Annual report - State Board of Health, State of Florida

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FLORIDA

STATE BOAfRD
OF
HE ALTH

1963

.!NNUA REOR

State Board of Health

State 4 7loida

1963

The following reports will be published separately:
SUPPLEMENT I FLORIDA VITAL STATISTICS, 1963
SUPPLEMENT II FLORIDA MORBIDITY STATISTICS, 1963

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

JACKSONVILLE, FLORIDA

c.

The Honorable Eugene G. Peek, M.D., President
Florida State Board of Health
Ocala, Florida

Dear Dr. Peek:

I herewith submit the annual report of the Florida
State Board of Health for the year ending December 31,
1963.

Sincerely yours,
WILSON T. SOWDER, M.D., M.P.H.
State Health Officer

May 1, 1964
Jacksonville, Florida

His Excellency, Farris Bryant
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, 1963, to
December 31, 1963, inclusive.

Respectfully submitted,
EUGENE G. PEEK, M.D.
President

May 1, 1964
Ocala, Florida

Members of the
FLORIDA STATE BOARD OF HEALTH

EUGENE G. PEEK, M.D., President
Ocala

T. M. CUMBIE, Ph.G., Vice President
Quincy

LEO M. WACHTEL, M.D.
Jacksonville

F. P. MEYER, D.D.S.
St. Petersburg

W. S. HORN, D.O.
Palmetto

OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH

December 31, 1963

DIRECTORS

State Health Officer................................ Wilson T. Sowder, M.D., M.P.H.
Coordinator of Research
Assistant State Health Officer...............Albert V. Hardy, M.D., Dr.P.H.
Encephalitis Research Center
Assistant State Health Officer..............James O. Bond, M.D., M.P.H.
Coordinator of Training...........................Robert V. Schultz, M.D., M.P.H.
Division of Health Education.................Elizabeth Reed, R.N., B.S.
Librarian...........................................Tomma Pastorett, B.S., M.A.
Division of Personnel............................ Miles T. Dean, M.A.
Division of Public Health Nursing..............Ruth E. Mettinger, R.N.
Bureau of Dental Health..............................Floyd H. DeCamp, D.D.S.
Bureau of Entomology.................. .....John A. Mulrennan, B.S.A.
Entomological Research Center .................Maurice W. Provost, Ph.D.
Bureau of Finance and Accounts........... ...Fred B. Ragland, B.S.
Assistant Director............................ Paul R. Tidwell, B.B.A.
Purchasing Agent..................... ...........Frank E. Craft, B.S., B.A.
Bureau of Laboratories............................Nathan J. Schneider, Ph.D.
Miami Regional Laboratory ......................Dwight E. Frazier, M.S.
Orlando Regional Laboratory..................Max T. Trainer, M.S.
Pensacola Regional Laboratory...................Emory D. Lord, Jr., B.S.
Tallahassee Regional Laboratory...............Robert A. Graves, M.S.
Tampa Regional Laboratory.................H. D. Venters, B.S.
West Palm Beach Regional Laboratory......Lorraine Carson
Apalachicola Marine Laboratory ..............Bernard E. Kane, B.S.
Bureau of Local Health Services
Assistant State Health Officer......................L. L. Parks, M.D., M.P.H.
Assistant Director...........................................Hubert U. King, M.D.
Division of Nutrition ...............................Mary Brice Deaver, M.S.
Division of Sanitation..................................A. W. Morrison, Jr., R.S.
Bureau of Maternal and Child Health
Assistant State Health Officer....................L. L. Parks, M.D., M.P.H.
Bureau of Mental Health
Assistant State Health Officer....................Wayne Yeager, M.D., M.P.H.
Associate Director.......... ...... ......Wade N. Stephens, M.D., M.P.H.
Assistant Director...............................Edward L. Flemming, Ed.D., M.P.H.
Bureau of Narcotics............................ ..Frank S. Castor, Ph.G.
Bureau of Preventable Diseases
Assistant State Health Officer.....................C. M. Sharp, M.D.
Division of Epidemiology (on leave)..........E. Charlton Prather, M.D., M.P.H.
Division of Radiological and
Occupational Health.........................Edwin G. Williams, M.D.
Division of Tuberculosis Control...............Dwight Wharton, M.D.
Division of Veterinary Public Health..........James B. Nichols, D.V.M.
Bureau of Sanitary Engineering................David B. Lee, M.S.Eng
Assistant Director........................Sidney A. Berkowitz, M.S.Eng.
Division of Industrial Waste.......................Vincent D. Patton, M.S.S.E.
Division of Special Services........................Charles E. Cook, C.E.
Division of Waste Water........................Ralph H. Baker, Jr., M.S. San.Eng.
Division of Water Supply...........................John B. Miller, M.P.H.
Bureau of Special Health Services
Assistant State Health Officer.....................Simon D. Doff, M.D., M.P.H.
Division of Chronic Diseases .....................J. E. Fulghum, M.D.
Division of Hospitals and Nursing
Homes (acting)............................... L. Nayfield, M.D., M.P.H.
Bureau of Vital Statistics..... .................Everett H. Williams, Jr., M.S. Hyg.
Division of Data Processing.........................Arnold Kannwischer, B.S.
Division of Public Health Records..............Oliver H. Boorde, B.S., B.A.
Division of Vital Records (acting)............Everett H. Williams, Jr., M.S. Hyg.

DIRECTORS OF COUNTY HEALTH DEPARTMENTS

(As of December 31, 1963)

Alachua..........................................................Edward G. Byrne, M.D., M.P.H.
Bay..................................... .............................A. F. U llman, M .D.
Brevard............ ................... .............T. Paul Haney, M.D., Dr.P.H.
Broward........................................................Paul W. Hughes, M.D., M.P.H.
Collier.............................................................. Clyde L. Brothers, M .D.
Dade....................................................... T. E. Cato, M.D., M.P.H.
Duval.................................. E. Morgan, M.D., M.P.H.
Escambia.......................................................J. C. McSween, M.D.
Hillsborough. ............................................John S. Neill, M.D., M.P.H.
Lake........... ..............................................J. Basil Hall, M.D., M.P.H.
Lee............ ...... .............. .........Joseph W. Lawrence, M.D.
Leon............................ ............................. Joseph M. Bistowish, M.D., M.P.H.
Manatee........................................................George M. Dame, M.D.
Marion ..................................P. H. Smith, M.D.
Monroe.................................................... John L. Ingham, M.D.
Okaloosa........................ ......................Henry I. Langston, M.D., M.P.H.
Orange............................ ..................Wilfred N. Sisk, M.D., M.P.H.
Palm Beach.................................. ...C. L. Brumback, M.D., M.P.H.
Pinellas................................ ..................... William C. Ballard, M.D., M.P.H.
Polk............ ................ .... .........James F. Cason, M.D.
St. Johns..............................................James C. Loranger, M.D.
Santa Rosa..................................................A. E. Harbeson, M.D.
Sarasota...................................................... R. H. Veldhouse, M.D.
Seminole..................................... .........Frank Leone, M.D.
Volusia........................................................ V. Galloway, M.D., M.P.H.
Baker-Nassau........................ ......... F. Woolsey, M.D.
Calhoun-Jackson........................................Terry Bird, M.D., M.P.H.
Flagler-Putnam ................................. ...James R. Sayers, M.D.
Gadsden-Liberty................................... D. Blackwelder, M.D., M.P.H.
Jefferson-Wakulla.......... ........................ ... L. Parks, M.D., M.P.H. (Acting)
Madison-Taylor..................................... L. Parks, M.D., M.P.H. (Acting)
Osceola-Indian River....................................... C. Flood, M.D., M.P.H.
Pasco-Sumter.............................................William A. DeFries, M.D.
Bradford-Clay-Union............................. A. Y. Covington, M.D., M.P.H.
Charlotte-DeSoto-Hardee................... .E. J. McLaughlin, M.D.
Citrus-Hernando-Levy.............. ..............Harold F. Bonifield, M.D., M.P.H.
Columbia-Hamilton-Gilchrist ............... .F. Barton Wells, M.D.
Franklin-Gulf.........................................Willa Dean Lowery, M.D., M.P.H.
Glades-Hendry-Highlands..........................William F. Hill, Jr., M.D., M.P.H.
Holmes-Walton-Washington ............... .L. L. Parks, M.D., M.P.H. (Acting)
Martin-Okeechobee-St.Lucie................... ..Neill D. Miller, M.D.
Suwannee-Dixie-Lafayette...............................J. Harland Paul, M.D., M.P.H.

TABLE OF CONTENTS

Page
Administration (including Activities of the Board; Coordinator
of Research; Encephalitis Research Center; Coordinator of
Training; Scholarships; Divisions of Health Education, Per-
sonnel and Public Health Nursing) ........................ ................. 1

Bureau of Dental Health ........................................................................ 26

Bureau of Entomology (including Entomological Research
C enter) ........... ....... ............... .. ................................... 29

Bureau of Finance and Accounts (including Purchasing and
Property) .......................................... ....... --.--....... --------.... ....... 48

Bureau of Laboratories ............................................................................ 58

Bureau of Local Health Services (including Divisions of Nutri-
tion and Sanitation; and Accident Prevention and Health
Mobilization Programs) ....................................................---- 74

Bureau of Maternal and Child Health .................................................... 114

Bureau of Mental Health (including Florida Council on Train-
ing and Research in Mental Health) ............................................ 123

Bureau of N arcotics ................................................................................. 134

Bureau of Preventable Diseases (including Divisions of Epi-
demiology [Venereal Disease Control Program], Radiological
and Occupational Health, Tuberculosis and Veterinary
Public H health) ............................................ .... 138

Bureau of Sanitary Engineering (including Divisions of Indus-
trial Waste, Special Services, Waste Water and Water
Supply) ........................---............. ..................-- ------------ 168

Bureau of Special Health Services (including Divisions of
Chronic Diseases and Hospital and Nursing Homes; and
Hospital Services for the Indigent Program) .................................. 200

Bureau of Vital Statistics (including Divisions of Vital Records,
Public Health Records and Data Processing) ............................... 222

Articles by Staff Members ............................... ......................... 237

GENERAL ADMINISTRATION 1

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

The office of the State Health Officer is the "nerve center" of the
State Board of Health (SBH) activities. A multitude of items involving
all phases of the organization's activities are handled by this office. It is
a difficult task to pick from these a few of the outstanding events or
achievements of 1963 from among the many that took place. There were,
however, several occurrences which should be mentioned because of their
general effect on the health of the citizens of Florida.
On January 1, 1963, the State Health Officer returned to Florida
after serving 14V2 months as Chief of the Office of Aging of the U.S.
Public Health Service (USPHS). His interest in this field of activity was
stimulated by federal legislation for Medical Assistance to the Aged (Kerr-
Mills Act) and by the passage of a law setting up a national health pro-
gram for Chronic Illness and Aging. The former was implemented in
Florida by state-appropriated funds in July 1963. Extensions and expan-
sions in this and other indigent medical care programs went forward
during the year, including nursing care in the home. With so many and
varied activities of the SBH concerning the health of the older person, it
was felt that more coordination was desirable. Malcolm J. Ford, M.D.,
Special Assistant to the State Health Officer, was given this responsibility.
Progress in the field of arthropod-borne disease control continued
throughout the year. Funds were appropriated for support of the SBH
Encephalitis Research Center in Tampa and a laboratory for the study
of the dog fly and related entomological problems to be constructed in
Panama City. Both of these are important not only to the health of the
citizens of Florida but to the state's continued development as a tourist
and recreation area.
Florida's progress as an industrial state has brought problems in air
and water pollution. Modest additional state appropriations were received
for an air pollution district in the Polk-Hillsborough County area. Grow-
ing citizen interest in urban areas has demonstrated the inadequate
resources of the SBH in this field.
The increasing competence of the SBH and the county health depart-
ments (CHD) in the research field was recognized by the award of a
General Research support grant to the SBH by the USPHS and by the
appropriation of state funds for encephalitis research.
Mental health planning has occupied much of the time and talent
of SBH and CHD employees as well as representatives of official and
voluntary organizations who have an interest in this public health en-
deavor. An unusually large number of lay citizens have also been involved.
All of this activity should result in an expanded and better coordinated
program that will benefit the mentally ill and the mentally retarded.
The Florida State Board of Health is fortunate now in having 12
committees (councils, etc.) who advise it on various specific public health
programs. Composed of experts in their fields plus lay representation in

2 ANNUAL REPORT, 1963

most cases they make a tremendous contribution to the solution of
many current health problems. New committees appointed this year
were an Encephalitis Advisory Committee and a Public Health Nursing
Committee.
The people of Florida as well as the State Board of Health owes a debt
of gratitude to its employees for their outstanding contributions during this
year.

STAFF ASSISTANCE
Although the State Health Officer receives assistance from all staff
members, there are certain staff specialists who report directly to him.
The internal auditor is available for the study of fiscal problems. His
primary responsibility is to conduct post audits of the financial transactions
of the agency to determine that fiscal matters are kept within the purview
of state and local laws and the policies of the SBH. The accounts of the
CHDs continued to receive major attention during the year. Since the
employment of an assistant, the accounts of 65 CHDs have been audited
and one is in process. An external audit report covering the operations
of a large CHD has been reviewed. The accounts of one CHD have been
audited twice.
Activities of the staff attorney during the first half of the year were
devoted primarily to legal review of proposed legislation prior to and
during the 1963 session of the State Legislature. During 1963, the
Board for the first time sought court relief for air pollution abatement
and for the second time assisted a municipality in defense of anti-fluorida-
tion litigation .... The staff attorney is responsible for the supervision of
the distribution of compiled agency regulations. Trends in the last quarter
of 1963 indicate that problems involving litigation and enforcement will
increase in future years.
During 1963, the news director sent 117 news stories to newspapers,
radio and TV stations. Assistance was given these media on 126 occasions:
supplying information; initiating stories, photos and interviews; and aiding
representatives to obtain their own material for stories, photographs, inter-
views, TV sound and tape and editorials.

ACTIVITIES OF THE BOARD
January 4-Lakeland
1. Welcomed the return of Wilson T. Sowder, M.D., to his position
as State Health Officer, Florida State Board of Health (SBH),
after a leave of absence of 14 months during which time he oc-
cupied a position with the U.S. Public Health Service as Chief,
Office of Aging.
2. The Board discussed the State Tuberculosis Board's offer to trans-
fer a portion of land on the grounds of the Southwest Florida
Tuberculosis Hospital to the State of Florida for the purpose of
establishing a SBH Regional Laboratory in Tampa.

GENERAL ADMINISTRATION

3. Approved a memorandum of Agreement regarding Laboratory
Services between the SBH and State Tuberculosis Laboratory.
4. Discussed with Drs. Bond, Hardy and Mr. Mulrennan the en-
cephalitis research project to be carried on in the Tampa Regional
Laboratory with the aid and assistance of a grant from the Na-
tional Institutes of Health in the amount of $186,000.
5. Discussed a proposed Memorandum of Agreement regarding the
Tampa Bay Regional Encephalitis Laboratory at the Southwest
Florida Tuberculosis Hospital.
6. Discussed a proposed budget for encephalitis prevention and con-
trol in the state and suggested revisions to it; and further asked
the State Health Officer to submit to them names of possible
members to a Scientific Advisory Committee to assist the SBH in
the encephalitis program.
7. Approved statements to the Interim Legislative Committee and its
membership regarding the county health unit bill and one on
medical services and advised Dr. Sowder to include his comments
in a covering letter to the Interim Legislative Committee.
8. Approved postgraduate training for two public health nurses.
9. Approved a request from the Lake County Commissioners regard-
ing the transfer of $10,000 for the building of an auxiliary health
center in Clermont.
10. Approved a revision of priorities for sewage treatment plant con-
struction grants.
11. The Board commended Dr. Hardy for his work as Acting State
Health Officer during Dr. Sowder's leave of absence.
12. The Board went on record as being grateful and commending
Ashbel Williams, M.D., for the fine service rendered to the SBH
while he was a Board member.
13. Dr. Peek advised the Board members that Leo Wachtel, M.D.,
had been appointed to fill the unexpired term of Ashbel Williams,
M.D.
January 5-Lakeland
1. The Board held a hearing on air pollution in order to discuss
some of the problems of the area.
2. The Board met with the Air Pollution Control Commission after
the hearing.
February 12-Jacksonville
1. The Board members welcomed Leo M. Wachtel, M.D., as the
new member replacing Ashbel Williams, M.D.
2. Approved an Agreement on cooperative procedures for adminis-
tering and regulating the sanitary control of the shellfish industry
by the SBH and the State Department of Conservation.

4 ANNUAL REPORT, 1963

3. Discussed a request from John Neill, M.D., health officer of
Hillsborough County Health Department (CHD), that the SBH
reconsider and build the Tampa Regional Laboratory in con-
nection with the CHD.
4. Approved the appointment of an Advisory Committee on Sani-
tary Engineering.
5. Approved a Memorandum of Agreement with the State Tuber-
culosis Board and the SBH regarding the Regional Encephalitis
Laboratory in Tampa.
6. Approved the appointment of Lake Lytal to the Advisory Com-
mittee on the Hospital Service for the Indigent to replace Fred
Gill.
7. Approved postgraduate training for Robert Schneider, biologist
with the Bureau of Sanitary Engineering, beginning June 1963.
8. Approved recommendations submitted by the Air Pollution Con-
trol Commission and Mr. Lee regarding the air pollution situation
in Lakeland.
9. Approved the continued employment of five persons beyond 70
years of age; and approved one to be not beyond that of June 30,
1963.
10. Approved the reclassifications of five Health Officers IV to Health
Officers V.
11. Approved the appointment of James Nichols, DVM., as director
of the Division of Veterinary Public Health, effective February 15.
12. Approved a bill to be entitled "An Act Amending Subsection
381.031, Florida Statutes, giving the State Board of Health the
authority to regulate the handling of highly toxic materials in
residential areas; and providing an effective date" to be submitted
to the Legislature.
13. Discussed the proposed Mental Health Plan to be submitted to
the U.S. Public Health Service for additional funds in the
amount of approximately $97,000 for planning in mental health.
14. Approved the transfer of the Division of Public Health Nursing to
the Office of the State Health Officer.
March 24-Jacksonville
1. Approved a policy on the licensure of physicians.
2. Approved a policy regarding supplementation of salaries.
3. Approved the appointment of an Advisory Committee on Public
Health Nursing.
4. Approved the appointment of an Advisory Committee on
Encephalitis.
5. Approved certain amendments to laws governing programs of the
State Board of Health to be submitted to the Legislature.

GENERAL ADMINISTRATION 5

6. Approved the request from Highland County Board of County
Commissioners and Highland CHD for release of funds for build-
ing of a health center.
7. Approved the request for certain changes in the School Rules and
Regulations by the State Board of Beauty Culture.
8. Approved a policy for longevity pay increases for employees
exempt from the Merit System.
9. Approved and appointed the members of the Board of Directors
of the Florida Public Health Association to be members of the
Insurance Committee of the SBH and stated that when the
membership of the Board of Directors changes, the membership of
the Insurance Committee changes accordingly.
10. Approved candidates for postgraduate training.
May 16-Hollywood
1. Rescinded regulations, Chapter 170 C-4, Individual Sewage Dis-
posal, and reverted back to old Chapter V and those sections of
other chapters which had to do with individual sewage disposal
systems after discussion.
2. Approved an Agreement of Understanding on Septic Tank Per-
mits in Monroe County.
3. Approved postgraduate training for public health nurse.
4. Approved a request from the Clay County Commission for the
transfer of funds for the building of the CHD.
5. Approved the awarding of medical scholarships.
6. Approved a pilot study for oral cytology to be conducted in Duval
County subject to the receipt of funds for the purpose.
7. Approved the establishment of three divisions in the Bureau of'
Vital Statistics as follows: Data Processing, Vital Records and
Public Health Statistics.
8. Approved financial participation in a seminar to be held by the
Arthritis and Rheumatism Foundation.
9. Approved study and lecture tour for Emile Van Handel, Ph.D.
July 14-Jacksonville
1. Discussed Monroe County septic tank problem with John M.
Ingram, M.D. and Mr. Lee.
2. Welcomed Carlton P. Maddox as part-time attorney replacing
Hans Tanzler who had been appointed as a judge in Duval
County.
3. Approved policy regarding per diem of SBH employees.
4. Approved appointment of Senator Cliff Herrell and Represen-
tative Ray Mattox to Advisory Committee for the Hospital Serv-
ice for the Indigent.

6 ANNUAL REPORT, 1963

5. Approved certain physicians for an additional year of employment
without a medical license.
6. Approved an amendment to the formula regarding county health
unit funds.
7. Approved a candidate for an osteopathic scholarship.
8. Discussed the establishment of a dog fly laboratory.
9. Reaffirmed the policy of the SBH with regard to the employment
of relatives and directed that this policy be applied to the student
trainees employed.
10. Discussed a plan for publicity during epidemics.

October 6-Jacksonville
1. Approved regulations for the Medical Assistance to the Aged
(MAA) Program.
2. Discussed a report on the construction of the Pensacola and
Tampa Laboratory buildings as presented by Nathan J. Schneider
Ph.D.
3. Received a report from Dr. Sowder on his trip to Ecuador.
4. Approved a site in Bay County for the construction of the dog fly
laboratory.
5. Welcomed Malcolm Ford, M.D., as a member of the staff of the
Florida State Board of Health.
6. Approved a travel fellowship for Simon Doff, M.D., for a period
of six weeks.
7. Approved a leave of absence without pay for Albert V. Hardy,
M.D., for a period of three months.
8. Discussed the resignation of W. L. Wright, M.D., director of the
Bureau of Local Health Services.
9. Approved the recommendation of Dr. Sowder that L. L. Parks,
M.D., be appointed as Acting Director of the Bureau of Local
Health Services.
10. Received a report from Dr. Sowder regarding the release of
funds for the Encephalitis Program and those for the Polk-
Hillsborough Air Pollution Control District.
11. Discussed their relationship with the Air Pollution Control Com-
mission.
12. Approved the request of the Lake County Commissioners to
transfer $3,000 from the county health unit fund for use in the
construction of an auxiliary health center in Clermont.
13. Requested the State Health Officer to secure an up-to-date study
of the health card situation to be brought to their attention at
the next meeting.

GENERAL ADMINISTRATION 7

December 8-Jacksonville
1. Discussed certain legal problems with regard to the air pollution
problem.
2. Discussed the regulations regarding the fluoridation policy but
took no action.
3. Received a report by George McCoy, M.D., on the Accident Pre-
vention Program.
4. Approved the appointment of L. L. Parks, M.D., as director of
the Bureau of Local Health Services.
5. Approved salary increases for the Health Officers V in CHDs.
6. Discussed the employment of David Crane, M.D., upon his return
to the United States.
7. Approved a revision of the rules and regulations for the MAA
Program.

COORDINATOR OF RESEARCH
ALBERT V. HARDY, M.D., Dr.P.H.
A major function of this coordinator is to assist others in the develop-
ment of their own studies. Hence, most of the reports on research will be
found elsewhere in the individual bureau chapters. The description of
the work of the Entomological Research Center, which has attained
national and international recognition, is a part of the report of the
Bureau of Entomology. The recently established Encephalitis Research
Center has had a busy and productive first year as described by its director
in the pages following. The investigations of infections due to the Un-
classified Mycobacteria have been carried on in close association with the
Division of Tuberculosis Control in whose report this work is described.
Cooperative studies in food sanitation have been initiated by the Bureau
of Laboratories and the Division of Sanitation. In reports of these and
other bureaus and divisions there will be a record of research, special
studies, experimental programs and other activities designed to establish
"more effective means" for the provision of public health service in
Florida.
Similar investigations conducted as a part of county health depart-
ments (CHD) are not described as adequately. There are the varied
studies in Pinellas County, all concerned with health problems and prob-
lems for the aging. An ongoing study is directed specifically to this broad
objective. A more limited investigation is assessing the extra nursing
needs of a retirement community. Through the cooperation of the Univer-
sity of Florida and the U.S. Public Health Service (USPHS), there was
an exploratory approach to the study of senility. Also a study of accidents
in the aging by the Division of Accident Prevention of USPHS has been
established in close association with the Pinellas CHD.
There have been two major research interests in Dade County. In
cooperation with the University of Miami Medical School there has

8 ANNUAL REPORT, 1963

been an active year of study and planning for research and service in
the neurological and sensory diseases.
The ongoing Development Evaluation Clinic, initiated and con-
ducted as a cooperative demonstration, is proving to be a very pro-
ductive approach to finding "more effective means" for providing service
to the mentally defective. Also, there have been studies of heart disease
control in association with the National Children's Cardiac Hospital.
Currently, funds for research are more readily available than persons
qualified by training and experience in community based research. With
the support of a Research Training Grant, the advanced or prolonged
training for research in the public health environment is being made
available to a very limited number of selected candidates. This is deemed
of the greatest importance in assuring the continued development of
productive studies.
There were two favorable developments relating to the budget,
during the year. The state legislature provided funds for encephalitis
research, a modest allocation, but of significance in the recognition of
the proper role of research within organized public health. Also from
USPHS there was a "General Research Support Grant." This is
made available to those institutions and organizations which have an
established research program. This grant provides flexible funds which
should aid in the organization and initiation of further public health
research in Florida.
Kellogg Project
A project in administrative research, now in its fifth year, has been
supported by funds from the Kellogg Foundation. During 1963 the
system of evaluation for public health programs developed and tested
during the preceding year was successfully applied to the demonstration
program for which it was devised. During the latter part of the year,
preparations were made to adapt the system for use in comprehensive,
community-based mental health planning, and a survey was conducted
in one county to develop guide lines for the adaption. Plans were made
for an intensive study of personnel problems to be made in 1964. Con-
sultation was offered to program directors, health officers and others in
the revision of long range plans and in the development of administra-
tive procedures.

COORDINATION OF TRAINING
ROBERT V. SCHULTZ, M.D., M.P.H.
Coordinator of Training
This new activity was established February 1, 1963, under the
general direction of the State Health Officer. It is concerned with
coordinating and providing assistance for program planning and ar-
rangements incident to intra- and intermural training activities for per-
sonnel in all disciplines and departments of the State Board of Health
(SBH) and county health departments (CHD). Such training programs
may be conducted in whole or part, by SBH and CHD personnel in

Organizational Chart of the

State Board of Health

1l ASSISTANT
Encephallit I sNCPHAuITIST STATE HEALTH
Advisory comlttee IllIlIlll E LS OFFICER
S ESEARCH CENTER (ResearchProgram
Planning,etc.)

Engineering IIIIIIIIIIInI| SANITARY
Co.m^ittee l IM 1 ENGINEERING

D DIVISION OF DIVIIONOF bliHealth
HEALTHON UIC HEALTH Ill"llI Nursing Cormittee
EDUCATION NURSING
(Library) I

County Health Departments

GENERAL ADMINISTRATION

related activities; jointly, in cooperation with institutions of higher
learning; through scholarships sponsored by the SBH or certain federal
traineeship programs and special grants, and through training courses
scheduled by health related professions or organizations, hospitals and
institutes. The Coordinator of Training is also responsible for the ad-
ministration of the Summer Student Traineeship Program and the Post-
graduate, Residency Training, Medical, Osteopathic and Mental Health
Scholarship Programs for professional education.
The services of this office are available, upon request, to SBH and
CHD directors, program supervisors and all personnel concerned with
training activities. By attendance at workshops, seminars, orientation
programs and other meetings, this office has acquired a framework of
reference concerning the nature and scope of some of the training
activities currently in operation. Because of the diversity and large num-
ber of training activities involved in the total program, it has been pos-
sible to date only to become reasonably familiar with some, acquainted
with others and make plans to observe hitherto unvisited training activi-
ties at the earliest opportunity.
As with any new activity, time will also be required to acquaint all
personnel concerned with the reciprocal relationships and services avail-
able to them from this office.
Of paramount importance in the development of these programs
are the working relationships currently established with committees ap-
pointed by the State Health Officer concerned with specific scholarship
programs; the "Advisory Committee on Training to the Coordinator of
Training" appointed by the Florida Association of County Health Offi-
cers; bureau, division Directors of SBH and CHDs; training program
supervisors and CHD personnel concerned with intermural or com-
munity training activities; the director, Division of Community Junior
Colleges, State Department of Education; the director of the Florida
Institute for Continuing University Studies (FICUS); the dean, Divi-
sion of General Extension of FICUS, and certain faculty members of the
universities and colleges of Florida and nearby states that have indicated
a manifest interest in and are prepared to review proposals for partici-
pation in appropriate SBH training programs.
Public Health Residency Training Program
The State Board of Health offers an AMA-approved residency in
public health. Under this program the following five physicians received
appointments for resident training in public health (the dates residencies
began are given) :
R. Christopher Brown, M.D. Palm Beach July 1963
Antonio L. Court, M.D. Hillsborough July 1963
Richard A. Morgan, M.D. Hillsborough* July 1963
Frank Leone, M.D. Seminole** November 1962
Charles M. Bradley, M.D. Volusia November 1961
* Sponsored by United States Army.
**State level resident assigned to Seminole County under the supervision
of Wilfred N. Sisk, M.D., M.P.H., Director, Orange County Health
Department.

