 1 0 0 21 4 0 23 42 27 0
0 0 0 0 14 1 0 10 26 14 2
0 0 0 0 30 6 1 25 67 10 0
0 0 0 1 101 9 2 57 178 29 8
0 0 0 0 4 0 0 5 8 1 1
0 0 0 0 14 0 0 7 17 1 0
0 0 0 0 15 0 0 13 23 6 0
0 0 0 0 9 0 1 10 20 4 0
0 0 0 0 7 2 0 4 9 1 0
0 1 0 0 22 6 1 34 47 7 2
0 2 0 1 603 53 8 328 1,170 210 8
0 0 0 0 7 2 0 17 34 8 0
0 0 0 0 3 0 0 8 10 3 1
1 1 0 2 321 34 4 303 583 193 10
0 3 0 0 102 10 4 94 218 48 3
0 1 0 0 2 2 0 3 11 4 0
0 0 0 0 8 1 0 2 16 2 0
0 0 0 0 27 4 1 42 44 36 4
0 0 0 0 2 0 0 1 4 2 0
0 0 0 0 3 0 0 2 2 1 0
0 0 0 0 3 0 0 7 12 5 0
0 0 0 0 10 0 0 12 22 13 2
0 0 0 0 17 1 0 23 22 2 0
0 0 0 0 1 0 2 3 16 3 0
0 0 0 0 4 1 0 15 16 2 0
0 0 0 0 13 3 0 17 47 6 0
1 1 0 0 298 44 15 210 598 195 1
0 0 0 0 13 1 0 18 21 8 0
0 0 0 0 15 1 2 5 25 4 0
0 0 0 0 21 6 2 60 72 12 5
0 0 0 0 8 0 1 18 18 26 1
0 0 0 0 4 2 0 1 6 4 0
1 0 0 0 48 4 1 32 92 42 2
0 0 0 0 33 2 2 38 74 5 3
0 0 0 0 33 1 1 36 63 19 4
0 0 0 0 10 3 1 10 22 9 1
0 0 0 0 3 0 0 4 7 2 0
0 0 0 0 10 1 0 22 41 15 3
0 0 0 0 51 8 5 45 121 17 0
0 0 0 0 38 6 1 51 102 47 5
0 0 0 0 8 1 0 8 26 7 1
0 0 0 0 29 5 0 16 39 12 0
0 0 0 0 11 2 1 15 28 11 0
0 1 0 0 9 2 0 15 31 12 1
0 0 0 0 5 1 0 0 6 1 0
0 1 1 0 136 12 2 144 327 60 4
0 1 0 0 26 3 2 19 66 4 0
2 0 0 1 136 18 5 109 310 79 3
0 0 0 0 32 1 1 29 67 19 0
0 0 0 0 277 29 2 256 675 70 11
1 1 0 0 149 10 8 115 308 66 6
0 0 0 0 29 4 1 19 82 11 2
0 0 0 0 27 4 1 30 79 24 2
0 0 0 0 22 3 0 21 53 6 1
0 0 1 0 16 2 0 14 34 8 0
0 0 0 0 37 4 2 37 96 16 0
0 0 0 0 41 6 0 28 49 18 7
0 0 0 0 7 1 0 6 21 8 0
0 0 0 0 22 3 0 12 51 11 3
0 0 0 0 10 0 0 20 24 5 1
0 0 0 0 7 1 0 10 14 3 0
0 0 0 0 113 11 3 100 286 54 4
0 0 0 0 5 1 0 6 6 4 2
0 0 0 0 17 0 0 18 36 13 0
0 0 0 0 4 0 1 8 30 3 2


*Includes all vascular lesions of central nervous system.


594 617 638 1,014
8 9 13 24
2 1 0 5
8 5 11 18
8 3 1 1
8 5 8 10
14 20 26 24
1 1 0 1
1 0 1 3
1 3 2 6
4 1 3 9
1 2 9 3
7 6 5 5
61 58 102 121
3 6 2 5
4 0 0 1
80 70 67 125
24 16 28 37
1 3 1 3
0 5 0 2
13 9 7 10
0 1 0 1
2 1 2 1
2 2 1 5
0 4 2 2
4 1 1 6
0 0 3 3
1 3 1 3
3 8 3 4
46 97 46 92
6 1 1 7
2 1 4 12
10 3 9 10
5 11 2 6
2 3 1 1
8 3 16 20
4 5 8 11
7 14 14 22
5 3 1 9
1 0 2 1
6 4 2 8
7 7 5 10
9 9 11 20
1 2 0 6
4 2 3 7
3 1 4 7
8 4 8 14
1 1 3 2
14 7 22 38
3 2 4 7
27 22 33 47
3 2 5 8
38 47 22 41
24 21 11 48
6 18 11 10
. 8 5 5 19
10 7 10 5
4 5 8 15
8 7 10 11
3 16 12 7
1 2 2 5
5 2 3 6
2 6 1 0
1 2 3 4
26 19 13 29
2 1 0 1
9 7 4 3
4 5 1












TABLE 11



THE FOLLOWING INDICATES THE NUMBER OF MARRIAGES,
DIVORCES, RESIDENT BIRTHS, DEATHS AND DEATHS FROM
CERTAIN CAUSES, BY MONTHS, FOR 1949 AS COMPARED
WITH THE PREVIOUS YEAR


MARRIAGES
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ......... ... 1,401 1.66f 1.746 1,774 1,553 2,287 1,706 1,665 1.953 1,802 1,955 2,303 21,811
1948 ___........... 1,733 1,823 1,979 1.903 1,814 2,568 1,687 1,676 1,567 1,454 1,490 1,816 21,510

DIVORCES
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ..._...... .. 1,235 1,259 1,680 1.688 1,767 1,672 1,546 1,415 1,391 1,308 1,278 1,384 17.623
1948 _._. ...... 1,312 1.375 1,696 1,723 1,647 1,709 1,597 1,378 1,239 1,373 1,377 1,379 17.805

BIRTHS
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 .................. 5,701 4,963 4,882 4.203 4,253 4,141 4,922 5,376 5.595 6,052 5.796 5,949 61,833
1948 .......... 5,264 4,716 4,691 4,226 4.262 3,978 4,987 5.671 5.640 5,562 5,225 5.463 59.685

DEATHS
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. fotal
1949 ................ 2,390 1,962 2,186 1,985 2,071 1,846 2,080 1,934 1,874 2,109 2,294 2,327 25,058
1948 ............. 2,508 2,044 2,094 1,945 2,009 2,014 1,888 1,916 1,899 1,994 1,992 2,172 24,505

INFANT DEATHS
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ..... ........ 218 159 198 152 173 143 161 152 158 186 202 164 2,066
1948 __........... 202 166 164 153 166 148 167 202 167 187 157 204 2.083

MATERNAL DEATHS
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ................ 12 7 10 7 8 7 8 6 9 8 14 8 104
1948 ............. 11 6 8 8 12 6 16 17 12 6 6 7 115

TUBERCULOSIS
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ......... 63 54 58 67 55 52 46 63 51 67 45 51 672
1948 .__........- 67 50 65 67 56 66 64 66 72 62 54 44 733

SYPHILIS
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ........... 14 16 23 23 12 8 11 19 13 18 18 17 192
1948 .......- 22 16 25 19 20 21 23 15 17 21 22 24 245

TYPHOID FEVER
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 .... 0 1 0 1 1 0 0 0 1 0 1 0 5
1948 _.......... .-. 0 1 0 0 2 1 0 0 0 0 0 0 4

DYSENTERY (All Forms)
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ..... 3 0 4 2 3 5 0 1 0 1 1 1 21
1948 1 4 0 0 0 2 2 2 3 1 3 0 18

DIPHTHERIA
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ...... 1 2 1 0 1 0 0 1 2 0 1 1 10
1948 ...... 0 0 0 1 1 1 1 0 2 2 3 2 13






















TABLE 12

THE FOLLOWING INDICATES THE NUMBER OF RESIDENT DEATHS FROM CERTAIN CAUSES
BY MONTHS, FOR 1949 AS COMPARED WITH THE PREVIOUS YEAR
WHOOPING COUGH
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ...__ 0 1 2 2 0 0 0 0 0 1 0 0 6
1948 .. 6 2 3 3 1 2 1 1 1 1 0 0 21

POLIOMYELITIS
Year Jan. Feb. March April May June July Aug. Sent. Oct. Nov. Dec. Total
1949 3 0 1 1 1 0 0 2 3 0 2 1 14
1948 0 1 0 0 3 2 4 2 4 2 0 1 19

TYPHUS FEVER
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 .... .... 0 0 0 0 1 0 1 0 0 1 0 0 3
1948 .......__ 0 1 1 1 1 0 0 2 0 2 0 0 8

MALARIA
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 0 2 0 1 0 1 0 1 0 0 1 0 6
1948 1.... 1 0 0 0 2 2 1 4 0 1 0 0 11

MALIGNANT NEOPLASMS (Cancer)
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ... ._.. 292 244 244 250 282 218 273 252 257 275 268 275 3,160
1948 ..... .. 267 257 229 216 258 270 242 244 232 265 243 246 2,969

INFLUENZA
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ... 22 17 12 10 7 3 4 2 8 7 10 20 122
1948 .. .... 25 24 23 4 3 2 2 3 4 10 6 14 120

PNEUMONIA
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ... .._ 77 55 67 43 38 47 54 41 39 34 39 60 594
1948 .................. 121 89 71 47 47 47 45 40 53 56 56 76 748

MOTOR VEHICLE ACCIDENTS
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ...._... 49 37 42 41 50 36 52 55 53 79 71 73 638
1918 ------ 61 52 49 58 73 52 47 52 42 55 52 75 668

OTHER ACCIDENTS
Year Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total
1949 ... ...-- ... 108 90 91 85 90 71 87 80 63 56 92 101 1,014
1918 ...................... 131 98 84 112 106 111 102 114 103 87 95 111 1,254









DIVISION OF HEALTH INFORMATION

Elizabeth Reed, Director

The Division of Health Information has the responsibility of
stimulating and coordinating activities in the State Board of
Health which are concerned with the dissemination of infor-
mation about health and health education. This includes con-
sultative and technical assistance to all bureaus and divisions
and county health departments, as well as the general public,
either collectively or singly, who may wish information con-
cerning health.
The Division of Health Information has fourteen employees:
1 Director
1 Supervisor of Food Handlers' Training Program
1 Press Secretary
1 Librarian
1 Library Assistant (Part-time)
1 Artist
2 Health Educators
1 Clerk (in charge of Film Library)
5 Clerks and Stenographers
Mr. Jess H. Wheeler served as acting director from Jan-
uary to June. Miss Elizabeth Reed returned from academic
leave in June and was appointed director. Mr. Wheeler was
assigned to the Food Handlers' Training Program until No-
vember 1 when he was transferred to the Division of Diabetes
Control.
Health Educators
Miss Betty Gardiner served as state consultant in hearing
and other health education programs. She left in September
on academic leave.
Jesse Meuse, Negro health educator, continued to work in
Jackson County under the direction of the county health of-
ficer. His activities have included: General health education
programs, utilizing audio-visual devices, school programs, san-
itary surveys, school examinations, radio and press broadcast
releases. The general objective of the entire program has been
the integration of school and community health.








Pamphlets
Regular surveys were periodically made to review all new
pamphlets in the field of health. Samples of those thought
worthy of note were distributed to the county health depart-
ments with notation as to their availability from this Division.
Many requests are answered daily from schools, organizations,
and individuals, as well as health departments. No new pam-
phlets originated in the Division. The price of literature con-
tinued to rise, and plans were made for a program to urge
more constructive use of the smaller supplies available.
Exhibits
Three new exhibits were constructed on the subjects of tu-
beiculosis, public health nursing, and local health service in
Florida. "Growth Through Unity," an intricate exhibit em-
ploying electrical devices, was shown at the American Public
Health Association Convention in New York City, where it won
an award of merit. The theme was the rapid growth of county
health departments in Florida. Dr. F. M. Hall, Director,
Alachua County Health Department, helped to design and con-
struct this exhibit.
Art Work
The work of the staff artist, in the field of graphic arts,
consisted of the following approximate totals: Cover designs
11; graphs and charts 66; illustrations 80; letterheads 7; maps
5; posters 20; and signs 68. A total of 51 layouts were drawn
for blotters, covers, exhibits, pamphlets, and posters. Not in-
cluded in this figure were many additional layouts for FLOR-
IDA HEALTH NOTES. Numerous stencils were cut for
mimeographing letters, folders, and report covers. Consul-
tation and cooperation were given in the completion of large
exhibits for tuberculosis, public health nursing, and the "Growth
of County Health Departments in Florida."
Blotters. The practice was continued of mailing a blotter
at monthly intervals to every physician in Florida. The cen-
tral motif is a stylized owl with the caption "Dr. S. Q. Lapius
Says." Each blotter bears a timely message and the current
month's calendar.
Postage Meter Ads-Four new postage meter ads were de-
signed by our artist for use in the postage machines operated
by the State Board of Health. All emphasized health.








Florida Health Notes
The publication of FLORIDA HEALTH NOTES continues
to be one of the most important activities of this Division. Ap-
proximately 1/3 of the total budget is spent on its production.
An endeavor is made to have various persons outside this Di-
vision cooperate in helping prepare manuscripts. Due to a
curtailed budget, publication was suspended two summer
months. Subjects covered were: Water, legislative needs, den-
tal decay, mental health, health statistics, diseases of animals,
health officers, laboratory services, nutrition and history of
public health in Florida. The last-named appeared in Febru-
ary on the 60th anniversary of the founding of the Florida
State Board of Health.
Press Secretary
In addition to handling routine press work such as weekly
releases to all papers and radio stations in the State, the pub-
licity section branched out to do more in the way of health
education.
Assistance was given in the preparation of exhibits, a num-
ber of special health articles for a State magazine, and four
HEALTH NOTES which were illustrated with photographs.
Several national publications were kept informed of Florida's
public health work.
The press was given "on the spot" coverage and photographs
of a number of medical and lay meetings including: A diabetes
seminar, Dental Health Day, mental health institute, mental
health meeting for lay audience, annual graduate short course
for physicians, heart seminar, and the Florida Public Health
Association annual meeting.
County health departments planning publicity campaigns or
programs on particular phases of public health were aided upon
request. A number of allied state and local agencies were also
given help on publicity.
Legislative Service
During the 1949 Session of the Florida Legislature this Di-
vision obtained copies of all bills introduced. These were scru-
tinized and public health personnel vitally interested in various
bills were immediately notified of any action taken. A summary
of all legislation pertaining to public health was prepared at the
close of the session.








