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 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 research
 Bureau of sanitary engineering
 Bureau of special health servi...
 Bureau of vital statistics
 Articles by staff members


PALMM UFSPEC



Annual report - State Board of Health, State of Florida
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Permanent Link: http://ufdc.ufl.edu/AM00000243/00034
 Material Information
Title: Annual report - State Board of Health, State of Florida
Series Title: Publication - Florida. State Board of Health
Physical Description: v. : ill., ports. ; 23-29 cm.
Language: English
Creator: Florida -- State Board of Health
Florida -- State Board of Health
Publisher: State Board of Health.
Place of Publication: Jacksonville Fla
Creation Date: 1964
Frequency: annual
regular
 Subjects
Subjects / Keywords: Public health -- Periodicals -- Florida   ( lcsh )
Genre: government publication (state, provincial, terriorial, dependent)   ( marcgt )
serial   ( sobekcm )
 Notes
Dates or Sequential Designation: Ceased in 1968.
Numbering Peculiarities: Report year for 1893/94 ends Mar. 31; for 189<7>-1968, Dec. 31.
Numbering Peculiarities: Reports for 1923-32 combined in one issue.
General Note: Reports for 1910-<17> issued as its Publication.
 Record Information
Source Institution: Florida A&M University (FAMU)
Holding Location: Florida A&M University (FAMU)
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 01569394
lccn - 07039608
System ID: AM00000243:00034
 Related Items
Succeeded by: Annual report - Division of Health, Department of Health and Rehabilitative Services, State of Florida

Table of Contents
    Front Cover
        Front Cover
    Title Page
        Page i
    Letter of tranmsittal
        Page ii
        Page iii
    Members of the Florida state board of health
        Page iv
    Official staff Florida state board of health
        Page v
    Directors of county health departments
        Page vi
    Table of Contents
        Page vii
    Administration
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
        Page 14
        Plate
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
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        Page 25
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        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
    Bureau of dental health
        Page 37
        Page 38
        Page 39
    Bureau of entomology
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
        Page 46
        Page 47
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        Page 50
        Page 51
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        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
        Page 59
        Page 60
        Page 61
    Bureau of finance and accounts
        Page 62
        Page 63
        Page 64
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
        Page 73
    Bureau of laboratories
        Page 74
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
        Page 82
        Page 83
        Page 84
        Page 85
        Page 86
        Page 87
        Page 88
        Page 89
    Bureau of local health services
        Page 90
        Page 91
        Page 92
        Page 93
        Page 94
        Page 95
        Page 96
        Page 97
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        Page 139
        Page 140
        Page 141
        Page 142
        Page 143
        Page 144
        Page 145
    Bureau of maternal and child health
        Page 146
        Page 147
        Page 148
        Page 149
        Page 150
        Page 151
        Page 152
        Page 153
        Page 154
        Page 155
    Bureau of mental health
        Page 156
        Page 157
        Page 158
        Page 159
        Page 160
        Page 161
        Page 162
        Page 163
    Bureau of narcotics
        Page 164
        Page 165
        Page 166
    Bureau of preventable diseases
        Page 167
        Page 168
        Page 169
        Page 170
        Page 171
        Page 172
        Page 173
        Page 174
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        Page 189
        Page 190
        Page 191
        Page 192
        Page 193
        Page 194
        Page 195
    Bureau of research
        Page 196
        Page 197
    Bureau of sanitary engineering
        Page 198
        Page 199
        Page 200
        Page 201
        Page 202
        Page 203
        Page 204
        Page 205
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        Page 222
        Page 223
        Page 224
        Page 225
        Page 226
        Page 227
        Page 228
    Bureau of special health services
        Page 229
        Page 230
        Page 231
        Page 232
        Page 233
        Page 234
        Page 235
        Page 236
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        Page 246
        Page 247
        Page 248
        Page 249
        Page 250
        Page 251
        Page 252
    Bureau of vital statistics
        Page 253
        Page 254
        Page 255
        Page 256
        Page 257
        Page 258
        Page 259
        Page 260
        Page 261
        Page 262
        Page 263
        Page 264
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        Page 266
        Page 267
        Page 268
    Articles by staff members
        Page 269
        Page 270
        Page 271
Full Text


FLORIDA
STATE BOARD
OF
HEALTH

1964


ANNAL EPOT








,Aucae Report






State Board of Health

State of 4 orida




1964




The following reports will be published separately:
SUPPLEMENT I FLORIDA VITAL STATISTICS, 1964
SUPPLEMENT II FLORIDA MORBIDITY STATISTICS, 1964


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


JACKSONVILLE, FLORIDA











e.-



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


Dear Dr. Peek:

I herewith enclose the annual report of the Florida
State Board of Health for the year ending December 31,
1964.

Sincerely yours,

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

May 1, 1965
Jacksonville, Florida















His Excellency, Haydon Burns
Governor of Florida
Tallahassee, Florida


Sir:

I herewith submit the report of the Florida State
Board of Health for the period of January 1, 1964, to
December 31, 1964, inclusive.

Respectfully,

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

May 1, 1965
Ocala, Florida

















Members of the
FLORIDA STATE BOARD OF HEALTH


EUGENE G. PEEK, JR.,
Ocala

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


M.D., President


Vice-President


LEO M. WATCHEL, M.D.
Jacksonville

WILLIAM O. SHUMPERT, D.D.S.
Ft. Lauderdale

W. S. HORN, D.O.
Palmetto









OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH
(December 31, 1964)

DIRECTORS

State Health Officer ........................................Wilson T. Sowder, M.D., M.P.H.
Deputy State Health Officer ........................Malcolm J. Ford, M.D., M.P.H.
Deputy State Health Officer ........................Elton S. Osborne, Jr., M.D., M.P.H.
Encephalitis Research Center
Assistant State Health Officer ............James O. Bond, M.D., M.P.H.
Coordination 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 ............Enid Mathison, R.N., M.P.H.
Bureau of Dental Health .........................Floyd H. DeCamp, D.D.S.
Assistant Director ........................... Delmar R. Miller, D.D.S., M.P.H.
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., M.P.H.
Assistant Director .....................................Warren R. Hoffert, Ph.D., M.P.H.
Miami Regional Laboratory ......................Dwight E. Frazier, M.S.
Orlando Regional Laboratory ....... .......Max T. Trainer, M.S.
Pensacola Regional Laboratory ................Emory D. Lord, Jr., M.S.
Tallahassee Regional Laboratory ..............Robert A. Graves, M.S., M.P.H.
Tampa Regional Laboratory ..............H. D. Venters, B.S.
West Palm Beach Regional Laboratory ....Lorraine Carson
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 (Acting) ..............L. L. Parks, M.D., M.P.H.
Division of Sanitation ...............................A. W. Morrison, R.S.
Bureau of Maternal and Child Health ........David L. Crane, M.D., M.P.H.
Bureau of Mental Health (Acting) ..............Elton S. Osborne, Jr., 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 ............................E. Charlton Prather, M.D., M.P.H.
Division of Radiological and Occupa-
tional 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 Research ......................... Albert V. Hardy, M.D., Dr.P.H.
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.S.E.
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 Nusing Homes..C. L. Nayfield, M.D., M.P.H.
Bureau of Vital Statistics ..........................Everett H. Williams, Jr., M.S. Hyg.
Division of Data Processing ................ Harold F. Goodwin
Division of Public Health Statistics ..........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, 1964)


Alachua........................................................ Edward G. Byrne, M.D., M.P.H.
Bay................................ ...... .........................A. F. U llm an, 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................................ .........................T. E. Morgan, M.D., M.P.H.
Escambia. ...................................................E. E. M etcalfe, M .D.
Hillsborough ................................................John S. Neill, M.D., M.P.H.
Lake.................................. ................ ..........J. Basil Hall, M .D., M .P.H.
Lee........................... ........ ...... ............. J. W Lawrence, M .D.
Leon........ .......... .......... ........... Clifford G. Blitch, M.D.
Manatee............................... .............George M. Dame, M.D.
Marion........................ ........................L. L. Parks, M.D., M.P.H. (Acting)
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............. ..... ....... .. ........ John T. Obenschain, 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................................ D. V. Galloway, M.D., M.P.H.
Baker-Nassau.......................... B. F. Woolsey, M.D.
Calhoun-Jackson............................................Terry Bird, M.D., M.P.H.
Flagler-Putnam........................................ James R. Sayers, M.D.
Franklin-Gulf....................................Willa Dean Lowery, M.D., M.P.H.
Gadsden-Liberty.........................................B. D. Blackwelder, M.D., M.P.H.
Jefferson-W akulla................................ ....... H. Smith, M .D.
Madison-Taylor............................ .......... L. L. Parks, M.D., M.P.H. (Acting)
Osceola-Indian River..-............................ C. C. Flood, M.D., M.P.H.
Pasco-Sumter........................ .............Walter E. Sharpe, M.D.
Bradford-Clay-Union ............. .... ..A. Y. Covington, M.D., M.P.H.
Charlotte-DeSoto-Hardee......... ........E. J. McLaughlin, M.D.
(on educational leave)
Francis R. Meyers, M.D. (Acting)
Citrus-Hernando-Levy......................................H. F. Bonifield, M.D., M.P.H.
Columbia-Hamilton-Gilchrist......... ............F. Barton Wells, M.D.
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.............................L. L. Parks, M.D., M.P.H. (Acting)








TABLE OF CONTENTS


Page

Administration (including Activities of the Board; Training Co-
ordination; Scholarships; Encephalitis Research Center;
Divisions of Health Education, Personnel and Public Health
N ursing) ........................ .. .. .. .......... .......... .......... 1

Bureau of Dental Health ............. ................... .. ............. 37

Bureau of Entomology (including Entomological Research
C enter) .............................. ..................... ............................... 40

Bureau of Finance and Accounts (including Purchasing and
Property) .............................................................. ................... ... 62

Bureau of Laboratories .........................--..........---------- 74

Bureau of Local Health Services (including Accident Prevention
and Health Mobilization Programs; and Divisions of Nutri-
tion and Sanitation) ........................................... ... ........ 90

Bureau of Maternal and Child Health ......................................... 146
Bureau of Mental Health (including Florida Council on Train-
ing and Research in Mental Health) .................................. ........ 156

Bureau of Narcotics ......................-- ------------------------ 164

Bureau of Preventable Diseases (including Divisions of Epi-
demiology [Venereal Disease Control Program], Radiological
and Occupational Health, Tuberculosis Control and Veteri-
nary Public H health) ....................... ................................ ..-- 167

Bureau of R research .................................................................. ....... 196

Bureau of Sanitary Engineering (Including Divisions of Indus-
trial Waste, Special Services, Waste Water and Water
Supply) .................................................................----- --. .. 198

Bureau of Special Health Services (including Divisions of
Chronic Diseases and Hospital and Nursing Homes; and
Hospital Service for the Indigent Program).................................... 229

Bureau of Vital Statistics (including Divisions of Data Process-
ing, Public Health Records and Vital Records) ............................ 253

Articles by Staff M embers ....................................... ......... ........... 269








GENERAL ADMINISTRATION 1

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

Annual Reports serve many functions. The historical value of these
became very apparent in 1964, the 75th Anniversary of the founding of
the State Board of Health (SBH). The first State Health Officer, J. Y.
Porter, M.D., was a prolific and interesting writer. The early reports pro-
vide a fascinating picture of the problems and developments of that era.
But now only the memory of persons still active can provide much of the
history of county health departments (CHD). It is a matter of concern
that often there are no local annual reports which will provide in the
years to come an adequate picture on the early history and the subsequent
development of these local units. Hence, the added importance of this
Annual Report.
The year under review provided a strengthening of administrative
organization which has long been desired. Two Deputy State Health
Officers were authorized, both with a background of experience in local
and state public health work in Florida, as well as at the national and
foreign service levels. Malcolm J. Ford, M.D., has responsibility for pro-
gram planning and Elton S. Osborne, Jr., M.D., for operations. Dr. Os-
borne has also served as acting director of the Bureau of Mental Health.
One additional organizational change established a Bureau of Re-
search. This was designed to give greater prestige to research and greater
assurance that it will continue in the future as an essential part of public
health. Much of the work previously handled by the coordinator of
research is the responsibility of this bureau. The director of this newly
established bureau is Albert V. Hardy, M.D., who was previously the
coordinator of research.
An outstanding problem in 1964 was the consideration being given to
the future place of mental health within the general public health pro-
gram. There are strong outside pressures for the establishment of a State
Department of Mental Health which will bring together community
health and mental hospital activities. Thus, on the one hand there was
the view that public health at the community level should be concerned
with total health, physical and mental, and on the other that all curative
and preventive mental health activities in hospitals, community centers
and community programs should be under one direction. The highly
important decision concerning this will be made by the Legislature. A
Legislative Committee during the year has devoted much attention to
this question.
Problems involved with the increasing use of project grants have
increased. It appears that the future distribution of federal funds may be
predominantly through project grants, rather than categorical or general
public health grants-in-aid. The preparation of grant requests is de-
manding a disturbing amount of the time of senior staff members. The
initiation of individual projects requires the establishment of new posi-
tions which call for the approval of both the Florida Merit System and








2 ANNUAL REPORT, 1964

the State Budget Commission. The time interval between the beginning
of planning for a project grant and the initiation of needed activities is
on the order of approximately six months or more. While highly desirable
public health activities have been supported for several years through
project grants renewed annually, still, this method of support provides
no assurance of continued financing or for constructive long-range plan-
ning.
Since a high percentage of the financial support of CHDs is derived
from local sources, there is understandable irritation when state pro-
cedural requirements appear to delay the initiation of essential activities
for which support is available. Thus, there has been some questioning of
the relationships between the SBH and CHDs. Through the years the
cooperative program under the county health units has worked well and
has contributed to the achievement of total coverage of the state by
county health units. Legislative action may also determine to what extent
this well established plan will be modified because of the counties' desire
for freedom from what appears to them to be undesirable obstacles to
local planning and action.
Multiple problems in the environmental field emphasize the im-
portance of these public health activities in this area. There is the increas-
ing volume of industrial waste and detergents which persist as objection-
able pollutants in water supplies. There is an increasing concern with
possible long-term significance of pesticides on human health and there
is the increasing problem of air pollution. Of concern is the possibility
that through federal legislation the authority for control of water pollu-
tion may be assigned to other than public health agencies. The nature
of federal as well as state legislation will have substantial influence on the
future of Florida's public health programs.
Florida experienced an unusually high incidence of measles along with
the rest of the nation but no severe disease emergencies. Fortunately, the
state was free of epidemic disease in 1964. There was a disturbing threat
of encephalitis, the eastern rather than the St. Louis type. This infection
was shown to be widespread in Florida involving unvaccinated horses.
The virus was also isolated on numerous occasions from mosquitoes. Four
human cases occurred: two of these were fatal and a child who recovered
has irreparable brain damage. The intensive studies of these infections are
providing information which will make the preventive programs increas-
ingly effective.
There was continuing difficulty in employing and retaining the
highly trained professional and technical personnel the SBH needs in
large numbers. The Florida Merit System and the Cabinet, however,
approved new salary scales for budgeting purposes subject to legislative
approval, which should give some relief from the problem.
During the year, the SBH lost, by resignation, Wayne Yeager, M.D.,
the director of the Bureau of Mental Health. It acquired a new director
of the Bureau of Maternal and Child Health, David Crane, M.D., pre-
viously with the Dade County Department of Public Health.