10 ANNUAL REPORT, 1963

Student Traineeship Program
Each summer for a number of years, the SBH has offered tem-
porary employment to a limited number of college and postgraduate
students during the summer months. They are assigned to positions in
activities related to their indicated or proposed careers in medicine,
dentistry, sanitary engineering, the allied sciences and health related
professions. During their period of employment, they assist in ongoing
programs and in addition receive special training and supervision de-
signed to orient them with the specific and over-all functions of the SBH
and CHD programs and activities.
In 1963, there were 480 applications for this program. Of these, 71
were selected for employment at the central offices and in the regional
laboratories of the SBH, the several regional offices of the Bureau of
Sanitary Engineering, the Encephalitis Research Center in Tampa, and
divisions or activities of the following counties: Alachua, Broward,
Dade, Duval, Escambia, Gadsden, Hillsborough, Leon, Orange, Palm
Beach, Polk and Sarasota.

SCHOLARSHIPS FOR PROFESSIONAL EDUCATION

The scholarship programs created by the 1955 Legislature for the
study of medicine, dentistry and the several disciplines concerned with
mental health were continued.
Scholarships for the study of medicine were awarded upon the
recommendation of a seven-man advisory committee authorized by
statute. The seven members were: George T. Harrell, M.D., Dean of
the School of Medicine, University of Florida; John C. Finerty, Ph.D.,
Assistant Dean of the School of Medicine, University of Miami; Arthur
J. Wallace, Jr., M.D., Tampa; James T. Cook, Jr., M.D., Marianna;
David W. Goddard, M.D., Daytona Beach; Homer L. Pearson, Jr.,
M.D. Miami; and Melvin M. Simmons, M.D., Chairman, Sarasota.
As authorized by the Legislature in 1959, one scholarship was
awarded for the study of osteopathic medicine. The recipient was recom-
mended by the State Board of Osteopathic Medical Examiners.
Scholarships for the study of dentistry were awarded by the Board
upon the recommendations of the State Board of Dental Examiners.
Scholarships in the several disciplines of mental health were award-
ed by the Board upon the recommendations of the Florida Council on
Training and Research in Mental Health.
Through the Federal Social Security Act of 1935, the SBH receives
federal funds which are used to provide stipends to its employees and
those in affiliated CHDs for specialized professional training. These
stipends are awarded to career employees who evidence a potential for
growth and service in specialized areas of public health.

GENERAL ADMINISTRATION

MEDICAL
Scholarships Awarded in 1963:

Kenneth L. Beckett ........Jacksonville
Calvin Collins, Jr. ..............Sanford
Beatrice Alfreda
Denefield ....................Jacksonville
Vincent Lamar Freer ........Ft. Pierce
Karl George Gerlach ..............Miami
Samuel Boykin Hunter ....Hawthorne

Ronica Mahoney
Kluge ......................St. Petersburg
Bodo Eitel Pyko* ..........Key Biscayne
Kathleen Mary Santi ............Martin
Shirley Rose Simpson ..............Pierce
Ira Harmon Wenze ........Tallahassee
Phillip Eugene Wright ......Lakeland

Continuing Scholarships Awarded Prior to 1963:

Awarded 1960:
Sylvester Barrington
Rodney Lee Brimhall
John Augustine Moore
Cupid R. Poe
Frederick Oliver Smith
Paul Vincent Sullivan
Tommie Lynn Thomas*
Robert Whelchel Miles

Awarded 1961:
Jack Denby Bergstresser*
George Duncan Finlay
Buford Gibson, Jr.
Ronald Loyde Haney
Oliver Hunt Harper
Braxton William Price
Joseph Thomas
Rabban, Jr.
David Oliver Westmark
Hubert Warren Wingate

*Studying osteopathic medicine.

Awarded 1962:
Richard Julian Bagby
Leonard Channing Bass
Lloyd Dale Gauvin*
Joseph William Haddock
Donald Gammon Hall
Gordon David Onstad
Laurie Miles Pardee
Richard Allison Pollock
Richard Thomas
Roby, Jr.
Howard Todd Willson

DENTAL
Scholarships Awarded in 1963:

John F. Bembry .....................Palatka
Norman M. Bevan, Jr. ...........Largo
Frederick A. Booth, III ..........Miami
Robert L. Ferdinand ...........Miami

Anthony B. Frilingos ....Coral Gables
George D. Sanchez ..............Tampa
Michael R. Kennedy ..St. Petersburg

Continuing Scholarships Awarded Prior to 1963:

Awarded 1960:
Teddy Wallace Brown
Emmett Alfred Kirksey
Charles H. Ritter
Allen R. Treadwell

Awarded 1961:
Clement W. Barfield
George B. Dorris
Guy Ronald Estes
John T. Griffin, Jr.
Charles A. Harrell
Arthur R. Higgs
Edward L. Peters
Ivan Beryl Roberts
David M. Strimer
William R. Warrender

*Scholarship surrendered in November 1963.

Awarded 1962:
George Wallace
Boring, Jr.
Robert Renne Burch
James V. Ferdinand
Ronald Emil Molinari
William Walker
Motley, Jr.
Alvan Carlton Smith
Gordan Dennis Wiebe*
John Paroy Youngman
Emory Turner Cain

MENTAL HEALTH
Clinical Psychology

Richard B. Bracewell ......Jacksonville
Charles E. Buchanan ........Gainesville
Mack R. Hicks ................Gainesville

Kemper
Dorothy
John F.

McCue ....................Miami
Ward ..............Winter Park
White ............Tallahassee

12 ANNUAL REPORT, 1963

Psychiatric Nursing

Josephine L. Hunt ....Winter Haven

Jo Ann McKay ................Gainesville

Psychiatric Social Work
Second Year

First Year

Charlotte Barbour ..........Palm Beach
David C. Bates ......................Tampa
George K. Bond ......................Miami
Elizabeth F.
Buckingham ............Ft. Lauderdale
Danny W. Edwards ........Tallahassee
Sara French ......................Tallahassee
Loren H. Hildebrant ........Live Oak
Laura K. Levine ............Tallahassee
Nancy Lee
Parham ........Green Cove Springs
Winifred K. Rasmussen ......Maitland
Frances
Rowland ........Indian Rocks Beach
William J. Simmons ........Plant City
Thomas J. Stewart, Jr ....Lake City
James E. Wetmore ..........Tallahassee

Raymond L. Edwards ......Tallahassee
Herbert W. Uppitt ..................Miami

Public Health Personnel
H. V. Gayles.......................Public Health Nurse II............Sarasota
R. W. Gillespie...................Sanitarian II.............................Hillsborough
R. L. Hebblethwaite..........Chemist II...................................State Board of Health
G. W. Hoover.....................Health Officer II........................State Board of Health
M. M. Lentz.......................Public Health Nurse III...........Broward
D. V. Logsdon...................Resident Trainee.........................Palm Beach
P. A. Maher........................Public Health Nurse II.............Palm Beach
R. L. M aston......................Sanitarian I.................................Duval
L. P. Robinson....................Sanitary Engineer II..................Pinellas
R. F. Schneider.................-Biologist II................................State Board of Health
H. E. Skipwith...................Nutritionist I..............................State Board of Health
M. H. Speakman................Public Health Nurse II.............Highlands
S. Van Ooteghem...............Public Health Nurse II.............Hillsborough
A. J. E. Wilson III...........Asst. Social Scientist...................Pinellas
L. L. Wood.........................Public Health Nurse III...........Pinellas
G. R. Wyman..................... Public Health Nurse I...............Alachua

ENCEPHALITIS RESEARCH CENTER
JAMES O. BOND, M.D., M.P.H.

Initiated as a temporary field station during the 1962 epidemic
of St. Louis Encephalitis (SLE), the Tampa Bay Regional Encephalitis
Laboratory assumed more permanent status on December 1, 1962,
following the award of a five-year grant from the National Institutes
of Health (NIH) to the State Board of Health (SBH). The laboratory
was established in a building provided by the Southwest Florida Tuber-
culosis Hospital on its grounds in Tampa. Later in 1963, the $186,000
NIH Grant was supplemented by $100,000 appropriated by the Florida
State Legislature for research, surveillance and control of encephalitis.

GENERAL ADMINISTRATION 13

A portion of the state money was allocated to the Tampa laboratory
which was then officially named the Encephalitis Research Center
(ERC).
The Center has a staff of 24, and the director is immediately respon-
sible to the State Health Officer. The activities of the center are co-
ordinated with other statewide research and surveillance activities in
encephalitis by the Coordinator of Research. The various scientific
disciplines in the ERC maintain close consulting relationships with their
appropriate bureaus in the SBH. The Research Center maintains close
cooperative relationships with the county health departments (CHD)
and the County Mosquito Control Districts in Hillsborough, Manatee,
Pinellas and Sarasota Counties. The Arbovirus Laboratories of the Com-
municable Disease Center (CDC), of the U.S. Public Health Service
(USPHS) in Atlanta, Georgia, and the University of Pittsburgh Gradu-
ate School of Public Health are utilized for special reference and
consultive assistance.
A nine-member Encephalitis Advisory Committee of nationwide
experts was appointed to advise the State Health Officer on statewide
research, surveillance and control activities, including those carried out
in the ERC. The committee was composed of W. McD. Hammon,
M.D., University of Pittsburgh; John P. Fox, M.D., Public Health Re-
search Institute of the City of New York, Inc.; Oscar Sussman, D.V.M.,
State Department of Health, New Jersey; George T. Carmichael, Chat-
ham County Mosquito Control District, Savannah, Georgia; Joel Ehren-
kranz, M.D., University of Miami School of Medicine, Miami; Carroll
N. Smith, Ph.D., U. S. Department of Agriculture Research Branch,
Gainesville; Carlton M. Herman, Ph.D., U.S. Fish and Wildlife Service,
Laurel, Maryland; Telford Work, M.D., CDC, USPHS, Atlanta,
Georgia, and Archie Hess, Ph.D., USPHS Greely, Colorado.
The scientific activities of the ERC in 1963, although planned as a
team effort, will be presented as a report from each section.
The establishment and maintenance of a surveillance and reporting
system for all central nervous system viral diseases in the Tampa Bay
area resulted in a high index of suspicion among medical and public
health personnel. Of 301 suspected viral infections of the central
nervous system in humans brought to the attention of the ERC, 82 were
finally appraised as representing cases of infectious encephalitis, aseptic
meningitis or paralytic disease. There were no acute cases of SLE with
laboratory confirmation in the four-county area during 1963, although
one was reported on the basis of clinical findings. One California virus
infection was confirmed, the second reported occurrence of encephalitis
following infection with this virus in the United States. Of the remaining
cases in which a definite etiology was established, two were from
measles; 13 from mumps; four, influenza; two, poliomyelitis; and one,
leptospirosis. In 64 per cent of the 82 cases, no etiological relationships
could be established.
Three major serologic surveys for inapparent SLE infection were
carried out or completed during 1963. These involved 3000 individuals

14 ANNUAL REPORT, 1963

from Bradenton, Sarasota, Clearwater, Tampa and rural Hillsborough
County. Prevalence rates for preceding inapparent infection with SLE
in these areas were as follows: Clearwater 8.1 per cent, Tampa 4.1 per
cent, Bradenton-Sarasota 3.4 per cent. A small group of the Hillsborough
County residents were rebled in December 1963 and there was no
evidence in their sera that any transmission of SLE virus to humans
occurred during the summer months. Small samples of the 3000 survey
individuals were also examined for prevalence of antibodies against
California and Tensaw viruses. It was found that one to six per cent
of these had previous infection with California virus and from one to
five per cent with the Tensaw virus. There was no evidence of inap-
parent infection with either of these viruses during the summer period
of 1963.
Studies on antibody response following acute clinical SLE were
carried out on selected patients from the 1959-1961 and 1962 epidemics.
Although not complete, early findings from these studies indicate that
the complement fixation (CF) antibodies are of very short duration,
usually persisting only a few months. The Hemogglutination inhibition
(HAI) antibodies fell to very low levels within the first two years and
were below detectable levels at the end of the third year. Serum
neutralizing antibodies, on the other hand, have been shown to persist
for the full three years of the follow-up studies.
The Entomological Section maintained chick baited traps on a
semiweekly operation at 12 stations from January to April, and at 28
stations from May to December 1. Six of these, (three in mosquito con-
trol areas), are key stations where temperature recorders and rain
gauges are operated and are adjacent to six truck trap runs. As of
December 31, 72,746 mosquitoes were captured by bait traps and sub-
mitted in 2592 pools for virologic testing. From eight pools of Aedes
infirmatus mosquitoes, isolations were made of a viral agent later iden-
tified as closely related to the Trivitattus virus which is a member of the
California group. A ninth isolation, from Aedes taeniorhynchus mos-
quitoes, was identified as Tensaw virus, a member of the Bunyamwera
group. The California group viruses were isolated from mosquitoes
trapped in Pinellas, Hillsborough and Manatee Counties, and the
Tensaw virus was obtained from Hillsborough County. In 890 pools
prepared from 47,093 Culex nigripalpus mosquitoes collected in bait
traps, no viral isolations were made.
Truck trap collections were used to establish the densities of various
mosquito species in the controlled and uncontrolled areas, and to deter-
mine the percentage of gravid and parous (fertile) female mosquitoes of
the sub genus Culex. A total of 61,759 mosquitoes were collected in
the truck traps, of which 13,725 were in controlled areas and 48,034 in
uncontrolled areas. The pattern of consistently lower numbers of mos-
quitoes collected by the truck traps in controlled areas was found in each
of the three counties. In Hillsborough and Pinellas Counties, the per-
centages of parous or gravid female mosquitoes were consistently and
significantly lower in the controlled compared to the uncontrolled.
Meteorological observations on temperatures and rainfall were com-
pared to the mosquito densities in each of the collection sites. Culex

GENERAL ADMINISTRATION 15

nigripalpus densities were unusually low in all three counties and were
particularly low in Pinellas County where intensive adulticide efforts
were carried out from early spring through late October. In all three
counties there were small amounts of rainfall in the spring and early
summer, and this combined with the low water table made conditions
particularly unfavorable for early nigripalpus development. Late in the
fall there was a rise in nigripalpus density, but apparently too late for
any significant effect on SLE transmission.
Virus activity in vertebrates was measured by serological and virolo-
gical examinations of sentinel chickens, nestling wild birds, trapped wild
mammals, and sick birds and mammals collected from the epidemic
area. During the period March through November, 794 sentinel chickens
were exposed in standardized traps during 10 separate three-week
periods. Sixteen of these chickens had low titers of HAI antibodies
against SLE, and all were negative against Eastern Encephalitis (EE).
The significance of these low HAI titers cannot be assessed until neu-
tralization antibody studies are performed on these sera. It is presumed,
however, that they likely represent nonspecific inhibitors in the sera
rather than the SLE antibodies. Three of 376 nestling rookery species
had low SLE-HAI antibody titers, and three of 390 urban nestling
species had similar titers. All three of these were from 333 nestling
doves collected in the epidemic area of St. Petersburg. Two of 42 marsh
and shore bird nestlings, and one of 324 small mammals also exhibited
low SLE-HAI antibody titers. Of the titers observed, only one, a titer
of 1:160 in a nestling redwing blackbird, was considered to be of
definite significance, representing recent infection with SLE.
Laboratory infection experiments carried out with four-day and
four-week old chickens indicated that viremia and high antibody titers
are rare in older chickens, but relatively common in the young. Similar
infection experiments with doves indicated that they respond with higher
antibody levels and a greater proportion have prolonged viremias, com-
pared to chickens.
Special ornithological observations were carried out by Dr. Glen
Woolfenden of the University of South Florida with the assistance of
graduate students. The avian populations in selected areas in the
three counties were measured using both a strip census and a nesting
census technique. Using the former technique, the densities of total
birds per census mile were found to vary from 160 in Tampa to
189 in St. Petersburg. A total of 74 species were recorded in all, but
90 per cent or more of the individuals could be accounted for by only
12 species. There were significant differences in the relative densities of
these 12 species in the four study areas. Comparative observations for
time of year, technique and area were made in both St. Petersburg and
Tampa in 1962 and 1963. Remarkably little variation was found in the
relative density of birds during the two periods of time. A special area
census of nesting birds was carried out during the spring and summer of
1963 in three plots in St. Petersburg. The housesparrow was most fre-
quently encountered, followed by the mourning dove. A close associa-
tion was found between the density of mourning doves and the type of
vegetation. High densities were found in pine plot areas, smaller densities

16 ANNUAL REPORT, 1963

in oak plots and very low densities in plots in which there was less than
one per cent standing vegetation coverage.
Following a period of renovation of space and training of personnel,
the virology laboratory began functioning on a routine basis in April
1963. Through December, 2592 pools of mosquitoes have been proc-
essed for virological specimens in suckling mice, and 5331 serum
specimens examined for the presence of antibody against various arbovi-
ral agents. In all, nine viral isolations were obtained as previously
described. Following a third suckling mouse passage, these viral agents
were shown by the ERC virology laboratory to be neither EE, SLE, or
Western encephalitis virus by the complement fixation and neutraliza-
tion screening tests. None of the isolates produced a hemagglutinin and
all were shown sensitive to sodium desoxycholate. They were then for-
warded to the University of Pittsburgh or the CDC virological labora-
tories for final identification. Eight of the isolates were demonstrated to
belong to the California group by cross-neutralization, CF and HAI
tests. They are most closely related to the Trivitattus agent, first isolated
in North Dakota in 1948. The ninth agent was shown to belong to the
Bunyamwera group by the ERC virology laboratory and confirmed at
both CDC and the University of Pittsburgh. Other cooperative and
comparative serological studies were carried out with CDC and the
University of Pittsburgh to determine the sensitivity and specificity of
the different arbovirus antigens used in the ERC battery.
In cooperation with the virology section of the SBH laboratories in
Jacksonville, additional virological diagnostic studies were carried out
on human specimens from the four-county area in which there was
no evidence of arbovirus activity. Of 133 stool specimens tested in
Jacksonville, nine enteroviruses isolations were made. Two of these were
poliomyelitis, and the reminder were Echo-6 and Echo-7. Attempts to
isolate virus from 55 cerebrospinal fluids were made; all were negative.
In addition, serological examinations were performed for mumps in 45
individuals, 13 cases were confirmed; leptospirosis, 73 examined, one
case confirmed; LCM, 36 examined, none confirmed; poliomyelitis, 47
examined, two confirmed; herpes simplex, 16 examined, none con-
firmed; and measles, two examined none confirmed.
Five students received training experience in the ERC during 1963.
Two were undergraduates in the field of biology and laboratory tech-
nology, and three were graduate students, one each from medicine,
entomology and biometry. A public health veterinarian and a public
health physician also spent some time in residence at the Center for
training experience in arbovirus epidemiology.

DIVISION OF HEALTH EDUCATION
ELIZABETH REED, R.N., B.S.
Director
The function of this division is to provide accurate knowledge about
health to the various publics in a manner which they can understand

GENERAL ADMINISTRATION 17

and accept and to motivate them to make full use of this information.
The division does not have a "program" but rather is a service activity
that seeks to assist other bureaus and divisions in extending the health
education aspects of their programs. To this end close contact is main-
tained with them, county health departments (CHD) and with many
official and lay health organizations, schools and civic organizations.
The Audio-Visual Library must constantly revise procedures in
order to cope with the increase in circulation. A revised booking order
form was placed in use eliminating several steps in typing and filing.
Part-time employees had to be employed on three occasions to meet
the heavy work load. The following figures give comparable evidence
of activity:
1962 1963
Total number of aids circulated 6,357 7,394
Total number of times all aids were used 11,660 15,136
Motion pictures used 5,892 7,007
Part of the reason for this increase was the large number of films
(181 prints) purchased with categorical funds at the end of the fiscal
year, as well as the 16 bought with division funds and 27 placed in the
library on loan from other agencies. Categorical funds also accounted
for the acquisition of some new equipment including a second electronic
inspection and processing machine, projectors, film racks, etc.
The results of a survey conducted among state health departments
was compiled and distributed. It revealed the policies and procedures of
the various states in the handling of audio-visual aids, and, therefore,
was of assistance in review of this library's functions.
A major problem is the difficulty encountered in trying to get key
personnel to review and evaluate new aids which are offered for pur-
chase; the lack of a balanced collection because categorical funds allow
purchases only in specific subject areas, and the need for the promotion
of use of certain excellent aids in the library on cancer, heart disease,
rehabilitation, etc.
Florida Health Notes' mailing list continues to grow (presently over
18,000). Subjects covered in 1963 included sanitation in suburban areas,
venereal diseases, safety, hospitalization services for the indigent, health
laws, voluntary health agencies, aging, household pests, food poisoning
and a simplified annual report. Other writing responsibilities in-
cluded the editing and publishing of State Board of Health (SBH)
monographs numbers 4 and 5, Epidemic Enteric Infections among Pris-
oners of War in Korea and Tampa Bay Area Arbovirus Investigations,
the Annual Report and numerous pamphlets and brochures .. Twenty-
eight television spot announcements were prepared. An informal survey
showed that most stations used them about four times a week. Ap-
proximately 25 spots were supplied to radio stations throughout Florida.
Four issues of the Intelligencer were issued (births, deaths, honors,
etc., of employees of SBH, CHDs and voluntary health agencies); 51
issues of the weekly announcement "Conferences and Meetings"; two
flipcharts were prepared one on general public and one on activities

18 ANNUAL REPORT, 1963

of the Bureau of Laboratories; and six postage meter ads were designed.
. This division also does all photography for the SBH, except that
which is used for publicity purposes. A small brochure was issued
entitled "We Lend" showing the location and availability of all the
audio-visual equipment in the SBH, including cameras, projectors and
specialized equipment. These are loaned to SBH personnel as the need
arises.
Nutrition, chronic and communicable diseases were the three most
popular categories in 325,000 pamphlets distributed this past year. This
was an increase of over 80,000 over 1962 despite the fact that quantities
are sharply limited. Spanish language pamphlets continue to grow in
popularity.
The work of the exhibits consultant increased by 10 per cent over
the previous year. Fairs and medical meetings required the setting up
of various types of displays, but the tremendous cost of those which will
effectively compete with commercial exhibitors somewhat limits partici-
pation. The consultant is spending more time in the preparation of ma-
terial for slides, charts, graphs, posters and the like as the SBH staff
realizes the potentialities of these aids.
The Medical Library's book collection grew and the collection now
totals 19,590. Books were purchased on dentistry, veterinary public
health, nursing and radiological and occupational health. The psychia-
tric nursing collection is probably the largest in Florida. Categorical
funds purchased many books on aging and maternal and child health
which were distributed to the CHDs. In 1963, 2330 books were checked
out, 12,749 journals circulated, 62 interlibrary loans requested from
other libraries, 1410 photocopies made, 2459 reference questions an-
swered and 18 bibliographies prepared. SBH personnel forms the largest
group served followed by CHD personnel, local physicians, dentists,
nursing students and a few college and high school students. Liaison is
maintained with the Jacksonville Hospital Educational Program and 115
loans were made to their six cooperating hospital libraries.
The librarian completed the requirements (at Emory University)
for Certified Medical Librarian. The library is an institutional
member of the Medical Library Association which enables it to dispose
of duplicate journals and request those to fill its needs. At the last
"exchange" 1541 journals were sent to other libraries. ... .A much
needed new card catalog was purchased.
Other activities of the staff included four Orientation Programs
with an attendance of 171... Worked with the Glades and Hendry
CHDs in setting up a gun safety program for Seminole Indians (as a
preface to an educational program on sanitation). Staff attended
many meetings with educational and PTA groups. Assisted, by
working with teacher groups, with the implementation of the new
Dental Health Bulletin. ... .Worked with a Rural Development Com-
mittee in stimulating the formation of a Community Health Council.
Major emphasis was given to cooperation with the following pro-
grams during 1963: accident prevention, tuberculosis, maternal and

GENERAL ADMINISTRATION 19

child health (Teachers Project in Health Education), mental health,
training, chronic diseases, venereal diseases, Encephalitis Research
Center. The director served on numerous inter-departmental com-
mittees including summer students, orientation program, publicity,
monographs Made many talks to such groups as classes at univer-
sities, Gulf Coast Health Conference, student practical nurses Super-
vised three summer student employees.
A constant activity was the recruitment of and consultation to all
health educators employed by the SBH and CHDs. The annual meeting
of this group was held in Jacksonville. A major problem is the inability
to recruit health educators at the present low salary levels.
Interesting projects in 1963 were those conducted in Escambia and
Santa Rosa Counties for getting out the adult population for X-ray
surveys; and the beginning of an ambitious program in Franklin County
to work to improve the home sanitation conditions of oyster workers.
A continuing objective is the employment of an assistant director,
and regional health educators to serve the Tallahassee and Gainesville
areas.

DIVISION OF PERSONNEL
MILES T. DEAN, M.A.
Director

Under the general direction of the State Health Officer, this divi-
sion is responsible for the administration of the personnel program of
the State Board of Health (SBH). This includes advising administrative
officers concerning personnel practices and development; putting into
effect procedures for carrying out approved personnel policies; partici-
pating in the preparation and administration of the approved Classifica-
tion and Compensation Plan; administering the leave regulations; main-
taining adequate personnel records on all persons employed in the
agency; acting as liaison official with the Florida Merit System involving
requests for certificates and reporting on the selection of eligibles, pro-
motions, salary advancements, salary adjustments, demotions, transfers,
dismissals, lay-offs and resignations; providing and administering a serv-
ice rating system; and the preparing of necessary reports both state and
federal. Payroll operation, also a responsibility of this division, includes
the administration of leave accounting, the employee insurance program,
retirement and Social Security, as well as the preparation of the ad-
ministrative payroll and distribution of warrants. Preparation of the
salary portion of the Legislative Requesting and the Operational Bud-
gets is also a responsibility of the Division of Personnel.
During 1963 the number of new employment continued to be
considerable. There were 776 employment during 1963.
Pay ranges for 104 classes in the SBH Classification and Pay Plan
were revised upward. The Merit System returned to the regular rules for

20 ANNUAL REPORT, 1963

administering the pay plan, as well as the regular rules for determination
of anniversary dates. Some problems in pay administration revolved
around a shortage of funds in certain county health units.
A procedure for coordinating personnel policies, practices and pro-
cedures was completed and a listing of corresponding personnel memos
was distributed.
Turnover continued to be a problem with a significant increase in
the number of public health nurses leaving the employment of the
SBH. Terminations during the year increased to 609.

TABLE 1
NUMBER OF EMPLOYEES IN THE FLORIDA STATE BOARD
OF HEALTH AND COUNTY HEALTH UNITS
AS OF DECEMBER 31, 1954 1963

State County Health Total
Year Office Departments Employees

1963............................. 762 1918 2680
1962............................. 692 1821 2513
1961............................. 626 1593 2219
1960.................... ....... 604 1534 2138
1959............................. 586 1396 1982
1958............................. 558 1821 1879
1957............................. 528 1234 1762
1956........... ....... .......... 481 1127 1608
1955.... .................... 442 1057 1499
1954.............................. 421 980 1401

TABLE 2

DISTRIBUTION OF PERSONNEL
FLORIDA STATE BOARD OF HEALTH
(OTHER THAN COUNTY HEALTH DEPARTMENTS)
DECEMBER 31, 1963

0

ADMINISTRATIVE UNIT
s I E a g5 a a a

k U2 En 1 0 5 0

Grand Total ......................................... 762 28 10 37 34 13 145 14 107 215 159
Administration
Training................... ......................... 16 1 ........ 6 1 1 1 2 2 ........ 2
State Health Officer................... ............... 29 5 ......................... .. 4 11 9
Health Education .................................... 12 .......................................... 6 5 1
Personnel............................................ 14 ........................... ........ .......... 3 10 1
Nursing ............................................. 13 ........ ........ 11 2
Encephalitis Research Center .......................... 21 ........ 10 . . 2 2 7
Research. ................ ............ 21 3 ................ ....... ...... 5 2 1 6 4
Dental Health .......................... .............. 13 ........ 10 .................1 2 .. .
Entom ology....................................... 83 ......................... 1 2 23 ........ 15 7 35
Finance and Accounts
Fiscal......................................................... ... .... 13 ....................................... ................ 5 7 1
Purchasing and Property. .................. ........... 6 ..................................................... .......... 4 2
Building and Facilities ................................ 35 ........ ........ ........................ ........ ........ 1 1 33
Laboratories
Central-Jacksonville ................................. 62 ...................................... 44 ................ 6 12
Miami .......................................... 21 .................................. .. 15 ........15........ 2 4
Orlando............. ............................... 10 ........ .......................... 6 ................. 1 3
Pensacola ........................................... 8 ....... ...................4 ................ 1 3
Tallahassee ...................................... 7 ................. ................... 4 ........ ........ 1 2
Tampa .............. 22 ................ ............. .. 11 ................ 3 8
W est Palm Beach...................... ........... 6 ................ ........ ........ ........ 4 ................ 1 1
Local Health Services
Bureau of Local Health Services................. ....... 14 4 ........ 1 ........ 2 ........ ......... .. 1 6 ..
Sanitation ........................................... 6 .... ............................ 5 ........ ........ ........ 1 ..
Nutrition ........................................... 6 .. ............ ...... ................ ........ 5 1 .
Civil D efense........................................ 2 ......1 1 ...
Accident Prevention .................................. 2 1 ... ........ 1 ...