Cooperation With Other Agencies
This Division cooperates with many state and local organiza-
tions in the dissemination of health information. These are too
numerous to mention. However, special mention is made of
activities in connection with the State Department of Education:
assistance in the preparation of health materials for schools;
consultation to teachers' workshops, and participation in Uni-
versity conferences are some examples of working together on
common health problems.
In-Service Education
A series of meetings were inaugurated to acquaint personnel
in the central office with current programs of the State Board
of Health. Speakers are directors of the various bureaus and
divisions. One meeting weekly is held for professional and
technical persons; another, for clerical personnel.
Film Library
The distribution of films in 1949 reached a new high. Witness:
% Increase
1949 Over 1948
Total number of films shipped 3,324 12
Total number of times shown 9,089 46
Total number of persons
in audience 836,185 3
Of the total number of films booked 379 were returned not
shown and 156 were returned without reports.
During 1949 twenty-three new titles and eight additional
prints of old titles were added to the library which now contains
over two hundred titles. These included films on the subject of
nutrition, mental hygiene, the human body, and dental health.
These titles were included in the new catalog which was issued
in September. Additional prints bring the total number of films
in the library to over 365.
The amount of equipment added during the year was com-
paratively small. This included one sound projector, one slide
projector, one turntable, and one screen.
There was a noticeable increase in the number of schools
booking films at the beginning of school for the entire school
term. This is very gratifying and is considered to be an indica-








tion that borrowers are using audio-visual aids more intelli-
gently.
The film library, as in other years, worked closely with the
Bureau of Tuberculosis Control. Both 35mm and 16mm educa-
tional films and x-ray trailers were distributed for use during
and preceding x-ray surveys. The library was closed during
the month of August in order to repair films, take inventory,
etc.
Future plans include a survey by mail of other state health
department film libraries in an effort to learn more of their
activities so that the service of our own film library may con-
tinuously be improved.




THE LIBRARY

Lora-Frances Davis, Librarian

CIRCULATION STATISTICS
Pamphlets
Date Books Periodicals & Reprints Total Borrowers
1946 908 682 520 2,110 No Record
1947 1,229 1,920 1,011 4,160 247
1948 1,287 2,604 1,238 5,329 436
1949 1,387 3,799 891 6,005 469
Actual Library usage has extended far wider than the statis-
tics show. Of the 469 regular borrowers, 22 were known to bor-
row for re-circulation within a group. At the close of the year the
Library had 722 books out on indefinite loan, and only the new
loans are shown in the circulation count. These indefinite loans
are either to people in the state offices who are making refer-
ence use of the books or to certain outside groups for special
study-mental health centers, branch laboratories, Rapid Treat-
ment Center, Duval Cancer Clinic, etc.
Decline in the circulation of pamphlets is attributable largely
to the change in routing system used within the Division of
Health Information. Also, the Division's pamphlet collection has
expanded so that it is now possible to send free pamphlets in
answer to many inquiries which formerly required library loans.
Of the reprints circulated 117 were microfilm loans from the
Army Medical Library. In October the Bureau of Vital Statistics








placed its microfilm reader in the Library. Since this reader
has become more accessible to library patrons, requests for
microfilmed articles have increased. Microfilm represents a
considerable saving over interlibrary loans, each microfilm from
a government agency representing a saving of $1.44 in transpor-
tation costs.
In 1949 the Library acquired 1,985 pieces of literature. Of
this number 544 were added through the binding of journals.
The other 1,441 were books and reports. A number of private
collections and individual items were presented by physicians
and their estates. The largest single contributors were Dr.
George Mitchell of Jacksonville and Dr. Mark F. Boyd of Talla-
hassee. The purchasing policy continued to be that of buying
first to meet the organization's actual needs and second to build
a well rounded collection. Federal funds made possible building
up the holdings on mental health, heart and circulation, maternal
and infant care.
To accommodate these new books three double-faced sections
of shelving were built by the Maintenance Shop.
Book lists were published in the November and December
issues of the Duval County Medical Society Bulletin and in the
Miami Heart Association publication. The December blotter,
mailed to physicians over the state, called attention to the li-
brary's services.
It is estimated that around 2600 reference questions were
answered during the year. Bibliographies are included in this
count. In 1950 a separate count will be kept, as bibliographies
consume over half of the librarian's time.
The Library received 472 current periodicals in English. Of
this number 302 were gifts, 85 being from the Florida Medical
Association. No effort was made to keep an account of the
foreign journals because a policy has been inaugurated of send-
ing all foreign journals on to the Army Medical Library.
This Library drew heavily on the Medical Library Exchange.
The Library of the Royal Society of Medicine (London) sent,
transportation free, one lot valued at $150, thus adding ten
years of the Proceedings of the Royal Society of Medicine. The
New Orleans Parish and Tulane Medical School Library sent
over twenty packages to complete volumes for binding. These
and many others cost only the postage.








In turn this Library assisted the Exchange with the Compila-
tion of a collection to replace the University of Chile Medical
School and Department of Public Health Library which burned.
Inventory was discontinued in July when the staff was cut.
However, inventory of the journals in the Library proper had
been completed. It is hoped that in 1950 the journals in the
attic and all of the books can be inventoried. To this end, a
part-time assistant was employed whose primary duties are
cataloging and inventory.
As the year ended the Library was interested in three special
projects: (1) assisting with the selections for the Tuberculosis
Hospital Library at Lantana, (2) processing books for the
Rapid Treatment Center at Melbourne, (3) processing books for
the Miami Heart Association. This last collection will be an
indefinite loan, and the books will be available for re-loan to the
Association's 104 member physicians.






FOOD HANDLERS' TRAINING PROGRAM

E. Russell Jackson, Supervisor

The Florida State Board of Health Food Handler's Training
Program continued its progress in 1949 with "schools" conducted
on a scheduled basis in the periods January 18-June 9 and No-
vember-December 15. This year, more schools were held in the
smaller counties, as the larger communities began to establish
permanent programs.
The Florida Restaurant Association and the Florida Hotel
Commission continued to approve this program.
Twenty food handlers' schools were presented in fourteen
counties. These programs certified 2,258 persons as having
completed the six basic hours in food handling sanitation. This
figure represents an average of 112.4 certifications per school,
which is below the previous average of 150.0 per school. Special
awards were issued 262 establishments for having 80 per cent
of their employees certified. (See Map in Appendix.)








1949 FIGURES
20 food handlers programs conducted in 14 Florida
counties.
2,698 first day registrations.*
2,258 individual certificates issued.
262 special awards issued establishments with 80
per cent employees certified.
In addition to the regular schools conducted, five special food
handling lectures were presented to select groups with an at-
tendance of 233.
Among the objectives of the Food Handlers' Training Program
is rendering assistance to counties and communities in the es-
tablishment of permanent schools. In 1948 Polk, Dade, and
Pinellas counties set up permanent food handlers' training pro-
grams. Pinellas County, however, did not begin the operation
of its program until January 1949 and, in this year, it was
approved by the State Board of Health. Escambia County un-
dertook food handlers' training in April 1949 and plans to hold
schools every three months. Leon County established its pro-
gram in November and anticipates conducting schools every
ninety days beginning in February 1950. Volusia, Orange, Palm
Beach, Broward, and Hillsborough Counties expected to organ-
ize and operate similar projects in 1949, but, due to inadequate
funds and personnel they have not been able to see them accom-
plished. Polk County has had to suspend its activity for like
reasons. The Dade County program, which conducts food
handler schools from October through May, on a weekly basis,
stands out above all programs in the State with 3,282 certificates
in 1949. All approved county programs are supervised by the
State Board of Health.
Other food handlers' training activities that should be noted
in 1949 are the City of Jacksonville program which certified
844 and the Jacksonville Naval Air Station which has issued
246 State Board of Health certificates to persons completing an
approved basic course.
In the fall schedule a new approach was attempted in the
presentation of the courses. This approach involved the utiliza-
tion of health department personnel, in as far as possible, in the

*First day registrations alone are indicated since certificates are issued
persons upon completion of all sessions of the three-day course. The
per cent of registrants certified is 83.6.









giving of lectures, i.e. the health officer, sanitarian and nurse
joined with the Food Handlers' Training Program Supervisor
in the instructions. This was done in three of the counties where
food handler schools were held in November and December.
The reason behind this approach is to further encourage counties
to establish permanent programs, identify the health department
more with food handler training and put it before the public
more effectively as joined with the State in this activity.

FOOD HANDLERS CERTIFIED NOVEMBER 1947 DECEMBER 1949
PROGRAM 1947 1948 1949 TOTAL
State ............. 260 8,035 2,258 10,553
Polk County ................ 308 106 414
Dade County .............. 943 3,282 4,225
Pinellas County ........ 881 881
U. S. Naval Air Station
Jacksonville ........... 246 246
City of Jacksonville
(12 hour course) ........- 716 844 1,500
TOTAL ...................... 260 10,002 8,489 18,751
The Food Handlers' Training Program was enhanced this
year by a Florida Food Handlers' Emblem which has been made
available to all certified food handlers in the State who have
completed a basic course in food handling sanitation approved
by the Florida State Board of Health. This is a project of the
Florida Junior Chamber of Commerce.
A mimeographed workbook, SUGGESTED OUTLINES FOR
USE IN ESTABLISHING PERMANENT PROGRAMS was
written to assist counties in planning programs and courses of
instructions.























(Foreword to Report on Preventable Diseases)

The report presented under the heading of "Preventable
Diseases" is somewhat illogical because it does not include all
of the diseases which belong in this category. For illustration,
tuberculosis control is administered by a separate Bureau by
that name. Likewise, mental and emotional disorders, and
heart disease are conditions which are preventable to a consid-
erable degree, but for administrative reasons, it has been found
more practical to designate them as a responsibility of the Bu-
reau of Maternal and Child Health. It will, therefore, avoid
confusion if it is understood that certain preventable diseases
are discussed in other sections of the report.








BUREAU OF PREVENTABLE DISEASES

L. L. Parks, M.D., M.P.H., Director

A glance at Chart I will show the organization of the Bureau
of Preventable Diseases. In the following pages a report is
included from the Division of Venereal Disease Control, the
Cancer Division, Division of Industrial Hygiene, and the Division
of Veterinary Public Health.
It is noted that Typhus Fever Studies are shown in Chart I
under Epidemiology. These studies were made by the Rocke-
feller Foundation representatives and the report on these studies
is also included in this report. (See appendix)
The Division of Epidemiology is practically non-existent at
the present time except for the studies by the Rockefeller Foun-
dation. Inasmuch as sixty-three of the sixty-seven counties
are now covered by full time county health departments, there
is little need for the service of an epidemiologist because each
of the county health officers takes care of this service in his
routine county health unit activities. In case the local health
officer is in need of additional epidemiological services the staff
of the State Board of Health is available for assistance, and
we in turn may also have the assistance of the U. S. Public
Health Service.
The following comments are of general interest for the year
1949 insofar as the overall communicable disease status is
concerned.
During 1949 there was no increase in morbidity from any of
the important reportable diseases. As a matter of fact, there
was a decided decrease in many of the diseases which were on
the increase in former years.
The reporting of cancer again showed a marked increase over
preceding years, almost doubling the number reported in 1948.
This is gratifying because it represents greater activity in case
finding.
There was a marked decrease in the number of reported cases
of diphtheria.
There were no notable outbreaks of enteric infections during
1949. There was a definite decrease in the number of bacterial
infections.








For the first time in several years there were no reported
cases of leprosy.
There was a marked decrease in the number of malaria cases
reported.
There was a slight decrease in the number of typhus cases re-
ported, although the number reported was almost comparable
to the preceding year. There was a marked decrease in the
number of cases of scarlet fever and whooping cough reported.
Compared to the preceding year the number of reported cases
of typhoid was approximately one half.
There was a definite decline in overall reporting of venereal
diseases, especially in the number of primary and secondary
cases of syphilis reported. The number of granuloma inguinale
patients remained at about the same level as the preceding year.
The incidence of all other reportable diseases, except tuber-
culosis, remained about equal to the median figures for preced-
ing years. Tuberculosis data are given by the Bureau of Tuber-
culosis Control.

VENEREAL DISEASE CONTROL IN FLORIDA

The year of 1949 brought forth some very encouraging de-
velopments in the problem of venereal disease control. Although
this is still a major health problem in the State it at last appears
that real progress is being made towards controlling these dis-
eases. For the first time in ten years the number of reported
cases of syphilis has fallen below 15,000 to a low of 12,363 in
1949. During 1947 and 1948 there was an increasing number of
primary and secondary cases reported, while 1949 experi-
enced better than a 50 % decrease in the number of these cases.
There was a decrease in the number of cases reported for the
other stages of syphilis also but not as marked as for the primary
and secondary stages. (See Chart in Apperdix.)
The other venereal diseases also show a decrease for 1949
with the exception of granuloma inguinale. It is believed that
the increase in granuloma inguinale cases is a result of better
diagnostic procedures and the use of the newer antibiotics in
treating this disease, with almost miraculous results, has caused
the patients to spread the word among their friends and resulted








in many more cases coming to diagnostic and treatment facilities
than ever before.
During the early part of the year an excellent program on the
diagnosis and treatment of syphilis was presented in Jackson-
ville, Miami, Orlando, Pensacola and Tampa in order to make
graduate instruction available to the practicing physicians.
Starting in July a state-wide educational program was inaug-
urated for the lay public. Practically every medium available
was used to arouse public curiosity and interest in the venereal
diseases, their cause, spread and cure. This program was carried
on by five field representatives utilizing the radio, newspapers,
literature, posters, pamphlets, talks, public address systems on
automobiles, and arranging planned programs before civic
groups, churches, schools, farm and industrial groups. After
this program had been in operation a few weeks the number of
persons reporting to clinics for diagnostic observations showed
a steady increase.
The ever increasing effectiveness of the new drugs for com-
batting the venereal diseases and an increased educational and
casefinding program should hasten the day when venereal dis-
eases are reduced to a minimum.
It is planned during the coming year to increase and strength-
en the field investigator staff and educational program in an all
out effort to bring the problem under control.