GENERAL ADMINISTRATION


STAFF ASSISTANCE
The internal auditor, the staff attorney and the press secretary pro-
vide direct assistance to the State Health Officer.
The internal auditor plans, directs and coordinates the internal au-
dits of the SBH, including the 67 CHDs. He has one assistant. He con-
ducts post audits of the financial transactions of the agency to determine
that fiscal matters are in accord with state and local laws and the policies
of the SBH. Accounts of 10 CHDs, a bureau and a special project were
audited during 1964. Also, audit work papers were prepared on the
accounts of nine additional CHDs. The collected fees audited in 1964
aggregated approximately $575,000.
The staff attorney provides legal advice on problems related to ad-
ministration and operations and participates in the formulation of the
agency's legislative and regulatory programs. He works with bureaus,
divisions and CHDs, and upon request or on referral of cases, gives
technical assistance to state attorneys, county prosecutors and attorneys
for municipalities. In 1964, 18 cases were brought to litigation, three to
administrative hearings and 12 were under investigation at the close of
the year.
During 1964, the press secretary sent 80 news stories to newspapers,
radio and TV stations and magazines. Assistance was given these media
on 98 occasions: supplying information; initiating stories, photos and
interviews; and aiding representatives to obtain their own material for
stories, photographs, interviews, TV sound and film footage and edi-
torials.
ACTIVITIES OF THE BOARD
February 9-Jacksonville
1. Eugene G. Peek, Jr., M.D., welcomed William O. Shumpert,
D.D.S., newly appointed member of the Board replacing F. P.
Meyer, D.D.S., whose term expired November 15, 1963.
2. The Board adopted a resolution in behalf of Dr. Meyer's services
to the Board of Health and Florida's public health program.
3. Dr. Peek advised the Board that W. S. Horn, D.O. had been re-
appointed as a member of the State Board of Health (SBH).
4. The Board reelected Dr. Peek as president and Mr. T. M.
Cumbie as vice-president of the Board of Health.
5. The members of the Board discussed with Wilson T. Sowder,
M.D., and C. M. Sharp, M.D., the format of the health card
and recommended certain changes in it.
6. Discussed the progress of the proposed construction of the Pensa-
cola and Tampa laboratories and the transfer of the present
Tampa site to the Board of County Commissioners, Hillsborough
County; and accepted a site next to the future Hillsborough
County Health Department (CHD).








4 ANNUAL REPORT, 1964


7. Approved the appointment of Chester Nayfield, M.D., as direc-
tor, Division of Hospitals and Nursing Homes.
8. Approved revisions in the regulations for nursing homes.
9. Discussed revisions for the control of radiation hazards and ap-
proved them. The Board designated March 31, 1964, as the
effective date for the registration of X-ray machines and other
radiation-producing equipment.
10. Approved the acceptance of a low bid of the Stenson Electrical
Company at $73,997 for alterations of the electrical system facili-
ties of the SBH, Jacksonville.
11. Approved the release of $6000 for Clay County Commissioners
for the construction of a health center.
12. Adopted a resolution commending Miss Ruth Mettinger for her
outstanding work with the SBH for the past 30 years as director
of the Division of Public Health Nursing; further expressed its
gratitude for this fine service and gave her their best wishes for
the future.
13. Approved the appointment of Miss Enid Mathison as director of
the Division of Public Health Nursing.
14. Discussed the report of the Advisory Committee on Public
Health Nursing.
15. Discussed the resignation of William Ballard, M.D., the Pinellas
County Health Officer, and the appointment of John Obenschain,
M.D. as acting director.
16. Discussed the proposed duties of Elton Osborne, Jr., M.D., who
reported for duty on January 1, 1964.
17. Discussed the assignment of David Crane, M.D., and his return
to duty March 16, 1964.
18. Approved extension beyond 70 years of age for certain employees.
May 9-Bal Harbour
1. Approved a statement of policy of the SBH on the Administrative
Structure of Future Programs in Mental Health and Mental
Retardation.
2. Approved the establishment of a Bureau of Research with Albert
Hardy, M.D., as director; and further approved the appoint-
ments of Malcolm Ford, M.D., and Dr. Osborne as Deputy
State Health Officers.
3. Discussed the appointment of John Milton, M.D., former Board
Member and employee of the Dade County Department of
Public Health, as obstetrical consultant in the Bureau of Mater-
nal and Child Health.
4. Heard an interim report by Dr. Osborne on the salary supple-
mentation problem.








GENERAL ADMINISTRATION


5. Discussed the appointment of Delmar Miller, D.D.S., assistant
director, Bureau of Dental Health.
6. Approved the naming of the arthropod laboratory in Panama
City as the West Florida Arthropod Research Laboratory.
7. Approved the name of the new laboratory to be built in Tampa
as the Homer D. Venters Laboratory Building.
8. Approved nine students to be awarded state medical scholarships.
9. Approved persons for postgraduate training.
10. Discussed payment for laboratory and other diagnostic services
in heart clinics and referred the matter to the Florida Medical
Association for study.
11. Approved the appointments of members to a Florida Coordi-
nating Council for Cardiovascular Disease as an advisory body
to the SBH in its heart program.
12. Discussed the policy for the purchase of books for distribution to
physicians with reference to the Venereal Disease Control Pro-
gram.
13. Approved appointments of members to the Advisory Committee
for the Hospital Service for the Indigent.
14. Approved the appointments of consultants for the Radiological
Health Program.
15. Approved resolutions for the Pensacola and Tampa laboratory
buildings for the acceptance of federal grant-in-aid funds for
the construction of these buildings.
16. Discussed the extension of employment of unlicensed physicians
beyond two years.
17. Abolished the Consultant's Leave Policy established by the
group on July 1963.
18. Approved an Addendum to Section II of the Memorandum of
Agreement between the Southwest Florida Tuberculosis Hospital
and the SBH regarding the Encephalitis Research Center at the
Southwest Florida Tuberculosis Hospital.
19. Approved a recommendation of the Florida Committee on
Smoking and Health that county health officers take an active
role in an educational program on smoking and health.
20. Discussed an invitation from Dr. Guillermo Arbona, secretary
of health, San Juan, Puerto Rico, to visit the health department
and discuss health programs.

May 10-Bal Harbour
1. Discussed action taken by the House of Delegates of the Florida
Medical Association regarding the future administration of men-
tal health programs.








6 ANNUAL REPORT, 1964

July 26-Jacksonville
1. Approved the appointment of Dr. Crane as director, Bureau of
Maternal and Child Health.
2. Welcomed Emily Gates, M.D., former employee of the SBH, on
her return to the staff of the Encephalitis Research Center in
Tampa.
3. Heard a report by James O. Bond, M.D., on the work being
carried on at the Encephalitis Research Center.
4. Discussed a policy on publicity regarding encephalitis cases.
5. Discussed the detergent problem with Mr. David Lee.
6. Approved revisions of Chapter 170 C-10, Garbage and Rubbish.
7. Heard a report by Mr. Lee on the Air Pollution Control Pro-
gram.
8. Confirmed telephone action regarding amendments to Chapter
170 C-8, Sanitary Facilities for Buildings Serving the Public
and Places of Employment.
9. Approved the appointment of Dr. Osborne, as acting director
of the Bureau of Mental Health, effective August 1, 1964.
10. Approved a bill providing for the establishment of a Planning
and Coordinating Commission for Mental Health and Mental
Retardation; and further that Dr. Sowder present this bill to
the Interim Legislative Committee in behalf of the Board.
11. Approved the contents of a letter to Mr. William G. O'Neill,
chairman, Subcommittee No. 12, Committee on Governmental
Reorganization and Efficiency, regarding the proposed bill de-
signed to transfer to the SBH the present functions of the Flor-
ida Development Commission relating to the administration of
Federal Hill-Burton Hospital Construction Funds.
12. Confirmed their mail approval of two amendments to Chapter
170 E-9, Medical Assistance for the Aged (MAA); (1) Time
limit on processing hospital claims and (2) Visiting nurse serv-
ices in MAA.
13. Approved the release of $6500 County Health Units Funds to
Indian River County Commissioners for the construction of a
new health center.
14. Approved naming of laboratory to be built in Pensacola as the
Herbert L. Bryans Building.
15. Approved extension of 16 months postgraduate training for
Maude Speakman, public health nurse, Highlands County.
16. Discussed the problems existing regarding Cuban dentists in the
Miami area.
17. Discussed a letter from Homer Pearson, M.D., executive secretary
of the State Board of Medical Examiners, regarding the un-
licensed physicians employed by the SBH.








GENERAL ADMINISTRATION


18. Approved the appointment of members to serve on the Advisory
Committee to the SBH for the Medical Scholarship Program.
19. Approved a budget for the biennium 1965-67 to be submitted
to the Legislature in 1965.
20. Dr. Peek presented a citation to Mrs. Astrid J. Ballard, executive
secretary to the State Health Officer, for 20 years of service
with the SBH. The Board adopted a resolution expressing to Mrs.
Ballard their appreciation for the fine service rendered the SBH
and the members of the Board.
September 13-Jacksonville
1. Heard a report by Dr. Sowder on a conference he had with
Governor Bryant.
2. Discussed Dr. Milton's status with the SBH.
3. Heard a report by Dr. Shumpert on a proposed bill on fluorida-
tion being discussed by the State Dental Society.
4. Heard a report by Dr. Ford on the Poverty Bill.
5. Welcomed Warren Hoffert, Ph.D., assistant director of the
Bureau of Laboratories, to the central office and as a member of
the SBH.
6. Discussed the Hospital Licensing and Hospital Construction Pro-
gram with various members of the central office staff.
7. Approved certain editorial changes in the regulations on nursing
homes.
8. Approved a revision in the regulations on the control of com-
municable diseases.
9. Approved revisions in the salary ranges of the exempt classes
under the Merit System.
10. Heard a report by Dr. Osborne on the Mental Health Planning
Program.
11. Discussing licensing of special hospitals including dual licensure.
12. Approved the release of $2000 to the Board of County Commis-
sioners of Lake County for the construction of a health center in
Clermont.
13. Approved the appointment of Senator Beth Johnson as a mem-
ber of the Advisory Committee on Hospital Services for the
Indigent.
14. Discussed the matter of local Board's of Health or Advisory
Boards to the CHDs.
December 4-San Juan, Puerto Rico
1. Met with Dr. Arbona, secretary of health, San Juan, Puerto Rico,
and members of his staff and discussed various health programs
and also visited many health facilities in Puerto Rico.








8 ANNUAL REPORT, 1964


2. Heard a report on the information received by Edward Byrne,
M.D., director of the Alachua CHD, from the county health
officers regarding local Advisory Public Health Committees.
3. Directed the State Health Officer to call attention of all county
health officers to the recommendation of the Executive Council
of the State Dental Society whereby they establish and maintain
some suitable liaison machinery with the organized dental pro-
fession and particularly with respect to the development and
operation of public health dental programs.
4. Approved a letter to Samuel Day, 'M.D., president of the Florida
Medical Association, regarding the routing of MAA patients
through Tumor Clinics.
5. Approved the appointment of Mr. Harry Goodwin as director,
Division of Data Processing.
6. Approved the reappointment of several members to the Public
Health Nursing Advisory Committee and also the appointment
of new members to the Committee.
7. Approved a resolution in behalf of F. P. Meyer, D.D.S., former
Board Member, deceased.
8. Discussed certain regulations in Chapter 170 E-7, Transportation,
Storage and Disinterment of Dead Human Bodies and recom-
mended that a committee be appointed to study this problem
and its report be brought before the Board.
9. Discussed a nursing home form recently circulated to nursing
home operators.
10. Expressed appreciation to Dr. Arbona, secretary of health and
members of his staff, for their many kindnesses to the members
of the Board; and also for the very informative discussions
regarding the health program of Puerto Rico.

ENCEPHALITIS RESEARCH CENTER

JAMES O. BOND, M.D., M.P.H.
Director
For the second consecutive year Florida experienced no epidemics of
human infection with arthropod-borne viruses. This past year did, how-
ever, represent a year of increased activity in the state for eastern and
western equine encephalitis viruses which produced severe clinical illness
in horses and man. Infection with these viruses was also detected in both
wild and domestic birds sentinel bird flocks and mosquitoes. Such activity
is neither new nor unusual for Florida, and has occurred in irregular cycles
for many years. The enlarged staff of arbovirus investigators in the state,
most of whom were in the Encephalitis Research Center (ERC) in
Tampa, made it possible to study this activity with an intensity and pre-
cision that had not previously been possible.








GENERAL ADMINISTRATION


At the ERC, western encephalitis (WE) virus was recovered from the
brain of a sick horse, the first such recovery in Florida and probably east
of the Appalachian Mountains. Eastern encephalitis (EE) virus was re-
covered five times from moribund horses. Both viruses were isolated re-
peatedly from Culiseta melanura mosquitoes which have long been in-
criminated as the vector of these viruses between birds. However, for the
first time, the EE and WE viruses were also obtained from a species of
fresh water Aedes mosquitoes (Aedes infirmatus). This may prove to be
the first identification of a vector carrying this virus from birds to horses
or to man. There were four confirmed human cases of EE in Florida
in 1964. In three of these, laboratory studies at the ERC in Tampa
assisted in the diagnosis. There was one each from Polk, Hillsborough
and Putnam counties. Of the four cases, two were fatal, and the sur-
vivors were severely damaged, emphasizing again the serious import of this
virus for the human population should an epidemic occur. Activity of EE
and WE viruses was readily demonstrated in wild and domestic birds in the
Tampa Bay area and in sentinel chicken flocks maintained by the ERG
to measure arbovirus transmission to birds.
Again in 1964, as in 1963, there was virtually no evidence of activity
of St. Louis encephalitis (SLE) virus in the entire state, or in the Tampa
Bay area. The negative evidence included observations for clinical
disease in man, for inapparent infection in man, virus isolation studies
in mosquitoes, and virologic and serologic observations in wild and do-
mestic birds, chickens, wild mammals, amphibians and reptiles. This ap-
parent disappearance of SLE virus was made doubly enigmatic by the
fact that 1964 represented the year of the largest SLE epidemic in the
U.S., involving the states of Texas, Colorado, Tennessee, Kentucky,
Indiana, Illinois, New Jersey and Pennsylvania.
The intensive search for arboviruses by ERG did however result in
the recovery of a number of other agents. These included arboviruses
belonging to the California complex, Tensaw virus, Hart Park virus and
unidentified viral agents recovered from two species of ticks and cotton
rats. The public health significance of these other viral agents is as yet
undefined. However, early information indicates that the viruses belonging
to the California complex may represent a new and significant arboviral
cause of human disability and disease, not only in Florida but in a large
area of the country.
A nine-member Encephalitis Advisory Committee of nationwide ex-
perts, was appointed to advise the State Health Officer on statewide
research, surveillance and control activities, including those carried out
by ERC. The committee was composed of W. McD. Hammon, M.D.,
University of Pittsburgh; John P. Fox, M.D., Public Health Research
Institute of the City of New York, Inc.; Oscar Sussman, D.V.M., State
Department of Health, New Jersey; George T. Carmichael, Chatham
County Mosquito Control District, Savannah, Georgia; Joel Ehrenkranz,
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,








10 ANNUAL REPORT, 1964

Maryland; Telford Work, M.D., Communicable Disease Center (CDC),
U.S. Public Health Service (USPHS), Atlanta, Georgia, and Archie
Hess, Ph.D., USPHS, Greeley, Colorado.
A separate report of the major activities of each of the four sections
of the ERC follows.