TABLE 2 (Continued)
DISTRIBUTION OF PERSONNEL
FLORIDA STATE BOARD OF HEALTH
(OTHER THAN COUNTY HEALTH DEPARTMENTS)
DECEMBER 31, 1963

ADMINISTRATIVE UNIT 4 S 5

I i II I *I 1 .s3 1 1

Maternal andChildHealth............................ 28 4 ....................... 1 2 1 6 4
Mental Health ...................................... 19 1 ........ 1 ............. 7 2 7 1
Narcotics ............................................ 17 ........ ........ ...... ....... ................ .......... 5 12
Preventable Diseases
Bureau of Preventable Diseases ......................... 3 ........ ................................................ 8
Radiological and Occupational Health.................. 17 1 ................ 1 ...... 3 ...... 8 4
Tuberculosis Control...................... ......... 20 2 ........ ...... ........ ....10 8 .....
Epidemiology and Venereal Disease Control .... ......... 6 1 ....... 6 ............... 2... 17 10 .....
Veterinary Public Health.............................. 4 .............. ................... 1 ....... ...... 2 1
Sanitary Engineering and Air Pollution Control ........ 77 ..................... 1 1 11 ............... 24 10
Special Health Services
Bureau of Services for Indigent ......................... 6 1 ........ ..... .. .... ..... ......... 2 .....
Hospitals and Nursing Homes........................... 12 1 ........ 1 ........ 1 ............... 5 4 .....
ChronicDiseases. ..................................... 21 3 ...... 1 ........ ........ 1 1 3 11 1
Vital Statistics
Bureau and Division of Vital Records ................... 44 ....................................................... 4 38 2
Statistics.............................................. 6 ................ ........ ...................... .. ..... 4 2
Data Processing.................................. ... 10 ................ ........................ ............... 3 7

ANNUAL REPORT, 1963 23

TABLE 3

DISTRIBUTION OF PERSONNEL IN COUNTY
HEALTH UNITS, FLORIDA, DECEMBER 31, 1963

BaCOUNTY.... 1 1 8 2 3

Alachua........ 88 2 1 13 2...... 6 ...... 4 ...... 8 6
Bay ............ 16 1 ..... 628 ...... 2 ...... 3 2
Bradford .... 6 1 ...... 2..... 1.... ....... .. .... 1 1
Brevard........ 41 1...... 12 1 7 1 2 2 13 2
Broward......... 89 3 1 24 2 18 ... 3 4 24 10
Calhoun...... 6............ ...... 1 ...... .. ...... 1 1
Charlotte...... .. 11 1...... 41 ................ .... 3 ......
Citrus......... 6 1 1...... 2 ....... 1 ...... 1 ....... 1 .
Clay........ ... 8 ... ...... 4 .... 1 2 1
Collier ........... 1 1 ...... 3 1 2 1
Columbia....... 8 1 ...... 3 ...... 2 ..... ...... ...... 1 1
Dade......... 418 46 14 156 3 59 8 13 11 84 24
D eSoto......... 6 ...... ...... ...... 1 ...... 1 .... 1 1
Dixie............. 4 .... ... 2 ...... ........... .. ...1 1
Duval.......... 51 2 1 15 ...... 9 1 7 1 10 5
Escambia...... 67 4...... 18...... 1 ...... 5 1 18 8
Flagler......... 3 .......... .. 2 .... .... .... 1 ..1....
Franklin....... 5 1 ...... 1 1 ...... ...... ...... 1 1
Gadsden......... 14 1 ...... 7 ...... 3 ...... .......... 2 1
Gilchrist........ 8 3 ............ 2 ....2 ....... ...... ... ........ 1 .
Glades......... 1 ...... ...... .. ...... ...... ...... ...... ...... 1 .
Gulf........... 5 ...... ....... 2 ...... 1 ............ ..... ...
Hamilton....... ...... 2... 1 ...... ...... ...... 1 1
Hardee......... 7 ...... ....... 1 ...... ............. 2 1
Hendry........ 11............ 4 ... .... 1................ 3 3
Hernando...... 2 ....... ...... 1 ...... ......... ...... .... .. 1 ......
Highlands...... 10 1 ....... 4 ..... 2. .. 1...... 2.
Hillsborough.... 187 6 3 65 2 37 1 4 6 32 31
Holmes......... ...... ...... 2 ...... 1 ...... ...... ...... 1 1
Indian River.... 11 1 .... ...... 2....... ...... 2 1
Jackson........ 14 1 ...... 5 ...... 2 ...... 1 ...... 2 3
Jefferson ...... 7 ...... ..... 2 ......2 1 1...... ....... 1 2
Lafayette...... 3 .... .... .. 1 ...... ....... ...... .1 1
Lake............ 17 1... 7 .... 3 ........ 4 2
Lee ............ 14 .1 ....... 5 ....... ...... 1 1 3 .
Leon......... 35 3 ...... 9 ...... 5 ...... 4 1 9 4
Levy........... 7 ...... ...... 3 ...... 1 ...... ......... .. 1 2
Liberty......... 3 1..... ...... 1 .................. ........... 1 1
Madison....... 6...... ...... .2 ...... 1 .. ..2 1
Manatee....... 33 1 ...... 11 ..... 6...... 3 2 7 3
Marion......... 12 1 ...... 2 ...... ...... 1 1 2 2
M martin ......... 5 ...... ...... 2 ...... 2 ...... ...... ...... 1 .
M onroe........ 18 1 ...... 6 .. 3 .... ...... .... 6 2
Nassau......... 12 1 ...... 4 .. 2 .................. 2 3
Okaloosa....... 17 1 ...... 6 .. 3 ......... 1 3 3
Okeechoee..... 4 .......... 1 ....... 1 ...... ...... ...... 1 1
Orange......... 75 4 ...... 24 1 12 ...... 2 5 18 9
Osceola........ 5 ............ 2 .... .... 1 ..... .... .......... 2 .
Palm Beach..... 97 2 29 2 16 ...... 8 2 19 14
Pasco .......... 8 1 ...... 3 ...... 2 ... ... .. .... 2 .
Pinellas........ 176 10 2 67 2 28 4 4 8 38 13
Polk........... 89 2 ..... 35 1 13 ...... 4 2 18 14
Putnam........ 16 1 1 5 .... 3..... 1 ...... 2
St. Johns....... 10 1 ...... 4 ...... 2 ............ ...... 2 1
St.Lucie....... 17 1 ...... 3 ...... 5 ...... 4 1
Santa Rosa..... 12 1 ...... 5 ...... 2 ...... ... ... ... 1 3
Sarasota........ 41 .... 1 14 ... 8 ...... 1 ... 13 4
Seminole...... 16 1 ...... 6 .... 3 ...... 1 .. 3 2
Sumter......... 4 ............ 1 ...... 1 ...... .. ...... 1 1
Suwannee...... 10 1 ...... 4 .. 1 ...... ......... 2 2
Taylor......... 5 ...... ...... 2 .. 1 1 1
U nion.......... 3 ...... ...... 1 ...... 1 ..... ...... 1 ..
Volusia........ 5 5 4 1 19 ...... 7 ...... 6 ...... 9 9
Wakulla........ 3 ...... ...... 1 ..... ..... ...... 1 ...... 1 .
Walton...... 6........... 2 .. 1 ...... ...... .... 2 1
Washington..... 5 ...... ...... 2 .... 1 .................. 1 1

24 ANNUAL REPORT, 1963

TABLE 4
PERSONNEL TURNOVER BY POSITION CLASSIFICATION,
FLORIDA STATE BOARD OF HEALTH AND
COUNTY HEALTH UNITS, 1963

CLASSIFICATION TERMINATIONS TURNOVER RATE

Physicians ....................................... 23 16.3
Dentists.......................... ............. .. 12 32.4
Public Health Nurses............................. 118 17.2
Sanitary Engineers................................ 4 8.7
Sanitarians...................................... 25 7.7
Laboratory Workers (Prof. and Tech.) .............. 15 9.3
Mental Health .................. ................ 5 5.0
Other Professional and Technical ................... 17 11.0
Clerical.......................................... .142 23.2
All Others...................................... 132 35.7
Total .................. ........... ............ 493 19.0

Not including persons employed on a temporary or for a specific duration. There were 116
such terminations.

TABLE 5
EMPLOYMENT TERMINATION, FLORIDA STATE BOARD OF
HEALTH AND COUNTY HEALTH UNITS, BY SALARY
RECEIVED AT TIME OF TERMINATION, 1963

MONTHLY SALARY

CLASSIFICATION Total Up to 200- 300- 400- 500- 600- 700- 800- 900- 1000
199 299 399 499 599 699 799 899 999
Total..................... 493 46 196 150 44 13 24 4 5 3 8
Physicians................ 23 ..... 1 1 6 2 1 ..... 2 3 7
Dentists.................... 12 .......... ............. 12 ....................
Sanitarians ................. 25 ..... ..... 11 10 3 1 ... ..........
Sanitary Engineers.......... 4 ..... ..... ........... 1 3 ....................
Public Health Nurses. ........ 118 ..... 7 93 17 1 .......................
Lab. Workers proff. and tech.) 15 1 6 4 3 .......... 1...............
Mental Health.............. 5 ..... ..... ......... ...... 3 ..... 1 ..... 1
Otherprofessionalandtechnical 17 ..... 1 1 6 5 2 1 1 ........
Clerical.................... 142 2 118 22 ........ .............
All Others.................. 132 43 63 18 2 1 2 2 1.....

DIVISION OF PUBLIC HEALTH NURSING

RUTH E. METTINGER, R.N.
Director
ENID MATHISON, R.N., M.P.H.
Acting Director

For the past year, the division has functioned as a separate section
reporting directly to the State Health Officer. It works with all other
bureaus and divisions to coordinate programs which use nursing services
in the development and maintenance of their public health programs.

GENERAL ADMINISTRATION 25

Guidance and assistance is given to public health nurses in county
health departments (CHD).
Five generalized nursing consultants serve districts of approximate-
ly 13 counties each. Their function is to study nursing administrative and
supervisory problems in the counties, and to observe, plan, counsel and
suggest ways in which programs might function more effectively. In
smaller counties where there is no supervising nurse the supervisory
process may be combined with consultation. A total of 193 visits were
made to the 67 counties by the generalized consultants.
The division continues to put emphasis on the initiation and ex-
pansion of home nursing care problems. This service is now available
to approximately 80 per cent of the population in the state. Subsequent
to the inclusion of this service in the Medical Assistant to the Aged
Program, plans were made to do detailed time and cost studies for vali-
dation of the cost of these nursing care visits.
The Field Training Center for public health nurses in Clay County
continues to give a two-weeks orientation for nurses from counties
initiating a home nursing care service. Ten nurses had this experience
in 1963. Five newly employed public health nurses also attended an
eight-weeks orientation program at this center.
Eleven nurses attended Rusk Institute and Kenny Institute for the
three-weeks course in rehabilitation nursing. This is a most valuable
experience for public health nurses as chronic disease patients are cared
for in increasingly large numbers.
A consultant who recently earned a Master's degree in Rehabilita-
tion Nursing has been added to the staff of the division. She will work
with public health nurses and nursing home personnel in evaluating
the nursing rehabilitation needs of patients, stimulate the availability of
services and facilities where none exist and assist in the training of per-
sonnel in techniques and skills needed in rehabilitation nursing.
For the first time since midwives have been licensed by the State
Board of Health, their number fell to 200. Twelve counties do not have
a midwife. As a result of cooperation between the Seminole CHD and
the Marie Francis Maternity Home in Sanford, a three-weeks observa-
tion and study experience was made available to midwife trainees. This
experience included maternal and child health clinics, field visits to
antepartum and postpartum patients and delivery room observations
and instruction. Even though the percentage of midwife deliveries (to
the total number of births) has decreased markedly, the actual number
has changed very little.
The nursing consultant in the mental retardation program of the
Bureau of Maternal and Child Health continues to provide information
to professional workers and the public on the care and training of men-
tally retarded persons, as well as the public health aspects of prevention.

26 ANNUAL REPORT, 1963

BUREAU OF DENTAL HEALTH

FLOYD H. DeCAMP, D.D.S.
Director

A comprehensive evaluation and comparison of the progress of this
bureau's program in 1963 gives proof that this year has been outstand-
ing. Added interest and cooperation has been shown by Florida dentists,
the State Department of Education (SDE), the teaching profession, the
general public, and most of all, the medical directors of all county health
departments (CHD).
The highlight of this closer association was the completion and
introduction into the county schools of a guide, DESIGN FOR TEACH-
ING DENTAL HEALTH IN FLORIDA SCHOOLS, (Bulletin 7).
This was sponsored jointly by the SDE, the State Dental Society and
the State Board of Health (SBH). These three agencies jointly assumed
responsibility of the cost of printing the first 18,000 copies a sufficient
number to allow one copy for every five teachers in the state. This
teaching guide has done more to aid the education program of the
bureau than any other event in its existence.

DENTAL PRECEPTORSHIP PROGRAM
As a means of enabling CHDs to staff their dental clinics, this pro-
gram was established in 1957. Many excellent young dentists from out
of state have elected to remain and establish their own private practice
when their tour of duty is completed.
Preceptorship dentists are selected by the State Board of Dental
Examiners and their work is supervised by a local committee of dentists,
an advisor from this bureau and the directors of CHDs in their respec-
tive areas. Preceptorship contracts are for one year but may be ex-
tended an additional year when circumstances warrant .... A five-day
postgraduate course was sponsored by the bureau.
A total of 19 counties received dental services from these pre-
ceptorships for all or a portion of 1963. These were Alachua, Broward,
Duval, Flagler, Glades, Hendry, Highlands, Hillsborough, Lake, Mana-
tee, Marion, Orange, Palm Beach, Polk, Putnam, Sarasota, St. Johns,
Santa Rosa and Volusia.
DENTAL SCHOLARSHIP PROGRAM
Recipients of scholarships (see Coordinator of Training elsewhere
in this Report) may receive up to $1000 a year for as many as four
years. The Dental Scholarship Law, as amended in 1961, requires
scholarship graduates to practice in an "area of need" (where there are
few or no dentists) for 12 months for each $1000 received. Under cer-
tain circumstances, students may repay the funds received. Since 1955
there have been 91 scholarships awarded, with two cancellations before
becoming effective.

DENTAL HEALTH 27

DISPOSITION OF THE 53 GRADUATES TO DATE:
Serving in "areas of need" ................................................ 27
Repaid scholarship in full ..................................... ............. 8
Completed compensatory practice .......................................... 2
In military service ............................................ ................ 9
Repaying scholarship ................................... .......................... 6
Unable to qualify for Florida licensure ................................... 1
53

DENTAL CLINICS
Those counties served by a full-time, licensed public health dentist
during all or a portion of the year were Broward, Dade, Liberty,
Marion, Orange, Palm Beach, St. Johns and Volusia. The Jacksonville
City Health Department also employed a licensed dentist a portion of
the year.
Two mobile dental clinics are maintained to serve underprivileged
elementary school children in areas having few or no practicing dentists.
Both clinics are fully equipped. Supervision of these dentists is furnished
by this bureau, the preceptorship committees and the county health
officers in the counties or areas to which the clinics are assigned.
During 1963, one clinic operated 12 months while the other
operated four months on half-time and four months on a full-time
basis. A summary of services performed follows:
School dental inspections ........................................................ 564
New patients ................................... .......................................1356
Repeat patients ..................................................................... 1012
Prophylaxes ................................................................................ 242
Fillings (all types) .................................................................. 4311
Extractions ....................................... 997
Miscellaneous treatments .... ................................................ 391
Talks given to school and civic groups ................................ 24
Pamphlets distributed .............................................................. 498
Due to an increase in interest of the individual counties to improve
their dental health programs, Orange CHD employed a full-time dental
hygienist.
During the year, the SBH dental hygienist conducted many dental
inspection surveys in both white and Negro schools as well as gave
lectures and classroom demonstrations on proper tooth brushing tech-
niques and home care.
New dental clinics began operating this year in Flagler and Liberty
CHDs. The Polk CHD increased its dental facilities with the opening of
a clinic at the Frostproof Health Center. The new CHD building erected
in Marion County in 1963 included a dental clinic which replaces a
clinic formerly maintained in the local hospital.
The interest and support of civic and professional groups continued
to play a strong role in local public health dental programs. In many
instances substantial gifts of money, equipment, materials and volunteer
assistance were given by these groups to sustain the operation of dental

28 ANNUAL REPORT, 1963

clinics. Numerous requests for information concerning the establishment
of dental clinics were received from interested counties.

FLUORIDATION
In 1963, Fort Pierce joined 23 other Florida cities in providing a
fluoridated water supply. Other cities now fluoridating water supplies are
Gainesville, Clewiston, Naples, Cocoa, Orlando, Ocala, Ormond Beach,
Leesburg, Belle Glade and Miami. An additional 13 suburban areas use
fluoridated water from the mains of Miami and Belle Glade. Key West
and other cities in Monroe County are supplied fluoridated water by the
U.S. Navy.
Jacksonville, Sarasota and 25 other communities are served by water
systems having approximately the correct amount of fluoride as a natural
component. Approximately 319,490 people are served in these cities and
another 745,094 are served in those cities having controlled fluoridation.
In all, areas having a combined population of 1,064,584 are receiving
the benefits of water fluoridated at near optimal level.
Throughout the year, the bureau has continued to receive an ever-
increasing number of requests for information regarding fluoridation.
Staff members of the bureau assisted with local efforts to obtain fluori-
dation in West Palm Beach, Pensacola, DeLand, North Miami Beach
and St. Cloud. The city commissions of West Palm Beach and Pensa-
cola passed ordinances favoring fluoridation.

HEALTH EDUCATION
The health educator participated in scores of faculty, health co-
ordinator and nurses meetings; the Health Project in Teacher Educa-
tion, state conventions, county lunchroom worker workshops and state
agricultural extension programs such as 4-H Short Course at the Florida
State University. Over 54,000 pamphlets were distributed.
The establishment of three new dental schools of oral hygiene in
the state has given new impetus to the dental program.. These schools
are located at the junior colleges at St. Petersburg, Pensacola and Lake
Worth.

LACTOBACILLI LABORATORY PROGRAM
The Bureau of Laboratories and this bureau in 1963 continued to
improve the service of the lactobacilli program. Though the number of
dentists using the program and saliva submitted to the laboratory did
not increase, the dentists using the program over a period of time have
continued to utilize the service on a broader scale.

BUREAU OF ENTOMOLOGY 29

J. A. MULRENNAN, B.S.A.
Director
This has been a year in which to assess the reasons for the 1962
St. Louis Encephalitis (SLE) epidemic in the Tampa Bay area.
The 12 light traps which have been operated for around 15 years
in Pinellas, Hillsborough, Manatee and Sarasota Counties showed a tre-
mendous drop in Culex (Culex) spp. breeding during 1963. The light
trap average Culex mosquito count for the year was 4.96, as compared
to an average count of 36.78 for 1962, the epidemic year.
The one thing which appears to be very significant is that the Culex
density for this section reached its highest peak in 1959, with an average
of 37.41 mosquitoes. This was the first year that SLE was observed in the
human population. The density of Culex mosquitoes remained high
through 1962, but was followed by the sudden drop of Culex mosquitoes
during the 1963 season.
There appears at this time to be sufficient information available to
theorize as to why the heavy production of Culex mosquitoes occurred
during this four-year period. It is a known fact that there was a tre-
mendous amount of rainfall in 1959 when highways and homes were
flooded with water. The St. Petersburg rainfall station recorded 87.62
inches of rainfall for that year. Apparently the water table in this area
remained reasonably high through 1962. The ground water table was
sufficiently high so that 10.23 inches of rainfall in June 1962, produced
ideal conditions for heavy production of the vector, Culex nigripalpus.
This species, it is believed, had built up in this area due to reasonably
warm winters and the perfect breeding conditions which existed until
the freeze in December 1962.
In the spring and early summer of 1963 it was apparent that the
ground water table was low, requiring considerable rainfall to produce
optimum breeding conditions; and, that it would be late in the year
before the density could build up to a dangerous level. Actually, the rain-
fall for the entire year was 4.5 inches greater in 1963 (62.54 inches) in
this area than in 1962 (58.01 inches), but the Culex population never
did build up to a level comparable to previous years.
Based on observations of the past, when there are warm winters
with a high water table, followed by considerable late spring and early
summer rainfall, conditions are ideal for the heavy production of C.
nigripalpus mosquitoes. If, in addition, SLE virus is circulating in a high
bird population (especially mourning doves), these conditions can lead
to an epidemic explosion of SLE in a susceptible human population.
During the 1962 epidemic it was believed that the large mourning
dove population in this general area, and most especially in Pinellas
County, was the main species of bird involved in carrying the virus.
Subsequent work has confirmed this theory. In 1962 around 30 per cent
of the mourning dove population tested showed evidence of having had
SLE. In 1963 inoculations with SLE have demonstrated that the mourn-
ing dove is a good carrier of the virus, and will circulate the virus for

30 ANNUAL REPORT, 1963

around three days. It is a known fact that this species nests in the spring
and throughout the summer months, making this bird an excellent
carrier and spreader of the virus when there is a large C. nigripalpus
population to carry the virus from bird to bird and to man.
This would indicate that the heavy concentration of temporary con-
trol work should be carried out in the spring and early summer, when
the greatest number of bird species is nesting, and there is a reasonably
high mosquito population.
For 1964 it is planned, in addition to operating mosquito light traps,
to operate two bird-baited traps each week from early March until
December in each mosquito control district. One trap will be operated
in a swamp and the second trap in a populated area to determine the
densities of the different species of mosquitoes during the breeding season
in the respective areas.
The 1963 State Legislature appropriated $65,000 to construct
and operate a dog fly laboratory in West Florida. The State Board of
Health (SBH) approved the location of the laboratory in Bay County,
and it is expected that construction will start in the early summer of
1964.

ARTHROPOD CONTROL
Source Reduction Accomplishments
The state fund matching rate for source reduction operations had
dropped from 28 per cent at the beginning of the year to 20 per cent at
the end of the year. The reduction in this matching rate each year is
having a marked effect on the amount of source reduction work being
performed.
In 1962 there were four 10-inch hydraulic dredges in operation.
There are now only two; one in Brevard County and one in Indian
River County. The latter county has reduced operations from a two-
shift per day to a one-shift, thus cutting costs and production approxi-
mately in half.
The number of miles of new ditches dug by dragline has also de-
creased substantially, although the job is far from being completed.
Maintenance of old ditches is requiring considerably more machine time
each year, and insufficient funds in many counties prevent purchasing
additional equipment to keep pace with drainage needs.
The number of landfills continues to increase. In a number of coun-
ties this program now requires the continual use of a dragline. These
machines were previously doing machine ditching for mosquito control
-another reason for the decline in the miles of new ditches dug or
maintained.
Dixie County withdrew from the state program in the early part of
1963, after qualifying to begin participation on October 1, 1962.
Volusia County discontinued, as of October 1, 1963, to operate a
sanitary landfill. This operation was taken over by the county com-
missioners and relocated in a remote site of the county.

ENTOMOLOGY 31

There follows a tabulation of the source reduction work accom-
plished during 1963 in 54 counties (58 programs) participating in the
state aid program. Unit cost figures are for labor only.
Machine Ditching 1962 1963
Number of counties participating ........................ 33 32
Miles ditches dug or maintained .......................... 518 466.43
Cubic yards earth excavated ..................................4,232,046 3,856,172
Average labor cost per cubic yards ..................... $0.088 $0.094
Machine Diking
Number of counties participating ........................ 5 5
Miles ditches constructed or rebuilt ...................... 71.5 51.86
Cubic yards earth excavated .................................. 893,993 773,442
Average labor cost per cubic yards ...................... $0.076 $0.070
Hydraulic Dredging
Number of counties participating .......................... 3 2
Number of dredges used ................................. .... 4 2
Cubic yards earth fill placed .................................. 747,200 523,073
Average labor cost per cubic yard ........................ $0.140 $0.108
Number acres mosquito breeding area eliminated.. 95 ?
Deepening and Filling (Draglines and Bulldozers)
Number of acres improved ..................................... 98 67
Average labor cost per acre .................................. $73 $192.85
Cisterns, Cesspools and Wells Filled
Number of counties participating ........................ 1 0
Number cubic yards fill material required................ 419 0
Number of cisterns, etc., filled ........................... 64 0
Average cost per cistern (labor and fill) .............. $44.22 0
Sanitary Landfills
Number counties participating ................................ 35 34
Number landfill sites operated ................................ 73 92
Cubic yards garbage buried ....................................4,909,266 5,248,533
Average labor cost per cubic yard .......................... $0.063 $0.069

Temporary Control Measures
Competitive bidding between the manufacturers of Malathion and
Dibrom resulted in the state and counties being able to purchase Mala-
thion 37.5 per cent cheaper than in the previous year. The annual sav-
ing in cost of insecticides for fogging amounted to many thousands of
dollars.
During 1963, the Entomological Research Center released recom-
mendations for use of a third insecticide Baytex which will be
satisfactory for use in fogging. This material is expected to be made
available in 1964.
The use of airplanes by counties for adulticiding (killing adult mos-
quitoes) increased considerably. Monroe County purchased two twin-
motored Beechcraft; Lee County added another DC-3 and one twin-
motor Beechcraft. Citrus, Brevard and Volusia Counties also own planes,
and at least four counties contract for airplane adulticiding.
The Northeast Duval County Mosquito Control District began
operations on July 1, 1963, with temporary facilities and two fogging

32 ANNUAL REPORT, 1963

trucks. The following is a summary of the temporary control work per-
formed in controlling mosquitoes.
Ground Equipment 1962 1963
Miles fogged with ground equipment ...................... 382,859 377,516
Gallons insecticidal formulation used ......................2,373,711 2,568,889
Labor cost per mile fogged ...................................... $0.513 $0.537
Airplane Equipment
Gallons of insecticide applied (fogging) ................ 122,445 84,905
Acres treated ........................................... ............1,222,956 881,321
Labor cost per acre ........................................ ..... $0.009 $0.0117
Gallons of insecticide applied (spraying) ................ 128,003 185,757
Acres treated ............................................................ 262,956 301,421
Labor cost per acre .................................................... 0.117 $0.134
Pounds of Paris green pellets applied (larviciding) 292,600 149,286
Acres treated ............................................................. 14,821 9,523
Labor cost per acre .................................................... $0.778 $0.413

Dog Fly Control
The dog fly control program continued in its normal routine pattern
in West Florida counties. Some field investigation work was done by
employees of the Department of Agriculture in an effort to learn more
about the extent of fly breeding areas.
The following is a summary of the dog fly control work performed
in the eight most western Florida counties which border on the Gulf of
Mexico:

Miles of shoreline treated .........................................
Gallons of 35% DDT concentrate used ............
Average labor cost per mile ..................................
Number man hours labor required ........................
Counties Participating and Local Fund Budgets

1962
3,301
15,705
$3.70
9,285

1963
1,284
8,456
$6.71
6,308

The following counties participated in the State Arthropod Control
Program during the year. Based on the fiscal year of the counties (Octo-
ber 1 to September 30) and as of December 31, 1963, the total amounts

of local funds shown in the certified
pod control activities are as follows:
Alachua ..........................$ 42,652.00
Bay .................................. 81,413.00
Bay (Gulf Beaches) ........ 38,050.77
Bradford ........................ 10,924.49
Brevard ........................... 310,514.53
Broward .......................... 66,796.06
Calhoun ........................ 2,500.00
Charlotte .......................... 72,668.20
Citrus .............................. 89,465.15
Collier .............................. 69,047.06
Columbia ........................ 17,228.06
Dade .............................. 239,577.00
Duval (East) .................. 84,798.16
Duval (Northeast) .......... 106,875.00
Escambia ........................ 114,416.93
Flagler ............................ 13,666.00
Franklin .......................... 15,000.00
Gadsden .......................... 11,710.00

budgets to be expended for arthro-

Gulf ................................ 36,500.00
Hardee ............................ 4,700.00
Hernando ...................... 4,262.87
Highlands ...................... 3,747.42
Hillsborough .................. 300,452.00
Holmes ............................ 7,000.00
Indian River .................... 258,623.65
Jackson ........................ 11,707.82
Jefferson ........................ 10,226.34
Lake ............................... 82,065.40
Lee .................................. 411,211.00
Lee (Ft. Myers Beach) ..$ 60,977.00
Leon .................................. 60,000.00
Levy .................................. 15,000.00
Madison .......................... 1,400.00
Manatee .......................... 101,961.79
Marion .......................... 12,275.00
Martin ............................ 37,767.43

ENTOMOLOGY 33

Monroe .......................... 224,000.00 St. Johns ........................ 71,024.40
Nassau ..... ................ 52,847.81 St. Lucie ........................ 143,835.36
Okaloosa ... .............. 38,165.00 Santa Rosa .................... 23,375.00
Orange ......................... 75,850.00 Sarasota ....................... 126,705.21
Osceola (Kissimmee) ...... 15,000.00 Seminole ...................... 15,000.00
Osceola (St. Cloud) ........ 17,407.00 Suwannee ...................... 9,301.34
Palm Beach .................... 277,587.00 Taylor .......................... 4,200.00
Pasco ............................ 68,922.00 Volusia ...................... 266,500.00
Pinellas .......................... 402,175.29 W akulla ........................ 18,000.00
Polk ............................ 170,772.05 W alton ..................... 10,375.00
Putnam .......................... 25,000.00 Washington ............. 2,500.00
Total local funds appropriated .....................................$4,865,722.59
Total funds appropriated by the state ................................ 1,650,000.00
GRAND TOTAL ..................................... ....... $6,515,722.59

Engineering
In cooperation with the regional entomologist, a survey was made of
south Walton County for the purpose of obtaining sufficient information
to serve as a basis for preparing a report with recommendations for a
mosquito program and the establishment of a mosquito control district.
No action had been taken by the residents at the end of 1963 to try to
get a district formed.
All of the proposed work plan budgets for arthropod control for the
fiscal year 1963-64 were reviewed, checked and referred to the bureau
director for approval. A number of programs were checked in the field
with the mosquito control director when questionable items were noted
in the work plans.
Specifications submitted by the counties and/or districts for the
purchase of heavy equipment were reviewed, and suggestions offered
when deemed necessary, for improving the specifications prior to ap-
proval of same by this office.