FLORIDA RAPID TREATMENT CENTER
MELBOURNE, FLORIDA
During the year 1949 operations at the Florida Rapid Treat-
ment Center, Melbourne, were carried out as in former years.
all five venereal diseases (syphilis, gonorrhea, chancroid, granu-
loma inguinale, and lymphopathia venereum) receiving atten-
tion.
During the year a total of 7,037 patients were admitted and
treated for a total of 72,057 days. Of these, 5,948 were suffer-
ing from syphilis in some form; these received treatment for
62,750 days. 624 additional patients held for observation or
found to have no venereal disease accounted for the balance of
4,802 reported days.
A breakdown of patients is shown in the accompanying
chart and summary.








Special cognizance should be taken of the fact that 3,110, or
more than half the total syphilis cases, were patients with pri-
mary and secondary, or early latent syphilis, thus indicating
that they were placed under treatment early enough to receive
optimal results from treatment.
In comparison with previous years, there has been a gradual
but well marked decrease in the number of patients admitted
to the center for all causes. This is, in part, due to greater acti-
vity by out-patient clinics throughout the state in treating
venereal diseases. In consequence, it has been possible to devote
more time to the examination of patients and to securing a
more detailed history of their condition. Greater effort is also
being made in the education of patients while they are at the
center-group talks, lectures illustrated with lantern slides as
well as standard educational movies are presented to the pa-
tients at frequent and regular intervals. Informal talks and
informative booklets are used to encourage their interest in
venereal disease. Patients are also urged to ask questions and
seek information in regard to their conditions at all times.
The staff consists of:
Medical Officers ....------. 2
Nurses ......-------.......---.. -- 6
Laboratory technicians 3
Clerical .........-- .....---------. 18
Attendants .-------...............18
Laborers --......-...........-----. 13
As in previous years, the serological department and labora-
tory have furnished valuable and reliable service and the inter-
viewer has been the source of considerable aid in uncovering
contacts.
A number of changes have been made in the buildings and
the hospital administrative system to meet arising conditions
which it is hoped may enable the Rapid Treatment Center to
function better in the future and be of greater assistance in
meeting the administrative responsibilities of those in charge of
the public health of the State of Forida.

CANCER CONTROL

For nine months of the year, the cancer control program was
seriously handicapped by a shortage of funds. Beginning Feb-








ruary 1, the fees to physicians were reduced one half and the
program was curtailed considerably by only accepting for state
aid those cases which showed an excellent prognosis. Question-
able cases were definitely rejected for care and were prevailed
upon to seek some other means of assistance. In spite of this
handicap, the program operated on practically the same level as
during 1948, but the shortage of funds precluded any expansion
in the program.
New clinics were contemplated and proposed in Tallahassee,
Orlando, and Lakeland, and by the close of the year, with the
receipt of new revenue from the state, it was again possible to
make plans for the new clinics. These clinics should be in full
operation sometime during the next year.
The cancer control law provided a four point program of (1)
Education; (2) Establishment of tumor clinics; (3) Tissue
diagnostic service to all needy patients; and (4) Financial aid
in diagnosis and treatment of medically indigent patients with-
in the limits of available funds. To provide these services, a
state appropriation of $200,000 per year was made available
by the Florida Legislature beginning with the fiscal year July
1, 1947. Beginning July 1, 1949, the Legislature appropriated
$300,000 per year for cancer control. However, only 75% of
the monthly allowance was available for the months of July
through September. Beginning October 1, 1949, 90% of the
monthly allowance was made available for the months of Octo-
ber through December.
The various maps and statistical charts covering the activities
of the cancer program follow.
Map I shows not only the number of cases reported for each
county of the state, but it also shows the number of cases that
were given aid under the cancer control program. It is noted
that all counties have received aid under this program from
its beginning in July 1947, through December, 1949. It is
also noted that in many counties there have been more cases
aided than there have been cases reported. This is due to the
fact that some of the cases turned out to be non-cancerous. The
number of cases aided in Duval, Dade, and Hillsborough is small
due to the fact that these counties operate their own city or
county hospitals and the state cancer program's objective is
not to take over the existing medical facilities, but to supple-








ment any existing medical services. This explains the low num-
ber of cases aided in these counties.
Map II shows the location of the cancer diagnostic, detection,
and treatment centers. It shows the distance in miles patients
may have to travel to obtain services from one of the clinics.
Chart II shows the number of cases aided by counties, the
amount of funds spent in each county for hospitalization and
medical services. It is noted that two counties; namely, Collier
and Jefferson, did not receive any aid for cancer patients dur-
ing the year 1949. In comparison with the year 1948, it is
noted that Flagler, Liberty and Okeechobee Counties did not
receive any cancer aid services. The only reason that these
counties did not receive any services has been that no applica-
tions were received from these counties during these respective
years.
Chart III shows the number of biopsies made during the past
three years. It is noted that the per cent of positives is showing
a slight decrease each year. It may be that physicians are mak-
ing more biopsies. As time goes by, it may mean that the
percentage of positive cancer cases will gradually decrease;
however, the number of specimens examined will probably in-
crease as the program continues. This table shows the number
of specimens examined under the biopsy mailing service and
includes examinations made for other than state-aid cases.
There are nineteen pathologists in the state practicing in
thirteen counties who are cooperating in this program.
Chart IV shows the number of biopsies examined by months
for the three years the cancer program has been operating.
Chart V shows the services rendered in each of the larger
tumor clinics. It is noted that the number of individual phy-
sicians attending each of the tumor clinics shows the interest
of the physicians in learning more about cancer. The control
of cancer requires the services of the various specialists and the
clinic sessions serve as instruction periods for physicians in
attendance.
Chart VI shows the average cost per case for hospitalization
and other services for the years 1948 and 1949.
Chart VII shows the number and percentage distribution of
cases of cancer by site, race and sex, for 1949.
Chart VIII shows the number and percentage distribution of
state aid cases according to status, by race and sex, 1948 and
1949.








VETERINARY PUBLIC HEALTH
The Veterinary Public Health Program, in the Bureau of
Preventable Diseases, is concerned with all those diseases of
animals transmissible to man,-those communicable by contact
and association and those by ingestion of animal and animal
food products.
Rabies still persists as a problem, but has been reduced ma-
terially from the previous year of 1948, when 332 animal and
one human case were diagnosed and confirmed by the labora-
tory. In 1949 seventy-three animal and no human cases of rabies
were reported. Table No. 1 gives these cases of rabies both
by county and species. Six hundred twenty-eight (628) ani-
mal heads were examined in 1949. Fifty-eight of these were
found positive by direct microscopic examination and fifteen
additional were found positive by mouse inoculation. Mouse in-
oculation, or mouse tests, were made on all those specimens
which were questionable upon microscopic examination or on
those specimens not suitable for direct smear examination.
Seven hundred seventy (770) doses of human Anti-Rabies
vaccine were dispensed in 1949 as compared to 1,322 treatments
in 1948. The reduction in rabies is directly a result of better
vaccination programs and stray dog control by those muni-
cipalities and County Health Departments where rabies existed.
A state-wide rabies law was sponsored by the Florida State
Board of Health and Florida Veterinary Medical Association,
but was not passed by the 1949 legislature. (Map in Appendix.)
Brucellosis is a disease which affects both farm animals
(cattle and hogs), and human beings, the latter receiving their
infection from the former. In farm animals the disease is known
as infectious abortions, or Bang's Disease, while in humans it
is called Undulant Fever. Much progress was made in combat-
ting Brucellosis in 1949. Major milk sheds in Florida, with the
exception of two, have adopted or modified their milk ordi-
nances with reference to Brucellosis. This ordinance requires
that all cattle producing milk to be consumed raw, must be
from herds free from this disease. A routine Brucellosis ring
test is being run on this milk, which will give a periodic
check on the status of the herd with each routine milk sample
(usually once a month), supplementing the annual blood test
as required to retain a negative herd status for milk to be








sold raw. Also all herds producing milk for pasteurization must
be under plans approved by the Florida Live Stock Sanitary
Board and the U. S. Bureau of Animal Industry. In the two
milk sheds mentioned above, all the cattle have been, or soon
will be, on an approved Brucellosis program. As Florida is a
dairy cattle importing state, this has been a major problem,
as many of the cows imported are found, on arrival, to be
infected. The family milk cow has not been overlooked and
county sanitarians are cooperating with the federal, state and
local veterinarians in arranging and assisting these veterin-
arians in testing and eliminating the infected animals. Brucel-
losis in man can only be controlled by eradication of the dis-
ease in animals. Eighty-six cases of human Brucellosis were re-
ported in Florida during 1948. Again this appears to be much
too low as compared to the disease incidence in the animal re-
servoir. In the past year, out of 99,456 cattle tested for Bang's
Disease or Brucellosis, 10,579 were found to be infected. This
high rate of infection, however, is the result of the concentra-
tion of effort in the commercial dairy herds where the per cent
of infection is highest. (See Map in Appendix.)

Bovine Tuberculosis-All cattle from which milk is sold
should be tested annually as required by the milk laws of Florida.
This again is important as Florida imports a large per cent of its
dairy cattle from areas where tuberculosis exists. Fifty-three
tuberculosis reactors were found in 87,610 cattle tested. These
reactors were in both dairy herds and in family milk cows. And
until tuberculosis is completely eradicated, the Florida State
Board of Health will encourage and continue to cooperate with
the various control agencies concerned. (Map in Appendix.)
Twenty-nine cases of Tularemia are reported by laboratory
diagnosis. No epidemiological survey of this disease was at-
tempted.
Following a survey made by Dr. Sondag, Director of the
Bureau of Preventable Diseases in 1948, in which, 1,100 phy-
sicians were contacted to determine the incidence of larva
migrans or creeping eruption, five hundred fourteen, (514) phy-
sicians had reported and stated they had treated 7,781 cases
in the previous six months. Creeping eruption of humans is
contracted by contact with soil contaminated with the hook-
worm larva of the dog and cat. A study was started in co-
operation with the U. S. Public Health Service, Communicable








Disease Center, and is still being made to determine the inci-
dence of hookworm (Ancylostoma braziliense) in the cat and
dog in Florida. Better control measures are being studied, which
include soil larvacides and their usefulness in destroying the
dog and cat hookworm larva in the soil. As this study is not
complete, the control of creeping eruption is yet to be worked
out. One obvious plan will be strict dog and cat control, espe-
cially on beaches and resort areas; the education of dog and
cat owners of the need to free their pets from the hookworm
infection and the practice of sanitary measures in disposing of
dog and cat feces. Another method of control is the broad use
of soil larvacidal agents, a number of which have been tested,
but before they can be recommended, additional work as to
their toxicity, etc., must be done.
The Veterinary Public Health Laboratory in the Bureau of
Laboratories, Florida State Board of Health, has expanded its
activities materially, thus giving additional assistance to
veterinarians, physicians, animal disease control agencies
and other phases of agriculture in better diagnosing those
diseases of animals communicable to man. At the request
of various veterinarians and the Florida State Veterinary
Medical Association, open house was held at the State
Board of Health Laboratory prior to the annual meet-
ing of the Florida Veterinary Medical Association. New tech-
niques and diagnostic aids, pertaining to veterinary medicine,
were discussed and demonstrated. This was very well received
and will probably become an annual custom. The report of the
veterinary section of the Bureau of Laboratories will appear
under the annual report of the Bureau of Laboratories.
Surveys of abattoirs and slaughtering plants have been made
in many municipalities and counties, regarding the inspection
and sanitation of meat and meat products. Meeting were held
with cattle men, meat packers and the Live Stock Sanitary
Board to plan more adequate and overall coverage of this phase
of veterinary public health. Until the public can be educated to
the need of this vital phase of food hygiene and demand that
measure be taken through legislation to govern this industry,
local and state health officials are at a loss. The committee on
Food and Milk Hygiene at the American Veterinary Medical
Meeting in San Francisco, reported that in 1947 more than 40,-
000,000 pounds of unfit meat went to public markets because of
failure of many states, and municipalities to provide complete








and adequate veterinary inspection at slaughter houses and
abattoirs.
Federal meat inspection applies only to meat for interstate
or foreign commerce. There are three such establishments in
this state. Florida has legislation governing the slaughter, pack-
aging and handling of meats and meat products on a voluntary
basis for those abattoirs which wish an unrestricted market
within the state. This is entirely voluntary and all but fourteen
abattoirs maintain this type of inspection. The balance of ani-
mals slaughtered for food in Florida, are under municipal in-
spection, which varies in its degree of adequacy or under no
sanitary supervision at all. There is a great need for state-wide
supervision of meat and meat food products.
Public Health Veterinarians of the State Board of Health,
have assisted in the training center, maintained by the Board of
Health in Alachua County. They have helped in training sani-
tarians in milk inspection, meat market inspection and in rabies
control as to investigation, quarantine and stray dog control
measures. Three such classes have received this instruction
in 1949. Also two Health Officers received some instruction
in Milk and Food Hygiene and Rabies control.
With the assistance of the Bureau of Health Information, ma-
terial was assembled for the July issue of FLORIDA HEALTH
NOTES, monthly publication of the State Board of Health, de-
voted to Disease of Animals Communicable to Man.

DIVISION OF INDUSTRIAL HYGIENE
In carrying out the Industrial Hygiene portion of the Divi-
sion's activities, 236 visits were made to 170 industrial plants,
and 29 studies of potential hazards were done. Improvements
were recommended in 38 cases and 19 improvements were ef-
fected. The work of surveying new industries was continued.
First visits were made to two Federal agencies, the U. S. Naval
Station at Green Cove Springs, and the Naval Submarine Base
at Key West.
The chemical laboratory made 493 analyses on the 240 sam-
ples submitted. The program of blood and urine lead deter-
minations was continued as was also the work on determination
of mercury in urine. The occurrence of new potential hazards
again widened the range of laboratory work.