VIROLOGY
In early 1964 a mouse-breeding colony was established adjacent to
the ERC to permit the production of suckling and weanling mice for the
virology laboratory. Approximately 125-175 litters of suckling mice are
produced each week and are utilized for virus isolation attempts, passages
and neutralization tests. An additional serologist was added to the staff
during 1964 to permit extension of serologic studies to include the diffi-
cult but more precise neutralization tests.
From 3926 specimens processed in the laboratory for viral isolation,
75 were considered positive for viral agents (Table 1). There were
3564 pools of mosquitoes tested (some collected in 1963) from which
55 recoveries of viral agents were obtained in the 1964 collections. The
type of virus found in each species of mosquito is also shown in Table 1.
Of 73 tick pools examined, seven have yielded viral agents. These
viruses are presently undergoing identification studies at the University of
Pittsburgh Arbovirology Laboratories by Miss Gladys Sather under the
direction of William McD. Hammon, M.D.
This year's most significant virologic findings have been the recovery
of WE virus from a horse, the isolation of both EE and WE virus from
A. infirmatus mosquitoes, which may be a newly recognized vector, and
the repeated recovery of two apparently different and distinct members
of the California complex in the Tampa Bay area.
Although the detection of Hart Park virus in the Tampa Bay area is
new, it is not considered to be particularly significant since this virus has
been found widely distributed along the eastern seaboard and Gulf
coast areas and is presently thought unrelated to any human illness. The
final identification of the tick viruses may also contribute new and signifi-
cant information; however, their importance cannot be assessed at the
moment.
The serology section utilizes the hemagglutionation-inhibition (HI),
the complement fixation (CF) and the serum neutralization (NT) tests
for the identification of arbovirus antibodies in human and animal serum.
A total of 6556 sera were tested during 1964, all by the HI test, 47 by the
CF test and 11 by the NT. These sera classified according to source were:
human diagnostics, 688; human survey, 388; sentinel chickens, 431; wild
birds, 2187; and mammals, 477. The significance of the findings and
interpretation is presented in subsequent portions of this report.
The laboratory section cooperated with other sections in carrying out
special studies during the year. The first was related to the problem of
nonspecific inhibitors in chicken sera to EE hemagglutionation (HA)








GENERAL ADMINISTRATION 11

antigens. A similar study of the problem of nonspecific inhibitors for Cali-
fornia encephalitis HA antigen in human sera was undertaken with the
University of Pittsburgh. In cooperation with the biology section, an
experiment was performed to measure the transovarian-transmission of HI
antibodies against SLE virus in chickens. Such transmission was demon-
strated to occur; however, most of the passively acquired antibody had
disappeared by the end of the fourth week of the chick's life.

EPIDEMIOLOGY
The activities of the epidemiology section were directed during the
first half of the year by Donald T. Quick, M.D., assigned from the CDC.
During the last half of the year, Emily H. Gates, M.D., assumed the
position of chief epidemiologist and assistant director.
In cooperation with the County Health Departments (CHD) in
Hillsborough, Pinellas, Manatee and Sarasota Counties, and hospitals and
physicians, a surveillance program for viral infections of the central
nervous system (CNS) was continued throughout 1964. During the year,
a total of 340 human cases was studied (Table 2). Of these 101
(29.7 per cent) were considered to represent true cases of infectious
encephalitis, aseptic meningitis or paralytic disease. There was no proven
case of acute SLE virus infection. However, one human case of EE was
confirmed in a resident of Hillsborough County, and one case of dengue
fever imported from Puerto Rico was identified. A third case of clinical
encephalitis occurring in Sarasota County had serological evidence of
possible recent California virus infection. This case, however, is still under
study.
In the remaining 98 cases with clinical evidence of viral CNS infec-
tion, etiologic diagnoses were finally established for 35. Mumps was the
most common cause of this type of illness and was diagnosed in 30 indi-
viduals. For each of the following there was one diagnosed case: varicella,
rubeola, poliovirus Type I, Coxsackie virus, Group B-4 and infectious
mononucleosis. There was one confirmed CNS infection due to lepto-
spirosis. Serologic or virologic tests for the nonarboviruses were per-
formed by the Virology Section of the Central Laboratory by the State
Board of Health (SBH).
These cases in which an etiology was considered to be firmly estab-
lished, either on clinical or laboratory evidence, represented 37.6 per cent
of the entire group of 101 viral CNS infections. However, studies upon
this group of patients are not yet complete, and further reports from
either the Central Laboratories, SBH, or from the CDC will undoubtedly
provide additional etiologic information.
Among the total of 340 individuals brought under surveillance, 21
were identified with SLE-HI antibody titers of 1:20 or above, which
remained at the same level on subsequent specimens except for three from
whom only single specimens were submitted. These results were inter-
preted as indicative of infection with a Group B arbovirus at some unde-
termined time in the past. These individuals undoubtedly represent a








12 ANNUAL REPORT, 1964


group of persons who have had previous infection with either SLE or
dengue or some other member of the arbovirus Group B complex. How-
ever, there is suggestive evidence that some Group B arbovirus, at present
unidentified, may have been active recently in the Tampa Bay area,
since the proportion of these positive sera changed markedly between
1963 and 1964.
There were three individuals with EE-HI antibodies detected in
paired sera and interpreted as indicating past infection with a Group A
arbovirus at some undetermined time. Similar observations were made on
two other persons utilizing the California antigens. Four of the above were
residents of Hillsborough County.
The ERC maintains a close liaison with the epidemiology and labora-
tory services of the SBH in establishing diagnosis and epidemiologic infor-
mation for the population in the Tampa Bay area, and to a lesser extent
in the entire central Florida peninsular portion of the state.
A total of 56 patients received epidemiologic and virologic consulta-
tion from the ERC, although they lived in counties outside of the four
surrounding Tampa Bay. Among these were three in which diagnosis of
current infection with EE was established by serologic studies in the
laboratories in the ERC, Jacksonville and CDC. The virus of EE virus
was recovered from both the brain and the cerebrospinal fluid of one of
these patients.
A measure of the inapparent human infection with arboviruses is main-
tained by re-bleeding a sample of sentinel human households throughout
the Tampa Bay area. After the 1963 summer season, a total of 313
individuals was re-bled, and during the current 1964 season re-bleedings
on the same households are currently in process. These studies supply
information on the occurrence of silent, inapparent human infection with
EE, WE, SLE, California and, to a lesser extent, Tensaw viruses.
A special follow-up examination clinic for post-encephalitis cases was
held in cooperation with the USPHS Accident and Aging Study Center
in St. Petersburg, and with the Pinellas CHD.
During the period March 11 through June 19, 224 persons were
examined. Ninety-six (96) of these were recovered encephalitis patients
from the 1962, 1961 and 1959 epidemics, and 128 were normal individu-
als matched by age, race, sex, education and occupation for comparison
with these cases. Tests on all individuals included those for psychomotor
and psychologic performance, vision, static and dynamic balance, Cornell
Index, and an accident history. Serologic studies for the persistence of
HI, CF and NT antibodies to SLE virus were carried out in the ERC
laboratory and the University of Pittsburgh. It was found that CF
antibodies persisted much longer and at higher titers than had originally
been anticipated; however, the HI antibodies declined more rapidly than
anticipated. All but three of the tested survivors had serum neutralizing
antibodies to SLE virus, indicating that the initial diagnoses were cor-
rectly made in the majority of cases. Further analyses of the extensive
information collected in this study are in process.,








GENERAL ADMINISTRATION


Following the 1962 epidemic of SLE, statistical studies of stillbirth,
neonatal, perinatal and congenital malformation death rates in Pinellas
County yielded suggestive evidence of some prenatal damage as a result
of maternal SLE virus infection. Accordingly, a retrospective study was
initiated to determine whether there was any significant excessive preva-
lence of SLE antibodies in the mothers of 58 infants who were recorded
as neonatal deaths associated either with congenital malformations or
stillbirths. Of the 58 mothers, 26 were located and serum specimens ob-
tained. In none were antibodies detected against SLE virus using the HI
test. It was concluded that there was no evidence from this study to
indicate any damaging effect of SLE virus in utero.

ENTOMOLOGY
An assistant entomologist, Carl Vickery, was added to the staff in
early 1964. Twelve (12) standard bait traps were maintained throughout
the year in Manatee, Hillsborough and Pinellas Counties with the Co-
operation of their respective Mosquito Control Districts. These were sup-
plemented with special collections from two areas in Hillsborough County
which later were added as standard collection sites. Other collections using
truck-traps, light-traps and aspirators were made in areas of suspected
arboviral activity as determined by the presence of equine or human
cases. From all collections, a total of 234,138 mosquitoes was obtained
during 1964 as indicated in Table 3. Of these, 130,544 have been tested
for virus isolations in 2717 pools representing most of the collections
through October. From the special collection sites in Hillsborough County,
there were nine recoveries of EE and five of WE. Eight of the EE viruses
and three of WE were obtained from C. melanura mosquitoes and one
eastern and two western from A. infirmatus. One of the recoveries of
WE from A. infirmatus was of special interest since the mosquitoes were
obtained by aspirator collections from the arm of a man in a suburban
area of Tampa. The EE and WE virus recoveries were made during the
period April-July, with 75 per cent in the month of May.
Viruses belonging to the California complex were obtained in 26
pools, all from A. infirmatus or Aedes atlanticus mosquitoes. All of the re-
coveries from A. atlanticus were from swamps of Hillsborough County,
whereas all but one of the California complex viruses found in A. in-
firmatus were from a swamp in suburban Pinellas County. Trapping
techniques and variations in preferred habitat for these two species of
mosquito explain some of this difference. However, there were certain
biological differences between the two types of California virus obtained,
and further strain identification studies are in process. The California
viruses were found in every season of the year, although there was a
slight increase in the frequency of recoveries in August with a large col-
lection of A. atlanticus.
There were nine recoveries of virus belonging to the Tensaw group,
all from Anopheles crucians mosquitoes. Due to selective methods of col-
lection, large numbers of A. crucians were not obtained. Six viral agents
presumptively identified as Hart Park were obtained from five pools of








14 ANNUAL REPORT, 1964


C. melanura, and one pool of Culex nigripalpus. These viruses were
found only during May, June and July, partially reflecting both the
seasonal changes in C. melanura density and the type of collection
methods employed.
It was of interest that of the total 55 recoveries of virus from mos-
quitoes, only nine were obtained from the 12 standard trap sites. The
remainder was detected as a result of special collections made in areas
where there was presumptive evidence of arbovirus activity. Since this was
chiefly related to the occurrence of equine encephalomyelitis in Hills-
borough County, most of the collections and therefore most of the identi-
fications of virus were in that county.
During the period January through May, special weekly truck-trap
collections were made in each of the three counties to estimate mosquito
densities and to obtain Culex mosquitoes for oviparity dissections. From
120 collections, 12,845 mosquitoes were obtained and a sample examined
for oviparity studies.
Portions of the gravid mosquitoes from the truck-trap collections were
also processed for virus isolation in 208 pools. Viral agents were obtained
from three pools; two from C. melanura and one from A. crucians.
During the period January through May, a sample of the bait-trap col-
lections of Culex mosquitoes was also reserved for oviparity dissections.
From Hillsborough, 202 were dissected; from Manatee, 333; from Pinel-
las, 340, and from Sarasota County, 218. The proportion of parous and
nulliparous mosquitoes from both truck- and bait-trap collections of Culex
species has been determined and the data are being analyzed by the En-
tomological Research Center in Vero Beach as part of a special study of
production and survivorship of Culex mosquitoes under natural condi-
tions.
Special entomological studies have included observations on the
relationship of larval production and adult mosquito densities to rainfall,
temperature, groundwater level and other ecological variables in a
special swamp site study area in Pinellas County. Host preference studies
in the field have been carried out with a number of different bait
animals including a donkey, chickens, various species of wild birds and
mammals, toads and turtles. A study comparing CDC light traps and
chick-baited traps involving 65,231 collected mosquitoes is in process.
With the Georgia Institute of Technology, a special study evaluating an
experimental method of tagging mosquitoes with boron or decaborane
compounds was also initiated. Meteorologic information was collected at
each of the standard bait trap collection sites and supplemented by rain-
fall data from official weather bureau stations and other cooperators in
Hillsborough, Pinellas, Manatee and Sarasota Counties. In anticipation of
precipitin tests in engorged mosquitoes for host preference studies, 1368
mosquitoes have been collected and preserved for this special study. All of
the above activities were carried out in close coordination with the
mosquito control districts in Pinellas, Hillsborough and Manatee Coun-
ties, and were under the general consultive guidance of scientists from
the Entomological Research Center at Vero Beach.















ORGANIZATION Lt CHART OF TEr

FlORID SmTAE 80ARD OF HAERTH








BOARD O?