Regional Entomologists
The bureau has continued its service throughout the state by main-
taining regional entomologists in Panama City, Jacksonville, Tampa,
Orlando and Miami. The statewide location of these workers enables
the bureau to give quicker and more personal service on arthropod
problems to the counties and districts. The general activities of project
surveys and approvals, budgeting, forming equipment specifications,
reporting and evaluating varied entomological problems, and maintain-
ing liaison between the Research Centers and the district or county
organizations has been continued.
New and continued work includes: A continuation of extension
work on calibrating airplanes for the application of Paris green pellets;
experimental application of new chemicals for blind mosquito control;
blind mosquito survey in Madison County, where a new problem has
appeared; assistance in locating and acquiring land for the new dog fly
laboratory (Stomoxys calcitrens); helping the newly organized mosquito
unit, in northeast Duval County which completes the organization of the
entire Florida east coast, in surveying the area for mosquito production

34 ANNUAL REPORT, 1963

and setting up systems of records and accounts; assisting in sanitarian
training courses; playing host to foreign students; investigating and mak-
ing recommendations for the control of Culex quinquefasciatus found in
sewage effluent; investigating structural pest complaints all over the
state, especially in the southern half; continuing the mosquito trapping
program with the New Jersey light trap, and doing preliminary work on
bird-baited trapping to determine the incidence and density of newly
incriminated encephalitis carrying mosquitoes; and, evaluating and
recommending necessary action for control of the host of insect problems
brought in by the public.

Arthropod Identification Laboratory
Arthropod identification, particularly of mosquitoes and allied in-
sects of public health importance, has continued at the headquarters in
Jacksonville.
"Salt Marsh Mosquitograms" have been published weekly through
the calendar year to give continuing records of the 43 New Jersey type
light traps operated around the periphery of the state as an aid to mos-
quito control districts in planning operations and to evaluate the gen-
eral control. Another 77 traps from inland Florida have continued
operations to further record evidence and quantity of other species
throughout the state. The laboratory identified from all 120 traps a total
of 1,256,477 adult mosquitoes, including 93,291 males and 1,163,186
females, as well as 1577 larvae. This does not include identifications of a
miscellaneous nature and information and specimens given to school
children for science projects.
The shaggy-legged Gallinipper, Psorophora ciliata, was unusually
abundant during the summer over much of Florida, as evidenced by the
numbers in the collections, and complaints from people generally.
During 1963 a study of the chironomids of Florida was continued
under a National Institutes of Health grant. There were 18,862 adult
chironomids from light traps, and 200 adults sent in by collectors iden-
tified. In addition, 1648 chironomid larvae were collected and put out
to rear. Two hundred and seventy-five adults (16.7 per cent) emerged
within 10 days and were identified. Of these, at least four were previously
undescribed species.

STRUCTURAL PEST CONTROL
The bureau continued for the 16th consecutive year its respon-
sibility for licensing the structural pest control industry and enforcing
the law and regulations governing the activities of this industry. En-
forcement was carried out satisfactorily for the first full year under
SBH Structural Pest Control Regulations which became effective on
June 30, 1962. No public hearings were held during 1963 to consider
changes in the regulations or to adopt minimum standards. Minimum
standards were given continuing evaluation as a possible additional
means of bringing to the public of Florida worthwhile, effective termite
control based on irreducible, minimum norms of treatment. The need
for official action has become less urgent as a result of the Florida Pest

ENTOMOLOGY 35

Control Association's adoption in 1962 and re-emphasis during 1963
of approved termite control guidelines for its industry membership ....
The number of licensed business locations increased five per cent as
it has every year since 1947, while identification card holders increased
over 13 per cent. Investigators of property owners' complaints (involv-
ing licensees) and unlicensed operators decreased by 28.4 and 40 per cent
respectively. The Commission renewed 455 certificates and issued 26
new certificates during the year.

TABLE 6
SUMMARY OF STRUCTURAL PEST CONTROL
REGISTRATION AND ENFORCEMENT,
FLORIDA, 1959-63

Registration 1959 1960 1961 1962 1963
State Board of Health Licenses issued... 228 261 274 296 811
State Board of Health Change of Address
Licenses issued ..................... 24 39 29 33 84
State Board of Health Licenses revoked* 2 2 0 0 2**
State Board of Health Licenses placed
on probation*...................... 0 5 1 0 0**
Employees' Identification Cards issued... 2,232 2,854 2,818 2,996 3,891
Employees' Change of Address
Identification Cards issued........... 122 340 186 145 160
Employees' Identification Cards
revoked or stopped*..................... ........ 0 7 15
Employees' Identification Cards
on probation* ............................. ......... 5 0 2
Thermal-Aerosol Certificates of
authorization renewed*................ 14 12 12 9 8
Enforcement
Homeowner complaints investigated..... 162 87 94 81 58
Unlicensed illegal pest control operators
investigated ........................ 9 15 35 21 11
Warrants filed against unlicensed
operators........................... 1 5 15 5 5
Letters of warning issued to unlicensed
operators. ........................ 2 6 10 9 4
Enforcement miles traveled
(Jacksonville office only)............. 11,583 16,647 18,222 16,865 17,107

*) By Structural Pest Control Commission of Florida.
*) Excluding one certificate revoked and three placed on probation.
Licenses, identification cards and thermal-aerosol certificates issued are based on 1962-63
licensing year.
All other entries are based on calendar year, 1963.

ENTOMOLOGICAL RESEARCH CENTER
MAURICE W. PROVOST, Ph.D.
Director
The year was characterized by advances in the biology and control
of Florida's vector of St. Louis Encephalitis, C. nigripalpus. Now that
another arbovirus agent, California virus, has been demonstrated in
Florida, its local vector, Aedes infirmatus, will receive special research
attention. With intensified arbovirus research in Florida it is to be ex-
pected that more viral agents will be uncovered, each with its own
peculiar vector. The program of this research center will have to re-
main flexible enough to launch "crash" studies of the newly-discovered
vectors as they are demonstrated.

ERC Research Grants 1963 Summary

Source Investigator Investigation
PHS........... Harrington............... Biology of larvivorous fish.....................
PHS.............. Lea........................ Autogeny in mosquitoes.........................
PHS.............. Rathburn........................ Insecticide aerosols ...........................
PHS ............ Yount....................... Lake limnology....................................
PHS ............. Lum................... Mosquito larval nurture.........................
PHS.............. Provost..................... Field production of mosquitoes.............
PHS............. Bidlingmayer............ Mosquito populations...........................
PHS- ............ Van Handel............. Lipid synthesis in insects...................
FWS.............. Trost/Provost........... Wildlife effects of salt-marsh flooding....

Sum
$ 21,799
26,450
4,550
27,180
29,911
21,298
26,048
53,688
6,000

$216,924

Time Status
6th year, 4 to go
4th year, 1 to go
3rd year, 2 to go
3rd year, 3 to go
2nd year, 3 to go
2nd year, 1 to go
1st year, 4 to go
1st year, 4 to go
3rd year, /Y to go

Applied for in 1963 and approved for 1964

PHS................................. ..... continuing grants............................. $205,806
FWS............................... continuing grants................................. 3,000
Approved 1963 Total... $208,806
Pending....................... (none)

ENTOMOLOGY 37

The total U.S. Public Health Service (USPHS) support for this
research center rose to $210,924 distributed among eight grants.

CONTROL RESEARCH SECTION
Most of the research effort of this section in 1963 was devoted to the
development of effective methods for control of the mosquito C. nigri-
palpus. Considerable progress was made toward this objective, as
described in appropriate sections of this report, and this work will be
continued in 1964.
Water-Management Studies
Most of the original objectives of the long-range water manage-
ment studies in impounded salt marshes were attained in 1963, results
being essentially the same as those reported in 1962. Briefly, adequate
control of salt-marsh mosquitoes can be obtained with only seasonal
flooding of marshes, and impounding with either fresh or brackish water
caused no special problem from the production of other species of
mosquitoes. It is expected that this project will be terminated in 1964,
during which time special emphasis will be given to a study of the effects
of salinity on controlling the growth of certain aquatic plants. The flood-
ing period for seasonal plots also will be shortened to determine the
feasibility of further reducing the cost of impounding.
Unfortunately, the plans for a more effective study of water man-
agement to control Psorophora mosquitoes in pastures did not mate-
rialize. Sites were selected and plans were formulated, but the light trap
worker did not perform the construction work. This project will be
dropped temporarily as this laboratory has no facilities for the earth-
moving work that is required.
Larviciding Studies
A new grade of vermiculite was made available in 1963 and
new formulations of granular Paris green larvicide were made on
this product and field-tested. This larvicide is now available for pur-
chase by mosquito control districts from commercial sources or the
districts can formulate the material. One of the new formulations
can be made for approximately $.056 per pound, which is only
two-thirds the previous cost, and makes this larvicide competitive
with almost any other granular larvicide.
Granular Paris green was tested in small field plots against larvae of
C. nigripalpus, the encephalitis vector, with encouraging results. The
average kill from four tests was 98.7 per cent. An effort will be made to
test this larvicide against this mosquito by aerial application in 1964. An
experimental formulation of diesel oil also was tested against larvae of the
encephalitis mosquito in small field plots. A dosage of one gallon per acre
gave a reduction of 95.4 per cent. Additional work is planned with this
larvicide in 1964. Repeated applications of Baytex and Malathion ap-
plied as aerial sprays over wooded plots failed to give satisfactory control
of C. nigripalpus larvae, presumably because the spray deposited on the
foliage before reaching the water. This emphasizes the necessity of using

38 ANNUAL REPORT, 1963

granular formulations of larvicides when applied by airplane over wooded
areas in Florida.
Adulticiding Studies
Much of the time of this Section during 1963 was devoted to re-
search on aerial fogging, aerial spraying and ground fogging against the
encephalitis vector, C. nigripalpus.
Tests with aerial fogs early in the year showed that this mosquito
requires a heavier dosage of insecticides than salt-marsh mosquitoes for
equal kills. Consequently, comparative tests were conducted with ground
dispersed aerosols against the encephalitis mosquito and salt-marsh
species. Results confirmed those of the aerial fog tests. It was found that
for comparable kills, eight ounces per gallon of malathion was required
for control of the encephalitis mosquito as compared to six ounces for the
salt-marsh species. Effective dosages of Dibrom against these mosquitoes
were 13/4 ounces per gallon and 1/2 ounces respectively when applied in
the standard ground fogging operation.
Aerial fogging tests against both the salt-marsh mosquito and the
encephalitis vector were discouraging. Satisfactory kills of adult mos-
quitoes were obtained only in open areas. Poor kills always resulted from
tests where the fog was applied above a thick canopy of trees or shrubs.
Owing to the poor results of the aerial fogging tests, a project with
aerial sprays was started in July and continued into October. This work
was not completed with all insecticides under study, but an effective aerial
spray operation using Dibrom against the encephalitis vector was deter-
mined. This insecticide applied at a volume of one gallon per acre, 0.1
pound of toxicant per acre, gave better than 95 per cent kill of caged
adult mosquitoes placed at ground level in two different types of wooded
habitats. In one hammock plot (an area of rich soil which is heavily
wooded) of greater than average foliage density, the kill was 77 to 89
per cent at a dosage rate of 1/2 gallons per acre, .15 pounds per acre.
This dosage rate killed 99 per cent in a swamp plot similar to Sawgrass
Lake Swamp in Pinellas County.
Malathion and Baytex at comparable or larger dosages were less
effective than Dibrom in the same test plots. Additional work will be
required to demonstrate effective dosage levels of these insecticides as
aerial sprays in various habitats.
The 1963 research program with insecticides makes available to the
mosquito control districts valuable temporary measures for use against
the encephalitis mosquito, in terms of effective mosquito kill. However,
this statement does not imply that encephalitis can now be eliminated only
by use of chemical insecticides to control mosquitoes. Even if it can be
demonstrated that insecticides alone can control encephalitis, and this
has not been shown as yet, there are serious problems of operations and
costs to be considered in such a program. Costs per acre for these insec-
ticide applications against adult mosquitoes are among the lowest for any
environmental insect control program, about $.08 per acre for ground
fogging and $.45 for aerial spraying. However, if it is required to treat
thousands of acres repeatedly to control encephalitis, costs can become
staggering.

ENTOMOLOGY 39

Basic Research on Particle Size
As reported in 1962, a camera was developed which successfully
photographs small particles, as in aerosols, sprays and mists. These photo-
graphs permit a much more accurate measurement of these small parti-
cles, than are possible with other known methods. The next objective in
this project is to demonstrate which size or range of sizes of particles is
most effective in killing adult mosquitoes.
Laboratory studies in 1963, using particles of less than 2.8 microns
in diameter showed that these small particles will deposit on mosquitoes
and cause mortality. This is of special interest, because it was previously
demonstrated with the aerosol camera that more than 99 per cent of the
particles produced by thermal aerosal generators used in mosquito control
are less than five microns in diameter. Additional work will be needed to
elucidate the relationship of particle size to mosquito kill, but these
results portend new concepts in this field.
Other work under this project was the development of a portable
meteorological tower for studying effects of weather on results of in-
secticide tests in the field. This equipment measures wind velocity,
temperature and relative humidity simultaneously at elevations of 1, 6,
10, 20 and 40 feet. Limited use of this equipment already has given
better understanding of the effects of wind velocities on results of field
tests.
Aerial spraying provided another opportunity for particle size
studies in 1963. By collecting particles on coated slides beneath tree
canopies and in open areas in the same tests, it was shown that an
average of 70 per cent of spray particles of 85 micron size were de-
posited on the foliage in heavily wooded areas before they reached the
ground, where adult mosquitoes rest during daylight hours.
Sand Fly Control Studies
A project was started in 1963 to find or develop an effective larvicide
for salt-marsh sand flies, specifically a larvicide which because of its
chemical composition will minimize the chances of developing resistance
in sand flies or mosquitoes. The mosquito resistance problem must be
considered in this project because mosquito larvae will be exposed to any
larvicide used in the salt marsh habitat of sand flies.
Thirty-eight insecticide formulations were screened in the laboratory
against the larvae of sand flies in 1963. Of the toxicants tested, two
aromatic solvents, two creosote fractions and pyrethrum showed the most
promise. These formulations will be field tested in 1964.
Midge Control Studies
In 1963 most of the research emphasis was placed on developing
Baytex as an efficient midge larvicide and studying its effects on other
aquatic life. Baytex applied in a granular formulation at a dosage rate of
0.20 to 0.25 pound per acre in water up to 30 feet deep gave excellent
control of the midge Glyptotendipes paripes without harming most of the
other aquatic organisms. The formulation which appeared to be most

40 ANNUAL REPORT, 1963

effective was a sand core granule; this formulation was effective not only
against chironomids but also appeared to be very effective against the
lake fly Chaoborus.
Thirty-two different formulations of 10 insecticides were checked as
possible midge larvicides. All chemicals were initially run at 0.1 pounds
per acre using the sand core Baytex granules as a standard. Of the com-
pounds tested, two experimental insecticides, American Cyanamid's
43,913 and 52,160, show definite promise.
Although the question of BHC (an insecticide) resistance in
chironomids was not fully answered after numerous tests, it was found
that fish do pick up this material. Significant quantities were found in
the tissues of fish, decreasing with time, but found as long as five months
after the initial application.
It would appear that some sort of tolerance to EPN (an organo-
phosphatic insecticide) was established in the midge population in one
lake after four applications of this insecticide in 1963. Baytex was ef-
fective against this midge population; therefore, the observed tolerance
to EPN was not general for organophosphate insecticides. The problem
of resistance in midges must be explored further before any definite con-
clusions can be made.
Several repellants and insecticides were tested as residual sprays
against adult midges. DDT applied at the rate 180mg/sq. ft. on un-
painted surfaces was effective for about a month.
ETHOLOGY SECTION
Production of Salt-Marsh Mosquitoes
The salt-marsh mosquito "nursery" was improved this year by the
construction, calibration and operation of a heated concrete trough in
one of the swales. This, when combined with Saran screening to control
sunlight penetration to the water, enables the water to be maintained at
any desired temperature, within certain limits. By controlling temperature
and larval diet, it is possible to synchronize the development of mosquito
broods, to make them pupate and emerge at any desired time of day or
night, and to make the mosquitoes at emergence big or small, lean or fat.
Also during the year many new techniques were developed for field-
production work: methods for transferring larvae or pupae from swale to
swale, methods for quick separation of larvae and pupae, methods for
counting larvae in the swales and for getting ratios of larvae to pupae,
methods of separating broods and marking the sub-groups of adults with
different colored dyes, and methods for moving these sub-groups about
in large cages.
The ultimate goal of all these studies is the production of millions
of adult mosquitoes, upon demand, of predetermined size, weight and
nutritional state at emergence, and at predetermined times for release in
dispersal studies. Dispersal experiments, with marked mosquitoes, are
scheduled to be resumed in 1965, after a 13-year lapse for "retooling,"
i.e. for developing necessary biological information and techniques.

ENTOMOLOGY 41

Biology of Culex nigripalpus
Parallel to bait, light and suction trap collections to study the
seasonal biology of C. nigripalpus, females were dissected on a weekly
basis to observe the percentage which were parous (i.e. had already laid
eggs) and hence more likely to be infected with an arbovirus. The ovi-
parity rate was found to exhibit considerable variation which has not yet
been correlated with weather factors. Analysis of winter bait trap col-
lections, on the other hand, shows that rain following warm weather
results in the maximum host-seeking activity.
Since the occurrence of mosquito larvae depends primarily on the
behavior of the egg-laying female and secondarily on the suitability of
the habitat selected, a study of oviposition in C. nigripalpus was under-
taken to explain the seasonal and ecological relationships of C. nigripal-
pus breeding. The work was started with open redwood boxes having a
screened drain in the center. Infusions of oak leaves and hay were much
more attractive than tapwater or water mixed with hammock soil, but
there was no consistent difference in the two types of infusion. Further
studies showed that the attractiveness diminished after a few weeks, also
that it was immediately weakened when the infusions were diluted by
rain. A test comparing oviposition under opaque and transparent shelters
and in exposed boxes disclosed no significant difference. Close observation
of C. nigripalpus in the laboratory has shown that the female may ovi-
posit on an open water surface without having any object to touch and
that she does not necessarily oviposit where she first touches the water.
Since the observations of C. nigripalpus in early 1963 suggested that
the females might enter a state of diapause (arrested development) in the
winter and utilize blood meals for normal daily activity instead of the
production of eggs, special observations were initiated in November to
follow blood-feeding and egg-laying throughout the winter. At the end of
the year, though both ovipositing and blood-seeking behavior were
reduced in amount, the retardation appeared to be solely a direct
response to cooler temperatures.
Toward the end of the year, investigations of longevity in C.
nigripalpus were initiated. The mosquitoes must live much longer than
the average if they are to transmit a virus. The role of the sugar meal in
permitting such long life is therefore being investigated. Methods for
establishing the age structure of any nigripalpus population are being
developed as an aid to understanding the epidemiology of SLE.

Bait-Trap Technology
The development of an improved bait-trap for C. nigripalpus was a
principal activity throughout 1963. The objectives were: concentration of
the live catch in one or more removable containers which might be
stored in a household refrigerator, use of a mature bird which would not
require frequent replacement, and a trap designed as a permanent cage
for the bird or else provided with a device for removing the bird easily.
Parakeets were found to be slightly more attractive to C. nigripalpus than
two- to four-week-old chickens, and a trapdoor solved the problem of

42 ANNUAL REPORT, 1963

removing the bait, but no trap was found that would take a large catch
and automatically concentrate it in one or more capsules. The closest ap-
proach, the chimney trap, is the familiar lard can trap with a trapdoor
for the bird, and a carton placed over a transparent tube inserted verti-
cally on each end of the top. Most mosquitoes by morning will have
moved into the cartons.
In the search for an improved trap, there was developed a new de-
vice for comparing different features at the two ends of a single trap.
It was also found that C. nigripalpus was more likely to remain in a trap
if the catching chamber were close to the bait, that mosquitoes were
extremely prone to leave collecting chambers when no bait was present,
and that the size of the baffle was important in retaining the maximum
number of specimens trapped.
Beyond the comparison of parakeets with chickens, very little was
done to compare potential hosts of C. nigripalpus. The work on parakeets
disclosed that they were relatively less attractive to Aedes taeniorhynchus
than chicks, and in a test of chicks, though cockerels attracted more C.
nigripalpus than pullets, they did not permit as large a percentage of the
mosquitoes to take blood.

Colonizing Culex nigripalpus
A laboratory colony of C. nigripalpus has been started from adults
caught in the Tampa Bay area in September. To solve the critical prob-
lem of obtaining fertile matings, adults of A. taeniorhynchus and Culex
quinquefasciatus were placed in the same cage with nigripalpus. It is not
known if the swarming, mating or mere flight activity of the introduced
species was the responsible factor, but successful mating of C. nigripalpus
was accomplished, and the colony was in the third generation at the
year's end.

ECOLOGY SECTION
Larvivorous Fish Studies
The exhaustive study of feeding habits and reproductive cycles in
the most important tidewater larvivore (i.e., fish which eats mosquito
larvae), Fundulus confluentus, continued through the year. Encoding of
all data on food organisms (300 categories), by collecting site, size of
fish, and month of year, is completed. Statistical analysis is one-fourth
completed and should be finished some time in 1964.
As this last extensive study of foods taken by salt-marsh fishes draws
to a close, preparations are under way to investigate the other end of this
chain, viz. marsh productivity. This will not only place larvivorous fish
within the whole web of life on the salt marsh, but will bring out all the
possible values of the salt marsh as an environment. Such information
will permit truly informed recommendations on management of salt
marsh and mangrove areas for mosquito control and sand fly control.
Studies of the hermaphroditic killifish, Rivulus marmoratus, were con-
tinued in 1963, and a series of scientific papers on this remarkable animal

ENTOMOLOGY, 43

was launched. The first paper, now published, described the 24-hour
rhythm of ovulation and oviposition. This is of considerable theoretical
interest because very little is known, in man or any other vertebrate,
concerning environmental influences on ovulation cycles. The second
paper, now in press, reports tissue-transplantation experiments which
proved that wild populations of this fish are highly homozygous, i.e. all
with identical inheritances, as in identical human twins. Such homozy-
gosity in entire populations of a vertebrate animal is new to science. The
third paper will be concerned with sex-control by manipulation of the
laboratory environment. Again, this will deal with a phenomenon new
to biological knowledge of vertebrate animals: experimental sex deter-
mination. It is expected that these studies and papers will establish
R. marmoratus as an invaluable laboratory animal for studies of verte-
brate biology.

Mosquito Sampling Studies
A new program of mosquito flight studies was begun which differed
from that of previous years by concentrating on the problem of which
segments of the mosquito population are taken in what kinds of traps
and during which periods of the night. This required ovarian dissections
of portions of all female collections in order to determine approximate age
as well as egg-development stage. An example of findings is that gravid
(i.e. ready to lay eggs) females of C. nigripalpus fly about mostly during
the twilight periods at dawn and dusk. Many other behavioral findings
are assured by this approach to sampling research.
The first half of 1963 was largely occupied by establishing trapping
sites and constructing traps and equipment. One trapping site was lo-
cated near the beach in order to sample mosquitoes associated with the
salt marsh and the other was placed inland where fresh-water mosquitoes
predominated. Each site is a headquarters for a variety of sampling
studies and has its own weather station. Mosquitoes flying within a mile
are also sampled by truck trap, as are mosquitoes at daytime rest, by
power aspirator.
The jeep-mounted power aspirator was developed and perfected in
1963. This device sucks mosquitoes out of their resting places in the
ground vegetation and litter. Since most of Florida's mosquito species rest
on the ground by day, this enables the Center for the first time to study
their total populations, as all sampling techniques used by night are
necessarily selective. These daytime aspirator collections contain, as might
be expected, large numbers of newly-engorged females. Since it is possible
to identify the blood in a newly-engorged mosquito, it follows that the
power aspirator opens up a tremendous opportunity to learn where
various mosquitoes get their blood meals.
The first attempt to scientifically evaluate a mosquito adulticiding
operation was also performed, and successfully, in 1963. This was a
matter of applying the best sampling know-how to the problem of
measuring mosquito populations before and after an adulticiding treat-
ment. This is an area of research which will have to be expanded. The

44 ANNUAL REPORT, 1963

Control Research Section has developed very effective adulticiding tech-
niques. These guarantee that mosquitoes reached by the adulticiding fog
or spray will die. Now the problem is to determine what percentage of
mosquitoes in the wild (not caged) are reached, how much replacement
of the dead by production or invasion occurs, and so on. In other words,
the population effects of adulticiding must now be studied. This calls for
the best knowledge of sampling and population measurement technique
available.
Midge Studies
Biological studies of the pestiferous midges of the Winter Haven
area continued in 1963. Seasonal rhythms of emergence in the dominant
midge, Glyptotendipes paripes, were investigated. The possibility of
sampling midge eggs as a measure of production was looked into with
some hope of success.
In early 1963, the Minute Maid Corporation granted permission to
study three lakes in the Lake Alfred area and to use as base of operations
an acre of land in their vicinity. Fourteen 100-foot-square ponds were dug
and lined with plastic. Studies of water productivity and its control were
then undertaken in these ponds as well as on the lakes.
Studies on the three lakes were carried out to get background data
on primary productivity and on distribution and production of lake
insects. Comparisons will then be made with conditions at the end of
1964 when one lake will have been aerated as a means of depressing
productivity, another lake exposed to hyacinth growth and harvest as a
means of nutrient removal, and the third lake left untouched as a check.
These studies are based on the assumption that midge production, algal
production and other growths which get out of hand are reflections of
the basic productivity of a lake which in turn is a matter of nutrients
being excessive in the water.
Effects of plant cover, specifically the water hyacinth and water
fern, on primary production, i.e. oxygen production, were studied in the
plastic-lined ponds. It was established that the commonly employed
technique for measuring primary production, the dark-light bottle, did
not work in the ponds. A new method was then developed which worked
equally well in lake or pond.
Salt-Marsh Wildlife Studies
In July 1961, under contract with the U.S. Fish and Wildlife
Service, a study was begun to determine the effect on bird life of im-
pounding salt marshes for mosquito control. This study continued in
1963 with results essentially as reported last year. Aquatic and wading
birds used flooded marshes far more than nonflooded ones. The amount
of open water and dead tree growth are important factors. Precise data
on these and many other factors are being gathered, so that there will no
longer be any guesswork in assessing the response of birds to such mos-
quito-control methods.
The contract will expire in July 1964. A thorough analysis of the
data will be made by then and a detailed report prepared.