The study of citrus dermatitis was continued. Over 1000
pH determinations were done, partly to determine whether the
alkaline bath was a potential cause of dermatitis and partly to
ascertain the pH range to which the sectionizer's skin is ex-
posed while at work. Most of the occupational disease claims
for citrus dermatitis were followed up. This problem still re-
quires extensive investigation in order to define the causative
factors.
Work was continued on dust studies initiated in West Florida
in 1948. Studies were made in a fuller's earth mill, a monument
works, and an iron foundry. A request was received from the
safety officer at one of the Naval Stations for assistance in de-
termining the degree of hazard at a wet sand-blasting opera-
tion. A study of this operation was made and recommendations
for the control of the hazard were submitted to the officer in
charge.
Requests for services totaled 53, many of them being
concerned with complaints of atmospheric pollution. For one
example, the division was called in consultation to investigate
the cause of an occurrence of damage to nylon stockings. Chemi-
cal analysis showed that the nylon threads had been dissolved
by a strong mineral acid carried by minute particles of soot.
The principal source of the acid was the combustion of a sulfur-
containing fuel oil.
A request was received from the school of Aviation Medi-
cine, Naval Air Training Base, Pensacola, for assistance in de-
termining the concentration of mercury vapor in the air of
some of their research laboratories. A mercury vapor detector
was borrowed from the U. S. Public Health Service for the pur-
pose of making this study. The concentrations of mercury vapor
were so small that they did not present a hazard to the exposed
workers.
One new problem which confronted the division during the
year was the potential hazard of cleaning gasoline tanks in air-
plane wings. Because the staff chemist was absent on post-grad-
uate work, it was impossible to undertake the laboratory work
required in such a study. The industrial physician concerned
with this problem was referred to the Ethyl Corporation of
America and satisfactory arrangements have been made to
study the potential hazard involved.
The most troublesome problem in atmospheric pollution was








presented by the operation of a small lead smelter. Discarded
storage battery plates were being reduced to metallic lead with
a small content of antimony. The dense fumes given off in the
process created a serious nuisance in a nearby housing develop-
ment as shown by the fact that the lead concentration in the
smoke at a distance of 1,000 feet downwind was in excess of
the maximum allowable concentration permitted in industrial
operations. Executives of the company made some changes in
the process when the hazard was drawn to their attention, but
the nuisance persisted. The residents of the community obtained
an injunction, halting the operation of the smelter until the nui-
sance could be corrected.
A considerable amount of attention was given to the preven-
tion of parathion poisoning. The circular issued by the U. S.
Public Health Service was mimeographed and 542 copies were
sent to insecticide and fertilizer plants, grove owners, and coun-
ty health departments. In addition, a short editorial on para-
thion poisoning was contributed to the Journal of the Florida
Medical Association. In spite of these precautions one man died
from parathion poisoning. One other patient had a relatively
acute case, but recovered and several minor cases were reported.
An investigation was made of an epidemic of anaphylactic
reactions to castor bean meal. While this disease entity had
been previously recognized, the medical literature on the subject
is rather scanty. It has been suggested to the attending phy-
sician that he publish his findings.
Suggestions were given to the Florida Industrial Commission
concerning the proposed revision of its publication containing
the rules and regulations for the prevention of occupational di-
seases. One inspector of the Florida Industrial Commission was
shown through a lead smelter in Miami, and the process of a
Tampa smelter was demonstrated to another inspector of the
Commission. As in previous years, copies of all claims of oc-
cupational diseases were referred to the Division of Industrial
Hygiene.
The director assisted in making the annual physical examina-
tions of personnel of the Florida State Board of Health. The
division was responsible for most of the First Aid treatment
rendered for personnel of the Central office. A revision of the
Merit System requirements for sanitary engineer was made
with the cooperation of the Bureau of Sanitary Engineering.









The only publication for the year was the paper on "Citrus
Dermatitis in Florida," published in the Journal of the Florida
Medical Association. A number of abstracts were contributed
to Excerpta Medica.
Among the meetings attended by one or more members of
the staff were the Annual Meeting of the American Conference
of Governmental Industrial Hygienists, and the Florida En-
gineering Society. In addition, a paper was read at the Florida
Medical Association meeting at Bellaire. A course on the Medi-
cal Aspects of Nuclear Energy, held in Washington, was at-
tended.
In September, 1949, Mr. W. E. MacDonald, Industrial Hygiene
Chemist, began a post-graduate course in the University of
Florida at Gainesville in order to qualify for the degree of
Master of Science.

Occupational Disease Claims
JANUARY 1, 1949-DECEMBER 31, 1949
TO TA L .............................................................................. ........................... 1352
Conjunctivitis ................................................. 237
W elders ......................................... ........ ............... ...... 232
Chemical ...................................... .. .. ... ............ 5
Infection ........................................................................................................ 43
M eat .......................................... .......................................................... 18
Undulant Fever ............................................. ....................... 1
Brucellosis ............................................ ........................................... 2
Tuberculosis ............................................................. ........... ......... 2
Typhus Fever ..................................................... ...................... 1
Other ............................................................... ............................... 19
Tenosynovitis ................... ............ .. ........ .... .................-. 12
Repeated Motion, Pressure & Shock ..................................................... 27
Respiratory Irritations ..................................... ..... ... ...... ........... 67
Temperature Changes ......................... ...................... 5
Gas ....................................................-. ... .. ...- .................. 2
M etals ........................................................................ ......... 4
L ead .......................................... ....................... ... .. .............. 3
Other .......................... ............................. ................. .... 1
Silicosis .................................................. .......... ....................... ... 1
Variations in Air Pressure ................................... ... ........... .... 2
D diagnosis Indefinite ....................................................................... ...- 3
Dermatitis ...................................... ...-...-........ 949
Fruit .......................... .. ............ .. .......... ............ .......... 214
A lkali --- ..................... ....... .. ..... ................... 178
Larva Migrans ........................................ 148
Other Chemicals ...................................................... 105
Fungus ..........................----. ...- .. .......... 71
Plant .4................................................. 42
Glue ................................. .... ..... .... -.-- ...--... --- ----..-.. 8
Creosote ................... .. ................. ... ..... 8
Solvents & Oils ................................... ...... ............. ..--.... 101
Actinic ................-........................---- ----------------- 2---- ..... 2
Parasite ............................ .... .............. ........................ 2
Other .............................-------------------- ------------------- ---------..... 70


























CHART I












CHART II STATE AID CANCER CASES AND EXPENDITURES
FOR 1949 BY COUNTY AND SERVICE RENDERED,
State
Aid HOSPITAL SURGERY
COUNTY TOTAL Cases Cs. Days Cost Cs. Cost


GRAND TOTAL
Alachua
Baker
Bay
Bradford
Brevard
Broward
Calhoun
Charlotte
Citrus
Clay
Collier
Columbia
Dade
DeSoto
Dixie
Duval
Escambia
Flagler
Franklin
Gadsden
Gilchrist
Glades
Gulf
Hamilton
Hardee
Hendry
Hernando
Highlands
Hills borough
Holes
Indian River
Jackson
Jefferson
Lafayette
Lake
Lee
Leon
Levy
Liberty
Madison
Manatee
Marion
Martin
Monroe
Nassau
Okaloosa
Okeechobee
Orange
Osceola
Palm Beach
Pasco
Pinellas
Polk
Putnam
St. Johns '
St. Lucie
Santa Rosa
Sarasota
Seminole
Sumter
Suwannee
Taylor
Union
Volusia
Wakulla
'alton
Washington


$124.495.63 1.176 556 4.700 51,154.16 216
332.75 36 22 1131 1.57.60 6
1 326.32 17 7 48 582.02 2


2,469.65 22 10 5
1385.271 19 6 42
698.20 ~ 2 31
132.45 2 18 12
809.20 17 5 14


15 I


2
42-
13 4


L.


1,711.70
1.97L.90


16.610.98

3,555.25
7.630.33
2,244.05
1.107.04
1,235.99
851.15
2.022.04
783.83
835.51


861.25


861.25
451.27
403).70
_,;.s '.70


588.00


76 587.40 o

15 211.50 1
10 135.98 4


8 102 1
4- 35 I


91 3


71 3


.071.86 I


15, 57.50
35.00
75.00


100.00
50.00
50.00
70.00


100.00
100.00


175.00


275.00
100.00
100.00
145.00
522.50
322.o50
120.00
120.00

125.00
21500.

400.00
110.00
25.00
822.50
292.50
210.00
167.50


85.00


150 1.462.89 5 55,00
119 1.018.54 17 1.022.50
317 3.334.28 12 1,212.50
98 976.95 5 372.
70 02.04 2 230.00
42 503.34 1 100.00
26 282.00 2 200.00
76 652.12 4 25.00
29 212.58 -
*n4 271.00 2 175.00


23


225.00
60.00
775.00
25.00
10.00
175.00





- i


S1
1 1

57


3











CHART II STATE AID CANCER CASES AND EXPENDITURES
FOR 1949 BY COUNTY AND SERVICE RENDERED (Continued)

X-RAY RX. X-RAY DIAG. RADIUM BIOPSY OTHER
Cs. Co C ost Cost Cs. Cost Cs. Cost Cs. Cost


23.408.00 396 5,077.90 60 4,736.37
517.50 13 1 2.75
357.50 6 62.50 -


).001 2


59.00 ;


.50 -


100.00 7


27.50 11


27.50 -
32.50 -
22.50


75.00


217.44


4,389.25 509 20,271.75
75.00 17 47.
4+5.0o 7 204.30
25.00 9 690.65
120.00 7 146 .5


- I2 1 53.00


-1 2


S1 -I 1


25.00
25.00
347.00
87.50
715.00


85.00 I


29.90
516.21
697.21

49.20
5.00
246.15

15.00
172.80
199.45
82.10

1062.31
218.50


148.75


5 1598.50
2 107.05
6 370.4Q
7 172.95


377.70
781.21

15.00
213'18
54.15
459.92
269.51


22 I 460.25 I 23 I 571.49


41 102.50


h


7.50 I


67.50 1 2


647.50


230.00


167.50


29 1.507.50


26 1


422.50 I 19


55.00


655.00

105.00
140.00
712.50

725.00
232.50


21


fCQ | .Ihj


-I




























TUMOR CENTERS AS OF FEBRUARY 1, 1950
SHOWING LOCATION AND DISTANCE BETWEEN CENTERS

DIAGNOSTIC X
DETECTION O
TREATMENT 0


0 -


CHART III

SPECIMENS EXAMINED
UNDER FLORIDA STATE BOARD OF HEALTH
CANCER CONTROL PROGRAM, 1947-1949
Non-
Year Examined Malignant Per Cent Malignant
1947 ................... 304 118 39.0 184
1948 ..------....---. 973 336 35.0 637
1949 -.....--....--....- 1149 395 34.0 754
Total ............-----. 2426 849 35.0 1575








CHART IV


BIOPSY EXAMINATIONS SUBMITTED
BY MONTH, 1947-1949

Total Number Examinations
MONTH1947 1948 1949
January .-..---..-------...-...--.---- -- -40 116
February -....-...-.....-- ...-................- 47 76
March --....-----........................ ....... .. 3 53 120
April .-..-...-..........-....- .......... ...... 15 50 96
M ay .............................. ............. 32 83 87
June ......-----.. -----.......--......-.....-- .. 32 64 85
July ...................... ............. ......... 43 105 109
August .--.............-........-- .............- 28 118 89
September -..................................... 24 89 99
October ..........................-............. 33 119 93
November ..-...-..-............................ 41 91 84
December ......-...---- .......- .........-.... --53 114 95
TOTALS .............................. 304 973 1,149



CHART V

CANCER CLINIC ACTIVITY REPORT FOR 1949



Number of:



Patients Reg. ....... 262 415 486 327 39 199 76
Clinic Sessions ...... 24 51 52 44 24 49 16
MD's Present ...--..- 47 301 273 392 64 326 116
Patients Ex.
(New) ......-...-- 131 415 395 326 39 199 55
(Follow-up) -- 134 1597 65 562 45 337 32
Medical Confs. -- ... 6 48 47 21 8 48 16
MD's Present ---.. 25 1405 370 340 103 590 116
Cases Reviewed .... 8 184 404 103 15 93 79
















CHART VI
FLORIDA STATE-AID CANCER CASES BY TYPE OF SERVICE
AND AVERAGE COST PER CASE FOR 1948 AND 1949

OTHER
X-RAY (Includes X-Ray
TOTAL HOSPITAL SURGERY Rx Radium Diag. & Biopsy)
SYear Cases Cost Cases Days Cost Cases Cost Cases Cost Cases Cost Cases Cost
1948 .......... 1074 150,751.32 509 5718 70,944.94 311 25,386.50 657 35,122.25 94 8,149.74 472 11,147.89
1949 ............ 1176 124,495.63 556 4700 51,154.16 216 15,457.50 442 23,408.00 60 4,736.37 1072 29,738.90
1948 Avg .... 140.36 11.2 139.38 81.63 53.46 86.70 23.62
1949 Avg. .. 105.86 8.4 92.01 71.56 52.95 78.94 27.74













CHART VII


NUMBER AND PERCENTAGE DISTRIBUTION
OF CASES OF CANCER AND OTHER MALIGNANT TUMORS
ACCORDING TO SITE, BY RACE AND SEX
FLORIDA STATE-AID, 1949


WHITE COLORED
SITE TOTAL MALE FEMALE MALE FEMALE
No % No I % No No % No % No %
a Buccal Cavity ............................... 22 3.4 12 54.5 3 13.6 3 13.6 4 18.2
Total Digestive Organs ................ 29 4.4 16 55.2 8 27.6 4 13.8 1 3.4
Stomach .......................... 13 2.0 4 30.8 2 15.4 6 46.2 1 7.7
Respiratory System .................... 30 4.6 19 63.3 2 6.7 4 13.3 5 16.7
Total Genital .................................. 32 4.9 12 37.5 13 40.6 7 21.9
Uterus & Cervix ............ 117 17.9 3 2.6 89 76.1 2 1.7 23 19.6
Urinary System.............................. 16 2.5 8 50.0 7 43.8 1 6.2
Breast ............................................... 72 11.0 2 2.8 48 66.6 1 1.4 21 29.2
Skin ................................................. 303 46.4 198 65.3 92 30.4 8 2.6 5 1.7
Other ............................................ 19 2.9 11 57.8 5 26.3 1 5.2 2 10.5
TOTAL .................... 653 100.0 285 43.6 269 41.2 37 57.0 62 9.5