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MEDICAL DENTAL COUNCIL HOSPITAL COMsMITT I
SCHOLRSIP SORSHIP ON TRAINING HOSPITAL 1 -CONT
ADVISORY ADVSORM RESTA ADVISORT SEAMECE FR CONTROL
PCOISTTE COMMITTEE IN MENTAL COUNCIL I THE MINDIGONT N




STATE
HEALTH
OFFICER


DEPY.STATE
HEALTH OFFICER
PROGRAM &
PLANNING


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DIVISION OF
DIVISION OP HEALTH
PERStNSSL EDUCATION
(Library)


IBS A P BU i EAU OP BU:E-lU O
MENTAL I LABORATORIES *PI FIMMCE
EaTSI I (Regional I MAND
cliic) RLaboratories) ACCOUTS


BUREAU OF
ESTOMOLOGY
(Research Center,
West Florida
Arthropod Research
Laboratory,
Mosquito Control
Districts
eodes Aegypti
Eradication)


I
BUREAU' OF
SANITARY ENSINEERING
(Stream Sanitation,
Waste Treatment
Construction)
DIVISION OF
INDUSTRIAL WASTES
(Air Pollution)
DIVISION OF
SPECIAL SERVICES
(Bedding Law,
Subdivision Planning,
Shellfish)
DIVISION OP
WASTE WATER
DIVISION OF
WATER SUPPLY
(swiSming Pools)


BUREAU OF VITAL
STATISTICS

DIVISION OF
VITAL RECORDS
DIVISION OF PUBLIC
HEALTH STATISTICS
DIVISION OF
DATA PROCESSINo


DEPUTY STATE
HEALTH OFFICER
OPERATIONS


I

ENCEPHALITIS DIVISION OP
RESE IROCH PUBLIC HEALTH
C RTER NURSING
1~,i


BREAU O SUREAU OF BUREAU OFr
ESEABCH DS.TAL NARCOTICS
Li LJT


I I ----- b -


BUREAU OF
LOCAL HEALTH
SERVICES
(CiVil Defense,
Accident Prevention)

DIVISION OF
SANITATION
DIVISION OF
NUTRITION




T'


BUREAU 0OF
MATERNAL
CHILD HEALTH
(Migratory
Labor)


BUREAU OP
PREVENTABLE
DISEASES
DIVISION OF
RADIOLOGICAL
OCCUPATIONAL
HEALTH
DIVISION OF
VETERINARY
PUBLIC HEALTH
(Milk Sanitation)
DIVISION OF
TUBERCULOSIS
CONTROL
DIVISION OF
EPIDEMIOLOGY
Control)


BUREAU OP
SPECIAL HEALTH
SERVICES

DIVISION OP
CHRONIC DISEASES
(HeartCancer.
Diabetes)
DIVISION OF HOSPITALS
AND NURSING HOMES
(Indigent Care,
Hospital & Nursing
Home LicSnure)


67 County Health Departments


N UNNOr I EG


~9--


a _,, I _








GENERAL ADMINISTRATION


BIOLOGY
During the latter half of 1964, an ornithologist was added to the
staff. The major efforts of this section during the year were devoted
to the study of equine encephalomyelitis in Hillsborough County. By
mid-May, an epizootic become evident among the horses in this coun-
ty, although the first case was reported in late March. A special effort
was made to obtain clinical and epidemiological information on all horse
cases reported to the ERC. In addition a sample survey of the horse
population was carried out by a veterinarian, Reuven A. Kathein,
D.V.M., assigned to the project during the summer months by the Univer-
sity of Pittsburgh. From the 22 clinical cases of encephalomyelitis in
horses which came to the attention of the ERC staff, 14 brains were
obtained. Six isolations of virus have been made from these brains; one
identified as WE and five as EE. It was of special interest that the WE
isolation was the first such recovery from a horse with a clinical illness
diagnosed as encephalomyelitis in Florida, and probably is the first on the
eastern seaboard of the United States. The equine population sample
indicated that there were some 6400 horses in Hillsborough County, of
which 40 per cent were unvaccinated. A sample of the vaccinated and
unvaccinated horses was bled for further serological studies. The latter
are incomplete; however, early findings suggest that the horse is a much
more sensitive indicator of SLE virus inapparent infection than had pre-
viously been suspected. As mentioned previously, the recovery of EE and
WE virus from Aedes mosquitoes in the areas adjacent to the horse cases
is strongly suggestive evidence that a vector of these viruses from birds to
horses has been identified for the first time.
The activity of both EE and WE viruses was also demonstrated by
studies in sentinel chicken flocks which were maintained throughout the
year at 14 different stations in the three counties. These sentinels were
supplemental at different times and in different places with sentinel
guinea pig, pigeon and opossum systems. Eastern and western virus
activity was identified at a sentinel chicken station in Hillsborough
County in May and at two different stations in the same county in June.
It was also identified in sentinel chickens in Pinellas County in August.
An additional sentinel system for the actual recovery of virus was
utilized by exposing one-day-old chicks for an overnight period in areas
where mosquitoes were biting heavily. Of 903 chicks thus exposed, four
yielded arbovirus isolations, two identified as EE and two as WE.
These were recovered during the month of May in the swampy area of
northern Hillsborough County adjacent to the horse cases.
Serologic evidence of arbovirus activity was also measured in sera
collected from 2187 wild birds, 477 mammals and 22 reptiles and
amphibians (Table 4). Special attention was given to rookery species
nesting in and around Tampa Bay and the dove population in St.
Petersburg. There was no evidence of recent SLE virus activity in any
of these animal sera. Evidence of both eastern and western virus activity
was found in the wild bird population of Sawgrass Swamp near St. Peters-
burg, and at the swamp site in northern Hillsborough County. Eastern








16 ANNUAL REPORT, 1964


virus was also active in urban birds within St. Petersburg, but WE
virus activity was not detected there.
From 3003 vertebrate specimens screened for SLE, WE and EE
virus by inoculation into one-day-old chicks, three viral agents were re-
covered. All failed to become established by further passage in suckling
mice; however, from cotton rats collected in December 1963, two viral
agents have become established and are presently undergoing identifica-
tion studies at the University of Pittsburgh.
A preliminary survey of 200 rodent sera for Powassan antibody was
carried out by Donald McLean, M.D., of the Toronto Hospital for Sick
Children. Five sera were found to have HI antibodies against Powassan
viruses; one was confirmed by NT. With this presumptive evidence of
possible Powassan virus activity in the area, tick collections were made.
Of 105 pools collected, 73 have been tested to date. Seven have yielded
viral agents, six from the common dog tick, Dermacentor variabilis, and
one from the common rabbit tick, Haemaphysalis leporis-palustris. These
are undergoing further identification studies at the University of Pitts-
burgh.
Ornithologists from the University of South Florida led by Glen
Woolfenden, Ph.D., continued their census of the breeding bird popula-
tion in both a large swamp and an urban area of St. Petersburg. Several
species, notably immature mockingbirds, were noted to move between
the swamp and residential area during the summer months. This
prompted a special study of bird dispersal in Pinellas County using the
fledgling mockingbird as a model. Of 200 mockingbirds marked and
released in the swamp during the month of July, 31 were reported as
sighted within the ensuing two week period in an area of at least 15
miles radius. This indicated a potential mechanism for transport of a
virus from the swamp into urban areas, and further studies on this
hypothesis are being initiated.
Laboratory infection experiments utilizing SLE virus and a variety
of wild birds including the dove and sparrow, and one mammal, the
cotton rat, were carried out. It was found that both the house sparrow
and the dove developed a relatively prolonged viremia and readily
developed HI antibodies after experimental infection. They can therefore
serve as effective reservoirs of the virus in nature. Cotton rats in contrast
did not develop HI antibodies one month after infection, so are presumed
to be relatively poor hosts for the SLE virus. A special study on the
transovarian transmission of HI antibodies against SLE virus in chickens
has already been mentioned.
















TABLE 1

VIRAL ISOLATIONS BY TYPE OF SPECIMEN COLLECTED AND EXAMINED, ENCEPHALITIS RESEARCH CENTER,
TAMPA, FLORIDA, 1964

Viral Agent Isolated Estimated
Type of Specimen number of
Eastern Western California Presumptive Presumptive specimens
Encephalitis Encephalitis complex Cal. complex Tensaw Hart Park Unidentified Total examined

Human ........................ 2 ............ ............ ............ 2 99
Pheasant ...................... 1 ............ .......... ...................... 1
Equine .....5 1 ......... ........... ..... ....... ............ ............ 6 903
Exposure chicks ............... 2 2 ............ ............ ................... ..... 100.. .4 (pools)
Culex nigripalpus .. 1 100 (pos... .. .... . : I 1 1004 (pools)
Aedes infirmatus ............... 1 ............ .... ... ......... ............ ..12 285
Aedes infirmatus ............. 1 2 12 31..
Aedes atlanticus ............... ........... ."... 12 3 ..................... ................. 15 55 "
Aedes atlanticus 5 12 22
Culiseta melanura ..... .... 8 3 .. .. ...... ...... 1
Aedes species ......................................... 9 124 ........................
Anopheles crucians ............ ............ .... ........ ............ ............ .. ...... ...... ........ .... 6 ) 124
Dermacentor variabilis ......... . .................................................. ) 7
Haemaphysalis leporis palustris....... .. ............ ............................................... .... 1 1
Total................... 19 8 19 7 9 6 7 75

















TABLE 2
CLASSIFICATION OF HUMAN CENTRAL NERVOUS SYSTEM SURVEILLANCE CASES, ENCEPHALITIS
RESEARCH CENTER, TAMPA, FLORIDA, 1964


County
Disease Combined 4-County Totals Hillsborough Pinellas Manatee Sarasota
Classification
Total Confirmed Probable Conf. Prob. Conf. Prob. Conf. Prob. Conf. Prob.

CENTRAL NERVOUS SYSTEM DISEASE
Viral.......................................... 101 38 63 ....... ................
Arboviral ................... .............. (3) (3) (0) 2 0 0 0 0 0 1 0
Other-(Rubella, mumps, varicella, Cox. B4, etc.) (98) (35) (63) 16 22 10 20 4 3 5 18
Bacterial ............. ........................ 12 6 6 5(c) 1 0 4 1 1 0 0
Non-infectious (Tumor, stroke, multiple
sclerosis, etc.) ............................... 119 97 22 81 13 9 4 4 1 3 4
SYSTEMIC DISEASE
Viral......................................... 50(b) 2 48 2 19 0 3 0 8 0 18
Bacterial, parasitic ... ........................ 11 5 6 3(c) 1 0 1 1 3 1 1
Non-infectious (Tumor, trauma congen. defect,
poison, etc.)..... .......................... .. 32 21 11 11 8 5 1 3 0 2 2
UNCLASSIFIED
(Data lacking, healthy Lontacts, etc.)............ 16 16 0 11 0 4 0 1 0 0 0
Total ............................. 341(a) 185 156 131 64 28 33 14 16 12 43

LEGEND: (a) 340 cases (2 confirmed diagnosis for one patient). (b) None due to arboviruses. (c) Leptospirosis.














TABLE 3

MOSQUITOES COLLECTED BY ALL METHODS IN THE TAMPA BAY AREA, ENCEPHALITIS
RESEARCH CENTER, TAMPA, FLORIDA, 1964


Number of Mosquitoes Collected
Number Total
Month Culex Aedes Anopheles Culiseta Aedes of Mosquitoes
nigripalpus infirmatus crucians melanura atlanticus- Others Collections Collected
tormentor

January..................... 3,000 290* 31 40 2 5,103 (281) 8,466
February.................... 884 1,665 36 153 2 12,939** (356) 15,679
March...................... 2,307 1,245* 105 988 0 8,635 (459) 13,280
April... .... ............ 422 701* 175 486* 4 3,594 (541) 5,382
May........................ 551 2,236* 599* 1,150* 654* 3,861 (475) 9,051
June....................... 2,026 1,231* 937* 215* 101* 3,770 (645) 8,280
July. ....................... 14,857* 4,968* 560 496* 730* 4,672* (553) 26,283
August ..................... 28,724 1,405 1,646 445 1,702* 3,736 (505) 37,658
September................... 36,553 1,092 3,152* 331 224 5,640 (490) 46,992
October. .................... 16,120* 996* 597* 218 11 3,942 (532) 21,884
November................... 17,086 77 440 424 0 5,753 (428) 23,780
December ................... 11,194 229 90 465 0 5,425 (468) 17,403
Totals.......... 133,724 16,135 8,368 5,411 3,430 67,070 (5,733) 234,138

*Virus isolations obtained from these groups.
** 9,881 of these were Cu. salinarius









20 ANNUAL REPORT, 1964

TABLE 4
VERTEBRATE SERA COLLECTED AND TESTED FOR ARBOVIRUS
ANTIBODIES, ENCEPHALITIS RESEARCH CENTER,
TAMPA, FLORIDA, 1964

Specimens Specimens
Type of Specimen Collected Serologically Examined

Sentinel chickens .............................. 431 431
Exposed chickens .................. .......... 903 847
Sentinel pigeons .............................. 34 24
Total .................................. 1,368 1,302
Wild Birds
Rookery species............................. 376 288
Mourning doves. ........................... 1,202 1,024
Mockingbirds.......... ................. .212 204
Blue jays.................................. 117 101
House sparrows ............................. 94 41
Other species ............................... 657 529
2,658 2,187
Mammals
Sick bats................................... 269 None
Rodents............................ ...... 406 277
Possums ................................... 87 77
H orses ..................................... 134 123
Total............................ 896 477
Reptiles and Amphibians
Turtles................ ...................39 12
Snakes. ................................. 47 10
Lizards..................................... 25 None
Frogs and toads ............................ 268 None
Total............................ 379 22
Grand Total ..................... 5,301 3,988




TRAINING COORDINATION

ROBERT V. SCHULTZ, M.D., M.P.H.
Coordinator of Training

This activity is within the office of the State Health Officer. It func-
tions under the general direction of the Deputy State Health Officer for
Program and Planning. The activities are primarily concerned with co-
ordinating and providing assistance in planning, program development and
arrangements incident to undergraduate and postgraduate training for
eligible employees in all disciplines and departments of the State Board
of Health (SBH) and county health departments (CHD); short courses
supported by the SBH, the U. S. Public Health Service (USPHS) or
special grant funds available for this purpose; meetings; seminars; work-
shops and other inter- and intra-mural training situations; special projects,
such as the Florida State Medical and Dental Scholarship Programs
created by the 1955 Florida Legislature and administered by the SBH;
and an American Medical Association (AMA) approved Residency








GENERAL ADMINISTRATION


Training Program offering qualified physicians one to three years indoc-
trination and postgraduate training in preparation for recruitment in
public health activities in Florida.
To achieve these objectives, the coordinator, where indicated, explores
the potential and reviews the established curricula of junior colleges, un-
dergraduate and postgraduate institutions of higher learning; the Florida
Institute for Continuing University Studies; training programs available
through established facilities of the USPHS; special courses and projects
conducted and supported by federal grants, private foundations, hospitals
and health-related professions, organizations and institutions. Where ap-
propriate, he provides close working relationships among faculty members
and others concerned with registration of personnel for the desired train-
ing, assists in developing and establishing new courses designed to meet
specific training requirements and arranges for resource personnel and
mutually suitable sites and facilities for these purposes.
The services of the coordinator are available on request to SBH and
CHD directors, program supervisors and all personnel concerned with
training.
He administers a Summer Student Training Program under general
plans and operational procedures proposed by a committee formed for
this purpose.
Biannually, in April and October, this office issues a Calendar of
Events a mimeographed listing of national, state and local meetings
deemed of interest or concern to personnel in all disciplines and activities
of the SBH and CHDs. This list projects the scheduled dates and sites
of meetings a year or more in advance. It is distributed to all concerned
with public health activities in Florida.
The coordinator is responsible for appropriate distribution of an-
nouncements, brochures, pamphlets, catalogs, fliers and other material
concerned with a wide variety of training courses available in all parts
of the United States. These publications are forwarded to CHDs for
information purposes only as the SBH assumes no responsibility or obliga-
tion to provide for fees, per diem or travel incident to attendance. At-
tendance is a matter for local decision by directors of departments
concerned, and support for such training must be from funds available
locally for this purpose.
This office develops appropriate programs for indoctrination of new
employees (carried out by the Division of Health Education) and con-
ferences and meetings for special guests and visitors to the SBH. It also
maintains a file of catalogs of Schools of Public Health and other in-
stitutes and facilities for reference purposes, and information concerning
these items is available upon request.