ENTOMOLOGY 45

PHYSIOLOGY SECTION
Growth and Pupation Studies
In attempting to understand the circadian (i.e. 24-hour) rhythm of
pupation in the salt-marsh mosquito, A. taeniorhynchus, experiments
were designed to learn whether this rhythm was due to larval feeding and
activity cycles brought on by dark and light periods, and whether such
entrained rhythms led to a synchronous pupation. Other species of
mosquito were studied in the same manner, for comparative values.
These experiments and others related to growth and pupation yielded the
following information:
(1) Larvae of taeniorhynchus at 32 degrees Centigrade require
72 hours of feeding before pupation. Larvae feeding no longer than this
accumulate energy reserves and the pupae and adults are larger. The
longer beyond 72 hours the larvae are allowed to feed before pupation,
the greater are the adult reserves of fat and glycogen. (2) Larvae feed
more actively by day than by night. A circadian rhythm of pupation can
be produced in constant light by subjecting the larvae to alternating 12-
hour periods of feeding and starvation. (3) The mechanism for syn-
chronous pupation of a group is set in the early instars and once set
the pupation follows a circadian rhythm even though in constant light
or constant dark. (4) Larvae reared in constant light need a minimum
break of three hours of dark per 24 hours to establish the circadian
rhythm of pupation. The same can be done for larvae reared in darkness
by only one minute of light every 24 hours. (5) C. quinquefasciatus
shows a circadian rhythm of pupation similar to the classical taeniorhyn-
chus, but no rhythm could be induced by any combination of food, tem-
perature or photoperiod in six foreign strains of Aedes aegypti.

Aseptic Rearing of Mosquitoes
Rearing larvae of A. taeniorhynchus under aseptic conditions was
started in September. Larvae will apparently grow in a liquid medium
if most of the chemical components used for growth are provided in col-
loidal form rather than in solution. A synthetic medium was used suc-
cessfully to demonstrate this point. The next step was a completely
chemically defined diet. This was achieved under aseptic conditions and
the larval growth was comparable to that on the usual contaminated
medium.
In formulating any synthetic medium it was observed that in order
to obtain favorable larval development it was necessary to provide a
buffer system to neutralize the metabolites produced by the larvae in
growing.

Egg Development Studies
General studies of autogeny (ability to produce a first egg batch
without a blood meal) in A. taeniorhynchus established the facts that
holding newly-emerged females at different temperatures for varying
periods affected the development of autogenous eggs, and both larval

46 ANNUAL REPORT, 1963

and adult diets influence the ability of females to produce autogenous
eggs.
Studies were continued on the hormonal regulation of autogenous
egg development. In addition to continuing certain experiments with
the corpora allata (a pair of glands in the neck of the mosquito which
produce a hormone involved in egg development), certain cells in the
brain were shown to influence egg development in certain species of
mosquitoes by noting the effect of removal. It is possible in certain in-
stances to start egg maturation by implanting groups of these cells into
females with their own cells removed and hence egg development halted.
Further experiments have been made to show that removal of these cells
from the brain has a drastic effect on sugar metabolism in both male
and female mosquitoes.

Energy for Flight
Experiments have been started to keep individual mosquitoes in con-
tinuous flight until they are exhausted and can fly no more. The intent
here is to determine whether mosquitoes use their fat reserves (which
under certain conditions are very great) during flight or whether they
can use only their carbohydrate reserves when flying. This information is
of primary importance in understanding the flight potential of mosquitoes
of different ages. It will have a considerable bearing on future mosquito
dispersal studies.

BIOCHEMISTRY SECTION
During the year, studies were continued on the effect of increasing
doses (i.e., meals) of sugar on fat and glycogen metabolism in Aedes
sollicitans. A new investigation was started on the effect of a single,
standardized sugar meal at different temperatures from 10 degrees C.
to 35 degrees C. Results so far have shown that the utilization of sugar,
and the net conversion to fat and glycogen (the primary energy reserves
for survival and flight, respectively) accelerated by a factor of two for
every 10 degrees of temperature increase. This suggests that these
metabolic processes follow laws of temperature reaction similar to those
of non-biological chemical reactions.
Another project initiated concerned the rate of oxidation and
synthesis (i.e., use and building up as reserves) of individual fatty acids
(the primary building block of fat), using gas-liquid chromatography.
The analytical part of this study was carried out in the department of
physical chemistry at the University of Leiden, Holland. Preliminary re-
sults show that temperature has little effect on the composition of fatty
acids synthesized from sugar by mosquitoes. The mosquito samples were
reared and prepared in Vero Beach and shipped to Holland for analysis.

MISCELLANEOUS ACTIVITIES
The Entomological Research Center continued its close collaboration
with the Encephalitis Research Center. The Ethology Section and the
director assumed the primary responsibility for designing the entomologi-

ENTOMOLOGY 47

cal phases of the Tampa Bay studies, and later in the year assisted in the
analysis and interpretation of results. There was a fruitful exchange of
ideas resulting from the work done there and the work done in Vero
Beach on the biology of C. nigripalpus, the vector of St. Louis En-
cephalitis in the Tampa Bay area.
From December 9-12, 1963, a Mosquito Biology and Control course
was given at the Entomological Research Center, sponsored by the SBH,
the Florida Anti-Mosquito Association, and the USPHS Communicable
Disease Center. A measure of the demand for such instruction in Florida
was the attendance of 78, an unexpectedly large number since the course
was given to 60 only two years ago. Of this year's registrants, 67 were
mosquito control workers representing 26 districts and counties, seven
were Bureau of Entomology personnel, and four were from the U. S.
Navy, the U. S. Air Force and the National Aeronautic and Space
Administration.

48 ANNUAL REPORT, 1963

BUREAU OF FINANCE AND ACCOUNTS
FRED B. RAGLAND, B.S.
Director
PAUL R. TIDWELL, B.B.A.
Assistant Director
Business and financial management of the agency is a major
responsibility of the bureau and includes accounting, budgeting, pur-
chasing, property control, duplicating services, mail, shipping, receiving,
automobile control and assignment and buildings and grounds mainte-
nance. This requires close working relationship with the State Board of
Health (SBH) program directors in planning full utilization of funds
that have been provided. Sound budget preparation for the various
health programs is necessary. When funds are provided and properly
budgeted, then a logical system of accounting for these funds and is-
suance of reports concerning their expenditure is required. This, along
with the dissemination of proper budget control information, is accom-
plished by this bureau. Funds are received from federal, state, county and
private sources. Each bears its own set of rules, laws and regulations as to
administration and expenditure.
The fiscal year ended June 30, 1963, was the second year of the
1961-63 state biennium for which the 1961 Legislature made available
to the agency state funds through the General Appropriation Act. These
appropriations were generally based upon maintaining present programs
at the same level with no additional funds for new programs or for
expansion.
Overall, approximately 24.5 million dollars was spent during the
fiscal year ended June 30, 1963. This represented almost $3.5 million
more than was spent the previous fiscal year. In three instances there was
notable increase. The Hospital Services for the Indigent program in-
creased about a million dollars to slightly over $5 million for 1963 as a
result of the state's greater use of federal participation for those on public
assistance rolls. The basic expenditures through county health depart-
ments (CHD) increased almost $1.5 million to a total of slightly over
$10 million for 1963, due primarily to more funds from local sources.
Cuban Health Services increased three quarters of a million dollars to a
total of approximately one million dollars. All funds for the Cuban
Health Services are provided by the federal government. Gradual in-
creases were experienced in the state's general public health programs,
such as chronic diseases, preventable diseases and public health labora-
tory support.
At the close of the fiscal year June 30, 1963, the number of state-
owned and operated automobiles was 91. These were driven approxi-
mately 1,350,000 miles during the year. In addition, the agency owned 35
trucks or special purpose vehicles such as: mobile tuberculosis, dental and
engineering laboratories. These units traveled approximately 300,000
miles during the year. Assignment and use of all vehicles is continually
reviewed to insure that they are used in the most effective and economical
manner in carrying out the agency travel responsibilities. During 1963,
18 old vehicles were traded and 24 new units acquired.

FINANCE AND ACCOUNTS 49

The bureau director and his staff continue to give assistance to the
overall planning of the health department activities, particularly in the
area of coordinating financial plans.
PURCHASING AND PROPERTY SECTION
FRANK E. CRAFT, B.S., B.A.
Purchasing Agent
The purchasing section is responsible for the procurement of the
agency's supplies, equipment and services. Purchases are made in ac-
cordance with rules and regulations issued by the State Purchasing Com-
mission covering the solicitation of bids, advertising for bids under certain
conditions, printing regulations, etc. Purchases are also made under
contracts and maximum price regulations negotiated by the State Pur-
chasing Commission. The purchasing department cooperates with other
state agencies in the exchange of information pertaining to contracts for
volume purchases which enables this agency to purchase certain items
under contracts negotiated by other state agencies and to permit pur-
chases under our contracts by others. The property division of this
section carries out the responsibility of recording, marking and inven-
torying of all property purchased (desks, chairs, office equipment, labora-
tory equipment, etc.). The State Statutes prescribe records that must
be maintained and the frequency of physical inventories.
The purchasing office issued 4545 separate purchase orders which
totaled $1,485,206.90 for the year 1963. This is an increase over past
years and represents the activity necessary to supply the increased needs
of the various bureaus and divisions of this agency. A considerable in-
crease in orders written was due to the purchase of equipment and sup-
plies for the newly established Encephalitis Research Center in Tampa.
CHDs normally handle purchases locally within the organizational
framework of the CHD; however, their purchasing procedures must also
conform to the Florida Statutes governing purchases, such as obtaining
bids and advertising for bids where required. The following of good busi-
ness practices in procuring materials through competitive bids is advo-
cated. The purchasing agent at the SBH assists the CHD wherever pos-
sible with their purchasing requirements.
Property Control
The responsibility of this section is to see that capital outlay items
are assigned property numbers, maintain records and process annual
physical inventories on over 160 locations.
Property values reflected by the SBH Plant Ledger as of June 30,
1963 were as follows:
Real property .................................................$2,819,024
Furniture and equipment .......................... 1,074,758
Automotive equipment and trailers........... 254,604
Books and film .............................................. 296,202

Total ................................................$4,444,588
Overall, dollar value increase as of June 20, 1963 was $361,309. This

50 ANNUAL REPORT, 1963

was considerably over the 1962 increase of $135,905. The Regional
Environmental Health Building, Winter Haven, was completed during
the period of this report.
Control of property and maintenance of records as required by
Florida Statute continues to be a job of considerable magnitude, not
only because of the dollar increase but as the SBH continues to grow
and departments acquire new quarters property cards have to be
changed or corrected for insurance purposes on any change of location.
The importance of correct maintenance and control of property is
continually stressed within the agency to insure that the records reflect
the current status of all property items owned by this agency.
Insurance
Fire insurance on buildings and contents is carried in the State Fire
Insurance Fund under the supervision of the State Fire Insurance Com-
missioner. Coverage on boilers and heating equipment is carried in a
master policy supervised in the office of the State Fire Insurance Com-
missioner. Scientific equipment in various mobile laboratories is pro-
tected by a "Floater" or "Transportation" policy. Automobiles, trucks
and other special-purpose motor vehicles owned by this agency are
covered by a fleet policy to include public liability, property damage,
fire, theft and comprehensive. The agency acts as self-insurors for col-
lision damage. Other major insurance coverages include: money and
securities, broad form, loss inside and outside of premises; position
schedule bond for narcotic inspectors; public employees honesty blanket
position bond; Workmen's Compensation.
Seven claims amounting to $3384.08 were settled under the agency's
fleet automobile liability policy during 1963. Damages to SBH cars
caused by others were settled for $273.56. This agency's insurance com-
pany repaired damages to SBH vehicles under comprehensive clause
$997.67 and theft $13.38. The SBH as self-insuror for damages caused
by collision paid $690.02 for repairs in this respect. This figure is con-
siderably less than the cost of carrying collision coverage in our fleet
liability policy.
BUILDINGS AND FACILITIES SECTION
JOHN C. CLARKE
Supervisor
Maintenance-During the year 843 written work requests were proc-
essed and only 21 were cancelled or uncompleted. Twelve thousand
"maintenance man" hours were available and about two-thirds of these
man hours were expended on the work requests. The remaining labor
availability was expended in preventive maintenance.
Perhaps the most important item undertaken during the past year
was the electrical engineering survey. The engineer's report disclosed
that the total connected electrical load far exceeded the maximum input
capacity and the capacity of the installed safety devices of the Hanson
building and the IBM Section of the J. Y. Porter building. In view of the
ever increasing electrical loads it was decided to explore the possibility of

FINANCE AND ACCOUNTS

making an electrical feed and branch circuit installation which would
obviate a continuing makeshift installation.
Shipping and Receiving-This activity continues to feel the increased
demand for the provision of drugs, printed forms, various types of con-
tainers, minor laboratory equipment and other incidental supplies. Lack
of working and storage space has also been a handicap.
Mailing-Rules and procedures have been instituted so that the
mail room now operates in a manner as nearly like a branch U. S. Post
Office as can be practicable in a state agency.
The ditto and addressograph functions have consolidated within one
area all machine addressing equipment utilized for addressing mail and
packaged items.
Security-Buildings and grounds security is maintained during non-
working hours. During the year 50 potential legal evidence specimens
were received after working hours and stored in accordance with existing
instructions. Officers have made five court appearances.
Duplicating-This year 1981 requisitions were processed through the
department, requiring handling of 2048 offset plates and 2924 stencils.
Total machine impressions by both methods of reproduction amounted
to 9,602,002.
FISCAL SECTION
BYARD W. HARRIS
Fiscal Officer
The essential function of this section is the determination of the
legality and propriety of payments under the various programs of the
agency, processing all bills and vouchers for payment, the financial record
keeping and preparation of required financial reports.
The financial transactions of the SBH for the fiscal year ended
June 30, 1963, as reflected by the records of the bureau, are presented in
a condensed form at the end of this section. A detailed financial report
for the fiscal year ended June 30, 1963, has been prepared and dis-
tributed to the Governor, members of the Board of Health, and all
bureaus, divisions and CHDs.
The funds received (or appropriated) for the fiscal year ended
June 30, 1963, were from the following sources:
State appropriations and funds ....................$ 8,421,743.00 34%
From local agencies for county
health departments ................................ 6,766,986.19 27%
From federal grants-in-aid ............................ 3,728,822.08 15%
From research grants .......................-............. 930,199.12 4%
From Hospital Services for the Indigent:
*Local sources .......................................... 295,873.05 1%
State Department of Public Welfare .... 4,600,333.03 19%
From federal for building ................................ 1,849.80 -

$24,745,806.27 100%
*These funds deposited with and disbursed through the State
Treasury. Does not include $2,679,402.78 disbursed locally.

52 ANNUAL REPORT, 1963

The operating and capital expenditures by the SBH were for:
Personal services (salaries and
professional fees) ....................................$11,604,220.37 48%
Contractual services (repairs, utilities,
travel expenses, hospital program) ........ 9,171,425.86 37%
Materials and supplies (office, medical
laboratory, mosquito control,
educational) .......................................... 1,439,416.45 6%
Current charges (rent, insurance, merit
system costs, registrar fees) .................. 350,681.24 1%
Capital outlays
(equipment and fixed assets) ............. 460,026.26 2%
Grants to counties and Mosquito
Control Districts .................................... 1,221,910.48 5%
Miscellaneous (education aids and
subsidies) .................................................. 158,273.27 1%

TOTAL ....................................................$24,405,953.93 100%
In addition to funds reported in the annual financial report and
summarized above, certain other funds and services were made available
by the U. S. Public Health Service (USPHS) to the activities of the
Board but were not paid directly to the SBH. They include:
Value of USPHS personnel on loan to
the Board in preventable disease programs ..............$217,351.23
Fiscal operation followed a budget plan of 183 departmental budgets.
These budgets were periodically revised as required.

SUMMARY OF RECEIPTS AND DISBURSEMENTS AND
BALANCES FOR THE FISCAL YEAR ENDED JUNE 30, 1963
RECEIPTS
FROM STATE FUNDS
From State Appropriations:
General Public Health ........................................................$ 3,668,644.00
Consolidated Mosquito Control .......................................... 1,650,000.00
County Health Units ........................................................... 1,660,000.00
Dental Students Scholarships ............................................. 40,000.00
Medical Students Scholarships ............................................ 40,000.00
Hospital Service for Indigents ............................................ 1,025,000.00
Mental Health Council .............................. .................... 140,181.00
Air Pollution .................................... 72,918.00
Purchase of Salk and Combined Vaccines............................ 125,000.00

Total State Appropriations ........................................$ 8,421,743.00
State Revolving Fund:
County Health Units ...................................... ................. $ 2,500.00

FINANCE AND ACCOUNTS

FROM FEDERAL GRANTS-IN-AID
Public Health Service:
General H health ......................................................................$
Chronic Illness and Care of Aged ........................................
Venereal Disease ................................................................
Tuberculosis Control .............................................................
Heart Disease ............................................. .......................
Cancer Control .............................................. ..............
Mental Health .......................................................................
Water Pollution ...................................................................
Radiological Health .............................................................
Mental Health Planning ...............................................
Cuban Health Services .................................... ..............
Children's Bureau:

434,228.00
457,530.70
156,607.00
77,790.22
192,392.50
89,938.50
164,357.30
117,527.00
38,540.00
25,000.00
1,148,000.00

Maternal and Child Health .............................................. 826,910.86

Total Federal Grants-in-Aid ......................................$ 3,728,822.08

FROM GRANTS AND DONATIONS ..............................................$ 930,199.12

FROM LOCAL AGENCIES FOR COUNTY
HEALTH UNITS ...................................................................$ 6,764,486.19

FROM HOSPITAL SERVICE FOR INDIGENTS
Local Sources .................................................................................$ 295,873.05
State Welfare Board .................................................................... 4,600,333.03

Total for Hospital Service for Indigents....................$ 4,896,206.08

FROM FEDERAL FOR BUILDING .....................................$. 1,849.80

TOTAL RECEIPTS ............................................ $24,745,806.27
Balance July 1, 1962 $3,301,849.51 (Less
expired appropriation of $443.50) ....................$ 3,301,406.01

TOTAL RECEIPTS AND BALANCES ..................$28,047,212.28

DISBURSEMENTS
OPERATING EXPENSES
Personal Services:
Salaries .............................................................................. 11,095,663.72
Other Personal Services Individual.............................. 358,376.89
Other Personal Services Other ...................................... 150,179.76
Contractual Services:
Travel Expense, including subsistence and lodging.......... 1,327,862.44
Communication and Transportation of Things ........... 320,564.72
U utilities ................................................................................ 147,409.96
Repairs and Maintenance ............................................... 140,555.40
General Printing and Reproduction Service .... 79,346.41

54 ANNUAL REPORT, 1963

Subsistence and Support of Persons ......................................6,782,496.89
Other Contractual Services ................................................ 373,190.04
Commodities:
Bedding, Clothing and other Textile Products ................... 2,781.58
Building and Construction Material and Supplies ............ 13,826.92
Coal, Fuel Oil and other Heating Supplies ...................... 12,289.97
Educational, Medical Scientific and Agricultural
Materials and Supplies ................................................ 1,093,488.27
Maintenance Materials and Supplies ............................... 83,502.61
Motor Fuel and Lubricants .................................................. 52,139.20
Office Materials and Supplies ............................................ 176,159.94
Other Materials and Supplies ................................. .... 5,227.96
Current Charges:
Insurance and Surety Bonds .............................................. 51,607.38
Rental of Buildings ........................................................... 114,107.05
Rental of Equipment ............................................................ 46,244.70
Other Current Charges and Obligations .......................... 88,743.92
M erit System .......................................................................... 49,978.19

TOTAL OPERATING EXPENSES ............................$22,565,743.92

CAPITAL EXPENSES
Books ........................................... $ 10,696.70
Buildings and Fixed Equipment ........................................ 40,269.06
Educational, Medical, Scientific and
Agricultural Equipment ......................................... 172,577.76
Motor Vehicles Passenger .............................................. 44,490.50
Motor Vehicles Other ................................................... 1,639.47
Office Furniture and Equipment ........................................ 182,499.17
Other Structures and Improvements .................................... 7,719.92
Other Capital Outlay ............................................................ 133.68
TOTAL CAPITAL EXPENSE ..................................$ 460,026.26

GRANTS, SUBSIDIES AND CONTRIBUTIONS
Grants to Counties and Mosquito Control Districts............$ 1,221,910.48
Other Educational Aids and Subsidies .............................. 158,273.27
Total Grants, Subsidies and Contributions.................$ 1,380,183.75
TOTAL PROGRAM EXPENSES ............................$24,405,953.93

NON-OPERATING DISBURSEMENTS
Transfers .................... .......................$ 117,527.00
Refunds .............................. .... ........... 118,437.01

Total Non-Operating Disbursements ............................$ 235,964.01
TOTAL DISBURSEMENTS ....................................$24,641,917.94

BALANCE JUNE 30, 1963 ........................... .........$. 3,405,294.34
TOTAL DISBURSEMENTS AND BALANCES ............$28,047,212.28

FINANCE AND ACCOUNTS 55

SCHEDULE OF EXPENSES
BY HEALTH PROGRAM ACTIVITY

Health Services to mothers, infants, pre-school
and school children ..................................................... ...........$ 3,503,900.00
Statewide Venereal Disease Control, Diagnosis and Referral of
Infectious Venereal Disease Patients to Treatment Clinics-
also Operation of Program ............................................................ 1,158,700.00
Mosquito and Pest Control Programs, Including Pest Control
Law Enforcement .......................................................................... 3,235,152.17
Indigent Hospitalization ........................................................................ 6,054,204.73
Statewide Sanitary Engineering and Environment Sanitation ............ 2,046,576.54
Statewide Cancer Control Program ...................................................... 628,700.00
Statewide Tuberculosis Control, X-Ray Survey and Follow-up
W ork ............................................................................................. 1,117,200.00
Mental Health Program ........................................................................ 1,300,300.00
Statewide Narcotic, Drug, Medical Practice Law Enforcement ........ 190,983.02
Radiological and Occupational Health (including Air Pollution).... 257,307.19
Chronic Illness and Care of the Aged ................................................ 1,540,400.00
Heart Disease Program .......................................................................... 481,300.00
Other Health Programs and Administration ........................................ 2,891,230.28

TOTAL EXPENSES .................................................................... $24,405,953.93

SCHEDULE OF EXPENSES
BY FUNCTIONAL ACTIVITY

General Public Health (also includes Miscellaneous Health Activi-
ties and training) ..........................................................................$
Vital Statistics .................................................. ..............................
Health Education ..........................................................................
Sanitary Engineering ............................................ .......................
Entomology and Mosquito Control ................................................
Laboratories ............................................. ........................
Tuberculosis Control ............................................ ..........................
Preventable Disease (excluding Tuberculosis Control) ..................
Mental Health .................................................. ..............................
Narcotics .........................................................................................
Maternal and Child Health ........................................ ................
Hospital Service for the Indigent ..................................... .............
Local Health Service ............................................ ..........................
Chronic Diseases ............................................... .............................
County Health Units ....................................................................

TOTAL EXPENSES

1,570,123.74
258,047.11
91,102.36
509,829.25
2,210,653.98
843,441.83
236,069.29
507,163.32
312,069.23
156,717.73
427,259.87
6,054,204.73
537,559.09
446,730.53
10,244,981.87
24,405,953.93

.... $

TABLE 7 ut

FUNDS RECEIVED BY COUNTY HEALTH UNITS FROM FLORIDA STATE BOARD OF HEALTH AND

LOCAL SOURCES FOR THE FISCAL YEAR ENDED JUNE 30, 1963

STATE BOARD OF HEALTH LOCAL FUNDS

COUNTY Total Board
Funds Total State Federal Total of County Board of Fees and
Commis- Public Cities Mis-
sioners Instruction cellaneous

Alachua ............................
Baker............................
Bay ................................
Bradford.........................
Brevard ............................
Broward ..........................
Calhoun............................
Charlotte ..........................
Citrus .............. .............
Clay ...........................
Clay Building Fund .................
Collier..............................
Columbia.........................
Dade...............................
D eSoto. .. ..........................
Dixie................................
Duval ...............................
Escambia ............................
Flagler...........................
Franklin.............................
Gadsden ............................
Gilchrist.............................
Glades................... ...........
Gulf ................................
Hamilton ...........................
Hardee .............................
Hendry .............................
Hernando ...........................
Highlands............................
Hillsborough. .... ..... ... .. ......
Holmes. ............ ...........
Indian River ........................
Jackson............................
Jefferson .............................
Lafayette .........................

$ 201,131
20,041
95,068
34,014
187,876
418,694
21,277
58,215
31,273
44,571
8,660
66,595
49,560
1,444,865
32,119
17,662
268,230
304.651
16,929
26,467
72,644
12,799
15,796
30,867
24,169
44,621
39,844
12,012
43,253
1,017,915
28,494
69,174
76,096
36,573
14,148

$ 63.822
7,608
46,613
14,370
50,606
105,247
9,018
17,751
18,257
19,832
............
29,392
21,256
269,987
20,354
8,018
123,141
86,664
5,400
10,218
35,527
3,850
5,422
13,329
10,475
14,088
11,183
8,805
24,292
145,482
13,597
25.644
41,530
15,270
6,139

$ 59,577
7,608
46,613
14,370
48,956
105,247
9,018
17,751
18,257
19,832

29,392"
21,256
134,615
20,354
8.018
117,861
50,781
5,400
10,218
35,527
3,850
5,422
13,329
10,475
14,088
11,183
8,805
24,292
63,536
13,597
25,644
33,720
15,270
6,139

$ 4,245

1,650

135,372

...5,286
35,883

81,946.

7,810

$ 137,309
12,433
48,455
19,644
137,270
313,447
12,259
40,464
13.016
24,739
8,660
37,203
28,304
1,174,878
11,765
9,644
145.089
217,987
11,529
16,249
37,117
8,949
10,374
17,538
13,694
30.533
28,661
3,207
18,961
872,433
14,897
33,530
34,566
21,303
8,009

$ 105,479
12,347
46,984
14,210
136,098
290,923
10,700
32,776
9,326
22,217
8,660
30,854
27,435
1,057,993
11,596
7,789
113,116
121,175
11,496
16,188
32,060
4,631
9,707
14,454
12,167
28,690
16,310
52
18,366
642,285
7,333
22,443
30,122
5,000
8,000

$ 9,100
............

..... "" .66..
2,8006
17,50066
600
............"
3,600

.....".......66

1.800
6,00066
............3
3,602
4,312
600
3,000
.......6....."
500

3,015
............
7,5006
3,000
3,000
4,000
............

$ 14,833
............'
2,400
..... ......"
2,290
1,500

2,4600

600

64,984
............
.773*

1,395

......i,666..
4,500
1,100

z
C:

2p-

$ 7,897 -
86
1,471
234
1,172 W
2,734
959
6,188
90
122
6,349 -
269
116,885
169 ,
55
28,013 '0
25,828 o.
33
61 M
682
6
67
84
132
1,343
12,351
140
595
230,148
64
3,587
344
12,303
9

TABLE 7 (Continued)

FUNDS RECEIVED BY COUNTY HEALTH UNITS FROM FLORIDA STATE BOARD OF HEALTH AND
LOCAL SOURCES FOR THE FISCAL YEAR ENDED JUNE 30, 1963

STATE BOARD OF HEALTH LOCAL FUNDS

COUNTY Total Board
Funds Total State Federal Total of County Board of Fees and
Commis- Public Cities Mis-
sioners Instruction cellaneous

Lake ...............................
L ee ................................
Leon. ............................
Levy ...........................
Liberty.......................
Madison ............. ..... ....
Manatee .................... .....
Marion ...........................
Martin ............... ...........
Monroe..............................
Nassau ......... ..............
Okaloosa ........ ..................
Okeechobee .......................
Orange ...........................
Osceola .........................
Palm Beach. ................ .......
Pasco..... ....... ............
Pinellas ...........................
Polk..... ................... .. ...
Putnam .............................
Santa Rosa ........................
Sarasota ......................... .
Seminole ...... ...................
St. Johns ..........................
St. Lucie .......................
Sumter.. .........................
Suwannee........................
Taylor ... .......................
Union ............................
Volusia ............................
Wakulla .........................
Walton. ........................
Washington ................. .....
County Health Units, State at Large....
TOTALS. ......... .................

$ 97,009
85,759
199,398
31,720
14,204
32,643
172,132
98,004
37,870
92,043
60.905
72,957
24289
434,629
37,540
546,489
36,855
935,902
393,271
76,468
48,091
220,399
73,041
60,448
96,131
24,075
32,033
28,133
17,296
307,367
16,818
34,612
28,537
38,567

$ 31,302
36,027
89,748
12,867
4,939
16,433
58,365
36,040
18,014
34,726
19,254
27,201
9,509
110,068
18,348
106,370
16,654
141,285
96,870
33,335
22,578
59,301
25,406
27,959
42,893
11,567
18,533
14,464
9,779
91,455
6,809
16,154
13,243
38,567

$ 31,302
36,027
78,273
12,867
4,939
16,433
58,365
36,040
18,014
29,686
19,254
27,201
9,509
90,982
18,348
94,171
16,654
80,554
74,769
33,335
22,578
50,373
25,406
27,959
39,941
11,567
18,533
14,464
9,779
87,990
6,809
16,154
13,243
38,567

$ ... ....
11,475

5,040

19,086"

12,199
60,731
22,101

8,928

2,952

3,465

$9,381,938 $2,618,250 $2,200,087 $ 418,163

$ 65,707
49,732
109,650
18,853
9,265
16,210
113,767
61,964
19,856
57,317
41,651
45,756
14,780
324,561
19,192
440,119
20,201
794,617
296,401
43,183
25,513
161,098
47,635
32,489
53,238
12,508
13,500
13,669
7,517
215,912
10,009
18,458
15,294
S. .. ... .. .