CHART VIII
NUMBER AND PERCENTAGE DISTRIBUTION OF CASES APPROVED FOR
STATE-AID ACCORDING TO STATUS, BY RACE AND SEX
FLORIDA, 1948-1949

1949


WHITE COLORED
TOTAL MALE FEMALE MALE FEMALE
STATUS No % No % No % No % No %
Cancer and other malignant tumors 653 57.1 285 43.6 269 41.2 37 5.7 62 9.5
No malignancy .................................... 310 27.1 87 28.1 161 51.9 18 5.8 44 14.2
SIncomplete information ................. 181 15.8 64 35.4 77 42.5 14 7.7 26 14.4
TOTAL .................................. 1144 100.0 436 38.1 507 44.3 69 6.0 132 11.5


1948

WHITE COLORED
TOTAL MALE FEMALE MALE FEMALE
STATUS No % 'No % No % No % No %
Cancer and other malignant tumors 776 51.6 253 32.6 341 44.0 56 7.2 126 16.2
No Malignancy .................................. 298 19.8 62 20.8 162 54.4 24 8.0 50 16.8
Incomplete information .................... 429 28.5 139 32.4 209 48.7 21 4.9 60 14.0
TOTAL .................................. 1503 100.0 454 30.2 712 47.4 101 6.7 236 15.7





















STATE BOARD OF HEALTH

BUREAU OF PREVENTABLE DISEASES


CANCER CASES REPORTED 1947-1949
( /ow./ n /in f'/t ./urPes county)

CANCER CASES APPROVED FOR
STATE AID 1947-1949
oS>n / second gures after' o'sas)


Exam/<,e: Co///e'r County/ 11-8
II cases reported
*S approvedf/orsiate aid


NUMBER OF VENEREAL DISEASE CASES REPORTED IN FLORIDA
BY DISEASES AND YEAR, 1945-1949

GRANU- LYMPHO-
GONOR- CHANC- LOMA PATHIA
YEAR SYPHILIS RHEA ROID INGUI- VENER-
____ NALE EUM
1945 16,546 18,088 722 244 197
1946 16,067 18,548 818 257 176
1947 16,653 20,160 745 271 216
1948 15,395 18,820 388 773 197
1949 12,363 15,388 343 827 127
(Out of State Cases Excluded)


- .






Total Number of Syphilis Cases Reported by Stage of Infection, Pregnancy Status, Race and Sex, Source of Reference, Age
Groups and the Number and Percentage of Cases Admitted to the Rapid Treatment Center by Counties, Florida, 1949.
STAGE OF INFECTION RACE AND SEX SOURCE OF REPORT AGE GROUPS Admissions
SWhite Colored to R.T.C.

COUNTY 1 o Z

Zd ^ R 0 -

TOTAL 12,405 1,077 1,297 4,817 4,731 483 897 1,437 1,420 3,946 5,602 6,396 5.339 366 304 47 62 294 3,598 3,395 2,231 1,308 600 330 540 5,949 48.0
Alachua 155 10 18 58 60 9 40 27 15 28 85 115 37 2 1 1 3 67 41 21 7 5 2 6 101 65.2
Baker 28 7 8 3 10 5 2 .1 11 11 24 1 13 6 4 3 1 16 57.1
Bay 156 36 16 59 39 6 6 29 33 32 62 76 76 I 1 6 61 11 25 11 9 2 87 55.8
Bradford 29 1 7 11 8 2 3 2 12 6 9 26 2 1 1 1 10 6 7 3 1 27 93.1
Brevard 113 7 6 35 64 1 4 7 2 38 66 38 73 1 1 29 4 27 12 8 3 68 60.2
Broaard 492 35 62 207 165 23 39 37 13 148 264 162 298 24 8 3 2 8 157 139 98 46 22 7 10 190 38.6
Calhoun 21 5 5 8 3 6 4 4 7 17 4 1 7 4 5 3 1 17 81.0
Charlotte 17 2 1 8 6 1 1 7 1 2 15 6 1 4 1 1 2 2 9 52.9
Citrus 44 2 26 15 1 5 2 9 11 22 40 4 1 21 6 8 3 4 1 17 38.6
Clay 22 1 6 10 3 2 4 4 7 7 13 8 1 1 7 3 1 1 25 113.6
Collier 14 1 3 6 3 1 2 1 1 4 8 2 12 -- 7 2 2 1 1 1 5 35.7
SColumbia 56 2 4 14 29 7 5 8 10 22 16 32 16 2 6 -- 3 13 16 10 6 5 2 1 36 28.6
01 Dade 2,465 301 186 966 965 47 112 388 336 694 1,047 1,034 1,393 14 21 2 5 24 581 738 516 300 128 64 107 63 2.6
DeSoto 62 4 9 24 20 5 5 7 3 20 32 32 28 1 1 1 5 14 13 13 6 3 2 3 62 100.0
Dixie 25 2 5 17 1 2 1 7 3 14 25 2 4 8 8 1 1 6 24.0
Duval 1,595 171 171 693 524 36 162 151 202 419 793 852 720 16 7 3 6 13 491 459 263 166 75 26 93 994 62.3
Escarnbia 510 37 84 220 154 15 22 47 58 172 233 375 127 3 -5 2 3 .6 160 166 99 51 10 7 6 412 80.8
Flagler 45 5 9 20 11 1 1 2 25 17 21 24 13 11 8 5 4 3 1 37 82.2
Franklin 33 1 2 10 18 2 2 3 5 10 15 22 11 1 12 5 9 5 1 21 63.6
Gadsden (Ex.) 145 10 25 65 39 6 15 5 9 46 85 129 16 1 5 77 23 21 5 2 1 10 116 80.0
State Hospital 93 9 83 1 25 10 33 25 93 8 12 19 31 13 7 3 -
Gilchrist 5 2 3 1 1 1 2 2 3 1 1 2 1 1- 20.0
Glades 10 1 6 3 2 3 7 9 1 4 2 2 1 1 16 160.0
Gulf 23 1 3 9 9 1 1 3 3 4 13 12 11 1 4 10 6 1 1 17 73.9
Hamilton 39 5 3 19 11 1 6 1 3 12 23 34 5 1 1 15 12 8 1 1 22 56.4
Hardee 16 5 9 2 4 2 3 6 5 10 5 1 1 1 3 5 3 1 2 10 62.5
Hendry 42 2 7 16 16 1 1 3 14 25 28 14 1 12 14 9 5 1 42 100.0
Hernando 11 5 3 3 2 1 4 6 8 2 1 5 4 1 1 11 100.0
Highlands 111 14 15 42 39 1 12 4 14 40 53 33 77 1 3 24 39 17 15 5 4 4 55 49.5
Hillsborough 956 91 89 332 424 20 63 158 148 304 346 462 401 90 3 1 3 10 266 2,5 183 118 62 41 27 456 47.7
Holses 7 2 1 4 6 1 5 1 1 2 1 2 2 8 114.3
Indian River 67 4 3 23 35 2 2 7 2 36 22 40 26 1 1 1 18 16 15 7 2 3 4 48 71.6
Jackson 92 8 6 28 22 28 11 11 6 36 39 69 10 13 3 3 19 37 17 6 4 3 55 59.8
Jefferson 24 3 8 12 1 6 1 2 5 16 15 9 -15 6 2 1 14 58.3







Total Number of Syphilis Cases Reported by Stage of Infection, Pregnancy Status, Race and Sex, Source of Reference, Age
Groups and the Number and Percentage of Cases Admitted to the Rapid Treatment Center by Counties, Florida, 1949. (Cont.)
STAGE OF INFECTION RACE AND SEX SOURCE OF REPORT AGE GROUPS Admissions
> WHITE COLORED to R.T.C.

COUNTY



Lafayette 8 4 4 1 3 5 8 -2 1 3 2 6 75.0
Lake 134 6 17 54 55 2 9 15 10 48 61 52 80 2 1 3 39 38 22 14 8 6 3 76 56.7
Lee 85 2 20 32 26 5 4 7 14 23 41 28 54 1 2 1 4 28 17 17 8 2 1 7 27 31.8
Leon 276 29 40 117 71 19 4 49 19 101 107 142 81 1 52 2 1 17 91 71 37 14 11 3 29 125 45.3
Levy 102 6 7 35 30 24 8 1 3 36 62 88 14 2 2 20 34 19 12 4 3 6 112 109.8
Liberty 6 1 5 1 2 3. 6 1 2 1 1 1 1 7 116.7
Madison 63 4 8 27 17 7 19 3 6 14 40 41 22 1 4 1 28 15 10 3 1 40 63.5
Manatee 116 7 12 52 40 5 12 6 8 34 68 70 45 1 2 1 3 38 29 15 10 6 5 7 73 62.9
Marion 164 14 44 46 56 4 11 10 6 66 82 101 59 2 2 2 1 2 75 31 23 18 7 5 112 68.3
Martin 32 2 7 12 11 2 4 7 19 24 8 8 12 6 4 1 1 22 68.8
Monroe 53 2 2 19 22 8 2 9 16 12 16 31 19 3 1 7 7 9 11 4 3 11 15 28.3
Nassau 19 4 3 8 3 1 2 2 4 5 8 12 7 1 6 3 2 4 1 2 12 63.2
Okaloosa 39 3 7 21 7 1 3 6 10 5 18 30 8 1 17 13 5 3 1 33 84.6
SOkeechobee 23 1 3 13 3 3 6 1 7 15 16 7 3 10 5 20 87.0
Orange 302 15 23 113 141 10 19 29 22 108 143 154 143 2 3 3 1 5 68 107 58 34 13 6 7 201 66.6
Osceola 23 2 8 11 2 4 2 4 7 10 13 9 1 9 3 4 2 1 3 1 20 87.0
Palm Beach 646 52 86 275 218 15 57 34 50 265 297 408 235 1 2 2 2 15 215 192 112 58 22 12 16 519 80.3
Pasco 64 1 10 21 26 6 3 11 9 22 22 40 22 1 1 2 2 13 23 9 10 3 1 1 48 75.0
Pinellas 569 24 31 203 279 32 42 106 96 143 224 252 283 32 2 1 1 24 134 126 87 71 46 47 29 241 42.4
Polk 729 60 69 222 324 54 36 62 71 258 338 364 301 62 2 5 6 39 187 157 148 68 38 24 57 473 64.9
Putnam 183 13 22 64 79 5 15 9 14 67 93 106 72 1 4 1 5 66 40 26 21 10 8 6 124 67.8
St. Johns 101 5 9 56 28 3 7 3 4 42 52 73 25 2 1 36 34 8 7 6 4 6 55 54.5
St. Lucie 125 24 17 39 37 8 22 3 6 43 73 81 44 4 1 43 40 19 12 2 4 71 56.8
Santa Rosa 22 1 1 7 13 4 3 8 4 7 16 6 9 4 6 3 18 81.8
Sarasota 122 12 8 55 47 4 13 11 31 67 54 66 1 1 23 43 29 11 7 3 6 22 18.0
Seminole 201 8 16 66 104 7 22 7 8 83 103 48 153 -1 4 62 51 28 25 4 2 24 79 39.3
Sumter 60 1 5 24 28 2 4 4 6 19 31 37 23 2 12 16 11 10 6 2 1 30 50.0
Suwannee 87 4 23 21 20 19 11 6 1 34 46 67 19 1 2 2 14 24 18 11 10 3 1 2 27 31.0
Taylor 34 1 2 14 13 4 6 1 6 12 15 27 7 1 16 6 5 3 1 2 25 73.5
Union (Ex.) 22 1 3 10 8 2 5 5 2 10 18 2 1 1 9 7 2 2 1 1 16 72.7
State Prion 140 1 112 26 1 35 3 80 22 40 29 50 29 17 4 1 10 -
Volusia 238 9 26 83 114 6 15 22 13 99 101 168 69 1 1 2 2 73 74 32 29 10 10 5 193 81.1
Wakulla 7 2 5 1 5 1 1 2 1 2 1 8 114.3
Walton 21 5 7 8 1 1 5 6 3 7 17 4 1 7 6 3 3 1 8 38.1
Washington 24 1 2 9 7 5 1 1 6 16 24 1 2 3 11 2 3 1 1 27 112.5
Out of State 42 3 1 13 25 1 17 8 14 3 9 19 6 8 5 15 8 4 10 -












REPORT OF IN-PATIENT CARE SUMMARY

Provided Under USPHS National Defense Funds

Melbourne, Fla.


SYPHILIS


Previous treatment .... ...--...
No previous treatment .........
Relapses ...... ..... ..... .. ....
Reinfections ... .. .......... .... ...
C Completed course treatment
I.------------


Primary
and
Secondary

. 52
883
4
79
1,043


549
1.297
196
50
2,075


Late or
Late
Latent Pregnancy

1.102 -
657
119 -


1,868


Congenital

63
2',3
33


3883


C
(
M


NS
Asymp. Total
eng.) Syphilis

224 1.990
299 3,429
48 400
129

568 5,912


Not in Combination with
Syphilis

Other No
Venereal Post Venereal
Gonorrhea Diseases Rx. Obsvr. Diseases

4 26 46
61 279 592
3 54 -
9 13 2
78 368 -


Total patient days .....-.. .....
Others _-.. .._....--
Total days, all patients subtracted
Total admissions for 1949 ......


Total No. patient days spent in Center, 73,761.