Public Health Residency Training Program
The Council on Medical Education of the AMA has approved the
following five Florida CHDs for residency training in public health: Dade








22 ANNUAL REPORT, 1964


(Miami), Alachua (Gainesville), Hillsborough (Tampa), Pinellas (St.
Petersburg) and Palm Beach (West Palm Beach).
The residency consists of one or more years of intensive training
under the guidance of the director of the CHD to which the resident
is assigned. The program conforms with the requirements of the Council
on Medical Education, AMA, to which reports are regularly forwarded
and is under the general administration and supervision of the coordina-
tor. It provides a framework of reference for physicians interested in
public health careers and is oriented to prepare them for employment
in Florida public health facilities.
In 1964, John J. Woodward, M.D., was appointed to a public health
residency in Hillsborough County. The following four physicians have
recently completed their residency training:
R. Christopher Brown, M.D. Palm Beach June 1964
Antonio L. Court, M.D. Hillsborough June 1964
Richard A. Morgan, M.D. Hillsborough June 1964
Frank Leone, M.D. Seminole June 1964

Student Traineeship Program
Each summer for a number of years, the SBH has offered temporary
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 designed to orient
them with the specific and over-all functions of the SBH and CHD
programs and activities.
In 1964, there were 205 applications for this program. Of these, 55
were selected for employment at the central office 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 recom-
mendation of a seven-man advisory committee authorized by statute. The
seven members were: Hugh M. Hill, M.D., Assistant Dean for Students,
College of Medicine, University of Florida; John C. Finerty, Ph.D.,
Assistant Dean of the School of Medicine, University of Miami; Arthur
J. Wallace, M.D., Tampa; E. B. Hardee, Jr., M.D., Vero Beach; David









GENERAL ADMINISTRATION


W. Goddard, M.D., Daytona Beach; Homer L. Pearson, Jr., M.D.,
Miami; and James T. Cook, M.D., chairman, Marianna.
As authorized by the Legislature in 1959, one scholarship was awarded
for the study of osteopathic medicine. The recipient was recommended
by the State Board of Osteopathic Medical Examiners.
Scholarships for the study of dentistry were awarded by the SBH upon
the recommendations of the State Board of Dental Examiners.
Scholarships in the several disciplines of mental health were awarded
upon the recommendations of the Florida Council on Training and Re-
search 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.


MEDICAL
Scholarships Awarded in 1964:


Daniel Leslie Benboe ........Tallahassee
Dale Miner Braman ........Gainesville
Clarence Monroe
Harris III ........Indian Rocks Beach
Jack Benson Owen ........Port Orange
Elena Suzanne Rose ............Orlando
Orville Leon Barks, Jr.* ........Sanford


James Patrick O'Leary ....Gainesville
Elizabeth Orene Vaughan ......Bartow
Charles Edward Walbroel .....Orlando
Rosetta Mae Bush ..................Miami
Edmond Delaney
Robinson ..................Ft. Lauderdale


Continuing Scholarships Awarded Prior to 1964:


Awarded 1961:
Jack Denby Bergstresser*
George Duncan Finlay
Buford Gibson, Jr.
Hubert Warren Wingate


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


*Studying osteopathic medicine.


Awarded 1963:
Kenneth L. Beckett
Calvin Collins, Jr.
Beatrice Alfreda
Denefield
Samuel Boykin Hunter
Ronica Mahoney Kluge
Bodo Eitel Pyko*
Kathleen Mary Santi
Shirley Rose Simpson
Ira Harmon Wenze
Phillip Eugene Wright


DENTAL
Scholarships Awarded in 1964:


Wayne D. Bradley ..............Escambia
Roger E. Gibson..........................Lake
Charles L. Graves, III....Palm Beach
James R. Hoover..............Hillsborough


Ronald J. Marien....................Broward
Conrad A. Mora.........................Dade
James E. Owens......................Gadsden
William A. Thompson......Palm Beach









24 ANNUAL REPORT, 1964

Continuing Scholarships Awarded Prior to 1964:


Awarded 1961:
Clement W. Barfield
George Dorris
Guy R. Estes
John T. Griffin, Jr.
Charles A. Harrell
Edward L. Peters
Ivan Beryl Roberts
David M. Strimer
*Scholarship surrendered


Awarded 1962:
George Wallace
Boring, Jr.
Robert R. Burch
*James V. Ferdinand
Ronald E. Molinari
William W. Motley, Jr.
Alvan Carlton Smith
Emory T. Cain
in September 1964.

MENTAL HEALTH
Clinical Psychology


Awarded 1963:
John F. Bembry
Norman M. Bevan, Jr.
Frederick A. Booth, III
Robert L. Ferdinand
Anthony B. Frilingos
George D. Sanchez
Michael R. Kennedy


Judith L. Anderson...............Lakeland
Charles E. Buchanan..........Gainesville
Carol W. Cardoza...............Plantation
William T. Dillon........St. Petersburg
Larry W. Dupree......................Tampa


Charles E. Moan......West Palm Beach
Jacqueline C. Raulerson......Bradenton
Carolyn B. Richards ........Jacksonville
Richard P. Toister........Coral Gables
Dorothy B. Ward ............Winter Park


Psychiatric Nursing


Analie J. Buchler........Pompano Beach
Carol Jean Delcher............Gainesville


Clytee C. Lally..................Avon Park


Psychiatric Social Work


First Year
Myron W. Bedgood..........Jacksonville
Bernard Blackburn ............Homestead
Woodrow W. Bryant, Jr...........Tampa
Donna Cornea ......................Lakeland
Thomas P. Holland .................Bartow
Loreta S. Howard .................Orlando
Sally K. Jackson..............Tallahassee
James O. Lasher................Jacksonville
Mary Jean Laycock..............Rockledge
Jan Mundorff ...........................Starke
Jonnie F. McCormac......Crawfordville
John A. Walker................Tallahassee
Roger L. Wallace....................Seffner


Second Year
George K. Bond* ....................Miami
Berlin G. Jones ..............Tallahassee
Jefferson Lee
Townsend ....................Tallahassee
*Withdrew in October-scholarship
granted to Townsend beginning No-
vember.


Public Health Personnel
M. Depew........................ Public Health Nurse III...........Broward
L. A. Dutton.....................Public Health Nurse II.............Escambia
H. V. Gayles.....................Public Health Nurse II.............Sarasota
D. L. Hilderbrand..............Public Health Nurse IV............State Board of Health
D. B. Jones..........................Public Health Nurse II.............Manatee
M. M. Lentz.....................Public Health Nurse III...........Broward
L. D. Lukin......................Sanitary Engineer V...............Palm Beach
P. A. Maher.....................Public Health Nurse II.............Palm Beach
E. J. McLaughlin...............Health Officer III.....................Charlotte-DeSoto-
Hardee Unit
M. A. Shirley.............Health Educator II................ State Board of Health
A. J. E. Wilson.................Assistant Social Scientist...........Pinellas
R. S. Wright.......................Sanitary Engineer IV.......... ......State Board of Health
M. H. Speakman................Public Health Nurse II...........Highlands








GENERAL ADMINISTRATION


DIVISION OF HEALTH EDUCATION

ELIZABETH REED, R.N., B.S.
Director

This division continues to serve and work with all other bureaus and
divisions, county health departments (CHD), voluntary health agencies,
health-related professions and the general public. Florida's burgeoning
population increases the number of requests received for assistance from
all sources. Positions for health educators on the local level are increasing
with a total of 13 and three vacancies at the year's end. Several more
CHDs are considering inclusion of health educators in their budget in
spite of the difficulty in recruiting suitable candidates at the present salary
levels.
There is more interest in working with people in small groups versus
the campaign type of approach. Increased emphasis has been placed on
adequate planning for the health education aspects of all State Board of
Health (SBH) programs. There has also been added cooperation with
the many persons who function as program representatives and health
field workers as well as with those classified as health educators.

Medical Library
In 1964, 1717 new books were added and 385 worn-out or obsolete
editions were withdrawn bringing the collection to a total of 20,922 on
December 31.
The library is used extensively with SBH personnel making up the
majority of borrowers, followed by those from CHDs. The Jacksonville
Hospitals Educational Program's (JHEP) libraries were next. Local
physicians, nurses, dentists, lawyers and students also are patrons.
The library contains an excellent collection of the latest editions in
the areas of maternal and child health, chronic diseases and psychiatric
nursing. This is primarily due to the availability of categorical funds. New
editions and additions are needed in other fields, particularly engineering
and sanitation.
A total of 1857 books was checked out; 536 issued on indefinite loan
and 10,489 journals were circulated. Many of the latter were mailed out
of town. A policy of restricting borrowing privileges to professional per-
sonnel while permitting on-premise use by others resulted in 2341 books
and journals being recorded as day loans.
Other statistics: 67 interlibrary loans of materials were borrowed from
larger libraries; 282 local interlibrary loans were made to the JHEP
libraries and 1839 photocopies were made.
The year 1964 saw the birth of a publication, Book Bulletin, which
gives the title of new books received. Circulation: SBH personnel,
CHDs and local libraries. Also a supplement to The Bibliography of
Articles by State Board of Health Personnel was compiled.








26 ANNUAL REPORT, 1964


Audio-Visual Library
Again as in 1963 the audio-visual library circulated more materials
than ever before in its history. The increase amounted to over 18 per
cent for the past year. There was also an increase in the number of times
materials were used. In 1963 all aids on which reports were received were
used 15,136 times; in 1964 they were used 17,935 times, an increase of
2799.
Motion pictures continue to lead the field in types of aids used. There
is a record of only one film being televised to an estimated audience of
10,000 persons in Miami.
Thirty-three prints of motion pictures were removed and 136 other
aids were removed primarily because of obsolescence, damage or surplus
titles. The latter included filmstrips, filmstrips with sound, 35mm slides,
tape recordings and one complete category; radio transcription tapes.
During the year 52 prints of motion pictures were placed on loan in
the audio-visual library. Purchases included 176 motion pictures. The
inventory presently totals 1170 prints of motion pictures and 135 other
aids. Other purchases consisted of: a rear projection system for display
purposes, two tape recorders, a lantern slide projector, motion picture
projector, two 35mm slide projectors, automatic filmstrip projector, a
splicer and screen. A new postage meter and scales were purchased.
The major problems continue to be insufficient space and personnel to
conduct an operation of this magnitude. Plans are presently being made
to further curtail circulation until these problems have been solved.
Exhibits and Illustrations
An exhibit made several years ago for an American Public Health
Association meeting in Miami called "The Patio of Public Health" has
now been seen by over 250,000 people and is still in demand. Other
exhibits and displays totaling 56 items were completed, revised or re-
furbished during 1964. Additional activities of the illustrator were: 56
exhibits and displays, 213 illustrations, 137 slides (photographs only), 101
charts-graphs-maps, 66 signs, 59 reproductions, 11 miscellaneous illustra-
tions, 42 conferences and three field trips.

Pamphlets
A record high of 330,000 pieces of material was distributed. This
increase was due in part to the publication of a "Guide for Teachers Wall
Chart" and a new "Public Health Flip Chart" (a speaker's aid), many
pamphlets on smoking, family planning and a number of leaflets in
Spanish. "The Sick Child in School" which describes the activities of
volunteer health workers in schools was revised and continues to be
popular.
Many students visit the pamphlet room and others write or call for
assistance with school projects. This division has a lobby which is not the
main entrance to the SBH yet almost 5000 visitors were received there
last year.








GENERAL ADMINISTRATION 27

Publications, Radio, Television
The circulation of Florida Health Notes (published 10 months a year)
continued to climb in 1964 until 19,000 are now being printed each
month. Only budgetary reasons restrict promotion of this popular publica-
tion. The mailing list was cleared during the year with over 56 per cent
of the cards being returned. Subjects covered in 1964 were: health and
exercise, medical quackery, death regulations, diabetes, mental retarda-
tion, communicable diseases, shellfish sanitation, animal diseases trans-
missible to man, health of Florida's Indians and a simplified annual
report.
Monographs number 6 and 7, Hillsborough County Oral Polio Vac-
cine Program and Millstones and Milestones, were published. Assistance
was given with 30 other books, pamphlets, brochures, etc., as well as the
Annual Report. There were over 140 photographic assignments. This
included the making of many slides.
Approximately 190 radio stations received 53 new spot announce-
ments. Subjects included heart disease, cancer, accidents, etc. Thirteen
TV spots were provided and an informal survey showed that they were
used approximately four times a week. A fruitless effort was a proposed
venereal disease spot announcement campaign.
Other nonroutine activities included preparation of a flip chart for
speakers on laboratory services and a slide series in ascaris.

Miscellaneous Activities
The health education activities of the staff health educator and the
director were multitudinous and included: numerous talks and attendance
at many meetings throughout the state, three regular SBH Orientation
Programs and a Firearms Safety Program for the Seminole Indians at
Brighton and Big Cypress Reservations in cooperation with the Florida
Game and Fresh Water Fish Commission. Assistance was given the
Health Project in Teacher Education (See report of Bureau of Maternal
and Child Health elsewhere in this Report).
There was participation in a number of workshops sponsored by the
Bureaus of Maternal and Child Health and Mental Health. The pos-
sibility of educational TV health programs for junior colleges and uni-
versities was explored with the Florida Institute for Continuing Univer-
sity Studies. One rural Health Council was assisted in its planning.
Consultation was offered to CHDs in the selection, orientation and
routine visits to local health educators. Personnel of the SBH are in-
creasing the number of their requests for assistance in planning the health
education aspects of their programs.
A new set of slides prepared in the division entitled, "How to Reach
the Hard-to-Reach," and given at various meetings in other states,
created much interest. Although prepared primarily for the immuniza-
tion program, it has been found they have many applications to other
public health programs.








28 ANNUAL REPORT, 1964

The major problems of the division are lack of space and the need
for an assistant to the director.

DIVISION OF PERSONNEL

MILES T. DEAN, M.A.
Director

Under the general direction of the State Health Officer, this di-
vision is responsible for the administration of the personnel program of the
State Board of Health. This includes advising administrative officers con-
cerning personnel practices and development; putting into effect pro-
cedures for carrying out approved personnel policies; participating in the
preparation and administration of the approved Classification and Com-
pensation Plan; administering the leave regulations; maintaining ade-
quate personnel records on all persons employed in the agency; acting as
liaison official with the Florida Merit System involving requests for cer-
tificates and reporting on the selection of eligibles, promotions, salary
advancements, salary adjustments, demotions, transfers, dismissals, lay-
offs and resignations; providing and administering a service rating sys-
tem; and the preparation of state and federal reports. 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 administrative payroll and
distribution of warrants. Preparation of the salary portion of the Legisla-
tive Requesting and the Operational Budgets is also a responsibility of
the Division of Personnel.
During the year, the number of employment soared to 1226 in com-
parison with 776 during 1963, a 58 per cent increase. This increase in
employment was due to increased turnover and especially to new project
grants, with the Aedes aegypti Eradication Program contributing the
largest number.
Revision of the Classification Plan for health officers, dentists, nurses,
sanitarians and nutritionists was proposed and is practically completed.
A classification section was added to this division.
Liaison with the Florida Merit System improved and a better work-
ing relationship has been developed.
Salary range changes were proposed and approved by the Merit
System Council to begin on July 1, 1965, provided necessary funds are
made available by the Legislature and other fund sources.
Turnover continues to be a problem particularly among sanitary
engineers, laboratory workers and mental health workers.