$ 63,703
47,798
80,526
11,055
9,259
16,101
98,653
51,229
18,179
42,874
41,518
40,192
14,709
246,351
16,650
300,443
18,300
652,168
238,966
39,930
18,401
137,383
33,955
24,624
37,352
11,876
13,375
12,750
7,492
161,077
10,000
8,950
15,231
S.. .. .. .. ...

$ ... ..
9,397"
5,700

4,000
750
6,000

5,000
25,300
2,400
29,415
6,059
28,125
4.200
4,000
11,916
1,920

800

19,350
7,000

$ 1,495

5,000

5,600
4,000

4,520

7,200

5,700
2,600

$6,763,688 $5,480,052 $245,261 j $146,650

I-4
F-4

$ 509
1,934
14,727
2,098
6 z
109
15,114 L
1,135
927
4,443
133
564
71 Z
48,390
142
107,761
1,901
136,390 t
22,110
3,203
2,912
19,715
1,764
245 0
8,386
632
125
119
25
35,485
9 CO
108
63

$891,725 Ut
N

,

58 ANNUAL REPORT, 1963

BUREAU OF LABORATORIES

NATHAN J. SCHNEIDER, Ph.D., M.P.H.
Director

The bureau provided laboratory services to the local health units
and to other bureaus and divisions of the State Board of Health (SBH)
for the successful performance of their varied public health programs.
Similarly, diagnostic and epidemiologic assistance was provided to li-
censed practitioners of the healing arts in Florida. The bureau carried
out its responsibilities as charged by state regulations to approve private
and hospital laboratories for the performance of syphilis serology on
prenatal and premarital patients; to assist the Board of Examiners in the
Basic Sciences to license medical technologists and medical technologist
directors; and to provide laboratory services in the regulation of the
sale of drugs, cosmetics and devices in Florida.
The Legislature at its last session appropriated funds for the con-
struction of replacement public health laboratory facilities in Tampa and
Pensacola. Planning funds were released and the architects were desig-
nated in December. The present antiquated facilities are in need of ex-
tensive repairs. Therefore, every effort is being made to proceed as
expeditiously as possible in the drawing of plans and initiating of con-
struction.

DIAGNOSTIC SERVICES
As in previous years, the laboratory offered a wide variety of
diagnostic services. Considering the general public health services only
as shown in Table 8, there was a total of 2,811,981 examinations per-
formed in the year under review as compared to 2,771,705 tests per-
formed in 1962. The major increase was noted in the number of exami-
nations of blood specimens for syphilis, sputum specimens for tuber-
culosis, stool specimens for enteric pathogens, drinking and pollution
waters for bacteriological examination and environmental specimens for
radiological activity. Offsetting these increases were reductions in exami-
nations for Rh blood typing, lactobacillus counts for dental caries
bacteriology and virology. As compared to the previous year, all of the
laboratories except Jacksonville and Tallahassee experienced moderate
increases in the overall number of examinations performed; reductions in
the Jacksonville laboratory were in syphilis serology and virology, while
in Tallahassee fewer dairy products accounted for most of the decrease
in work load.
The trend of increased demands for sanitary bacteriology was
particularly noticeable in water examinations. Drinking and swimming
pool waters increased from 171,498 examinations in 1962 to 183,914 in
1963. Seven county health departments (CHD) have been approved for
testing private water samples by the membrane filter procedure. This in-
crease was significant because specimens which might have been sent to
the state laboratories were examined in the counties. Four of these

LABORATORY SERVICES 59

counties, St. Lucie, Pinellas, Manatee and Charlotte, have also been ap-
proved for testing public waters and swimming pools.
Pollution water survey examinations have increased from 66,680 in
1962 to 83,060 in the year under review. This increase was a direct result
of the bacteriological surveying of new oyster growing beds along the
coastal areas of Florida. Additional equipment was obtained and part-
time college students used to supplement available laboratory facilities to
accommodate a crash program of surveying oyster beds in the Tampa
Bay area and along the Atlantic Ocean from St. Johns County to St.
Lucie County. Demands for more bacteriological examinations of waters
used for drinking, industry and recreational purposes can be expected
in Florida.
The results of examinations by findings are presented in Table 8;
a total of 731,750 blood specimens were examined for syphilis of which
40,158 were found reactive. Excluding the specimens unsatisfactory for
testing, the proportion reactive was 5.6 per cent. This compares to 4.9
per cent in 1960, 5.4 per cent in 1961 and 6.1 per cent in 1962. Al-
though it is too early to state, it is hoped that the downward turn in the
proportion of reactives in 1963 was indicative of reduced syphilis in-
fections in Florida. Special attention was given to blood specimens sub-
mitted from problem cases of suspected syphilis to rule out biologic false
positives. These specimens were subjected to a special battery of tests
which included the Kolmer fifth volume nontreponemal cardiolipin
antigen procedure, the Kolmer Reiter Protein (KRP) procedure and the
fluorescent antibody (FTA-200) tests. Of particular interest was the
latter; a total of 299 specimens were examined by the FTA-200 pro-
cedure and 50 per cent were reactive. This compares to the findings of
116 specimens referred to the Venereal Disease Research Laboratory of
the U. S. Public Health Services (USPHS) for the Treponemal Pallidum
Immobilization (TPI) test viz. 65 per cent were reactive or weakly
reactive.
The number of diagnostic specimens found positive for diphtheria
in 1963 was 65; this continues a downward trend in percentage positives
which were 4.5 per cent in 1960, 3.3 per cent in 1961, 2.6 per cent in
1962 and 1.2 per cent in the year under review. Apparently the extensive
immunization programs are having their effect on the clinical cases of
diphtheria being detected in Florida. It is noted, however, that most of
the diphtheria isolations were made in north Florida.
The total number of public health tuberculosis specimens examined
during 1962 amounted to 45,057 of which 1974 or 4.4 per cent were
positive for M. tuberculosis or the unclassified mycobacteria, as compared
to 8.2 per cent in 1962 and 7.1 per cent in 1961. There remains a
significant reservoir of undetected infection in Florida. Considerable
savings in technician time was noted in the elimination of smear exami-
nations of sputum specimens from known tuberculosis patients. Ap-
proximately 20,000 such specimens were examined by culture only.
Assuming five minutes were required to prepare, stain and examine
each smear, 166 additional technician hours were available for more
careful microscopic and cultural bacteriologic examination of specimens

60 ANNUAL REPORT, 1963

from suspect tuberculosis patients. Thus, cooperation from clinicians in
requesting smear examination on undiagnosed patients enabled the
laboratory to meet demands for increased service.
Microscopic smear specimens submitted for the presence of N.
gonorrhea and other infections decreased moderately during 1963. The
proportion of positives for gonorrhea was 15.5 per cent in 1963 as com-
pared to 16.0 per cent for 1962. Similarly, cultures for N. gonorrhea
decreased from 25,824 in 1962 to 11,228 in 1963, due in part to the
changeover from culture to the fluorescent antibody (FA) technic for
gonorrhea in the Jacksonville laboratory. Further comments on the
efficacy of the FA procedure are given later in the section under special
studies.
There was a marked increase in the number of fecal specimens sub-
mitted for examination for enteric pathogens; 54,239 specimens in 1963
as compared to 47,728 in the preceding year. A total of 105 typhoid and
867 Salmonella isolations were made, representing a substantial increase
in number of actual isolations as compared to the preceding two years.
In contrast, Shigella isolations which had increased from 94 in 1960 to
215 in 1962 declined to 164 in 1963.
Human leptospirosis was confirmed by laboratory findings in seven
patients during the year under review. Paired serum specimens of
patients with clinical aseptic meningitis of suspected viral etiology were
tested for a rise in agglutination titer against killed leptospiral antigens.
Among the miscellaneous examinations, there was a decline in the
finding of early cases of syphilis. In the year of this report, 64 darkfield
specimens were found positive for T. pallidum, continuing a decline
which started in the preceding year. In 1957 and 1958 there were no
positive darkfields reported; in 1959 there were 72; in 1960-160; in
1961-194 and in 1962 there were 150. The finding of T. pallidum in
lesions is diagnostic evidence of syphilis.
There was a small increase in specimens found positive for mycology;
in 1963, a total of 1680 specimens as compared to 1631 in 1962. Ap-
proximately 80 per cent of the positives were Candida albicans and 19
per cent were dermatophytes.
A total of 2129 bacteriological cultures were received in the labora-
tory for identification. This service is of value to hospital and private
clinical laboratories which, because of limited facilities or lack of
specific and specialized reagents, seek assistance or confirmation in
identifying bacteriological isolations made in their laboratories.
There were numerous miscellaneous special bacteriological services
offered by the bureau including typing of beta streptococci, urine bac-
teriological plate counts, sterility testing of drugs and biologicals. A total
of 855 specimens were submitted under these categories.
In the field of dental caries bacteriology, 3053 saliva specimens were
examined for lactobacillus counts. Reports of findings were sent to the
dentists through the Bureau of Dental Health which provides professional
interpretation of results.

LABORATORY SERVICES 61

There was a modest increase in the number of stool specimens
examined for intestinal parasites during the year under review as com-
pared to the preceding year. The proportion positive for hookworm was
somewhat lower; in contrast, there were more fecal specimens positive
for ascaris, enterobius, trichuria, E. histolytica and other protozoa. Again,
as in the preceding six years, no positive malaria blood smears were
found in the state laboratories.
In the chemistry laboratory, there was a substantial increase in the
number of blood specimens examined for blood sugar, cholesterol and
hemoglobin. It has been the practice of the laboratory to accept such
specimens only from the CHDs in connection with their diabetic,
prenatal and other case-finding clinics. Clinical chemistry "Autoanalyzers"
were purchased and installed in the Jacksonville, West Palm Beach and
Tampa laboratories where demands are met for blood sugars and related
clinical chemistry tests. There is a need to provide autoanalyzers in each
of the other regional public health laboratories in anticipation of in-
creasing chronic disease case detection programs in CHDs.
The radiological chemistry section, established in the Orlando labora-
tory in late 1960, was equipped with a multichannel analyzer and other
sophisticated radiological testing equipment. There was a substantial
increase in the number of water, milk, air and other environmental
specimens tested for radiological activity. In 1963, chemical and radiologi-
cal procedures were developed and adapted to the needs of the state
surveillance program. Milk samples delivered to the regional laboratories
were filtered through ion exchange resins and the resins were shipped to
Orlando for the measurement of Iodine-131. Other milk samples to be
tested for Strontium-89, Strontium-90 and Cesium-137, were shipped di-
rectly to the Orlando laboratory for testing. Tissues and feed samples
were also tested. This activity, part of the background surveillance pro-
gram, is carried out directly under the guidance of the Division of
Radiological and Occupational Health. Close liaison was maintained with
the USPHS Radiological Laboratories in order to standardize and
evaluate test procedures.
The number of veterinary public health specimens examined in the
laboratory remained at a low level. With the establishment of the Animal
Diagnostic Laboratory at Kissimmee and the Poultry Diagnostic Labora-
tories of the State Department of Agriculture, virtually all requests for
diagnosis of animal diseases were referred to those laboratories. However,
a few specimens for such zoonoses as Eastern Equine Encephalitis (EEE),
leptospirosis, brucellosis, anthrax, etc., which have public health sig-
nificance were accepted for examination.
Diagnostic services for viral and rickettsial infections were offered
on a statewide basis from the Jacksonville laboratory. The decrease in
numbers of viral serology and isolation specimens was due in part to the
establishment of the Encephalitis Research Center in Tampa which
examined selected specimens for St. Louis Encephalitis (SLE) and other
arboviruses from suspect cases in the Tampa Bay area. Close liaison was
maintained between the two laboratories to avoid duplication of diag-
nostic procedures. Specimens found negative in the Tampa laboratory

62 ANNUAL REPORT, 1963

for SLE and certain arboviruses, were examined in Jacksonville for en-
teroviruses and other appropriate central nervous system viruses as indi-
cated by clinical and epidemiological history of each suspect case.
The total animals examined for rabies increased substantially during
the year under review. There were 21 more positive animals in 1963 than
in the preceding year. Most of the increase was noted among raccoons;
however, there were 13 positive bats found also. The fluorescent antibody
(FRA) procedure was used routinely to supplement the direct brain
smear examination in the diagnosis of animal rabies. The Tampa Region-
al Laboratory and the Jacksonville Central Laboratory performed FRA
procedures.
Viral and rickettsial diagnostic findings for 1221 patients examined
in 1963 are given in Table 10. There were fewer positive findings
largely because of the presence of the SLE epidemic in the Tampa Bay
area in 1962 and the absence of SLE infections in 1963. The six SLE
positive findings recorded in 1963 were obtained on cases that occurred
late in 1962 and laboratory findings were completed during the year
under review. The most significant virological findings during the year
was in the increase in poliovirus isolations, particularly Type I. Partially
as a result of laboratory findings, mass oral polio vaccine programs were
stimulated in various communities in the state.
The cooperative program in the laboratory field, established between
the SBH and the State Tuberculosis Board completed its eighth success-
ful year. This arrangement has been of mutual advantage to both agencies
in contributing to a better tuberculous control program in Florida. The
nature and extent of the laboratory studies performed in the laboratories
of each hospital are given in Table 12. A total of 45,800 bacteriological
examinations were made for tuberculosis and 3945 cultures of M. tuber-
culosis were tested for drug susceptibilities. The latter information is
helpful to the clinician in the management of his patient. The bac-
teriology laboratory performed a large number of bacteriological and
mycological examinations. In the clinical laboratory sections of the
tuberculosis hospitals, there was also much activity as indicated by the
23,713 hematology, 16,144 chemistry and 5606 urine examinations.

SPECIAL STUDIES
The bureau continued its active program of special studies as listed
in Tables 8 and 9, indicative of the wide variety of projects with which it
was concerned.
The identification of cultures belonging to the Salmonella-arizona
family was performed. A total of 1175 cultures were typed during the
year under review as compared to 823 in the preceding year and 598
during 1961. This information is useful in determining the source of an
enteric infection. Excluding S. typhosa, there were 57 different Salmonel-
la types found in Florida during 1963. There were at least three major
food poisoning outbreaks in Florida due to three different Salmonella
types, viz. montevideo, enteriditis and oranienberg. The bureau par-
ticipated in a nationwide Salmonella surveillance program by furnishing

LABORATORY SERVICES

listings of the Salmonellae typed in the laboratory each week to the
USPHS Communicable Disease Center (CDC) in Atlanta. The ubi-
quitous nature of the Salmonella group is being recorded with the hope
that patterns spread of infections may suggest control methods which are
not readily apparent.
Diarrheal disease studies supported by a contract with the Armed
Forces Epidemiological Board (AFEB) of the U. S. Department of De-
fense were carried out in the Miami laboratory. It was concerned with a
study of shigellosis as a cause of diarrheal disease and the therapeutic and
prophylactic effect of a concomitant lactobacillus infection in the in-
testinal tract on the cause of the shigellosis. Preliminary observations sug-
gest the potentiality of utilizing the marmoset monkey as a test animal
for the study of experimental Shigella infections.
Enterovirus sewage studies were performed in the Jacksonville and
Miami laboratories. Both involved collections of weekly specimens from
sewage systems and examinations for the presence of polio and other
enteroviruses. The Jacksonville laboratory received specimens from Mana-
tee, Hillsborough, Palm Beach, Duval, Leon and Escambia Counties.
The Miami laboratory examines those specimens collected in Dade
County only. Numerous enteroviruses, particularly ECHO and Coxsackie
were found during the summer months. Indications of the presence of
poliovirus Type I was found in the Jacksonville area prior to a Type I
outbreak in August. The statewide project was terminated in December
at the end of the two-year period for which it was planned. The Miami
project will be completed early in 1964. Enterovirus surveillance, based
on poliovirus isolations from sewage systems have become increasingly
less meaningful because of the widespread continuing use of the live oral
polio vaccine in Florida. Since it is impractical to differentiate vaccine
strains from wild virus, sewage isolations have become less dependable
as a system to determine the circulation of wild polioviruses in the
community.
A separate poliovirus surveillance study was completed in Hills-
borough County following the mass feeding of oral trivalent polio vaccine
early in 1962. Rectal swabs were collected at monthly intervals from
children in selected day nurseries. Poliovirus was undetected in the com-
munity for approximately 12 months after the completion of the mass
oral vaccine program but it became detectable after this period.
Fluorescent antibody (FA) examinations for rabies, syphilis serology
and Group A streptococcus grouping have become more or less routine
in the laboratory. However, because this procedure is relatively new, it
remains an area for special studies, particularly as it may apply to other
procedures. For example, the FA procedure for the diagnosis of N. gonor-
rhea in females continued as a special study in the Jacksonville labora-
tory. The local VD and prenatal clinics in Jacksonville cooperated in
supplying appropriate specimens for the study from which there were
preliminary findings to indicate the usefulness of this test. The FA pro-
cedure appeared to be more sensitive and more specific than the cultural
technic. It would lend itself to mailed specimens if clinic personnel were
willing to inoculate the culture media, incubate it overnight and prepare

64 ANNUAL REPORT, 1963

a microscopic smear from the resultant growth. The smear could be
mailed to Jacksonville for subsequent FA examination. Obviously, the
preliminary procedures are somewhat cumbersome for clinics to perform
on a routine basis. It could be used, however, in special situations where
more intensive workup of suspect gonorrhea is indicated.
Studies of rabies in bats in wildlife have been supported by a
USPHS research grant for the past nine years. The current year was the
last of the present grant and the activities consisted mainly of closing out
the grant. Further USPHS support was not requested since the public
health interest in rabies in wildlife would require an experienced biologist
to carry field and laboratory studies and the former one has been trans-
ferred to the Encephalitis Research Center in Tampa. Continued interest
in this problem will be maintained and will largely consist of surveillance
for wildlife rabies as part of the routine laboratory service of the bureau.
Examinations of mosquitoes and tissues collected in the Tampa Bay
area were carried out in Jacksonville until facilities at the Encephalitis
Research Center became available. Collections of mosquitoes were made
during the winter of 1962 and tested for arboviruses in suckling mice in
Jacksonville during the first quarter of 1963. No isolations were made
from these collections.
Late in 1962, funds were obtained from the USPHS in support of a
study to determine the usefulness of the Sabin-Feldman Toxoplasmoses
dye test in the diagnosis of chronic eye disease. During 1963, the dye test
procedure was established in the Jacksonville laboratory and the service
was made available to ophthalmologists and other interested clinicians.
A total of 150 specimens were examined and findings reported. Prelimi-
nary findings seem to indicate that dye test results are difficult to inter-
pret because of the widespread presence of toxoplasmosis dye test anti-
bodies in apparently healthy adults. In addition, the absence of antibodies
may not necessarily rule out Toxoplasma gondii as the etiologic cause of
chronic uveitis and/or chorioretinitis. The fluorescent antibody proce-
dure was also investigated as a diagnostic aide in toxoplasmosis infections.
This study was carried out in cooperation with CDC in Atlanta.
Studies of the unclassified mycobacteria were continued under the
guidance and direction of the Division of Epidemiology. (See Division of
Epidemiology elsewhere in this Report). However, some additional in-
formation regarding the comparison of cultural findings of M. tuberculo-
sis and unclassified mycobacteria by laboratory during 1963 is provided
in Table 11. A total of 42,829 specimens were examined in the state
laboratories. Four per cent were found to be positive for M. tuberculosis
and 1.6 per cent positive for the unclassified mycobacteria. Most interest-
ing was the variation in percentage positive of cultures submitted to labo-
ratories in different areas of Florida. Specimens from patients in the
southern part of the state served by Lantana and Miami laboratories
yielded 4.2 and 4.9 per cent positive M. tuberculosis cultures as compared
to 3.7 and 3.4 per cent positives in Jacksonville and Tallahassee labora-
tories, respectively. Considering isolation rates of unclassified mycobac-
teria, Tallahassee, which served the panhandle area west of Jefferson
County, yielded only 0.7 per cent positives as compared to 1.5 per cent or

LABORATORY SERVICES

greater yields in the remaining state laboratories. No ready explanation
for these differences was apparent. Since uniform cultural procedures
and culture media were made available in all of the laboratories con-
cerned, the apparent differences in isolation rates may be attributed to
other variables.
Limited airborne pollen studies were carried out during 1963 in
order to fill in certain gaps left in a 1961-62 study. Seasonal trends of
three allergenic (ragweed, oak and grass) pollens were determined. Con-
tinuing studies do not appear indicated; this type of study needs to be
done intermittently, possibly at five or 10 year intervals.
The demonstration of a fat soluble toxin in oysters similar to that
which produces paralytic shellfish poisoning on the Pacific Coast of the
United States resulted in special studies being carried out to determine the
nature and extent of this toxin in Florida oysters. A total of 444 samples
were tested and reported to the appropriate CHD submitting samples.
Oyster growing areas were approved only after negative tests were
obtained.

CONSULTATIVE AND EDUCATIONAL SERVICES
Technical and consultative guidance was provided to eight medical
technologists, one pathologist, eight sanitarians and water plant operators,
two classes of student sanitarians and three medical visitors from foreign
lands. High school and college students were provided orientation tours
of the laboratories in cooperation with local hospitals and nearby educa-
tional institutions.
In accordance with an earlier cooperative arrangement between the
Graduate School and the Department of Bacteriology of the University of
Florida, a candidate for the Ph.D. degree was provided with a course
in public health microbiology (BCY650) given in the Jacksonville labora-
tory. This course is open to graduate students interested in a career in
the public health laboratory.
A total of 23 additional clinical laboratories was approved to per-
form standard serological examinations for syphillis for premartial and
prenatal patients. There was a total of 283 approved laboratories as of
the close of 1963.
The bureau carried out the registration of 59 medical laboratories
and assisted the Board of Examiners in the Basic Sciences to license 441
medical technologists and 140 medical technologist directors as provided
by Chapter 483 of the Florida Statutes 1955.
Continuing visits and inspections were made to 26 commercial and
public health dairy laboratories to certify performance of bacteriological
and related tests in accordance with Standard Methods and USPHS
requirements for interstate shipment of milk.
During 1963, the USPHS promulgated a policy of certification of
water laboratories which test drinking water for interstate carriers in
accordance with the 1962 Public Health Service Drinking Water Stan-

66 ANNUAL REPORT, 1963

dards and the Interstate Quarantine Regulations. In accordance with this
policy, triennial certification of the SBH laboratory by the USPHS and
like certification of sublaboratories by the state laboratory are required.
This new responsibility resulted in the inspection and certification of the
drinking water testing section of the Jacksonville laboratory by the
USPHS. In turn, the senior sanitary bacteriologist performed certification
of water testing procedures performed in six regional public health lab-
oratories, five county laboratories and seven municipal water plant
laboratories within the state.
Close technical cooperation was maintained with several federal
laboratories. CDC carried out a technical and administrative program
review of this bureau and made pertinent recommendations as to the
rearrangement of services in order to minimize nonproductive services
and test procedures. Implementation of these recommendations was
initiated and will be carried out subject only to budgetary limitations
and overall SBH policies. The Robert A. Taft Sanitary Engineering
Center performed technical program reviews of the milk and water
testing sections of the Bureau of Laboratories to assure compliance with
the uniform procedures recommended in Standard Methods as published
by the American Public Health Association. The Venereal Disease Re-
search Laboratory of the USPHS reviewed the syphilis serology pro-
cedures in the Jacksonville, Pensacola and Tallahassee laboratories. All
of these reviews were made on invitation from the SBH as part of the
continuing interest in maintaining the highest levels and standards of
proficiency in laboratory procedures. It is on this basis that the bureau
attempted to provide similar consultative guidance to local governmental
and private laboratories within the state.
A total of four members of the laboratory staff took training and
refresher courses in fluorescent antibody procedures, syphilis serology,
toxoplasmosis serology and virology.
Revision 1963 of previously published list of Laboratories approved
for Premarital and Prenatal Serology:
ADDED
Brevard Hospital Laboratory, Melbourne
Doctor's General Hospital Laboratory, 6701 W. Sunrise Boulevard,
Plantation
Duval Medical Center Laboratory, Jacksonville
Fred I. Dorman, M.D., Medical Arts Building, 1417 Lakeland Hills
Boulevard, Lakeland
Eustis Clinic, 201 Magnolia Avenue, Eustis
Hernando County Hospital Laboratory, 100 S. State Road 700,
Brooksville
Drs. Horton and Raulerson, Osceola and 10th Avenue, Okeechobee
Dr. James B. Leonard's Laboratory, 1201 S. Highland Avenue,
Clearwater
Martin General Hospital Laboratory, Stuart

LABORATORY SERVICES

Medical Arts Laboratory, 2321 Espanola Way, Melbourne
1333 Medical Laboratory, 1333 S. Miami Avenue, Miami
Mt. Dora Clinic, Mt. Dora
Northwest Hospital Laboratory, 1060 N.W. 19th Street, Miami
Pembroke Medical Laboratory, 6449 Pembroke Road, West Hollywood
Dr. Phillips' Memorial Hospital, 2500 W. Church Street, Orlando
St. Joseph's Hospital Laboratory, Port Charlotte
South Miami Hospital Laboratory, South Dixie Highway at 62nd
Avenue, Miami
Darrell L. Vaughn, M.D., The Cove, Deerfield
Venice Hospital Laboratory, Venice
George E. Weems Memorial Hospital Laboratory, Apalachicola
Winter Park Medical Laboratory, 157 N. Lakemont Avenue, Winter Park
G. Pierce Wood Memorial Hospital Laboratory, Arcadia
REMOVED
Anderson Medical Clinic, 61/2 2nd Street, Hialeah (Deceased)
Clermont Clinical Laboratory, 676 Montrose, Clermont
Luverne Domeier, M.D., 149-1st Ave. N., St. Petersburg
Lake Alfred Medical Center, Box 1295, Lake Alfred
Little River Medical Laboratory, 8340 N.E. 2nd Avenue, Miami
Mercywood Hospital Laboratory, US 1 South Federal Highway,
Hollywood
North Florida Medical Laboratories, 1648 San Marco Boulevard,
Jacksonville

TABLE 8

EXAMINATIONS PERFORMED BY THE STATE BOARD OF HEALTH LABORATORIES, FLORIDA, 1963

Jackson- West Palm Pinellas Franklin Jefferson
Examination ville Tampa Miami Pensacola Tallahassee Orlando Beach County County County TOTAL

GRAND TOTALS ................. 935,407 642,612 577,260 158,529 139,714 170,757 132,523 45,781 3,936 5,462 2,811,981

SEROLOGY
Syphilis ..........................
Agglutinated & related tests........
Blood typing (Rh) .................
DIAGNOSTIC BACTERIOLOGY
Diphtheria & associated infections...
Tuberculosis .................. ...
G.C.- Smear......................
Culture. ...................
Enteric..........................
Blood culture ...........
Leptospirosis......................
Miscellaneous.. ...........
SANITARY BACTERIOLOGY
Dairy products ..................
Water, drinking & pools..........
Pollution surveys ................
Food (sanitary quality tests).......
Food poisoning ..................
Utensils ........... ......
DENTAL CARIES BACTERIOLOGY
PARASITOLOGY
Intestinal parasites ...............
Malaria........................
MYCOLOGY......................
CHEMISTRY
Blood ...........................
Spinal fluid..................... .
U rine........................
Toxicology & narcotics ............
Drugs & cosmetics...............
W ater ................... ........
Other............................

397,881
1,903
4,690

8,731
84,197
16,810
487
78,546
536
598
85,503
20,370
28,696
18,400
2,735
792
212
5,832

50,405
36
15,642

11,507
814

1,880
65
3,309
2,619

382,992
181
4,340

1,743

23,700
15,931
61,010

15,653

45,474
39,672
13,810
180
187

23,949
38
54

9,428

372,882
963
3,154
1,725
19,123
21,214
4,751
17,520
32

3,951i
24,828
27,240
11,535
1,197
960
6

11,936
20
207
980
99
39
1,148

7262
7,656

87,153
31
1,678
32

5,610
2,788
9,520
144

14,262
11,450
5,585
105
168
..........

12,285

6,696
6
. .. . .
... .

56,951
73
704
2
7,010
10,384
2,313
24,782
88
. .......3i6

13,872
11,134
575
224
12

9,873
6
18
1,177
20

.........::::::::::.
.. ..