Table 3. TOTAL NEW ADMISSIONS
Color MALE FEMALE
Under 20 20.24 25 & Over Under 20 20-24 25 & Over
White .............. .... 73 72 342 109 100 308
Non-white .......... ... 544 573 1721 931 723 1541

Total: 1004 White
6033 Non-white

7037


20,733


19,043


3


20.739


2.092


6


4,900


19.067


Total


Total
Patients

2,066
4,361


610
6.388


1.878


62,691


4.904


16


389O


62,750


5.948


48


193


68.096
576 640
4,609 72.957
592 7.037


48


1


-


.
_


I


1906


2092 1 87














TABLE 1


Reported Cases of Animal Rabies (By Species) Tularemia and

Undulant Fever, by County, Florida, 1949


ANIMAL RABIES


COUNTY sl



TOTAL 75 2 66 2 4 1 29 1 86
Alachua 1 1 1 2
Bay 1 I1 I 2
Bradford I 1
Brevard 1 | 1__ 1 I
Broward___ ___ 2
Charlotte_____ 2
Citrus 1 __ I
Columbia 1 __ 1 __ 2
Dade 9 __ 9 __ 2 11
DeSoto I___ _F_ 1_
Duval 1 5I1 I_ 5 5
Escambia 1
Flagler __ I 1
Gadsden 1 4 11 3 1 __
Gulf 2
Hamilton II_____1 I 1
Hendry
Hernando 2 2 __ I
Highlands 1 1
Hillsborough 9 __ 8 1 2 16
Holmes _
Jackson 1 1 2
Jefferson I 2 3
Lake I 1 ____ 1 3
Lee 1 I I
Leon 9 1 8
Levy________ 3
Madison __ 1_ ____ 2
Marion ___ I
Nassau 1
Okeechobee 1
Orange I 1 1 1 3
Palm Beach I 1 2 1
Pasco 6 6 ___ _1
Pinellas I 2 1 3 2
Putnam I 1
St. Johns 5 5 1 1


St. Lucie 1
Santa Rosa
Sarasota
Sumter


Suwannse I


Union


Unoni1


I I
I I 2


t 1
6


I


V.1u~i.


SI


I 17 I


Vnlurin




TOTALS OF REPORTED CASES OF NOTIFIABLE DISEASES, BY COUNTIES, FLORIDA, 1949
I a

; i S
IZ I K *
YEAR 1949 g -
g S g I 5 5 g
I3 .3 a p o i Q E f a r

Total This Year 4,394 343 2,841 75 134 206 135 77 T0 22 4 43 15,388 827 6,636 258 4 0 0 127 43
Alachua 38,245 109 6 29 2 7 1 1 2 47 23 319 36 1 1
Baker 6,326 10 13 1 29 7 4
Bay 62,200 26 4 4 2 1 230 21
Bradford 12,400 22 2 1 3 1 75 4 103
Brevard 22,050 34 8 5 1 1 53 6 3 2 3 2
Broward 59,300 163 4 220 4 3 7 2 1 2 123 22 83 4 1
Calhoun 8,230 6 1 1
Charlotte 4,690 19 1 1 1 1
Citrus 5,427 17 3 5 1
Clay 13,000 9 2 8 1 1 1 22 2 153
Collier 4,957 9 6 34 3
Columbia 17,350 33 5 2 5 2 2 6 16 2 3
Dade 355,300 779 139 1,075 16 91 2 30 23 2 3 20 2,957 49 23 39 2 28 2
DeSoto 6,854 13 1 3 1 37 5 112 3
Dixie 4,926 3 22 3
Duval 327,600 435 39 90 3 5 25 71 19 1 5 3 4 2,236 145 68 1 17
Escambia 131,100 148 28 6 29 1 1 1,437 39 396 3 1
Flagler 2,652 3 10 68 1 2
Franklin 9,700 19 1' 3 3 82 2 15 5
Gadsden 31,300 25 2 29 4 340 15 64
Gilchrist 3,466 3 7 11 3
Glades 2,281 4 1 17 104
Gulf 7,060 7 1 1 57 6 68 1


Hamilton 8,731
Hardee 8,585
Hendry 5,066
Hernando 5.700
Highlands 22,100
Hillsborough 231,100
Holmes 14,627
Indian River 9,190
Jackson 34,590
Jefferson 11.066


17 4
21 1
2 1 12 1
8
18 3 1 1
458 28 378 19 5
21
23 32 1 1
34
10 2


5
1

1
30 2 3 2 6
4


15 6 416
6 1 2
19 4
28
137 8 4
6 1,801 42 629 39 1
1 1 172
88 2 2
48 7
84 102


3
23 1


1


Q,
cD





Leon 38,700 34 4
Levy 9,902 20 1
Liberty 3,193 4
Madison 15,537 18 1
Manatee 27,400 (C3 2
Marion 38,500 47 6
Martin 6,094 13
Monroe 23,200 44
-1 Nassau 10,900 18
Okaloosa 18,950 13 1
Okeechobee 2,919 8 1
Orange 100,800 162 5
Osceola 11,000 31
Palm Beach 139,500 188 22
Pasco 13,729 39 1
Pinellas 162,500 358 5
Polk 134,000 205 6
Putnam 17,837 35 1
St. Johns 22,900 27 2
St. Lucie 13,800 26 5
Santa Rosa 17,800 19
Sarasota 21,800 50
Seminole 26,500 48 3
Sumter 10,417 12
Swannee 18,000 30
Taylor 10,738 11
Union 6,051 11
Volusia 62,500 215 3
Wakulla 5,059 8
Walton 13,871 22
Washington 11.889 12 1


10 J1
16 4
19
2

1 1

25 1
9


3 6

1 8
1
4
16 15
1 2

2 5
1 4

11



7
1
1
2


471
1
74
4
32
25 20
11
22
6
1

11
8

2

50
34

16


3

1
1
1

1



1
2
1
1 1 1
4 9 1 1
2 3 3
2
1


1
2


6( 2


1


20 4 157 74
1 73
2 84 4 201
159 11 225
268 20 276 1
5 2 6
326 1 1
10 3 71
2 75
22 2 1
413 26 163
8 1
348 149
22 8
1 536 15 5 1
3 420 48 221 7
3 175 13 20 10
290 9
178 8 84
2 59
51 6 53
1 159 15 2 4
76 142
77 6 1
4 3 85
13 2 111
471 20 109
24 2 50
24 2 776
23 2 6


1

1



2

6

3 1
7
1 2
1
3 1


4


1

3 2
1

1


------------


TOTALS OF REPORTED CASES OF NOTIFIABLE DISEASES, BY COUNTIES, FLORIDA, 1949 (Continued)




YEAR 1949
U a
IO -: 0 0 >

Lafayette 3,995 5 1 1
Lake 28,600 51 1 67 2 1 1 1 49 6 167
Lee 28,700 39 3 29 4
--I11 18 1R8 I 1 3





TOTALS OF REPORTED CASES OF NOTIFIABLE DISEASES, BY COUNTIES, FLORIDA, 1949 (Continued)

s la'

YEAR 1949 I
.E .0 E. 4
5I 4' 4) l & J s g &
Y A 1949 : s i e .s 4) -j *i .ia a -
o) 4) a) C) 4)) n cn w w c' r ^ C) & a
) -1 .4 ) C) 4 ) 4
4)~~ ~ C)) C) r lc .^ 2 ~ .S *X .CC) 4


Total This Year
Alachua
Baker
Bay
Bradford
Brevard
Broward
Calhoun
Charlotte
Citrus
Clay
Collier
SColumbia
Dade
DeSoto
Dixie
Duval
Escambia
Flagler
Franklin
Gadsden
Gilchrist
Glades
Gulf
Hamilton
Hardee
Hendry
Hernando
Highlands
Hillsborough
Holmes
Indian River
Jackson
Jefferson


3,753
61
1
37
197
141
74


41 1,791
1 14

2
1
20
1 13


11 686
12
2

1
1 13
8


83 2

1
621 5 300


0 12


2 1
93 9


1 1



4


2 1 2
489 5 235


19 1

3
159 24

1
7 3


7 2
3

2

3
1

1


1

20
2

.2
8

2
2


1


1


264 0 120 12,363
3 7 155
1 28
5 156
29
1 2 113
5 492
21
17
44
5 2 22
1 1 14
1 56
35 34 2,465
62
25
39 18 1.595
10 510
45
33
1 238
1 5
10
2 23
39
1 16
1 3 42
11
111
39 16 956
7
67
1 3 92
24


71 3,198 29
58 1
7
67
17
21
7 69
13
.2
11 1
1 16
1
14
8 433 2
8 1
4
11 526 5
4 100
2
2 3
41
3
3
6
7 1
7
1 11" 1
2
1 20 1
10 235 2
7
12
27
1 2


86 97
2


191 1


1 2
3 3 11

1
20 12 5
6 3 1


1 10
1 1


1 1 1
4 13 16
1
1
2 2
7 3






TOTALS OF REPORTED CASES OF NOTIFIABLE DISEASES, BY COUNTIES, FLORIDA, 1949 (Continued)


YEAR 1949


Lafayette
Lake 237
Lee
Leon 24
Levy 6
Liberty 3
Madison 8
Manatee
Marion 1
Martin 1
Monroe 197
Nassau 135
" Okaloosa
Okeechobee 14
Orange 32
Osceola 3
Palm Beach 17
Pasco
Pineallas 14
Polk 207
Putnam 78
St. Johns 6
St. Lucie 28
Santa Rosa 8
Sarasota 3
Seminole 40
Sumter 5
Suwanee
Taylor 1
Union
Volusia 89
Wakulla 27
Walton
Washington


.0 0 a 34o
4,,*- 0 4, 4) a .S -aS.
a. 3 S4 4. 4 T s =0^
9~r* 9 4. -..o4 4 ,
4, 4, .s ; p g~
S- 5 2 -o: -d t .a 4, -
4,i E i' I IT 04 .4 5
: 0. 0 0: 0 0 '4 0 --'
.2 5: 5, -, -. .9 0e .
-~~ o s. 4, .


55

2 22
6


2 15

1 18
2 4

1
2 266

103
1
1 47
1 44
3
20
2 3

1
3
38


8

14
1

2
1


1

4


1 1

5
52
1

2


4
13


1

28 1 1 2 17
10 4
2
1


3 15


8
4 134
1 85
7 276
102
6
63
116
2 164
32
53
19
39
23
302
23
646
64
1 569
7 729
4 183
101
125
22
122
1 201
2 60
87
34
162
2 238
7
21
24


1
6 14
1
1 8

6 35
22
3 1
1
2
3
1
1 5
2 2
1


4


12
2
2 4
1
1
2
1 1

1 3 2
1
2 3 1
1 1
3 5 2
3 5
1 1 1
1 1 3
1 1'
1 2

1

1 3
1
1
1 3 2


1 10

49

2
2 7
2

2









BUREAU OF LABORATORIES


Albert V. Hardy, M.D., Dr. Ph., Director
Organization
The Bureau of Laboratories includes the Central Labora-
tory in Jacksonville, and five Regional Laboratories located in
Tampa, Miami, Pensacola, Tallahassee and Orlando. There are
two affiliated laboratories, located in the Melbourne Hospital
and in the Pinellas County Health Department
The Central Laboratory carries responsibility for state-wide
activities. The senior professional staff share with the Director
the broad supervision of technical services in regional and af-
filiated laboratories. They also are expected to develop produc-
tive investigative studies, which must be a part of every pro-
gressive public health laboratory. Broad educational activities
designed to improve the quality of all laboratory service avail-
able to physicians and people of the State are fostered by the
Central Laboratory. Certain technical services are available only
in the Jacksonville Laboratory, as for example, complement-fix-
ation, Rh typing and detailed chemical examination of water.
Equipment and supplies are procured through it and distributed
to the regional laboratories. Furthermore, the "Supply Section"
receives, stores and distributes biologicals, and other materials
and supplies for other Bureaus and Divisions. Approximately
one-fourth of the activities of the Central Laboratory are di-
rected to these state-wide services.
The general diagnostic laboratory services are divided between
the Central and the Regional laboratories. The counties most
accessible to Jacksonville are served from the former, and the re-
mainder of the state is served from the regional laboratories.
There are no rigid boundaries but the divisions are made con-
sidering transportation time and the capacity of the laboratory.
The physicians and health departments are provided mailing
containers bearing the address of the laboratory for their region.
This regulates satisfactorily the direction of flow of specimens.
Each regional laboratory is being developed as a complete unit,
equipped to provide all of the usual public health laboratory
services.
The affiliated laboratories differ only in that they provide
particular and limited services and are supported by the institu-








tion or area obtaining that service. The Melbourne Hospital
Laboratory gives those diagnostic services needed by the Rapid
Treatment Center, while the Pinellas County Laboratory handles
the sanitary bacteriology for that county. Both function as an
integrated part of the Bureau of Laboratories.

Personnel
Laboratory personnel include a professional staff, technical
workers, non-technical assistants and a clerical group. The pro-
fessional staff are the bacteriologists, serologists, parasitolo-
gists, and chemists and the college graduates being trained for
these positions. The technical worker ordinarily joins the Bu-
reau as an inexperienced high school graduate, but in time pro-
gress from a laboratory assistant carrying limited responsibil-
ity, to the junior and senior technician grades with very sub-
stantial responsibilities. (College graduates currently are ac-
cepting appointments in these classifications). The non-techni-
cal assistants aid in preparing culture media, clean and sterilize
glassware, assemble mailing containers, handle supplies, and
perform other varied duties. The clerical group has the respon-
sibility of keeping records, mailing reports of examinations and
handling the general office work. As in every team activity, all
are essential, and efficient performance calls for balance and
cooperation.
The post war period was one of instability and change;
laboratory personnel came and went. This was a difficult period.
During the past two years, a feeling of permanence and stability
has developed. The present status of personnel is summarized
and is compared with that of January, 1948.
For the Bureau as a whole, the total persons employed has
remained notably constant, 115 at the beginning of 1948 and
113 two years later. (Within this period the examinations per-
formed by the Central and Regional Laboratories has increased
by 38 per cent). There has been a gradual shift from the
Central to the Regional Laboratories. Those working in the
former, decreased from 69 to 57, while those in the regional
laboratories increased from 46 to 55. Several in the Central
Laboratory give attention to providing service to the state as
a whole or to the central offices of the Board of Health. The
distribution of personnel is closely in line with the distribution
of services.