GENERAL ADMINISTRATION 29






TABLE 5
NUMBER OF EMPLOYEES IN THE FLORIDA STATE BOARD
OF HEALTH AND COUNTY HEALTH UNITS
AS OF DECEMBER 31, 1955- 1964


State County Health Total
Year Office Departments Employees
1964......................... 843 2326 3169
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










TABLE 6

DISTRIBUTION OF PERSONNEL, FLORIDA STATE BOARD OF HEALTH
(OTHER THAN COUNTY HEALTH DEPARTMENTS)
DECEMBER 31, 1964





ADMINISTRATIVE UNIT 2 0 l
a0 "



Grand Total. ................................... 843 26 10 59 33 18 130 12 130 243 182
Administration
Training.. ... ................................. 22 2 ........ 7 1 ........ ........ 3 1 3 5
State Health Officer.............................. 20 2 ........ ........ ....... ... ..... ................ 5 9 4
H health Education........................ ....... 14 ......... ........ ............... ......... ........ ........ 7 6 1
Personnel.................. .................... 18 ...................... ....... .. ...... ................ 6 12
Nursing....13...................................... 13 ................ 11 ............................................
Encephalitis Research Center................... .. 9 2 ....... ......... .... 2 ... ... 1 4
Research ....................................... 18 1 ........ ........ ........ ......... 2 1 2 6 6
Dental Health ... ................................ 14 ....... 10 ........ ........ ...... ...... ........ 1 2 1
Entomology
State and Regional Offices........................ 20 ........................ 1 ........ 2 ........ 9 5
Research Center-Vero Beach ..................... 62 ........ .......................... 28 ........ 8 4 22
Finance and Accounts
Fiscal ......................................... 14 ........ ........ ....... ........ ................. ........ 5 7 2
Purchasing and Property ......................... 7 ....................................... ...... ......... ........ 4 3
Building and Facilities ............................ 35 ...................................................... 1 1 33
Laboratories
Central-Jacksonville ............................ 60 ........ ........ ........ ........ 1 38 ........ ........ 9 12
Miami................. .... .... ....... 23 ........ ................. ...... .. ....... 16 ................. 2 5
Orlando ....................................... 10 ........ ........ ..... .... ................ .............. 1 4
Pensacola ..................................... 6 ........ ........ ........ ........ ........ 3 ........ ........ 1 2
Tallahassee............................ .......... 7 ........ ............ ..... .. ......... 4 ........ ........ 1 2
Tampa ......................................... 23 .................... ..... ... ........ 11 ........ ......... 2 10
W est Palm Beach........................ .. .... 6 ....... ....... .... ......... ........ 4 ........ ........ 1 1
Epidemiology of St. Louis Encephalitis. ............. 19 ....... ........ 1 ................. 7 ........ 1 2 8
Local Health Services
Bureau of Local Health Services ................... 14 4 ........ 1 ........ 1 .............. 2 6
Sanitation................ ......................... 6 ........ .......................... 5 .............. .......... 1
Nutrition ....................................... 10 ................................. ....................... 8 2
Civil Defense............................................... 2 ......................... ............. 1 1
Accident Prevention.... .......................... 2 1 ........ ........ .................. ....... ....... 1 .......











TABLE 6 (Continued)
DISTRIBUTION OF PERSONNEL, FLORIDA STATE BOARD OF HEALTH
(OTHER THAN COUNTY HEALTH DEPARTMENTS)
DECEMBER 31, 1964





ADMINISTRATIVE UNIT a




Maternal and Child Health ....................... 47 5 ........ 17 ....... 2 ....... 4 3 12 4
Mental Health. .................................. 18 1 ...... 1 .............4 3 8 1
Narcotics ......................................... 18 ................................................................ 5 13
Preventable Diseases
Bureau of Preventable Diseases................... 6 2 4
Radiological and Occupational Health.............. 25 1 ...... 1 ........ ........ 12 6 3
Tuberculosis Control ............................. 26 2 ......... ............... ........ 12 10
Veneral Disease Control .......................... 20 ........................................... 16 4
Veterinary Public Health ......................... 5 ...2 ....................... 2 1
Vaccination Assistance Project.................... 36 ............... 19 .... ..... 1 ........ 4 9 3
Sanitary Engineering and Air Pollution Control... 86 ........ ................4 3 ........ 3 1 22 25
Special Health Services
Bureau of Services for Indigent................... . 6 ........ ...................... 3 3
Hospitals and Nursing Homes ..................... 11 1 ..... ...... ............... 5 4
Chronic Diseases................................. 19 2 ........ 1 1 1 11
Community Cancer Demonstrations................ 3 ........ ................ .................. .... ....... 1 2
Vital Statistics
Bureau and Division of Vital Records.............. 44 ........ ......... .. ..... ............... ................ 3 39 2
Statistics................................... .. 6 ..................... .. 4 2
Data Processing ................................. 13 ........ ........ ........ .... :: ........ .. .. ........ 3 10









32 ANNUAL REPORT, 1964

TABLE 7

DISTRIBUTION OF PERSONNEL IN COUNTY
HEALTH UNITS, FLORIDA, DECEMBER 31, 1964













Baker 4 ...... ...... 1 ..... 1 .....1 1 .

Bay ... .. 16 1 ...... 6 ..... 3 ..... 2 ...... 2 2
Bradford...... 7 1 ...... .... .... 1 1
Brevard..... 45 1 .... 14 1 8 .. 2 1 15 3
Broward a.... 236 19 27 2 19 3 9 4 18 10
Alachua....... .44 2 1 12 ...... 1 ..... .... 10 7
Charlotteker .......... 4 .... 1..... ..... ...... 1 1.


Citrus........ 6 1 ...... 2 ...... 1 ...... ..... 1 .....
Bay........... 16 1 6 ...... 3 ...... 2 ...... 2 2
B radford....... 7 1 ...... 3 1 ...... 1 ..... 3 1
ColuBrevard....... 14 1 ...... 14 1 8 ...... 1 1
Browarde ........ 8 1 27 2 19 7 13 4 82 31
Calhounto ....... ..... 1 ..... ...... 2 ...1
DixiCharlotte...... .. 12 14 ......... ......... ...... ...... ..... 1
Citrusal........ 6 1 ...... 1 ........ 1 ...... 1 11 4



Escambia ... 68 4 ...... 19 ...... 13 ...... 4 2 17 9
Clagler.......... 2 ...... ...... ...... ....... ..... ...... 1. 1


Colankliner.... ..5... 12 1 1...... 1.... ...... 2 1
Columbia...... 10 1 4 3. 1 1


Dadde.......... 426 47 14 1 57 4 7 13 2 82 31
Gilchrist .... 7 ...... ...... 2 ............ 1. .... .. ... .. 1 2
D ixie ........... 4 ...... ... .... ...... 1 ..... .... 1 ..
Duval ......... ...... 16 ...... 1 ...... ...... ... 2 11 4
Escambiat ...... 68 4 ...... 19 13... 4 2 17 9
F a lee...... .. ... ................. ... .... .. 2 1
Gadden....... 14 1 .... 7 ...... 1 .................. 2
Gilheristnando...... 2 3 ...... ...... 2 ...... ..... ................ .1 .

Highlades........ 2 ... ...... 4 ... ... ..... ...... 2 .1
Gulf........... .5............ .. ......... 1 ................. .2



Hillsborough .... 196 6 2 71 2 38 1 4 6 35 31
Haoe ...... 5 ...... ...... 2. ...... 1 ..... ..... ...... 1
Hnde ... 10 ..... .......... 1 ................ 2 1


Jakesondy........ 15 1 ...... 5 ...... 12 .................. 2 4
Jeffernando...... 2 1 ........... 1 ...... ...... ..... ...... ... ... 1


Highlands...... 10 .1...... .......... 1 ..... ...... 1 1
Hillsborough.... 196 6 2 71 2 38 1 4 6 35 31

Home ........ 1 1 1 7 ...... 3 ...... ...... ..... 4 1
Indian River... 10 1 ...... 6 ...... 4 ...... 1. ..2 1..
Leckson... ....... 1 ...... 1 ...... 2 ...... 1 11 4
Jeferson...... ...... 2 ...... 1 ...... ...... ...... 1 2
Lafayette .... 4 ...... ...... 1 ...... ... .... ....... 1 1
L ake.dison ....... ....... ...... 3 ...... ...... .. 4 2
Manatee....... ... 17 1 ...... 1 6...... 6 ...... 2 7 3
Leon.......... 39 3 ...... 11 ...... 6 ...... 3 1 11 4

M arioLevy ......... 1 ...... ...... 3 1 ...... .. 1 3 2
Libertin ........ 3 ...... ...... ............ ...... .... .... 1
Madonroe....... 622 1 ........ ...... 1 1 1....
Manatee........ 32 1 ...... 4 11...... 2 ...... .... 3
OMarion....... 1. ........ ....... .3 .......1 1 3 2
OkeeMartin..........hobee.... ..... ...... 3 ...... ...... ...... 1 1
Monroe........ 22 1 1..... 7 ......4 1 .. 4
Nassau. ......... 13 1 ...... 4 ...... 2 .................... 3 3
Okaloosa....... 15 1 5...... 6 ...... 3 ............. .. 1 3 2
Okeechobee..... 6 ............. .. 3 ...... 1 . . 1 1
Orange......... 91 4 ...... 26 1 16 ...... 4 4 22 14
Osceola ..... .. 5 ...... ...... 2 ...... 1 ...... ...... ...... 2 .
Palm Beach ... 111 6 2 32 1 20 ...... 9 5 23 13
Pasco.......... 9 1 ...... 3 ...... 1 ...... ...... ...... 3 1
Pinellas........ 181 9 1 71 3 30 3 5 8 36 15
Polk........... 95 3 ...... 39 1 12 ...... 4 2 19 15
Putnam ........ 15 1 ...... 5 ...... 4 ...... 1 ...... 3 1
St. Johns....... 10 1 ...... 4 ...... 2 ...... ...... ...... 2 1
St. Lucie....... 19 1 ...... 3 ...... 5 ...... 4 ..... 5 1
Santa Rosa..... 12 1 ...... 5 2...... 2 ...... ........ 2 2
Sarasota ....... 44 1 1 15 ...... 8 ...... 2 ..... 14 3
Seminole....... 18 1 ...... 8 ...... 3 ...... 1 ...... 3 2
Sum ter........ 4 ...... ...... 1 ...... 1 ...... ...... ...... 1 1
Suwannee...... 9 ............ 4 ...... 1 ............ ...... 2 2
Taylor......... 5 ...... ...... 2 ...... 1 ...... .... ...... 1 1
Union......... 3 ...... ..... 1 ...... 1 ...... ..... ...... 1 .
Volusia........ 58 3 1 20 .. 8 ...... 7 ...... 10 9
Wakulla....... 3 .. ...... 1 ...... ............ 1 ..... 1
W alton........ 7 ...... ...... 2 ...... 1 ...... ...... 1 1 2
Washington.... 5 ...... ...... 2 ...... 1 ...... .............. 1 1










GENERAL ADMINISTRATION 33




TABLE 7 (Continued)

DISTRIBUTION OF PERSONNEL IN COUNTY
HEALTH UNITS, FLORIDA, DECEMBER 31, 1964








Bowrd A A. 4 5 1 4
COUNTY I i S




Eradication of
Aedes Aegypti
M osquitoes..... 8 ...... ...... ...... ..... ............ ..... 2 6 .....
Broward A.A... 45 ........................ ........................ .... 1 44
Dade A.A...... 107 ..... ..................... .................. 2 105
Hillsborough
A.A.......... 49 ......... ................ ....... ........... 1 48
Manatee A.A.... 23 .......... ......................... ... 1 22
M onroe A.A.... 15 ...... ...... ...... ...... ...... ............ ...... 1 14
Palm Beach
A.A.......... 19 ...... ..... ...... ...... ...... ........ ..... ...... 1 18
Pinellas A.A.... 40 ...... ......... ....... ................40
Polk A.A....... 1 ........................ ...... ..................... 1






TABLE 8

PERSONNEL TURNOVER BY POSITION CLASSIFICATION,
FLORIDA STATE BOARD OF HEALTH AND
COUNTY HEALTH UNITS, 1964


CLASSIFICATION TERMINATIONS TURNOVER RATE

Physicians. ...................................... 29 20.0
D entists ......................................... 2 6.0
Public Health Nurses .......................... 107 14.2
Sanitary Engineers.................................... 9 18.8
Sanitarians...................................... 30 8.6
Laboratory Workers (Prof. and Tech.) ............... 27 17.8
M ental Health ................................... 23 22.8
Other Professional and Technical................... 34 20.0
Clerical............................... .... 143 21.8
All Others..................................... ..195 29.7
Total. .......................................... 599 20.8

Not including persons employed on a temporary or for a specific duration. There were 208 such
terminations.









34 ANNUAL REPORT, 1964


TABLE 9
EMPLOYMENT TERMINATIONS AND TURNOVER RATES BY
CLASSIFICATION AND SALARY, FLORIDA STATE BOARD OF HEALTH
AND COUNTY HEALTH UNITS, 1964
(FULL-TIME EMPLOYEES ONLY)


SALARY

CLASSIFICATION Total Under 200- 300- 400- 00- 600- 700- 800- 900- 1,000
199 299 899 499 99 9 9 799 899 999 Over

TERMINATIONS 1964

Total-All Employees....... 541 24 152 239 68 19 19 4 3 3 10
Physicians ................. 18 ....... 1 . 2 10
Dentists................... ..... 2 ...
Sanitarians................ ..... ..... 1 16 1 .
Sanitary Engineers..... ....... ...... ... ...... 5 2 ..... ..... ..
Public Health Nurses....... 107 ......... 28..7. 1 1..............
Laboratory Workers
(Prof. & Tech.)........... 15 ..... 8 3 4 .....
Mental Health................ .... .... ... 5 4 6 1 2.........
Other Professional and
Technical................ 25 ..... 2 9 3 6
Clerical.................... 134 3 100 29 2 .... .
All Others ................. 186 21 42 112 4 4 1 1

TURNOVER RATE-(ANNUAL PERCENTAGE)

Total-All Employees....... 18.6 57.1 31.3 22.1 9.8 8.2 12.9 9.8 7.7 23.1 10.4
Physicians................. 15.9 .............. .... .... 50.0 ..... 10.0 12.8
Dentists................... 6.0 ..... ..... ..... .... ..... 10 ..
Sanitarians................. 9.2 .......... 23.6 8.9 ..... 2.8 ...................
Sanitary Engineers.......... 16.0 ..... ..... ..... ... 50.0 20.0 .. .... 20.0 ....
Public Health Nurses ....... 14.6 ..... ..... 22.6 8.1 ..... 12.5 10.0 ..............
Laboratory Workers
(Prof. and Tech.)....... 13.5 ..... 44.4 9.1 13.8 26.7 ........................
Mental Health............ 22.5 .............. 55 11.1 26.1 25.0 33.3.........
Other Professional and
Technical................ 15.6 ..... 83.8 28.8 16.1 9.7 22.2 .................
Clerical.................... 20.8 88.8 32. 9.9 7.1 ..... ... ... ....
All Others ................. 28.3 42.9 27.5 3.4 8.7 22.2 4.2 8.3 9.1... ...