59,829
80
446

190

2,440
31,696
296

14,779

11,070
19,606
9,790
336
622
1,247

11,975
606

413
13

53,850
34
981

15
9,859
744

1,072
376

2,484

22,308
25,560
7,935
30

4,345
12
141
2,559
1
217

12,612
19,572
13,290
35

155
117

984
2,140
812

.. ... 1,411,538
34 3,299
195 16.188

3,378

. . ..... ....... 36
.......... .......... 2

1,610
207

12,438
120,189
80,902
26,270
224,146
1,472
598
126,684

164,796
183,914
83,060
5,444
2,764
1,652
5,832
124,804
114
16,668
34,370
940
476
3,028
65
3,726
10,392

TABLE 8 (Continued)

EXAMINATIONS PERFORMED BY THE STATE BOARD OF HEALTH LABORATORIES, FLORIDA, 1963

Jackson- West Palm Pinellas Franklin Jefferson
Examination ville Tampa Miami Pensacola Tallahassee Orlando Beach County County County TOTAL
RADIOLOGICAL CHEMISTRY
Water (ground & precipitation)..... ........ ........................................ 1,247 ........................................ 1,247
Air.............................. ... 2,714 ........................................ 2,714
Milk (Srs,Cei,I, etc.).............................. ....... ................ 78....................................... 78
Other ... .............246 .......... .......... .................... 246
VETERINARY PUBLIC HEALTH
Leptospirosis...................... 460 .......... ........... ................. .......... ......... ........... .................... 460
Other ....E ..................... 706 .... ..................................................................................... 706
VIRAL SEROLOGY
Hemagglutination-inhibition ....... 44 .......... ........ .......... ......... .......... ........ 44
Neutralizations .................... 1,080 ........................................................................................ 1,080
Complement-fixation ............. 28,64 .............. ..................... ............................................. 28,364
VIRAL ISOLATIONS (except rabies). 8,947 .......... 1,278 ........ .................. 10,225
Rabies-microscopic ............... 2,162 1,768 658 396 180 738 ...... .......................... 5,902
fluorescent antibody....... 6,453 2,502 ................... .......................................................... 8,955
mouse inoculation ......... 880 ....................................................................................... 880
SPECIAL PROJECTS
Salmonella typing ................ 7,050 ....................................................................................... 7,050
Diarrheal disease studies (AFEB).... .......... .......... 16,986 .......... ..........................................................16,986
Enterovirus sewage studies ......... 10,377 ......... 24,910 ..................................... ... ............ 35,287
Polio surveillance .................. 3,568 ........................................3.................................................. 568
Flourescent antibody-gonococcus. .. 10,630 ................. ............. ......... ............... 10,630
Wild animal (rabies) ............... 954 ............ ............... ...................................................... 954
Arthropod-borne virus isolations
Mosquitoes ..................... 605 .................................... 605
Toxoplasmosis dye test............. 2,250 .......................................... ..................... 2,250
Unclassified mycobacteria .......... 2,564 .............. ................... .......................................... 2,564
Airborne pollen studies.............. 2,009 ...................................................... .... .......... .. ...... ....... 2,009
Toxin in oysters ................... 3,108 .......... .......... .......... .......... ......... ................... .......... ......... 3,108

70 ANNUAL REPORT, 1963

TABLE 9

SPECIMENS SUBMITTED TO STATE BOARD OF HEALTH
LABORATORIES FOR EXAMINATIONS BY FINDINGS,
FLORIDA, 1963

Number of Specimens

Positive Specimens
EXAMINATION
Negative Unsat. Total
One or Positive
More for
Positive Findings
Findings Indicated
SEROLOGY
Syphilis............................. 40,158 ......... 680,777 10,815 731,750
Agglutinated & related tests........... 494 .......... 2,311 131 2,936
Typhoid ............... ...... ........... 128 ............................
Typhus...................... ......... 2 ............................
Brucellosis................. .. ........ .... 19 ...............................
Tularemia....................... ........ .. 8 ................... ........
Heterophile...................... .. ........ 363 ...........................
O ther.......................... .. .. 11 .. ... ... .. ... .. ..
Blood typher g (Rh)........................... ....... ..................... 15,595
Blood typing (Rh) ................ 15,595
DIAGNOSTIC BACTERIOLOGY
Diphtheria & associated infections..... 1,974 ............ 3.258 1 5,233
C. diphtheria ..................... .. 65 ......... 65
Vincents .................. ....... ........ 47 ...........
Streptococci ................... .. ......... 901 ......... ....
Other........... ....... ...... .. .......... ..... .. ...... .. .
Tuberculosis.............. ...... 2,491 .......... 40,081 2,485 45,057
Sputum ........................... ......... 2,228 ................
Aerosol.................... ....... ......... 149 ..............
Urine .................................... 12 ..............
Gastric ......................... .......... 65 ..............
Other fluids & exudates ............. ... 30.... ....
Animal inoculations (G.P.)....... ....... ...................... 6
Gonorrhea-Smears ................. 23,042 ......... 17,409 239 40,690
Intracellular Gram negative diplococci .......... 6,254 ..............................
Extracellular Gram negative diplococci ......... 353 .............................
Trichomonads................................ 4,035 ............ ....
Yeasts ................................ 2,114 ....................
Vincents organisms................ ........ 285 ..... .........
Many pus cells ........................... 11,228 ........ .. ..
Gonorrhea-Cultures.................. 1,307 .......... 23,656 426 25,389
Enteric infections .................... 1,275 ......... 52,849 115 4,239
S. typhosa ............... ........ ...... 105 ............... ...... ....
Other Salmonella .................. .......... 867 ..... .........
Shigella (flexneri & sonnei)......... .......... 164 ....... ..... ...
O ther............ ............... ....... 82 ............
Blood cultures....................... 25 ....... .159 2 186
Brucella ................. ................. ........... ..................
Other. .................... .......... .. 0...... 30 .......
Leptospirosis .................. ... 7 .......... 590 1 598
Miscellaneous ...................... 12,193 .......... 5,281 48 17,522
Darkfield-T. pallidum........................ 64 ............................
Chancroid-Ducrey's...................... 4 .............................
Granuloma-Donovan bodies........ .......... 12 ... ......................
Gonococcus in eye ................ .......... 16 ............................
Other eye smears.................. .......... 129 ............................
Other eye cultures................. .......... 64 ..............
Urine cultures ............................... 901 ..............
Other fluids & exudates............. ........... 4,225 ............................
Mycological examinations...................... 1,680 .......... ..................
Organisms for identification ...... .......... 2,129 ............................
Sensitivity testing ................. ......... 889 .............................
Other examinations ................ .......... 1,725 ....................
Miscellaneous special services........ ........ 855 ................. .. ..
SANITARY BACTERIOLOGY
Dairy products ................................ .................... .......... 27,485
Water, drinking & pools............. .......... .......... ......... ............ 91,957
W ater, solution surveys .............. .......... ......... .......... ...... .... 16,689
Foods (sanitary quality tests)......... .......... .......... .......... ........ 1,229
Food poisoning................................ ..................... ........... 439
Utensil swabs ................... .. .. ....... ..................... ....... 1,653

LABORATORY SERVICES 71

TABLE 9 (Continued)

SPECIMENS SUBMITTED TO STATE BOARD OF HEALTH
LABORATORIES FOR EXAMINATIONS BY FINDINGS,

FLORIDA, 1963

Number of Specimens

Positive Specimens
EXAMINATION

Negative Unsat. Total
One or Positive
More for
Positive Findings
Findings Indicated

DENTAL CARIES BACTERIOLOGY..
PARASITOLOGY
Intestinal parasites ..................
Hookworm............ .....
Ascaris ................. ........
Enterobius...... ...........
Trichuria ..............
Other helminths ...................
E. histolytica......................
Nonpathogenic amoeba.............
Flagellates .....................
Other.........................
M alaria.................... ........
CHEMISTRY
Blood.
Blood.................. ............
Spinal fluid. ................ .....
Urine... ...........
Water... .
Toxicology & narcotics...............
Drugs & cosmetics...................
Other ................
Radiological chemistry
Water (ground & precipitation) ......
Air............................
Milk (Srgo, Ceia8, ILs, etc.)..........
Other .........................
VETERINARY PUBLIC HEALTH
Leptospirosis ............ ....
Other.
VIRAL SEROLOGY
Hemagglutination-inhibition...........
Neutralizations......................
Complement-fixation .................
VIRAL ISOLATIONS (except rabies)....
Rabies (microscopic) .................
Dog .......................... .
Cat......................... .
Fox .......................... .
H orse ............................
Raccoon..........................
Skunk.................. .........
Bat...........................
Wildcat ....... .............
Mouse inoculations..................
SPECIAL PROJECTS
Salmonella typing ...................
Diarrheal disease studies (AFEB)......
Enterovirus sewage studies...........
Polio surveillance ...................
Fluorescent antibody-gonococcus.....
Wild animal (rabies).................
Arthropod-borne virus isolations
Mosquitoes ....................
Toxoplasmosis dye test..............
Unclassified mycobacteria ............
Airborne pollen studies..............
Toxin in oysters.....................

21,344

6,144
5,481
3,703
1,883
86
134
4,407
3,008
33

103,460

57

1,432

3

12 .......... 93 10
36 ......... 62 1

93 ......... 2,854 18
.......... 3 ....................
.......... 1 .......... ..........
.......... 3 .......... ..........
.......... 1 .......... ..........
.......... 65 .......... ..........
.......... 5 .......... ..........
... ....... 13 .......... ..........
.......... 2 .......... .........

8,053
126,236

60
32,794
542
476
1,292
1,710
7
10,392
685
1,058
241
160
115
99
12
85
6,944
1,508
2,965

880

1,175
3,793
12,988
626
2,126
37
359
150
124
75
444

TOTAL....................................... ... .................... 1,291,864

..... ... ....l~iijjjii

72 ANNUAL REPORT, 1963

TABLE 10

STATE BOARD OF HEALTH LABORATORIES, FLORIDA
VIRAL AND RICKETTSIAL DIAGNOSTIC FINDINGS, 1963

Tests Positive Negative Total

Lymphocytic choriomeningitis ........................ 1 180 181
Mumps. ............................ ........ ...... 26 332 358
Eastern encephalomyelitis................................ ..... 317 317
Western encephalomyelitis ........................................ 262 262
St. Louis encephalitis ................... ....6.... 6 249 255
Herpes simplex ............. ...................... 3 63 66
Poliovirus type 1..................................... 25 322 347
Poliovirus type 2 ................... .................1 346 347
Poliovirus type 3................... .................. 2 344 346
Measles....... .................................... 2 25 27
Vaccinia-variola ............................ ......... ............ 14 14
M urine typhus.......... .............................. 32 82
Rickettsialpox-Rocky Mt. spotted fever ............... ............ 53 53
Qfever ............. ................. ......... ........ 29 29
Influenza A................. .................. 30 116 146
Influenza B.......................................... ............ 157 157
Parainfluenza 1 & 3.................................. ............ 145 145
Respiratory syncytial ................................ ...... 2 2
Psittacosis-LGV ......... ....................... 1 67 68
Adenovirus............... ......................... .......... 151 151
ECHO types 3, 4, 6, 7, 8, and 9........................ 20 320 340
Coxsackie types A9 and B6 ........................... 9 339 348
Other-Undetermined viral agents) .................... 6 143 149
TOTALS .................. ........ ....... 132 4,008 4,140*

* 1221 Patients examined.

TABLE 11

COMPARISON OF CULTURAL FINDINGS FOR M.
TUBERCULOSIS AND UNCLASSIFIED MYCOBACTERIA
BY STATE BOARD OF HEALTH LABORATORY,
FLORIDA, 1963

Positive M. Positive Unclassified
Specimens tuberculosis Mycobacteria
Laboratory Examined ------ ---
Number Per cent Number Per Cent
Jacksonville................... ........ 0,064 1,141 3.7 467 1.5
Tallahassee ........................ 2,49 88 3.4 17 0.7
Lantana............. .... ... ..... 2,950 126 4.2 76 2.5
Miami............................ 7,266 361 4.9 114 1.5
TOTAL....................... 42,829 1,716 4.0 674 1.6

LABORATORY SERVICES

TABLE 12

EXAMINATIONS PERFORMED IN TUBERCULOSIS
HOSPITAL LABORATORIES*, FLORIDA, 1963

Tampa Lantana** Tallahassee** Totals
Totals-excluding special studies.......... 48,080 30,429 26,959 105,468
Tuberculosis
Diagnostic ........................... 18,378 14,750 12,672 45,800
Drug susceptibility .................... 2,166 858 921 3,945
Mycology .............................. 499 102 127 728
Miscellaneous bacteriology .............. 1,523 1,873 4,978 8,374
Hematology............................. 11,553 6,644 5,516 23,713
Chemistry ............................. 10,071 4,580 1.493 16,144
Urine analysis.......................... 3,103 1,595 908 5,606
Other ............. ....... .......... 787 27 344 1,158

Special studies and reference tests:
Unclassified mycobacteria (human) ..... 5,461
Tween 80 degradation tests............. 259
Unclassified mycobacteria (soil)........ 164
Silica mouse inoculation studies......... 65
BCG immunization studies ............. 100
Other limited studies................... 471

Operated under direction of Bureau of Laboratories; budgetarily supported by State Tubercu-
losis board.
** Combined regional public health and hospital laboratories.

74 ANNUAL REPORT, 1963

BUREAU OF LOCAL HEALTH SERVICES

L. L. Parks, M.D., M.P.H.
Director
Hubert U. King, M.D.
Assistant Director
The major responsibilities and functions of the bureau remained es-
sentially the same during 1963 as in the past. Foremost among these
responsibilities was the continued supervision of the 67 county health
departments (CHD) and the coordination of their public health
programs.
The bureau is administered by a director and assistant director with
the assistance of a small clerical staff. Included are the Division of Sani-
tation, Division of Nutrition, Accident Prevention Program and the Civil
Defense-Health Mobilization Program. In addition, the bureau has a
staff of consultants who provide clerical consultation to the counties.
The Division of Public Health Nursing, formerly a part of the bureau,
was detached during the year and placed directly under the State Health
Officer for an extensive evaluation of this program.
Recruitment of well qualified personnel continues to be of vital
concern. Recruitment of professional workers is still a major problem
although salary levels have improved, more state and local funds are
available, and an active recruitment program has been pursued.
The bureau has played an active role in providing and stimulating
both in-service and postgraduate training for professional staff members
in cooperation with the Coordinator of Training and other bureaus and
divisions. Orientation of new health officers and the training course for
sanitarians are a direct responsibility.
Major activities include consultation on general administrative
problems; assistance to county health officers in the preparation of bud-
gets and budget control; assistance in the recruitment of personnel, pro-
cessing of personnel papers and training of new employees; assistance in
local program planning and evaluation; and coordination of programs
over the state in cooperation with other bureaus and local staffs.
CLERICAL SECTION
The activities of this staff were limited due to staff vacancies and
the assignment of one consultant full-time to the Civil Defense-Health
Mobilization Program. Included were consultation to CHD staffs in mat-
ters relating to the processing of personnel papers; financial records and
procedures including budgets, bookkeeping, etc.; general records proce-
dures; vital statistics; and orientation of new clerical staff members.
Special assignments included assistance in the Civil Defense Program;
assistance in the establishment of records and office procedures for the
Encephalitis Research Center and assistance in the establishment of one
Mental Health Guidance Center. Nineteen counties were visited to give
consultation on clerical procedures during the year. During 1963, there

LOCAL HEALTH SERVICES

were some 310 clerical personnel on CHD staffs in addition to 50
clerical workers on special programs.
COUNTY HEALTH DEPARTMENTS
No major change was made in the organizational pattern of county
health units during the year. Each of the 67 counties had a CHD pro-
viding basic public health services to every part of the state. There were
25 single county departments; nine bi-county units; and eight tri-county
units for a total of 42 county health units.
In addition to providing basic services such as immunizations and
communicable disease control, maternal and child health programs,
school health programs, health education, chronic disease programs,
environmental sanitation programs, maintenance of vital records, and
laboratory services 1963 saw the expansion of the immunization pro-
gram to include intensive follow-up of newborn children; significant
expansion of the home nursing care and chronic illness and aging pro-
grams; intensification of services and programs in environmental health
relating to air and water pollution, industrial health, accident prevention,
etc.; civil defense program activities increased with inventory of some 35
civil defense emergency hospitals and increased interest in training
courses; and continued attention to the health and welfare problems
of agricultural migrant workers and Cuban refugees.
Some 68 physicians were employed full-time in CHDs during the
year. Four local directors resigned and one director transferred, and four
new directors appointed. At the year's end there were three vacancies for
local directors in the state. Five public health residents received approved
training during the year. One health officer completed postgraduate
training leading to the Master of Public Health Degree.
Staffing and Financing: (See reports of Bureau of Finance and Ac-
counts and Division of Personnel elsewhere in this Report). As of De-
cember 31, 1963, there were 1761 employees on the staff of CHDs and
budgets totalled $10,818,523 for fiscal year 1963-64. Of this amount,
$7,405,777 was from local contributions; $2,174,397 from state funds;
$931,000 from federal funds; and $307,349 came from the CHD bud-
geted reserve. The 1963 Legislature approved an increase of $750,000
for the biennium 1963-65 or $375,000 per year. This increase in state
funds, the first in several years, helped to alleviate the increasing prob-
lem of financing CHD program growth.
Health Center Construction: New headquarters centers were com-
pleted in the following counties: at Ocala (Marion); Ft. Pierce (St.
Lucie); and Cross City (Dixie). Auxiliary health centers were also com-
pleted or obtained at Interlachen (Putnam); Boca Grande (Lee); and
Chattahoochee (Gadsden). Construction was begun on the new head-
quarters center for Gadsden County at Quincy. In addition, plans were
approved for the construction of new headquarters centers at Rockledge
(Brevard) and Ft. Lauderdale (Broward). Auxiliary center plans were
approved for new health centers at Melbourne and Titusville (Brevard)
and Yulee (Nassau). Additions to existing health centers were approved
for the Alachua CHD and Manatee CHD.

76 ANNUAL REPORT, 1963

HIGHLIGHTS OF LOCAL PROGRAMS
Table 14 will give a complete statistical report of CHD activities
indicating the number and type of various services provided by CHDs.
However, the following summary will present some of the more unusual
or outstanding program developments in the CHDs:
Alachua In July the Mental Health Division of the Alachua
CHD began a Rotating Internship Program in cooperation with the Uni-
versity of Florida Health Center and University of Florida Infirmary
(Psychology Service) supported by a grant obtained by the Health Cen-
ter. This is in addition to the joint program of training for psychology
students which has been in effect for the past several years ... The Board
of County Commissioners appropriated $50,000 in their 1963-64 budget
for construction of an annex to the rear of the present health department
building which will permit additional space for the Mental Health and
Public Health Nursing Sections. The mental health facilities are planned
to function as part of a "Community Mental Health Center" which will
operate cooperatively with the Psychiatric Unit of the Alachua General
Hospital, now under construction ... The Child Spacing Program of the
CHD successfully entered its second year of operation. Patients are rou-
tinely given a pelvic examination and Pap smear. The program has been
well received by patients and private physicians and it is expected that
through the assistance of local physicians the program will be expanded
during the coming year.
Baker Made significant progress in the area of environmental
sanitation with addition of a sewage treatment plant at the Olustee
National Park; improvement of school cafeterias and sewage disposal
systems; and improved garbage disposal services at Glen St. Mary .
With the assistance of one of the local doctors incorporated cytology and
child spacing programs into the maternal health program Reports
great success in the communitywide oral polio vaccine program with
95 per cent of the population immunized with Type I vaccine... Began
dental screening and treatment in cooperation with State Board of Health
(SBH) Bureau of Dental Health on the first three grades in the schools
in addition to selected high school students ... In cooperation with school
officials conducted health education programs on venereal disease in
selected schools and on the effects of smoking among high school students
. The home nursing program continues to develop with good com-
munity support Worked with a group of women volunteers in pro-
viding assistance and educational programs for low income families.
Brevard The CHD broke through its "space barrier" in 1963 with
the approval of three new health centers to meet the skyrocketing needs.
Within the next two years there will be three well equipped health
centers at Rockledge, Titusville and Melbourne, at a cost of over
$500,000. Land has been donated for the Rockledge Center, which will
cost about $300,000. The Melbourne and Titusville Centers will cost
about $125,000 each and it is expected that land will be donated for them
also. The lack of adequate space entered into many of the CHD proj-
ects for the year, slowing some, deferring others until a location for
equipment and people could be found. The mental health program is an

LOCAL HEALTH SERVICES

example. There was no place to put personnel. The School Board pro-
vided space at the old Brevard Junior College building and offices in that
building have been remodeled. The mental health staff now consists of
two psychologists, a clinical psychiatric worker, a mental health worker
and two secretaries. At present, program activities are limited to children.
Water came under considerable surveillance by the CHD during the
year. As a result of thorough sampling of the Indian River, its eastern
half is now approved for swimming and oyster harvesting for the first
time. The CHD is now awaiting approval from the SBH for the river's
western half. When SBH approval is secured, it is expected that an entire
new industry for Brevard County will be developed. To accomplish the
systematic sampling an extra man was employed and a boat was pur-
chased for his use. With the construction of new facilities, it is expected
that laboratory samples, now being run in Jacksonville by the SBH, will
be done locally ... The CHD took a long stride in 1963 toward lessening
the problem of sewage disposal. A sewage control program was begun
soon after the State Legislature passed an act permitting the program.
Large area franchises will be available to investors in sewage treatment
facilities. The county has already issued several such franchises. There are
presently about 30 sewage treatment plants in the county and it is ex-
pected that eventually this number will be reduced to 10 or less. Fewer
and larger plants will be much more efficient and better regulated as well
as more profitable for investors. Within four years, sewage facilities should
be available for every foot of land suitable for home building in Brevard
County. Regulations from the CHD governing sewage plant operation
are now in the hands of the County Commissioners and are expected to
be acted on early in 1964.
Broward The County Commissioners approved a $270,000 build-
ing program which will provide a new CHD building to be located in
southwest Fort Lauderdale. All first grade children were offered skin tests
for tuberculosis. Where the tuberculosis rate appeared unusually high in a
given school district, intense casefinding was pursued in that area. X-ray
services have been doubled with the purchase of a second 70mm X-ray
unit. With the two X-ray machines, it is expected that the number of
chest X rays taken will be approximately 100,000 a year... An intensive
survey of first grade children in low socioeconomic areas and in control
areas was conducted to determine the extent of intestinal parasite infesta-
tion in the county Broward County's first community psychiatrist
began his duties during the year. Working under the guidance of the
psychiatrists in the community in cooperation with the CHD, he is work-
ing with the two main hospital districts and the Henderson Clinic to
provide care for indigent patients For the past 10 years the CHD
has been advocating better garbage and rubbish disposal in the com-
munity. During 1963 the Board of County Commissioners made applica-
tion for assistance through the Federal Public Works Program for the
construction of three incinerators in the county. Approval was granted
for construction of two 300-ton per day incinerators at a cost of $2.5 mil-
lion. These modern incinerators will serve several small municipali-
ties as well as unincorporated areas of the county. Several undesirable
dumps will be eliminated.

78 ANNUAL REPORT, 1963

Collier The Visiting Nursing Program operated by the CHD,
which began in the Naples area in 1962 at a slow pace, gained significant
momentum during 1963 and is now accepted by the community as an
essential service X-ray equipment costing some $2000 was donated
to the CHD by the Collier County Tuberculosis and Health Association
. Plans were completed to do routine serological tests for syphilis and
chest X rays on all prisoners confined in the county jail.
Dade The Metropolitan Dade County Commission approved the
construction of two new health centers, the North Miami and Miami
Beach Health Centers. The commission also adopted a Pollution
Control Ordinance creating a Pollution Control Board with provision for
a staff of professional workers. A Pollution Control Section will be estab-
lished as part of the organization of the Dade County Department of
Public Health (CDPH) with the Pollution Control Officer being ap-
pointed by the County Manager ... Approximately 15,000 children from
55 public schools were examined during the "crash program" from Octo-
ber-December. Under the direction of the CDPH, physical examinations
were provided for all first and seventh grade children and those screened
from other grades who were unable to receive this service through a
private physician. Follow-up of defects will be done by the public health
nursing staff The U.S. Public Health Service (USPHS) awarded a
grant of $150,000 to the University of Miami School of Medicine to in-
vestigate the use and effects of insecticides in Dade County. The CDPH
will assist in this study and conduct the epidemiological studies The
CDPH was awarded $69,574 by the USPHS for a comprehensive health
care project to improve health conditions of migrant farm workers and
their families. Four clinic centers will be established in the farming areas
of the county to carry clinical, nursing and sanitation services to the
migrant, rather than offering these services at inaccessible or distant
points An intensive program, made possible by the USPHS Vaccina-
tion Assistance Program, is being developed to promote immunizations
for infants and other preschool children The CDPH assumed total
responsibility for medical aspects of the Conservation of Hearing Pro-
gram. Qualified audiometrists from the CDPH conducted screening
examinations in the schools and promoted effective follow-up of defects
through close cooperation with the School of Medicine, Jackson Me-
morial Hospital, local school officials, and private ear, eye, nose and
throat physicians. Intensive health education programs for Cuban
refugees continued and have been well received. Directed by the CDPH
with active participation by voluntary groups and Cuban physicians, the
programs have focused on such topics as heart disease, cancer, diabetes,
etc.... A total of 136 Miccosukee Indians received a variety of screening
tests during a two-day clinic provided by the CDPH, USPHS, SBH and
U.S. Bureau of Indian Affairs. Intensive follow-up of defects and correc-
tion was provided where indicated The CDPH conducted a "seat
belt campaign" for its employees. Some 346 belts were purchased by
employees.
Escambia A survey of all dental and medical X-ray equipment
was made during the year. Many of these machines did not have ade-
quate collimation or filtration. A resurvey of dental machines showed that

LOCAL HEALTH SERVICES

all machines had been adjusted to conform to SBH recommendations...
The CHD, at a cost of some $6500, purchased radio communication
equipment for the sanitation staff. This provides direct radio communi-
cation between all sanitarians and the office making the program highly
flexible with more rapid and efficient service to the public ... During the
1963 legislative session, a special local act for Escambia County was passed
covering the inspection of all natural gas and liquefied petroleum gas
installations. The Board of County Commissioners put the program into
effect in October with supervision of the program being the responsibility
of the CHD. Thereby all inspection services of the county-plumbing,
electrical, gas installations and environmental sanitation are now under
the direction of the CHD The planned parenthood program of the
CHD has been in operation one year. Patients counseled and cared for
are the indigent or semi-indigent who cannot afford private care. Initial
contact is usually made through the maternity and well baby clinics. Some
are referred by the nursing staff. At the close of the year, some 270
patients were registered in this clinic. Over 22,500 units of medicine were
dispensed. The number of patients seen in the clinic has been steadily
increasing each month.
Flagler The home nursing program gained momentum during the
year The dental program continued to render needed services in the
county. This county shares a dental preceptor and dental assistant with
Putnam County The mental health program was given added atten-
tion with the assignment of another part-time mental health worker to
the unit.
Gadsden After 28 years in inadequate and cramped quarters,
construction was begun on a new $97,500 health center at Quincy which
will serve as headquarters for the CHD staff. New quarters were secured
at Havana for the auxiliary center there last year and the auxiliary
quarters at Chattahoochee have been remodeled Organization of
the home nursing care program was completed and a new public health
nurse was added to the staff ... During the latter part of the year a local
physician was employed on part-time basis to assist the health officer
in the clinical program During the summer in connection with the
SBH Summer Student Training Program, a home economics student and
physician were assigned to the county to study the nutritional status and
needs of prenatal patients .. A study of the reasons for school "drop-
outs" was begun by the summer students which has been continued by
the regular staff Increased emphasis was placed on the planned
parenthood program.
Highlands-Glades-Hendry Through a Maternal and Child Health
(MCH) grant, a nutritionist was assigned to this health unit on a special
project to study the nutritional needs of a rural community. Objectives
of the program are to determine community needs in this area; to estab-
lish a baseline of the existing nutritional status of its citizens; to explore
ways of meeting the needs; and to evaluate the effectiveness of such a
program in a predominantly rural area. Highlands CHD Construction
was begun in December 1963 on new health department quarters to be
located in the new courthouse annex which is to cost some $179,000