The clerical group has been reduced from a total of 18 to 15;
the smaller number are carrying the increased volume of work.
The non-technical assistants numbered 38 at the beginning of
the two year period and 39 at its termination. The number of
technical workers has remained unchanged, a total of 21, but
with at present two less technical assistants and two more ex-
perienced technicians. These are very essential workers when
identical tests are being performed on numerous specimens.
The quality of laboratory service is dependent primarily on
the qualifications and abilities of its professional staff. In
numbers, including trainees, these have decreased from 38 to
36. However, two years ago there were only 24 with profes-
sional appointments as bacteriologist, serologist, parasitologist
or chemist while 14 were trainees. Currently there are 33 with
professional appointments and only three trainees. Further-
more, exclusive of the Director and Assistant Director, at the
beginning of 1948 only six in the Bureau held a Master's degree;
two years later there are 15 with this degree, and an additional
five has secure plans which should lead to this goal within the
next biennium. The attainment of advanced academic degrees
is a fair symbol of the advancement in training and ability of
the professional staff.
The program of selecting able young graduates of Florida's
colleges and providing opportunities for training, in cooperation
with the University of Florida and other institutions, has been
sound. Improvements and advancement through training must
be continued. The high potential abilities of professional work-
ers must be still further developed. The Public Health Serv-
ice, in the Laboratory Division of the Communicable Disease
Center, Atlanta, offers short courses of intensive training for
professional workers employed in public health laboratories.
Knowledge and skills are advanced, but even more the workers
are stimulated and return with an enthusiasm which is re-
freshing. Future plans must provide for more personnel to have
the advantage of this training under the leading scientists and
able teachers in Atlanta. The other need in training applies
to a very small number only. The laboratory system should
have some who have advanced from their Masters to a Doctorate
degree. Candidates of excellent promise are at hand; it is
hoped that opportunities for this next step in training may be-
come available without prolonged delay.
Guests with an appraising objective view who have visited








the Board's laboratories agree that the laboratory staff is one
of high competence-and an exceptionally harmonious, hard
working, and cooperative team.

Diagnostic Services
The examinations performed in each and in all laboratories
in 1949 and in three preceding years are given in Table I. The
growth in volume of work has continued through 1949. The
total services exceed those of any previous year. Over two
million examinations were performed on over one million speci-
mens submitted by health departments and physicians. During
the four years, 1946-1949, there has been a 66 percent increase
in examinations performed. The central and each regional
laboratory has had a progressive but variable increase in this
period. There was nearly a five fold increase in the Tallahas-
see regional laboratory and almost a four fold increase in
Pensacola. The volume in Miami approximately doubled and
in Tampa, it increased by over one-half. The Jacksonville labora-
tory held its increase to a little less than one-third. Within the
four years one regional laboratory in Orlando has been added
and the Melbourne Hospital and Pinellas County Laboratories
have become affiliated with the Bureau.
There was a moderate total increase in examinations per-
formed in 1949 as compared with the preceding year. The in-
crease was substantial (15 to 21 percent) in the Tallahassee,
Pensacola and Miami Laboratories. The limited increase in
Tampa and Jacksonville is explained by the growth of the new
Orlando Regional Laboratory which is now serving areas prev-
iously submitting specimens to Jacksonville and Tampa.
The number of examinations by laboratory and by type of
test shown in Table II. There was a sharp increase in examina-
tions for tuberculosis and of dairy products submitted for bac-
teriological and chemical tests. There was some decline in tests
for gonorrhea and a more marked decline in animal heads
examined for rabies. Other than these, the distribution of work
compares closely with that of the preceding year.
The types of specimens examined with findings are given in
Table III. As in the preceding year almost 100,000 specimens
gave a positive reaction to the serological test for syphilis.
There was an increase in specimens positive for M. tuberculosis,
which is particularly noteworthy since the Orlando Sanitorium








early in the year began to perform its own bacteriological exami-
nations. A more careful follow-up of typhoid carriers resulted
in an increase in the isolations of S. typhosa. The examinations
for intestinal parasites increased as did the positive findings.
In contrast, the specimens positive by darkfield for T. pallidum
(syphilis) and those positive for C. diphteriae declined notably
as would be expected with the reduction in prevalence of pri-
mary syphilis and diphtheria.
Many special tests are performed which are not reported in
the table, as for example: In the Jacksonville laboratory all
milk samples with findings suggesting that water might have
been added are examined by special procedures. As a result
samples from 54 supplies were found to contain added water
varying from 3 to 34.5 per cent and averaging 13.5 per cent.

Research
A series of studies are under way or have been completed.
It is of particular importance in a public health laboratory to
ascertain the best procedures for handling volume work with
high technical reliability. The relative efficacy of various avail-
able culture media in examining for M. tuberculosis, C. diphthe-
riae, N. gonorrhea and Salmonellae (other than typhosa) has
been studied comparatively. The findings in one are illustrative.
Five culture media designed for the identification of M. tuber-
culosis have received favorable reports. Selected for routine use
was the one which, from the literature and from its wide usage,
one would judge to be as good as the best. Careful comparative
studies were initiated, however. Specimens from patients be-
lieved to be discharging very few organisms were obtained.
The various media were inoculated by identical technics so any
difference in findings would be related to variations in the cul-
ture media. Positives were obtained on all. Considered alone
each medium could be regarded as satisfactory. However, the
total numbers of positives varied significantly. Three of the
five media were found to give better results than the one,
selected for use by this and many other laboratories. The best
increased the number of positives by 20 percent as compared
with the medium in use. This superior preparation was no more
costly or difficult to use. On the basis of findings it was adopted
for routine use. The current emphasis in tuberculosis is on the
diagnosis of minimal infections. The culture medium previously
employed would have missed one positive sputum in each five








which now will be found culturally. Without adding time to the
daily routine, the reliability of findings has been substantially
improved by this relatively simple comparative study. The
effort expended in this investigation obviously was very produc-
tive.
The study of cultural proceedings for the isolation of
Salmonellae from animal feces extended further. No preparation
currently available was effective in preventing overgrowth by
the proteus organisms which commonly are present in animal
feces. Observations led to an entirely original modification of
medium which by comparison with the unmodified preparations
yielded an increase in positive findings of 38 percent.
The study of cultural procedures for C. Diphtheria and N.
Gonorrhea were instructive also. Even though these did not
lead to any intmediate modification of procedures, they did keep
before each worker the stimulating question as to whether me-
thods employed were the best which were available or could be
devised.
The second type of study had to do with the development or
modification of rapid or simplified techniques. Two of these were
in the field of enteric bacteriology; one was in agglutination
tests. In the latter a rapid slide agglutination test for tularemia
was devised. This was reported in a paper read at the A.P.H.A.
meeting in New York and will be published. (A Rapid Slide
Agglutination Test for Tularemia, Nathan J. Schneider and Al-
bert V. Hardy).
A new "Ring Test" for the detection of Brucellosis in
cows has been described and is being given some attention in
this country. This was studied intensively over a six months
period in the State Board of Health's laboratories. Findings
were compared with those obtained by blood agglutination and
by the less widely used whey agglutination tests. The sim-
plicity of the new procedure commends the test, and findings
suggested it has high potential practical value. These observa-
tions were reported also at the A.P.H.A meeting in New York
and will be the first publication on the subject in public health
literature. (The Brucella Ring Test, Addie Hamilton and Albert
V. Hardy, American Journal of Public Health, March, 1950).
The most extensive investigation has been in Salmonellosis.
Here there was an approach to problems in epidemiology. The
infection has been identified in dogs but the relative importance








of domestic pets as a source of these infections in humans has
not been explored adequately. There has been substantial pro-
gress in this study and the problem appears of greater impor-
tance than was suspected heretofore. Unexpectedly it led to
an investigation of the cause of acute diarrheal disease of dogs
-a common epidemic ailment of animals closely associated in
kennels. The studies of Salmonellosis are being expanded
through support from the Armed Services Epidemiological
Board with the hope that basic information on epidemiology,
prevention and therapy of Salmonella infections may be as-
sembled. One report in this field of work was published within
the year (The Public Health Laboratory Diagnosis of Enteric
Infections, Mildred Galton, Albert V. Hardy and Roland B.
Mitchell, American Journal Tropical Medicine, January, 1950).
The problem of the epidemiology of creeping eruption is
being examined further under the general leadership of the
State Public Health Veterinarian, and in cooperation with the
Divisions of Parasitology and Veterinary Public Health of the
Communicable Disease Center, Atlanta, Georgia. Adult hook-
worm specimens are collected from dogs in the various pounds
of the State and these are identified as to species in the labora-
tory in Jacksonville or Atlanta, Georgia. Data as to relative
prevalence of the two varieties of hookworm in dogs, A. Bra-
ziliensis (the embryo of which causes creeping eruption) and A.
caninum are being accumulated gradually. Experimental studies
related to control measures are planned also.

Cooperation with other Medical Laboratories
Late in 1948 it became practicable to initiate an active
program designed to improve reliability of serological tests per-
formed in the approximately 100 general medical laboratories
doing this work in Florida. In part, this was meeting an obliga-
tion since the laws relative to premarital and prepartum sero-
logical tests require that the State Board of Health approve
laboratories for the performance of these tests. The only reason-
able basis for this is an adequate measurement of quality of
performance. The evaluation procedures employed have been
described. (The Reliability of Serological Examinations as Per-
formed in Medical Laboratories in Florida, Albert V. Hardy,
Journal Florida Medical Association, January 1950). It in-
volves distributing test specimens and comparing finding by
specific test with those obtained in three control laboratories.








A scoring schedule is used and the quality of performance is indi-
cated by the percentage of total possible score obtained. If
more than one test procedure is used these are scored and
tabulated separately. Recently the 104 laboratories participating
reported 151 series of findings. The observations by date of
evaluations are given in Table IV.
The improvement in quality of serological performance
is striking. During the first three months, 30 per cent had poor
or very poor performance, and an additional 14 per cent had
results which were highly unreliable. In the most recent series
the results were poor in 5 per cent and very poor in 3 per cent
but no laboratory was in the highly unreliable class. Only four
of the 12 laboratories with this defective performance parti-
cipated in the evaluations from their beginning. Also on the
first series, 28 per cent had excellent performance, (one third of
these were tests performed in the Board of Health Regional
Laboratories). Recently, 70 per cent had this high quality of
performance.
These results have been attained, in part, by an associated
program of group instruction and by individual consultations.
The response to these was very favorable. The degree of im-
provement in the limited period is better than was expected. It
gives substance to the hope that all serology in Florida soon will
be of excellent quality.
The significance of this cooperative program warrants em-
phasis. Prior to its initiation almost one half of the blood speci-
mens submitted to hospital and private laboratories were so
examined that results were poor to highly unreliable. At pres-
ent almost all serological tests in these laboratories yield satis-
factory to highly reliable findings. An activity which thus im-
proves the quality of serology performed in other laboratories
has equal public health value to the performance of many addi-
tional tests in our own laboratories. Evaluations, consultations
and education consume time and effort, but the expenditure
for these is small as compared with the results attained. More-
over, the laboratories participating in the evaluations have been
appreciative. The program produced dividends of good will.
There is an increasing interest in developing similar
activities in other fields. Studies elsewhere have revealed weak-
nesses in clinical chemistry as marked as those discovered in
serology. Probably the same is true of bacteriology, parasitology








and hematology. The importance of improving practice in all
laboratory fields is evident. A cooperative approach and volun-
tary participation are essential and the assistance of some
laboratory as the Central Board of Health Laboratory, is needed.
A future major contribution of public health laboratories
may be through making possible a program designed to aid
medical laboratories progressively to improve the quality of
their work. The high importance of such an activity warrants
full cooperation from the Bureau.

Needs and Opportunities
There has been progress. More and better diagnostic labora-
tory services have been made available, research and special
studies have been fruitful and cooperative activities with other
laboratories have had a favorable initiation. The proficiency of
our personnel has been improved progressively. The need in
these is for continuing progress. The maximum value of labora-
tory service cannot be attained by limiting attention to the
laboratory alone. Judgment supported by adequate knowledge
in the requesting of tests, and care in the collection and sub-
mission of samples are needed. Even more, the physician must
be clearly aware of the exact significance of reported laboratory
findings. A program to be fully adequate, must give attention to
aiding the physicians and others served to utilize the services
of the laboratory fully and effectively.
Again the urgent need for adequate laboratory space must
be stated. The Orlando laboratory has excellent quarters and
those in Pensacola are adequate. Elsewhere there is a need for
extensive renovation, the addition of space or the provision of
entirely new laboratory buildings.







































TABLE 1

TOTAL NUMBER OF EXAMINATIONS PERFORMED BY

LABORATORIES, 1946-1949

Laboratories Year
1946 1947 1948 1949

Jacksonville Central 673,316 808,396 845,957 868,359
Tampa Regional 286,067 336,750 440,172 445,022
Miami Regional 217,950 227,561 364,739 417,908
Pensacola Regional 35,262 56,726 112,486 128,655
Tallahassee Regional 19,828 18,531 76,691 93,433
Orlando Regional 19,727* 50,208
Melbourne Hospital 15,461* 58,776 38,564
Pinellas County 11,700* 21,317

Total 1,232,424 1.463,425 1,930,248 2,063,468
*6 months operation.