DIVISION OF PUBLIC HEALTH NURSING

ENID MATHISON, R.N., M.P.H.
Director

The responsibility of this division is to plan, promote, develop and
administer a statewide public health nursing service through the county
health departments (CHD). This involves continuous correlation and
coordination with the programs of other bureaus, divisions and related
health agencies.
The consultants participate in planning for and implementing studies
and research relating to nursing, assist CHDs in integrating and co-
ordinating services to provide for continuity and improvement of public
health nursing and nursing care of the sick at home programs, promote








GENERAL ADMINISTRATION 35

continuing education and inservice training for nurses and interpret
State Board of Health policies to nursing personnel.
Plans are being developed for additional field teaching centers in the
state to conduct a two months' orientation in public health nursing for all
newly employed nurses who have not had preparation in public health
in their basic nursing program. A U.S. Public Health Service Short-term
Traineeship Grant made possible a three weeks' workshop at the School
of .Public Health, University of North Carolina, in June. One consultant,
one university faculty member and two supervising nurses participated
in the workshop, designed to develop course material for use in the
orientation programs. The nursing consultants assume a very active role
in the inservice education programs in counties. This includes assistance
in planning, conducting and evaluating. Much emphasis is given to the
coordination of the resources of other health agencies in the area of
education and service. Joint planning committees are encouraged and
consultants serve on many of these on a state level.
Nursing care of the sick at home is being more widely accepted as an
important component of comprehensive care. There has been a gradual
increase in the expansion of CHD programs to include this service.
Forty-two areas in the state have included this in their generalized public
health program. This is done in cooperation with, and in many areas
partially supported by, community nursing councils incorporated as non-
profit bodies. Fees collected from patients are administered by the
community nursing councils; these are adjusted to the ability of the
patient to pay for nursing care. No one is denied service because of in-
sufficient funds. In the smaller counties where there is not yet a formally
organized program, care is being given on a limited basis. Referrals from
a physician are required for continuing care of the sick in the home.
Six of the larger metropolitan areas in the state have independent
voluntary visiting nurse associations.
A method for determining the time and cost of units of nursing
activities was devised. Directors, supervisors and senior nurses were in-
vited for a two day conference to learn the method. A primary reason
for the studies was to validate the cost of nursing care of the sick at home
for Medical Assistance to the Aged patients. Five CHDs have completed
the study and seven more are in the planning or tabulating stage. Six
visiting nurse associations have completed cost studies. The average cost
of nursing visits in counties which have reported is approximately $5.62.
The division schedules visits by public health nurses to mental and
tuberculosis hospitals and Sunland Training Centers on a year-round
basis. All fields of nursing are represented, making it possible for them
to see the improved facilities available in Florida for the care of people
with long-term illnesses and learn of the advances in the care and
treatment of chronic diseases.
The nursing consultant assigned to the mental retardation program
assumed major responsibility for scheduling and planning orientation
programs at the four Sunland Training Centers. (See Bureau of Maternal
and Child Health elsewhere in this Report.)








36 ANNUAL REPORT, 1964


In July a position was assigned to the division for a consultant in the
nursing home program. This nurse works closely with the Division of
Hospitals and Nursing Homes, receiving her technical guidance from
there. She has made 15 visits to CHDs and 31 visits to nursing homes.
Orientation for this consultant included participation in an Institute
on Home Care in Cincinnati, Ohio, and an Institute on Administration
of Nursing in Medical Care Programs at the University of Michigan.
Programs of 12 hours each entitled, "The Role of the Nurse in Re-
habilitation of the Patient with a Stroke," were held in nine areas of the
state in cooperation with the Florida Heart Association. The rehabilita-
tion consultant has conducted 17 educational programs in 12 nursing
homes and 15 inservice study groups for public health nurses.
The gradual decrease in the number of midwives licensed continues;
in 1964 they were reduced to 191. The number of counties without a
midwife has risen to 15. Despite the decease in number of midwives and
births attended by them, 12.8 per cent of the nonwhite mothers are de-
livered by midwives. New candidates for midwifery are required to
attend the trainee program at a maternity home in Sanford. Supervision
of the program is provided by the maternal and child health consultant
and CHD personnel. Fifty-five visits to 22 counties were made in the
interest of the midwife program.








BUREAU OF DENTAL HEALTH 37

FLOYD H. DeCAMP, D.D.S.
Director
DELMAR R. MILLER, D.D.S., M.P.H.
Assistant Director

In 1964, this bureau began its 15th year which has been the most
successful in its history.
PRECEPTORSHIP PROGRAM
This program continued to fulfill its primary purpose as a method of
recruiting dentists to staff dental clinics in county health departments
(CHD). Since the beginning of the program in 1957, nearly 100 qualified
young dentists from out-of-state have been employed. A major portion are
now engaged in private practice in the state and maintain a keen in-
terest in the public health problems of their respective communities as a
result of previous experience in the CHDs.
Dental preceptees are selected by the Florida State Board of Dental
Examiners and supervision of their work is provided by a dental con-
sultant from this bureau, a committee of dentists from the local dental
society and the director of CHDs in their respective areas.
Counties served by dental preceptees during all or a portion of the
year were Alachua, Broward, Collier, Flagler, Glades, Hendry, Highlands,
Hillsborough, Lake, Manatee, Marion, Palm Beach, Polk, Putnam,
Sarasota, Santa Rosa and Volusia.
DENTAL SCHOLARSHIPS
The dental scholarship law, as amended in 1961, provides a stipend
of up to $1000 a year for as many as four years for recipients who must
agree to practice in "areas of need" (where there are few or no dentists)
for 12 months for each $1000 received. Under certain circumstances,
students may repay the funds received. Since 1955, 101 scholarships have
been awarded with four cancellations before becoming effective.
Disposition of the 59 graduates to date:
Serving in areas of need ......................................... ......... 26
Repaid scholarship in full............................... .............. 13
Completed compensatory practice ........................................ 5
In military service .................................... ............... ......... 9
Repaying scholarship ...................................... ................ 4
Unable to qualify for Florida licensure ................................---- 2
59
DENTAL CLINICS
An increased number of counties were served by full-time licensed
public health dentists. These counties were Alachua, Broward, Dade,
Duval, Liberty, Jackson, Orange, Palm Beach, St. Johns and Volusia.
Two fully equipped mobile dental clinics are maintained to serve
underprivileged children in areas having few or no practicing dentists.








38 ANNUAL REPORT, 1964


During 1964, one clinic operated for a period of seven months. The other
clinic was operated by a dental preceptee for a period of 10 months.
A summary of services performed follows:
School dental inspections .................................................... 743
New patients ...................................................................... 1743
Repeat patients .................................................................... 927
Prophylaxes ................-...........---- .......... ............................. 470
Fillings (all types) .......................................... 4290
Extractions................................................................................. 1416
Miscellaneous treatments ........................................... 265
Topical fluoride applications ....................................... ..... 5
Talks given to school and civic groups .......................... 22
Pamphlets distributed ...................................................... 150
In addition to routine dental services, one mobile clinic was utilized
for one month to provide dental services for underprivileged children
attending a special school for the handicapped. The results obtained were
satisfactory and indicate a need for further effort in this area.
New dental clinics began operating this year in Collier and Jackson
CHDs. The Hardee CHD completed equipping a dental clinic and a
dental preceptee was employed to begin work in January 1965. Plans
were initiated to establish clinics in Charlotte and DeSoto CHDs also.
New CHD buildings completed in Highlands and Putnam Counties in-
clude dental clinic areas.
Plans were made in 1964 to acquire the additional equipment neces-
sary to ready the Palm Beach CHD dental clinic facilities to provide
training tours for students at nearby Palm Beach Junior College, School
of Dental Hygiene. Plans for a dental clinic are included in the proposed
new health unit scheduled for Venice in Sarasota County.
A licensed dental hygienist was employed for 11 months of 1964.
Working in seven different counties, she gave dental inspections to 9740
children in 23 schools. She also lectured and engaged in other health
education work. Special work was done for students at the Florida School
for the Deaf and Blind at St. Augustine and 4-H Club girls at the state
encampment in Marion County. More than 200 prophylaxes and stan-
nous fluoride treatments were given.
Strong support was received from civic and professional groups by
many local dental health programs. Contributions of money, equipment,
materials and volunteer assistance helped sustain operation of clinics.
The bureau received and responded to many requests for consultative
services in connection with plans for establishing or modifying dental
clinics in CHDs.

FLUORIDATION
This important means of reducing dental decay continued to be of
great interest to many communities in the state during 1964. Pensacola
and Palatka began fluoridating their water supplies during the year.
Active programs to secure fluoridation continued through the year in
DeLand and North Miami Beach.








DENTAL HEALTH 39

Currently, 26 Florida cities with a combined population of 813,000
are fluoridating water supplies. An additional 27 cities with 325,000
people, including Jacksonville and Sarasota, have water supplies con-
taining approximately the correct amount of fluoride as a natural com-
ponent. In all, areas having a total population of nearly 1,138,000 are
now receiving benefits of water fluoridated at near optimal level.

LACTOBACILLUS LABORATORY PROGRAM
An increased number of dentists utilized this service during the past
year. In all, 103 dentists participated in the program this year, and a
total of 2935 specimens was tested by the Central Laboratory and reports
were made to individual dentists by this bureau.

EDUCATION
The distribution of the State Department of Education's Bulletin
No. 7 A Guide-Design for Teaching Dental Health in Florida Schools
in 1963 was followed in 1964 by activities which would encourage its
further distribution and use. The Florida State Dental Society initiated
a plan by which private dentists are appointed to serve as dental ad-
visors to schools, to initiate and encourage the use of this Bulletin by
the teachers.
This bureau conducted meetings in cooperation with the dental
advisors, CHD personnel, county school administrators and teachers to
demonstrate dental teaching materials and develop channels of communi-
cation for the interchange of information between the key persons in
school and community health programs.
The dental health educator continued to work with dental health
programs on a local and state level and acted as consultant and lecturer
to schools of dental hygiene, universities, 4-H club groups, the Florida
School for the Deaf and Blind, etc.

ORAL CYTOLOGY PROGRAM
This bureau applied for funds to the U. S. Public Health Service and
was granted sufficient funds to initiate a study program to obtain further
information on the effectiveness and reliability of exfoliative oral cytology
as a means of early oral cancer detection.
This program in its initial phase was limited to the Northeast Dental
District and began in June 1964 with an orientation session held for all
dentists practicing in the 17 counties of the district, participating general
pathologists and members of the Florida Division of the American Cancer
Society.
Cooperating pathologists began examining the smears (and in some
instances, biopsies) submitted by participating private dentists in July
1964. These services are paid for by this bureau.
This program was designed to include service to recipients of public
assistance and to patients of private dentists since it is intended to test
the applicability of the technique for both groups.








40 ANNUAL REPORT, 1964


BUREAU OF ENTOMOLOGY
J. A. MULRENNAN, B.S.A.
Director

This has been a year of bureau reorganization and the initiation of
the federally supported Aedes aegypti Eradication Program.
Plans were started in February to secure federal funds to assist in the
construction of the West Florida Arthropod Research Laboratory at
Panama City. On August 21 a construction grant was received of
$45,600 from the Research Facilities and Resources Section of the Na-
tional Institutes of Health. It is expected that by the first part of 1965
construction will be started on three structures to house the laboratory
facilities to carry out the applied research on all arthropods affecting the
health and comfort of man.
The 1963 Legislature appropriated $65,000 for the construction and
equipment of this laboratory. With the additional funds obtained from
the federal government the facility needs in this field will be projected
for many years to come.
The federally-supported Aedes aegypti Eradication Program was
started in May in the following counties: Monroe, Dade, Broward, Palm
Beach, Manatee, Pinellas and Hillsborough. The program, for the most
part, has consisted of spraying with 2/2 per cent DDT all types of con-
tainers on the premises in the residential and industrial areas of the
counties.
The first contract for this operation with the U. S. Public Health
Service (USPHS) was for the period April 1 to September 30, and was
extended to December 31 and carried $607,475 in funds. This contract
authorized the employment of 281 inspectors, 31 supervisors, seven clerks
and two clerk-supervisors. During the year the eradication program met
with excellent reception from the public. At the year's end over one-half
million premises had been inspected or sprayed. The Aedes aegypti in-
dices were highest and most persistent in Broward and Dade Counties.
The lowest indices following treatment have been found in Pinellas,
Hillsborough and Monroe Counties.
ARTHROPOD CONTROL
Source Reduction Accomplishments
The number of counties and/or mosquito control districts participating
in the state aid program for the control of arthropods totaled 57 pro-
grams operated in 53 of the 67 counties in the state. Holmes County
withdrew temporarily from participation this year due to legal difficulties;
a new district was formed in south Walton County and began participa-
tion as of October 1; and, two city programs in Osceola County were
combined under one operational plan with the county when the county
budgeted funds for arthropod control work. Two separate programs are
now being operated in individual areas of Bay, Duval, Lee and Walton
Counties.








ENTOMOLOGY 41

Source reduction methods consisted of the construction of dikes to
impound water on salt-marsh mosquito breeding areas; drainage and
ditch maintenance; hydraulic filling of mosquito breeding areas using
two 10-inch hydraulic dredges; deepening and filling, using draglines
and/or bulldozers; and, the operation of sanitary landfills.
The following tabulation shows the amount of source reduction work
performed, based on reports made to this office by counties and districts.
A gradual change in reporting program costs is being made, which will
account for unit cost differences in sanitary landfill operations when
compared with figures shown in previous annual reports:

1963 1964
Machine Ditching and Maintenance
Number of counties participating .......................... 32 33
Miles of ditches dug or maintained .......................... 466.43 447,164
Cubic yards earth excavated ........................ .......3,856,172 3,604,286
Average labor cost per cubic yard ............................ $0.094 $0.1032
Construction of Dikes (Draglines)
Number of counties participating ............................ 5 4
Number of miles of dike constructed ...................... 51.86 47.54
Cubic yards earth placed in dikes ............................ 773,442 937,037
Average labor cost per cubic yard .......................... $0.070 $0.0615
Hydraulic Dredging (Two 10-inch Dredges)
Number of counties participating .......................... 2 2
Number of dredges used .......................................... 2 2
Cubic yards earth fill placed .................................. 523,073 1,023,298
Average labor cost per cubic yard ...................... $0.108 $0.0575
Deepening and Filling (Draglines and Bulldozers)
Number of acres improved ........................................ 67 97.631
Average labor cost per acre .................................. $192.85 $132.21
Sanitary Landfills
Number of counties operating landfills ................... 34 35
Total number landfill sites operated........................ 92 121
Number of cubic yards garbage buried ..................5,248,533 4,989,121
Average labor cost per cubic yard .......................... $0.069 $0.075
Total field costs per cubic yard .............................. $0.121

Temporary Control Measures

This method consists of repetitive application of chemical insecticidal
formulations by ground and aerial equipment in an effort to provide tem-
porary relief from mosquitoes, midges, dog flies and occasionally other
arthropods of public health importance.
Dibrom and Malathion continued to be the principal insecticides used
against mosquitoes. Baytex was not used, since only one bid was re-
ceived and the bidder could not furnish material directly.
Both Dibrom and Malathion were made available for delivery in
bulk quantities for the first time this year, at some savings in cost to the
purchaser as compared with the cost of drum quantities.