80 ANNUAL REPORT, 1963

... Conducted an intestinal parasite survey in selected areas with follow-
up and educational programs directed at the families in these areas. The
home nursing care program is progressing slowly but it is felt community
interest is increasing.
Hillsborough Because of the outbreak of viral encephalitis in the
Tampa Bay area in 1962, the CHD conducted an extensive community
education program for the eradication of mosquitoes. Known as "Fite the
Bite" program, every avenue of public education was used radio; TV;
newspapers; information to employee groups, civic clubs, churches,
schools, etc.; bumper stickers; fliers were distributed through the CHD,
food stores, and various other businesses; employee bulletins and church
bulletins carried educational material; the medical and dental societies
pledged their support and distributed fliers Continued the infant
immunization program with an immunization reminder card system using
birth certificates to secure basic information Working with the SBH
Heart Disease Control Program staff completed a survey on the incidence
of acute rheumatic fever and acute glomerulonephritis; collected urines
for 5-methoxy tryptamine survey on rheumatic fever cases; and began
a rheumatic fever incidence survey in high schools ... Assisted the En-
cephalitis Research Center in clinical viral surveillance in the county ...
As a participating agency in the program for rehabilitation of stroke
patients at the county hospital proved the efficacy of rehabilitation in that
64 per cent of the patients admitted returned home ambulatory as com-
pared with 32 per cent in 1962. Follow-up rehabilitation nursing services
in the home were provided by the CHD.
Jefferson The Demonstration Health Profile Screening Program
was begun by the CHD in February. This long awaited program has been
in the planning stages for several years and is a cooperative undertaking
between the CHD, local physicians, Division of Chronic Diseases of the
SBH and Healthways, Inc. Stated objectives of the program are to offer
multiple health screening tests to the public; refer positive screenees to
the family physician; and to promote health education and encourage
regular health examinations. Included among the procedures are history;
height and weight; blood pressure; test for venereal disease, blood sugar
and cholesterol; visual testing; tonometery: hearing test; hemoglobin;
urinalysis; feces for intestinal parasites and blood; chest X ray: tuberculin
skin test; electrocardiogram; and Pap smear. Even though the program
has only been in operation a short while, a number of physical defects
have been discovered and referred for treatment.
Lee The staff of the CHD spent a great deal of time on the civil
defense program during the year. Medical self-help courses were taught
to various community groups by members of the CHD staff. The County
Commissioners provided space for the storage of a Civil Defense Emer-
gency Hospital. Blueprints of five large buildings in various parts of the
county were made and plans were laid for the possible use of these build-
ings as hospital sites in a civil defense emergency. The countywide disaster
plan for civil defense was completed with the exception of minor details.
The director of the CHD wrote a disaster plan for the local hospital for
emergencies other than civil defense or hurricanes With the support

LOCAL HEALTH SERVICES 81

of the local medical society, a program to develop stronger regulations
for stray dogs and the registration and inoculation of these animals was
planned. Such plans should lead to a more effective rabies control pro-
gram ... The CHD held two mass 70mm X ray clinics during the year.
S.. Pollution of area waters continued to be of concern to the CHD staff.
Ft. Myers is constructing a secondary sewage treatment plant which
should materially reduce pollution of the Caloosahatchee River.
Manatee Plans were approved for the addition of a new wing to
the present CHD building. Construction of this wing will increase the
present 4500 to 6500 square feet at a cost of $20,000. New offices for the
director, mental health worker, sanitation director, regional sanitary
engineer and health educator will be provided. There will also be a new
office for sanitation, new library and conference room, water-testing
laboratory, equipment room and interviewing room Bradenton be-
came a seaport this year. A fruit company is operating a small fleet of
boats between Mexico and Bradenton. The CHD will cooperate with the
USPHS in this activity ... Operating under a special local act the Mana-
tee CHD was designated to administer a well drilling ordinance. The
director of the CHD was approved chairman of the county board for
this program Manatee County has obtained approval and Federal
assistance to dam the Manatee River. The project will create a reservoir
from which a system of pipelines will supply water to the entire county.
. The Manatee CHD and Manatee County Medical Society sponsored
a community oral polio vaccination program the latter part of 1962 and
early 1963. Type I vaccine was given to 47,395 persons; Type II to
42,965; and Type III to 29,130.
Monroe Among important program developments in the county
was a dental survey conducted by the CHD with assistance of the dental
society. The first, third and fifth grades in all schools were examined.
Fluoridation of the community water supply also began this year ... As
a result of long experience with the naval establishments in the county,
the CHD took in stride the increased responsibilities created by military
activities due to the Cuban situation Much time was spent on the
environmental health program especially relating to sewage disposal. It is
felt that significant progress has been made in this program The
public health nurses have been taking the training courses for home
nursing care which will prepare the staff for the development of a
home nursing program Land was donated at Marathon next to the
hospital for construction of an auxiliary health center Discussions
were held with interested citizens in an attempt to develop a good mental
health program in the community.
Nassau Construction of a new auxiliary health clinic for Yulee
was approved by the Board of County Commissioners. The new quarters
will be housed in a community building which will cost $22,000. The
building will be conveniently located and adequate space will be provided
for the CHD staff. Tentative plans are under consideration for similar
quarters at Hilliard The dental trailer of the SBH visited the county
from May-December. Some 1194 children received dental care during this
period The CHD staff actively participated in securing, organizing

82 ANNUAL REPORT, 1963

and giving oral polio vaccine in December. Seven clinics were estab-
lished which gave the vaccine to some 12,822 people out of a population
of 19,000. Follow-up clinics were held at the CHD. Local doctors, nurses,
school people, civic clubs and others cooperated in the program to make
it a success ... Cooperating with civil defense, a medical self-help course
was presented to the emergency sheriff's platoon in a "crash" program.
Two eight-hour sessions were held. Because of widely differing back-
grounds in education and experience of students it was felt that this
course was not too successful A "Gray Lady" (Red Cross) program
was begun in a second school in the county. These workers man school
health clinics. Two Future Nurses Clubs are active and enthusiastic .
The sanitation staff participated in a statewide arbovirus survey program
in cooperation with the SBH. A number of chicken flocks were tested in
the area The mobile chest X-ray unit of the SBH visited the county
with foodhandlers and school personnel being X-rayed. Chest X rays were
also taken of all Federal Aviation Authority personnel at the Air Traffic
Tower in Hilliard.
Okaloosa A Community Nursing Council was organized and
chartered by law as a nonprofit organization providing nursing service.
This is a cooperative program between the Council and the CHD which
actually provides the community nursing service. Six public health nurses
provide care for the sick in the home. Approved by the county medical
society, this service is available on request of the attending physician.
Although the program is new, those concerned are well pleased by the
wholehearted reception of the program by patients, their families and
attending physicians During 1963, additional interest was developed
regarding the elimination of pollution of the north Choctawatchee Bay.
The County Commissioners have given their full support to a program
for surveying, studying and locating all sources of human pollution of
these waters. Cities on the north and west shores have recently installed
additional community sewerage systems to serve the rapidly increasing
population. The city officials have demonstrated their complete coopera-
tion in working with the CHD staff so that the bay can be fully utilized
for oystering, fishing, boating and swimming.
Palm Beach Approval was received for a new Alcohol Clinic
financed through the Florida Alcoholic Rehabilitation Program. Rather
than establish this as a separate program, the clinic was incorporated into
the recently organized Psychiatric Clinic which is an outpatient clinic
serving adults ... An addition to the Migrant Project was approved under
the new Migrant Health Act. This addition provides for a staff of two
sanitarians and a health educator who will carry out a program for
improvement of the personal health and environmental sanitation of
migrant workers. These additional services will be incorporated into the
original project as part of an overall team effort to promote health serv-
ices for agricultural migrants. Emphasis will be placed on health educa-
tion techniques. Funds have also been secured to provide an improved
mobile clinic. This will carry services to the farms and housing areas
where migrants are located Expansion of the rehabilitation program
has continued under the direction of a physiatrist. A full-time physical
therapist and occupational therapist are now employed. The program

LOCAL HEALTH SERVICES 83

provides direct services to patients in the county homes and private nurs-
ing homes as well as being an educational program for others working
with disabled people An accident prevention program was initiated
in cooperation with the SBH which includes a survey of hazards in homes
and other premises visited by nurses and sanitarians. Another aspect of
the program pertains to analysis of factors contributing to death by
drowning The newborn immunization program was expanded
with the addition of two new nurses to the staff ... A survey was made
to determine the effect of industrial wastes from the rapidly expanding
sugar industry in the area of Lake Okeechobee. The survey report and
conferences with representatives of the industry has resulted in the re-
taining of consulting engineers to study the problem in order to abate the
pollution through appropriate treatment. One plant has already pre-
sented a plan for treatment of wastes which has been approved by the
SBH ... As a result of reorganization of the Division of Engineering and
Sanitation, the scope of services has been expanded. A Specialized Service
Section has been added which undertook a complete review and approval
of all swimming pools in the county Stream pollution surveys were
conducted on the Loxahatchee River and Lake Worth. These surveys
were designed to investigate the effectiveness of recent sewage treatment
facilities in coastal municipalities All of the labor camps which house
migrant farm workers were surveyed and evaluated during the year.
The 110 labor camps in the county are undergoing remodeling and re-
building to meet code requirements.
Polk A Public Health Nurse Coordinator Project was begun at
the Polk County Hospital to provide continuity of services for patients
by the hospital, CHD and Community Nursing Services of the county.
During the first three months of operation, some 100 patients were re-
ferred for public health nursing care .A chronic disease multiphasic
screening project was carried out in one community to determine the
advisability of instituting such a program on a countywide basis .
Child-spacing information is included in all MCH visits with materials
supplied at cost when prescribed by clinic physicians. No serious adminis-
trative or medical problems have been encountered .Phenylketonuria
(PKU) screening is done on all infants seen by the CHD using the
ferrous sulphate method A staff nurse qualified in physical rehabili-
tation taught three series of classes to local hospital personnel. A
Community Nursing Council of one area sponsored and financed Pap
smears for maternity patients in that area. This program is expected to
be expanded to cover the entire county in January 1964 Tuberculin
skin testing on infants conducted in one area will be extended to other
parts of the county in 1964 ... Cooperated in a program to evaluate home
situations before prematures and problem pediatric patients are released
from the hospital Community nursing services were extended to
include the ninth of the 14 communities in the county Began a pro-
gram to inspect and license commercial child care centers under authority
of a local act passed by the 1963 Legislature Two new auxiliary
health centers were completed and dedicated during the year the
Frostproof Center built at a cost of $40,000 and the Auburndale Center
which cost $45,000.

84 ANNUAL REPORT, 1963

Putnam The community home nursing care program begun by the
CHD about a year ago is progressing and is gaining community interest
and support Plans are being made to participate in the newborn
immunization program The tuberculin skin testing program in
schools was discontinued because the results did not seem to warrant the
amount of time spent on the program Construction was begun on a
new headquarters health center at Palatka. Cost of the building will be
approximately $163,000. It is centrally located on the courthouse grounds.
St. Johns In October the CHD observed its third birthday as a
full-time health department affiliated with the SBH. It is felt the CHD
has made immeasurable gains in instituting effective public health pro-
grams. Despite personnel shortages, continued progress and improvements
are evident. Branch clinics in the outlying areas have been expanded. Two
civil defense hospitals have been placed in the county and the CHD is
working closely with the local civil defense office. The school health
program has grown materially with more immunizations and examinations
of school children being done. The CHD has worked closely with city
officials in promoting renovation of the sewerage system at St. Augustine.
The CHD cooperated with the local medical society in setting up a mass
oral polio vaccination program during the latter part of 1963. Despite
staff vacancies, the environmental sanitation program has also continued
to grow with emphasis being placed on inspection of eating establish-
ments, water supply and sewage disposal.
Santa Rosa Conducted a tuberculin skin testing program on some
6151 school children in order to compare the Heaf and Mantoux tests.
Follow-up X rays were done on reactors ... Members of the CHD staff
participated in a morals education program for over 2000 high school
students lecturing on sex education and preparation for marriage .
Staff members taught medical self-help courses to 4-H Club members and
conducted mother and baby care courses for expectant mothers A
local bill for compulsory inoculation of dogs, passed by the 1963 Legis-
lature, was put into effect during the year. The CHD set up clinics at
which two veterinarians inoculated 1470 dogs A mobile chest X-ray
program was completed in September. Out of 3710 people X-rayed, 7
active cases of tuberculosis, 5 lung tumors, 17 enlarged hearts and 30
cases of other pathology were discovered ... The CHD provided physical
examinations for all preschool children, bus drivers, driver education
students, high school football and basketball teams and students in one
high school. Physical defects found were referred for treatment ... Began
a study of 269 suspected "exceptional children" in the schools. An attempt
will be made to relate physical disease to some of the intellectual, per-
sonality, social and other problems encountered Continued to study
the hookworm problem in the county which apparently has shown a
significant decrease during the past three years A brief educational
program on the importance of smallpox vaccination resulted in almost
a 100 per cent increase in smallpox vaccinations over the previous year.
Sarasota Plans are being discussed with the Board of County
Commissioners for the construction of a new health center in the southern
part of the county The Dental Preceptor Program begun in late 1962

LOCAL HEALTH SERVICES 85

developed during the year through the cooperation of the local dental
association, School Board, Junior Woman's Club, and Bureau of Dental
Health. One elementary school was selected for a five-year pilot study
and an intensive educational program is being carried out... In coopera-
tion with the local School Board, the medical self-help training course
has been approved for all junior high schools in the county. Many stu-
dents have already completed the course. The local Red Cross has also
included this in their first aid course... As a result of the success of the
Hospital-PH Nurse Coordinator in the Sarasota Hospital, one of the
nurses in the Venice office is now serving on a limited basis in this capac-
ity at the Venice Hospital. The Medical Assistance to the Aged program
for visiting nurse service has been approved for the county and is in
effect. In an effort to acquaint Visiting Nurse Association (VNA) Board
members with the actual day-to-day work performed by the nursing
staff, members of this board accompanied the public health nurses in
the field for half a day. A manual was prepared for VNA Board members
to keep them informed of program developments ... The TOPS ("Take
Pounds Off Sensibly") Club which has been meeting at the CHD for the
past four years has grown and a night class has been started so that
working people may attend. The CHD has encouraged this group and
presented programs when requested to do so ... Due to the interest and
efforts of the public health nurses in the Venice office, an Association
for the Mentally Retarded has been organized. A school for retarded
children was opened in that area with local financing The CHD
cooperated with the Mental Health Association to develop two new serv-
ices for psychiatric patients: Friendship House and Horizon Center. The
mental health worker participated in planning, initiating and establishing
Friendship House which provides social and occupational therapy to
mentally ill and geriatric patients. This facility opened in October and
has a club room, reading room and space for arts and crafts. The clinical
social worker serves as Director of Friendship House with most of the
work being done by members and volunteers. Horizon Center opened in
December. The center provides living quarters for white female patients.
The goal of the center is social and vocational rehabilitation. Each
patient has her own physician with follow-up services provided by the
visiting nurses and mental health worker A survey of community
facilities and resources has been made with plans for a Comprehensive
Community Health Program. This program will include services to the
chronically ill and aged with counseling, homemaker services and a
program for training and supervising volunteer workers ... A premedi-
cal student was employed during the summer to study the problem of salt
water infiltration into the fresh water supply. Investigations were made
to determine how to maintain water quality in existing and new wells.
Chemical tests were run to see if proper casing of wells, cementing of
annular space, would prevent a mixture of poor and high quality water.
. The sanitation staff worked closely with the Department of Conser-
vation in studying the "red tide" problem and its effect on shellfish.
Seminole Conducted a dental screening and oral hygiene pro-
gram in the elementary schools in the southern part of the county during
the early part of the year Began a countywide venereal disease con-

86 ANNUAL REPORT, 1963

trol program in March with an intensive educational program directed at
upper elementary and high school students in cooperation with the VD
staff, SBH. A course in preventable diseases has been added to the school
curriculum ... Trained 41 "Gray Ladies" to work in school health clinics.
S. In cooperation with the local Lions Club special eye examinations
were given to 100 needy children with glasses being provided for 77. The
CHD director was appointed to the Board of Sheba, Inc. (Seminole
Hospital Eye Bank Association) ... Plans previously made resulted in the
initiation of the community home nursing care program in the county in
October. Response to this program has been good Four midwife
trainees received training through the CHD The nursing staff pre-
sented programs on weight control to the eight Home Demonstration
Clubs in the county In cooperation with the District Heart Associa-
tion, the CHD sponsored several programs on resuscitation using the
manikin, "Resusci-Annie," and movies Promoted the medical self-
help program in the schools with the result that this program has been
made a part of the school curriculum ... Operating under a special local
act concerning rabies control, the CHD has gained the support of the
Jaycees, who have taken this program as a project ... Child care center
regulations were adopted in three cities in the county.
Volusia Special emphasis was placed on the school health program
during 1963. With the assistance of the sanitation consultant, SBH, an
improved program of school sanitation was begun. All schools in the
county will be visited regularly with defects found being reported to the
school principals. Once each year, a review of all schools will be made
and a report will be submitted to the Board of Public Instruction A
guide book was prepared to help school health coordinators plan and
execute better school health programs. Every school in the county now
has a school health coordinator with some large schools having two. They
work with the public health nurses and teachers in conducting school
health programs. There are 57 schools with some 30,000 children in the
county. The school health guide is loose-leaf and constructed to permit
continuous revisions as new material is added. The guide includes infor-
mation on all health and sanitary regulations of the state as well as
forms, schedules and other information important to the program .
With the cooperation of the local medical society the following programs
were carried out: a glaucoma screening program with about 3000 persons
tested; organization of a Diabetes Society and diabetes screening pro-
gram; physical examinations for all high school driver education students
sponsored by the medical society; plans were made for participation in
the newborn immunization follow-up program; a mass Sabin oral polio
immunization program was begun in the county; and a health exhibit
of venereal disease was shown at the Annual Home Show The CHD
conducted a program to standardize all X-ray units in the county. The
pollution survey of rivers and lakes in the eastern part of the county is
still underway and is furnishing guide material for the shellfish and
industrial waste programs.
Walton In addition to a general program, continued emphasis
was placed on civil defense. A written civil defense plan was completed

LOCAL HEALTH SERVICES

by the staff as requested by the SBH. As part of this plan, 27 women
were trained in the American Red Cross First Aid Instructor Course and
have begun teaching first aid to various groups in the county.

ACCIDENT PREVENTION PROGRAM

GEORGE A. McCOY, M.D., M.P.H.
Director
The purpose of the Accident Prevention Program (APP) is to give
guidance to the County Health Departments (CHD) in expanding their
accident prevention activities in the fields of home, school and off-the-job
safety. While it is still felt that traffic and industrial safety are the respon-
sibiliy of other agencies, a greater interest in this area has been taken
this past year. Efforts were made to encourage the use of seat belts by
all CHD personnel, thus incorporating traffic safety into their daily
activities. Personnel from the Automotive Crash Injury Research (ACIR)
Program visited the APP on two occasions and as a result of these meet-
ings, it was decided to institute the ACIR into Florida early in 1964. This
will be in cooperation with the Florida Highway Patrol, The Florida
Medical Association (FMA) and the Florida Hospital Association
(FHA).
Early in the year the Florida Industrial Commission launched its
second annual safety campaign at a conference in Orlando. The APP
participated in regional safety conferences which were held throughout
Florida. Through these conferences a great number of people were in-
formed of the State Board of Health's (SBH) interest in accident pre-
vention and the contribution which the various CHDs were able to make
at a community level. Cooperation was thus established between two state
agencies interested in a common purpose; namely, the decrease in number
and severity of accidents.
Early in the year the Aetna Insurance Company cooperated with
APP in conducting a series of safety conferences throughout the state.
Safety control officers and interested health officers from the various CHDs
attended these meetings. Not only was the investigation of accidents to
employees discussed but greater participation in the APP by all CHD
employees more fully explained. As a result of improved investigation
of accidents to employees, it is felt that the purpose of this reporting pro-
cedure is more thoroughly understood.
In May, a seat belt campaign was conducted among employees of
the SBH in Jacksonville. As a result, over 500 seat belts were installed
in privately owned vehicles of the employees in the Jacksonville office.
One of the belts purchased during this campaign saved the life of the
previous director of the APP. Another employee was hospitalized as a
result of an accident in which seat belts were not used. This campaign was
later extended and made available to all SBH employees throughout the
state. This did not result in a great cessation of traffic accidents to CHD
employees, as two were seriously injured while riding in a state-owned

88 ANNUAL REPORT, 1963

vehicle which was equipped with seat belts but which were not in use at
the time of the accident.
About the middle of the year, hospitals of the FHA other than those
in which the poison control centers are located, were visited in the interest
of reporting accidental poisonings. In conjunction with this campaign to
increase the reporting of accidental poisonings to the CHDs, 10 auxiliary
poison control centers were established. This increased interest in poison
prevention has resulted in 2990 reports having been received throughout
the last six months of 1963, in comparison to 1995 during the first
six months, during which time reports were received from some 20 partici-
pating hospitals. Follow-up visits by CHD nurses totalled 2082 for the
last six months in comparison with 1735 for the first six months of the
year an increase of 20 per cent.
Of the 4985 reports analyzed, 3018 (60 per cent) occurred in chil-
dren under five years of age and of these, 1322 were two years old. As
in previous years, the substances most frequently ingested by this age
group were aspirin, other internal medications, cleansing and polishing
agents, insecticides and kerosene in that order.
It is interesting to note that of the total poisonings now reported, 40
per cent are five years of age and over. This is an increase of two per
cent over 1962. A total of 1358 suicide attempts were reported August
and October being the months in which suicide was attempted most fre-
quently. This correlates with the total number of poisonings reported, as
August and October led in total numbers reported.
The snake bite study begun the previous year was continued. A total
of 250 bites were reported during 1963, and of these there were two
fatalities as compared to 277 reported bites and three fatalities in 1962.
As in the previous year, 60 per cent of the bites reported were those of
venomous snakes. Cooperation with the Venomous Snake Bite Committee
of the FMA was maintained so that the committee could continue its
evaluation of the clinical management of the cases. Liaison was main-
tained with the University of Florida where work was begun on the
domestic production of a modified coral snake antivenin.
At the September staff meeting of the Palm Beach CHD, the person-
nel decided on an accident prevention campaign for 1964, with special
emphasis toward the prevention of accidental drownings. In this con-
nection a hazard report has been developed which will be utilized by the
CHD personnel in locating and eliminating various hazards noted during
routine visits. This activity is to be coded as an accident prevention
activity on the monthly activity report.

HEALTH MOBILIZATION PROGRAM
CLAUDIUS J. WALKER, B.S., M.S.P.H.
Director
The Medical Self-Help Program is continuing as a county health
department (CHD) function but has been incorporated into the school

LOCAL HEALTH SERVICES 89

curriculum in 23 counties as well as the parochial schools in the Diocese
of St. Augustine and that portion of the Diocese of Mobile-Birmingham
which lies in Florida. Efforts to expand this program into other school
systems, secular and parochial, is continuing. Television video tapes
designed to orient teachers to the program have been prepared and were
shown over the facilities on Channel 7 (ETV) Jacksonville. Personnel
of the Duval County Board of Public Instruction and Duval CHD were
used. Direction of the programs and use of the facilities were provided by
television station WJXT-TV, Jacksonville. It is planned to use these
tapes for the same purpose in other counties in the near future, if this
program proves effective in the pilot county.
The State Board of Health (SBH) has accepted custodial respon-
sibility for 16 of the Civil Defense Emergency Hospitals (CDEH) pre-
positioned in the state. Correction of outstanding deficiencies among the
remaining 19 have proven unexpectedly difficult. Acceptance of further
units has been postponed until the federal inspection teams have left
the state late in January 1964. This is to prevent confusion due to
the change of custodians. Supply additions designed to bring the CDEHs
up to a 30-day operational capability are being shipped into the state
as the units are accepted by the SBH. There will eventually be four
supply additions for each CDEH. To date the state has received only
Addition No. 1. By December 31, 1963, the SBH had accepted respon-
sibility for $472,000 worth of CDEH property. When the transfer of
responsibility is complete, the SBH will be responsible for $1,732,500
worth of property. In addition, 20 new 1962 model CDEHs have been
allocated to Florida by the U.S. Public Health Service. If all of these
are accepted, the SBH will become responsible for another $990,000
in property, for a total of $2,722,500.
A new position, that of CDEH Storage Coordinator, was created late
in the year and a person was found to carry on these duties on a tem-
porary basis. Application has been made to the Florida Merit System to
formalize the position and make it permanent.
The CDEH Training Program, located at St. Petersburg, has con-
tinued to grow. During the year, the teaching program has been form-
alized and a permanent teaching staff assigned. These assignments are
a part-time duty for all staff members. A second training center is in
process of development at Mt. Sinai Hospital, Miami Beach.
Florida has received one of 20 prototype training units. These are
experimental units and were allocated to selected states for experimental
teaching programs in local areas.
Liaison between the SBH and the State Office of Civil Defense has
been greatly improved to the benefit of both agencies during the
year.
One of the program coordinators received training at the Civil De-
fense Staff College, Battle Creek, Michigan, in management and plans
and operations during the year.

90 ANNUAL REPORT, 1963

DIVISION OF NUTRITION

MARY BRICE DEAVER, M.S.
Director

This division is responsible for organizing, planning, developing and
promoting a sound nutrition service as an effective part of the health
program throughout the state. The primary purpose is to improve the
nutritional status of the people of Florida including all ages and socio-
economic levels. The importance of nutrition in conditions of physiologic
stress such as growth, pregnancy and lactation has long been recognized.
Knowledge that many types of disease such as those which are infectious,
metabolic and degenerative are influenced by nutrition, increases every
year. Recent investigations indicate a close relationship between nutrition
and many forms of pathologic stress such as severe infections or trauma.
Consequently, it becomes increasingly evident that nutrition must be a
vital part of any good health program interested in prevention and con-
trol of disease.
A nutritionist was employed in August to begin work on the Rural
Demonstration Project, a position which had been established the previous
year but had not been filled prior to this time; and one county health
department (CHD) employed a nutritionist for the first time as a mem-
ber of the staff in the Division of Adult Health and Aging.
In each region counties may receive service on a regularly scheduled
basis or upon request. In those counties where the nutrition consultant
visits the county on a regular schedule, it is evident that there is far more
continuity of service and effective nutrition programing than in those
counties not visited regularly.
During the year a considerable amount of time was spent in the
planning, preparation, preliminary field trials and evaluation of a system
for recording statistical data on nutrition services performed which could
be machine processed. Such a system has now been put into operation.
This past year has seen a combined effort on the part of all the nutri-
tionists, the Kellogg Project staff and the Data Processing staff in work-
ing through a variety of suggestions for data collection and reporting. The
final product is a simple, short, easily kept instrument which should pro-
vide accurate data for program planning and evaluation on a county,
regional and statewide basis. Since it is extremely difficult to evaluate
a program which is largely educational in nature, it is felt that this is a
real step forward in the evaluation process.
Although it was necessary to sacrifice the collection and compilation
of complete statistical data for this year in order to try out and refine
the instrument to be finally adopted for this purpose, sufficient data were
available to indicate that the major concentration of service was in the
following categories: maternal and child health, diabetes, institutional
food service, normal diet and weight control.
The age groups for whom these services were primarily intended
were: adults from 21-64, the older age group 65 and over, the school
age child from 6-13 and the adolescent from 14-20.

LOCAL HEALTH SERVICES

The cultural groups to whom the greatest amount of service was
rendered were: Anglo-Saxon most frequently; Negro next; and third,
Latin.
Services were given most frequently through the CHD staff and in
descending order of frequency through schools and institutions. A con-
siderable amount of service was also given to patients themselves, in-
dividually and in groups.
By far the major portion of services was given indirectly. When given
directly, it was primarily for therapeutic diet instruction on the order of
a physician.
In providing services to CHDs, emphasis was placed on in-service
education needed for ongoing health activities. Where possible, nutrition
was considered in its relationship to an area of service such as its role
in the home care program. Because of much recent investigation and
published information on diet and heart a large number of requests were
filled for in-service programs concerning this topic.
There has been much interest in information on diet with regard to
the inborn errors of metabolism. Individual assistance was given to
parents of children with phenylketonuria (PKU) as well as to profes-
sional personnel working with such patients.
On the Migrant Project in Palm Beach County, the nutritionist con-
tinued to provide consultation to the CHD staff and some direct clinic
service to patients. The study on the growth patterns of migrant children
continued and plans were made for this to be carried on after the nu-
tritionist resigned from the project. The regional nutritionist is providing
as much assistance as possible to the project until a replacement can be
secured.
A special project was started in Gadsden County during the sum-
mer months to provide more detailed information on the dietary habits
of the pregnant women attending the CHD clinics. When the data is
complete, an educational program to meet the needs indicated will be
planned and put into effect. The project was set up at the request of the
county because of the many dietary problems encountered, the high num-
ber of midwife deliveries and the low economic status of many of the
prenatal patients. Individual interviews at the clinic and several home
visits to each patient were made by the home economics student working
for the summer under the direction of the regional nutritionist. Special
physical examinations with emphasis on nutritional status were done and
laboratory tests made. Preliminary data indicate that approximately half
of the prenatals interviewed were between the ages of 14 and 20, indicat-
ing the tremendous need for more information on the requirements of
the pregnant teen-ager and the equally important need for teaching
nutrition as early as possible. None of the diets so far analyzed meet
National Research Council recommendations for all nutrients.
In the area of chronic diseases, much time has been spent on de-
veloping suitable materials for use in instructing diabetic patients who
have difficulty interpreting the diet material ordinarily available. The

	Front Cover
	Title Page
	Letter of tranmsittal
	Members of the Florida state board...
	Official staff Florida state board...
	Directors of county health...
	Table of Contents
	Administration
	Bureau of dental health
	Bureau of entomology
	Bureau of finance and accounts
	Bureau of laboratories
	Bureau of local health service...
	Bureau of maternal and child...
	Bureau of mental health
	Bureau of narcotics
	Bureau of preventable diseases
	Bureau of sanitary engineering
	Bureau of special health servi...
	Bureau of vital statistics
	Articles and monographs by state...

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