TABLE II

EXAMINATIONS PERFORMED BY LABORATORIES, 1949


Jacksonville Tampa Miami Pensacola Tallahassee Orlando Melbourne St. Petersburg Totals
Serology
Syphilis 503,064 310.495 311,809 82,298 49,492 27,809 24,984 22,000 1,309,951
Agglutinations and Related Tests 23,800 7,350 9,565 1,596 1,906 1,617 0 0 45,834
Blood Typings (Rh) 8,053 0 0 0 0 0 0 0 8,053
Diagnostic Bacteriology
Nose and Throat 7,236 2,557 670 2,862 262 267 0 0 13,854
T. B., Sputum 39,758 3,961 6,731 113 1,670 1,481 0 0 53,717
Other 1,854 0 50 0 100 216 0 0 2.220
G. C., Smear 14,962 22.804 15,951 4,777 5,865 1,927 0 0 66,286
Culture 8,912 11,073 11,626 3,237 2,553 0 0 0 37,401
Enteric 70,314 23,180 2,708 6,491 9,115 7,062 0 0 118,870
Blood Culture 1,012 3 8 0 0 10 0 0 1,033
Food Poisoning 1,155 11 357 18 0 2 0 0 1,543
Rabies 341 166 96 6 0 0 0 0 609
0 Miscellaneous 10,902 317 571 51 92 80 2,617 8 23,638
Sanitary Bacteriology
Dairy Products 11,835 25.601 23,211 6,744 9,225 2.468 0 9,158 88.242
Water, Drinking 15,068 5,630 6,767 1,606 3,757 1,004 0 7,655 42,087
Pool and Beach 4,098 1,503 1,732 485 664 1.619 0 953 11,054
Poll. Surveys 35,700 999 9,183 2,641 743 849 0 3.378 53,543
Shellfish 803 0 0 0 0 0 0 0 803
Utensils 0 0 0 0 0 0 0 46 46
Parasitology
Intestinal Parasites 64,354 26,266 6,932 15,043 7,329 2,603 0 0 122,527
Malaria 2,005 479 128 151 618 17 0 0 3.398
Chemistry
Blood 7.115 1.722 60 470 0 319 167 0 9,853
Spinal Fluid 4,647 905 1,052 58 44 5 10,734 0 17,445
Urine 4,331 0 90 8 0 59 62 0 4,550
Toxicology 589 0 3,355 0 0 0 0 0 3,944
Water 2,972 0 3,218 0 0 194 0 119 6,503
Other 3,951 0 2,035 0 0 0 0 0 5,986
Veterinary Pub. Health 10,528 0 0 0 0 0 0 0 10,528
Grand Totals 868,359 445,022 417,908 128,655 93,435 50,208 38,564 21,317 2,063,468













TABLE III

SPECIMENS SUBMITTED FOR EXAMINATION BY FINDINGS


Number of Specimens
Positive
One or More Positive For Unsatis.
EXAMINATION Positive Finding Negative factory Total
Finding Indicated
Serology
Syphilis 99,827 490,589 11,675 602,091
Agglutination and Related Tests 1,218 9,398 321 10,937
Typhoid 287
Typhus 496
Brucellosis 234
Tularemia 248
Other 90
Blood Typings (Rh) 7,131
Diagnostic Bacteriology
Nose and Throat 515 6.241 12 6,768
C. Diphtheria 194
Vincent's 191
Streptococci 95
H. pertussis 0
Tuberculosis 3,660 27,316 1,536 32.512
Sputum 3,603 26,238 1,526
Urine 12 251 2
Gastric 36 427 5
Pleural Fluid 3 105 1
Other 6 295 2
Gonorrhea-Smears 27,312 33,218 595 61.125
Intracellular Gram negative
diplococci 7,067
Extracellular Gram negative
diplococci 1,574
Trichomonads 1,156
Yeasts 537
Vincent's organisms 393
Many pus cells 21,846
Gonorrhea-Culture 2,216 28,890 460 31,566
Enteric Infecions 631 24,394 146 25,174
S. typhosa 159
Other Salmonella 127
Shigella (Flexner and Sonne) 90
Blood Culture 32 308 0 340
S. typhosa 0
Other Salmonellas 3
Streptococci 3
Other 29
Food Poisoning 42 131 0 173
Staphylococci 26
Salmonella 1
Other 15















TABLE III CONTINUED

Positive
One or More Positive For Unsatis-
EXAMINATION Positive Finding Negative factory Total
Finding Indicated
Diagnostic Bacteriology, Cont'd.
Rabies 75 524 29 628
Dog 66 358 17
Cat 2 107 11
Fox 0 2 0
Cow and Horse 2 14 0
Other 5 43 1
Miscellaneous 2,981 2,921 63 5,965
Darkfield-T. pallidum 471 930 16
Chancroid-Ducrey's 111 244 1
Granuloma-Donovan Bodies 743 520 10
Gonococcus in Eye 126 272 12
Other Eye Cultures 56 0 0
Urine Culture 506 176 5
Spinal Fluid Culture 40 209 0
Pleural Fluid Culture 81 79 0
Other Fluids and Exudates 315 190 5
Mycological Examinations 109 189 4
Organisms for Identification 334 6 3
Other Examinations 9 106 6
Sanitary Bacteriology 1326
Dairy Products
Water, Drinking 32,374
Water, Pools and Beaches 4,412
Water, Pollution Surveys 9.610
Shellfish 47
Utensil Swabs 88
Parasitology
Intestinal Parasites 32,505 82,576 1,566 116,617
Hookworm 21.671
Ascaris 3,549
Enterobius 2,001
Trichuris 686
Taeniae 16
Other Helminths 148
E. histolytica 102
Non-pathogenic amoebae 7,522
Flagellates 2,699
Other 10
Malaria 12 3,385 181 3.578
P. vivax 2
P. falciparum 0
Untyped 9








BUREAU OF SANITARY ENGINEERING

David B. Lee, Director

Public health engineering in its broadest sense experienced
the greatest measure of expansion in the state in 1949 in the
field of sanitation of natural waters. Highly significant, and it
is felt to be a result of departmental effort in considerable de-
gree, is the material participation in stream and tidal water
sanitation activity by two of the state's outstanding industrial
groups. The overall interest in natural water pollution is re-
flected in the inauguration of two programs during the year
jointly by the department with the pulp and paper and the
pebble phosphate mining industries, respectively, to determine
the nature and extent of detrimental conditions, if any, which
are created by their operations in waters receiving their indus-
trial wastes.
Paralleling the intensified activity in measuring the sani-
tary condition of the state's natural waters by collection of fac-
tual data which will produce long range results, but which have
more immediate benefit, is the continued program of construct-
ing sewage treatment and disposal works by municipalities.
Projects were approved during the year which will correct some
of the worse conditions.
Environment control, for public health purposes, of urban
fringe areas continued as a problem. Leading up to and in reg-
ular session of the State Legislature, a rather strong but unsuc-
cessful effort was made to see legislation enacted as a state-wide
law carrying provisions whereby local citizenry may vote to
organize a political subdivision for the purpose of creating one
or all of the services of water supply, sewage disposal and gar-
bage disposal. Some indication of the need is seen in the many
public water works projects approved for real estate develop-
ments outside of city limits, likewise, the large number of house-
hold septic tanks for such. It is felt that effort may better be
redirected to promotion of special acts for local legislation with
more consideration to public works aspects of the urban fringe
problem.
The State Board of Health continues to improve its posi-
tion to more nearly fulfill its public health .engineering respon-
sibilities because of the regional engineers functioning with the








organization. There continued on assignment during the year
five regional engineers located at vantage points in the state.
Their activities, while applied rather thinly because of exten-
sive areas covered, meet to some degree a long-felt need; and it is
hoped to make this effort more effective through further assign-
ment of engineering personnel thereto whenever resources are
made available for this need.

PUBLIC WATER SUPPLY AND TREATMENT
New and Proposed Construction
Those projects for public water supply and treatment facili-
ties and improvements covered by plans and specifications sub-
mitted to and approved by the department during 1947 are
listed in Table I. There were 63 of these projects having an
estimated aggregate cost of $2,574,920. The continued down-
ward trend in dollar volume of projects approved is seen in
comparing 1949 with the previous year. Interesting enough,
however, is the fact that the volume of construction represented
by the approved plans is comprised of a considerably larger
number of projects, there having been a 56 per cent increase
from this standpoint over the previous year. In part this means
that a greater number of towns and cities instigated improve-
ments to their respective water supplies, but it also reflects
the fact to some extent that municipalities did not in many in-
stances extend water utilities to housing developments where
relatively many public water supply systems were approved for
construction in real estate subdivisions.
Important highlights in the water works field included
placing in operation the new municipal filtration plants at Or-
lando and Quincy. At Bradenton units were placed in operation
which double plant capacity for softening-color control and fil-
tration. At Gainesville, where a new filtration plant was placed
in service in 1948, the municipality commenced application of
limited concentrations of sodium fluoride at the water plant on
October 31, 1949, as a measure designed to control dental caries
among children. Control procedure for the projects which were
the first of the kind in the state was outlined and approved by
the department.










TABLE I
PUBLIC WATER SUPPLY PROJECTS APPROVED IN 1949


MUNICIPALITY


PROJECT


$EST.
COST


Glynlea Park S/D (Duval) Water supply system 50,000.00*'
So. Peninsula Water Co.
(Volusia) Water main extensions 44,761.00*'
Winter Haven Water works improvements 204,000.00*
Ft. Lauderdale Water main extensions *
Winter Park Water works improvements 42,250.00*
Panama City Ground reservoir 33,000.00*
Miami S. W. Miami water supply 165,000.00*
system
Miami S. W. Miami chlorination
system
Deerfield Beach Subaqueous water main 18,500.00*
Hallandale Water plant and system 500,000.00
Haven Gardens S/D (Duval) Water system 5,000.00*
Lakeland Water main extensions 15,000.00*
Macclenny Water distribution system 50 000.00*
San Jose Estates S/D (Duval) Water system 8,000.00*1
Murray Hill Gardens S/D
(Duval) Water system 15,000.00*
Ribault Hills S/D (Duval) Water system 10,000.00*
North Miami Beach Distribution System 75,000.00*
Pirates Cove & Timuquana
Manor. Water main 'extensions 7,500.00*
Miami Construction misc. structures.. 71,000.00*
Warrington New water well 17,5000.00*
Orlando Rehabilitation of existing
filters 85,000.00*
Cocoa Water main extensions 10,000.00'
Lincoln Gardens S/D (Dade) Unit 2 Tract 3 water system 5,000.00*
Ft. Lauderdale Water main extensions 31,000.00*
Ft. Lauderdale Gravimetric feeders for lime 4,000.00*
Ft. Lauderdale 500,000-Gal. elevated tank
and main ext. 110,000.00*
Curtiss Park Dev Co. Opa
Locka Distribution system 5,000.00*
Highland Park Alterations & repairs to elev.
tank 5,000.00*
Daytona Beach Additional well field 90,000.00*
South Ponte Vedra Beach Water system 2,000.00*'
Lincoln Gardens S/D (Dade) Unit 1 Tract 2 water system 6,500.00*
Haven Gardens S/D (Duval)Water system 8,000.00*
Herman Housing Unit 1 5,000.00*
(Dade) Water system 5,000.00*
Herman Housing Unit 2 152,000.00*
(Dade) Water system 4,000.00*
Miami Springs Water main extensions
Pompano Beach Water works improvements 16,000.00*'
Lauderdale Surf & Yacht Water mains
Estates 10,000.00*
Wildwood New deep well and pump 2,763.00*
Odessa S/D (Duval) Main extensions 6,500.00*
Whitaker Bungalows, Inc. Water system 8,700.00*
Westview S/D (Leon) Water system
Ocala Water treatment plant 270,000.00*
Hialeah Ground storage and additional 12,000.00*
pumping facilities
Ft. Lauderdale Main extensions 12,000.00*


I;

c



I:





r


c

I:
r





b










r

c





r

r
r.









TABLE I (Continued)
PUBLIC WATER SUPPLY PROJECTS APPROVED IN 1949


MUNCIPALITY


St. Petersburg 24" water main extension
Riverwood Park S/D (Duval) Water system
Lakewood S/D (Duval) New water plant
Live Oak Manor S/D (Duval) Water system
Roosevelt Gardens S/D
(Duval) Distribution system
Herman Housing No. 3 (Dade)Water system
Sunset Construction Co. New water system
(Miami)
Lake Forest S/D (Duval) Main extensions
Baldwin Water system
Ormond Water plant additions
Perrine Bungalows, Inc. Water system
Haven Gardens Extensions
Melbourne Water plant improvements


North Miami Beach
Lake Park
Fleetwood S/D (Duval)
Riviera Beach
Junior Beach
Phillips Hwy. Tourist
Court (Duval)
Hollywood
Ribault Hills S/D (Duval)
Jacksonville
Jacksonville


and extensions
250,000-Gal. elevated tank
100,000-Gal. elevated tank
Distribution system
Water main extensions
60,000-Gal. elevated tank
Water system
Salt well and pumping station
Main extensions
Revisions Southside pumping
station
Well drilling at River Oaks
station


$ EST.
COST
40,000.00**
8,000.00*
75,000.00*
6,000.00**
10,525.00**
5,000.00*
7,000.00*
8,500.00**
75,000.00
15,000.00*
7,000.00*
2,000.00**
140,000.00
25,000.00*
15,000.00*
2,925.00*
10,000.00*
15,000.00*
2,000.00*
8,000.00*
1,500.00


$2,574,920.00
* Under construction; ** Completed; II Part of plans for $5,000,000 ex-
tension program for City of Jack-
sonville approved February 28,
1947.
63 Plans approved for new water plants and/or systems or extensions
18 Completed
41 Under construction
4 Status quo

Operations
Public water works operation and its sanitary supervision
continued to receive considerable attention of the department
during the year. Field engineers in the several regions per-
formed the bulk of this activity. The assignment of engineers
on a regional basis continues to be a prime factor in organized
effort for improved operation.
In-service training of water works operating personnel was
again carried out at the University of Florida. Actively co-
operating in the cooperative undertaking, personnel of the de-
partment served as part of the instructing staff during the an-








nual one-week short course and conference. While the value of
the short course held at the University annually is not doubted
as to improvement in water works operation, the fact con-
tinued evident during the year that this program is far less
effective than is desired. Incomplete results on a survey of
operating personnel being made by the department show only
a minor fraction of the total are benefitted because the major
fraction do not attend the course. Attendance at Gainesville
this year was very good, using as a standard attendance records
of recent years, but the survey apparently points out the sharp
need for expanding water works in-service training on regional
basis to improve its accessibility.

Public Water Supply Wells
Pursuant to the State Board of Health's statutory respon-
sibility for sanitary jurisdiction over the waters of the state,
there were exactly 100 permits issued for the construction of
public water supply wells. It is felt that coverage of this facet
of water control is still not complete, however, even though the
number of permits issued represents an increase of 54 per cent
over the previous year. Apparently, continued efforts of the
State Board of Health to gain a more thorough degree of co-
operation of the well drilling industry are pointed in the right
direction.

Bottled Water Plants
There were 33 permits issued by the State Board of Health
during the year for the operation of bottled water plants, which
represent a slight increase (10%) over the number of such
permits issued in the previous year. Inspections for sanitary
control were performed and reported by accredited local health
departments and regional engineers under minimum bacterio-
logical and sanitary standards of the department. In Table II
there are listed the establishments to which bottled water plant
permits were issued in 1949.




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