42 ANNUAL REPORT, 1964

The following is a summary of the temporary control work performed
in controlling mosquitoes by the 46 counties and/or mosquito districts:
Adulticiding with Ground Equipment
1963 1964
Number of miles fogged .......................................... 377,516 372,537
Gallons of insecticidal formulation used ................2,733,711 2,559,085
Labor cost per mile .................................................. $0.513 $0.570
Beginning on October 1, 1964, revised reporting procedures for ground
fogging operations were placed in effect. The cost of the insecticidal for-
mulation used, plus labor and all other direct field costs, is reported and
used to compute fogging costs on a per hour and per mile basis. The
following is a summary average of the fogging work performed by the
41 counties and/or districts doing this type of control work during the
October-December 1964 period. All reporting in the future is expected
to be on the basis of field costs.
(October-November-December 1964)
Number of counties or districts doing ground fogging........................ 41
Total hours fogged .................................................................................. 5,205
Total miles fogged ................................................................................ 31,473
Gallons insecticidal formulation used ................................. .... 219,127
Average cost per hour fogged .............................................................. $22.00
Average cost per mile fogged ............................................... .... $ 3.64
Adulticiding and Larviciding with Airplanes
1963 1964
(1) Airplane Fogging
Gallons of insecticidal formulation used.................. 84,905 227,041
Acres treated .............................................................. 881,321 2,706,840
Gallons applied per acre .................................. .0963 0.10235
Labor cost per acre treated ..................................... $0.0117 $0.0112
(2) Airplane Spraying
Gallons of insecticidal formulation used.................. 185,757 160,124
Acres treated .............................................................. 301,421 221,864
Gallons applied per acre ........................................ 0.6163 0.7217
Labor cost per acre treated ................................. $0.134 $0.125
(3) Airplane Larviciding
Pounds of paris green pellets used ................... 149,286 236,465
Acres treated ................................. ........... 9,523 22,779
Pounds applied per acre (average 5 per cent mix).. 15.67 10.38
Labor cost per acre treated ................................. $0.413 $0.4945
Dog Fly Control
Dog fly control work carried out in the eight most western Florida
counties bordering the Gulf of Mexico consisted of patrolling the shoreline
at seven to 10-day intervals from July until sometime in October, and
spraying windows of marine grasses deposited along the shoreline. A
high velocity stream of salt water, containing five per cent emulsifiable
DDT, was used as an insecticide to prevent breeding and emergence of
dog flies from these windows.
The program was reasonably effective, as only one or two minor
outbreaks were noted, and these were of short duration and local in
extent.
Authorities in charge of the large fish and wildlife refuge in Wakulla









ENTOMOLOGY


County did not permit any treatments to be made on their properties this
year. Since no inspections were made along the 25 to 30 miles of shoreline
on this property, it is not known at this time how much this treatment
omission affected the remaining part of the county.
The following is a summary of the dog fly control work performed:
1963 1964
Total miles of shoreline treated ................................ 1,284 962
Gallons 35 per cent DDT concentrate used ............ 8,456 12,634
Average labor cost per mile .................................... $6.71 $8.33
No. man-hours labor required .................................... 6,308 5,686

Counties Participating and Local Fund Budgets
The following counties participated in the State Arthropod Control
Program during the year. The amounts of local funds budgeted for
arthropod control activities during the fiscal year October 1, 1964
through September 30, 1965, are (as of December 31, 1964), as follows:
Local Local
Amount Amount
County Budgeted County Budgeted
Alachua ..........................$ 54,240.00 Leon ...............................$ 60,000.00
Bay (Co. Comm.) ........ 90,799.00 Levy ................................ 15,000.00
Bay Co. (Gulf) .......... 47,900.20 Madison ................... 1,953.00
Bradford ................ 13,024.64 Manatee ................ 90,465.91
Brevard ........................ 306,851.15 Marion ...................... 15,000.00
Broward ................. 68,247.00 Martin .................... 40,800.00
Calhoun ........................ 2,500.00 Monroe ................... 241,838.82
Charlotte ...................... 63,106.83 Nassau ..................... 55,749.00
Citrus ............................ 98,278.40 Okaloosa ............... 38,803.19
Collier ......................... 143,119.22 Orange ...................... 74,000.00
Columbia ...................... 15,228.06 Osceola ..................... 46,830.26
Dade ........................ 241,458.00 Palm Beach ............. 273,278.00
Duval (East) ............ 91,840.50 Pasco ..................... 62,249.00
Duval (Northeast) ........ 110,565.00 Pinellas .......... 247,577.90
Escambia ...................... 133,311.90 Polk ......................... 207,683.78
Flagler ..................... 14,303.54 Putnam .................... 25,000.00
Franklin ................... 15,000.00 St. Johns ................ 75,693.62
Gadsden ........................ 11,710.00 St. Lucie ................... 135,553.00
Gulf .............................. 37,500.00 Santa Rosa .............. 32,565.53
Hardee .......................... 4,700.00 Sarasota .......................... 166,408.59
Hernando ...................... 6,242.16 Seminole ................ 15,000.00
Highlands ...................... 4,483.00 Suwannee ................ 9,490.24
Hillsborough .................. 313,400.00 Taylor ...................... 5,000.00
Indian River .................. 320,496.22 Volusia .......................... 289,000.00
Jackson ........................ 4,060.38 Wakulla ..................... 18,000.00
Jefferson ...................... 10,255.58 Walton ...................... 6,800.00
Lake ................................ 82,065.40 Walton (South) ........... 18,544.24
Lee (District) ................ 337,554.00 Washington .................... 2,800.00
Lee ( Beach) .............. 60,325.03
Total local funds appropriated .......................... .............$4,973,649.29
Total state funds appropriated ............................................ 1,650,000.00
TOTAL........................................................ ............$6,623,649.29
Engineering
Assistance was given a considerable number of counties and districts
in reviewing their proposed specifications for the purchase of heavy








44 ANNUAL REPORT, 1964

equipment, and offering suggestions for changes in these specifications
where needed.
Considerable time was given to the review of all proposed work plans
and budgets submitted by the counties and districts. Field reviews of
programs and construction of projects were made.
In cooperation with the Division of Sanitation a survey was made of
Broward County's garbage and refuse disposal problem in December.
Based on field survey work and consultation with the design engineers,
recommendations were made to the City of Punta Gorda pertaining to
clearing of the Shell Creek water storage reservoir, for mosquito control
purposes, prior to impounding. The gates were closed in the late fall.
However, the reservoir had not reached the designed operating pool
elevation by the end of the year.
A survey of a proposed impoundment near Middleburg in Clay
County was made, construction plans reviewed, and an approval was
issued.

Regional Entomologists
Regional entomologists have maintained headquarters and serviced
their respective areas from Panama City, Jacksonville, Orlando, Tampa
and Miami. Mosquito control and landfill operations are standard year-
to-year functions, requiring services from the regional entomologists in
planning, budgeting, consulting on operational methods, evaluating and
reporting activities of the 57 local programs. These men guide and co-
ordinate the state and local interests, so that the field work gives the best
results to all concerned. They are also on call for any entomological or
special allied program that develops within the state.
Special duties this year have included meeting with county com-
missioners to discuss organization of mosquito districts; inspecting hurri-
cane disaster areas and advising on emergency fogging or control measures
and restoration of ditches; supervising the construction, design, operation
and location of new bird-baited traps being used in encephalitis studies;
locating, relocating, arranging for new construction and repairs of equip-
ment and hurricane-damaged areas, training and securing cooperators
(who man mosquito collecting stations), and handling correspondence for
the salt-marsh mosquito trapping program; assisting in the structural pest
control program (particularly in the Orlando, Tampa and Miami areas);
writing and distributing pest control leaflets; collecting and assisting in
collecting mosquitoes for encephalitis studies reported elsewhere; and,
otherwise helping people who telephone or visit the bureau with their
insect and pest problems.
During this year Putnam, Marion and Levy Counties were added to
the Northeastern Region (Jacksonville), and Collier County to the
Southern Region (Miami).








ENTOMOLOGY 45


Arthropod Identification Laboratory
This basic work evaluating the salt-marsh mosquito populations
for the effectiveness of mosquito control, includes the identification of
mosquitoes caught in 43 traps near salt marsh areas around the coastal
margin of the state (as recorded in the weekly "Salt Marsh Mosquito-
gram"), fresh water mosquito collections from 70 other traps operated
at Woodruff Dam, North Bay Impoundment, Shell Creek Impoundment
and special locations distributed over the entire state. In addition, identi-
fications and information were frequently furnished to the general public
on all kinds of arthropods and miscellaneous pests.
The laboratory identified 10,063 adult and 33 larval collections, con-
taining a total of 856,706 adult and 608 larval specimens respectively
in connection with the regular program. For the bird-baited trapping
program 23,611 specimens from 2158 collections were identified from
samples taken in 47 counties from March through December.
During 1964 it has been necessary to increase the services at Jackson-
ville to include the identification of mosquitoes caught in bird-baited
traps from all sections of the state and from specially selected locations
where encephalitis is known or suspected.
The laboratory has undertaken the identification of mosquitoes col-
lected live by regional workers for processing in the SBH virus labora-
tory. In the period May 19 through December 31 the arthropod labora-
tory identified as to species 750 pools of mosquitoes, each pool containing
50 to 75 mosquitoes of a single species. Forty-nine (49) of these pools have
been found positive for a virus. A total of 42,825 mosquitoes were identi-
fied from suspected encephalitis areas. These were collected in 20 coun-
ties between Polk and Jackson Counties with one collected from Dade.
Midge Studies
The study of the life history and ecology of the Chironomidae of
Florida was continued, supported by a grant from National Institutes of
Health.
Thirty-six (36) collections totaling 2247 larvae from various parts of
the state were put out to rear. From these, 465 adults (20.7 per cent)
emerged. A total of 22,501 nuisance midges was identified from light
traps in four counties. An additional 311 miscellaneous insects from pri-
vate collections and 202 sandflies (Culicoides) were identified.

STRUCTURAL PEST CONTROL
The bureau continued for the 17th consecutive year its responsibility
for licensing and issuing identification cards to structural pest control
firms, and enforcing the law and regulations governing this industry.
Enforcement functions under authority of the Structural Pest Control
Act of 1959 and SBH Structural Pest Control Regulations adopted
June 30, 1962, continued satisfactorily. The former prohibits issuance of
a license unless the structural pest control activities of a licensee are
"in charge of" an operator certified in the categories of structural
pest control performed by the licensee. Failure of the law to define









46 ANNUAL REPORT, 1964

"in charge of" has been and remains a sorely vexing problem for en-
forcement personnel.
There were no public hearings in 1964 to consider regulatory changes
or to adopt minimum standards. Minimum standards were given con-
tinuing evaluation as a possible additional means of bringing to the public
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 Control Association's adoption in 1962
of approved termite control guidelines for its membership. Serious con-
sideration is being given by the Association and others outside the SBH
toward amending the law by the addition of a fourth category of pest
control to be known as "lawn and ornamental pest control." The SBH
would continue as the enforcing agency under this proposal.
The bureau was host on February 25 and 26 in Jacksonville to the
fifth annual meeting of the State Pest Control Regulatory Officials.
Eleven (11) states were represented.
Both the number of licenses and employees' identification cards issued
increased by six per cent over 1963. The number of investigations of
property owners' complaints (involving licensees) remained unchanged,
whereas investigations of unlicensed operators increased by 72.7 per cent
over 1963. The Structural Pest Control Commission renewed 472 certifi-
cates and issued 17 new certificates during the year.
TABLE 10
SUMMARY OF STRUCTURAL PEST CONTROL REGISTRATION
AND ENFORCEMENT, FLORIDA, 1960-64

Registration 1960 1961 1962 1963 1964
State Board of Health Licenses issued... 261 274 296 311 329
State Board of Health Change of Address
Licenses issued...................... 39 29 33 34 44
State Board of Health Licenses revoked* 2 0 0 2 1**
State Board of Health Licenses placed
on probation*.................... .. 5 1 0 0 3**
Employees' Identification Cards issued... 2,854 2,818 2,996 3,391 3,588
Employees' Change of Address
Identification Cards issued ........... 340 136 145 160 237
Employees' Identification Cards revoked
or stopped*.................................. 0 7 15 10
Employees' Identification Cards on
probation*......................... .......... 5 0 2 2
Thermal-Aerosol Certificates of
Authorization renewed*............... 12 12 9 8 6
Enforcement
Homeowner complaints investigated..... 87 94 81 82*** 83
Unlicensed illegal pest control operators
investigated ...................... 15 35 21 11 19
Warrants filed against unlicensed
operators........................... 5 15 5 5 9
Letters of warning issued to unlicensed
operators.......... ................. 6 10 9 4 9
Enforcement miles traveled (Jacksonville
office only)......................... 16,647 18,222 16,865 17,107 18,608

*By Structural Pest Control Commission of Florida.
-"Excluding one certificate revoked and two placed on probation.
***Correction from 1963 report.
Licenses, identification cards and thermal-aerosol certificates issued are based on 1963-64 licensing
year. All other entries are based on calendar year 1964.








ENTOMOLOGY 47

ENTOMOLOGICAL RESEARCH CENTER
The transfer of the Control Research Section to the new West
Florida laboratory in Panama City was the most significant event of
the year. The consequent reorganization is bringing about a new Vector
Section in this Center which will concern itself with the immediate
biological problems of disease spreading by mosquitoes. This new section
is occupying the laboratory building vacated by the Control Research
Section. Its 1964 researches are incorporated below, and for the last time,
under the Ethology Section.
Before the end of the year, three new National Institutes of Health
research grants had been awarded to Entomological Research Center
(ERC) personnel. However, these will not be activated because they,
along with the ongoing research grants will be brought under a new
Program-Project grant. This grant was designed to encompass all the
mosquito-biology researches at the ERC. The Program is called "The
Natural History of Mosquitoes." Approval for five years and the first
year's grant of $225,608 were received in early December.

ETHOLOGY SECTION
Salt-Marsh Mosquito Research
Before resuming dispersal studies with Aedes taeniorhynchus it was
necessary to develop more refined techniques for mass rearing in the
field. The main problem is control of energy reserves at emergence when
rearing is under crowded conditions because of radioisotope demands for
marking. Laboratory studies showed that larvae could be reared to
adulthood at a density of three larvae per cc of water, with less than
10 per cent mortality. An unexpected but valuable bonus effect brought
on by crowding was better synchronization of pupation and adult emer-
gence. These same tests demonstrated brewers' yeast and powdered beef
liver to be the best larval food. It was also soon apparent that the size,
stored reserves and expressed autogeny (developing eggs without a blood
meal) of adults could be greatly affected by the amount of food given
the fourth-instar larvae. A single low-diet feeding of the latter resulted
in small adults, low in stored reserves and in expressed autogeny. How-
ever, in order to obtain an equally good recovery (i.e., low mortality) of
large adults, high in stored reserves and in expressed autogeny, it was
necessary to renew the food supply and provide clean water every 12
hours until pupation.
With the preceding information from the laboratory, a pilot study
was designed for one section (2 x 6 feet) of the concrete, bottom-heated
trough in the field plots. Over 800,000 larvae were reared successfully,
with 90 per cent pupating within a three-hour period. Adult emergence
occurred over an eight-hour period with very low mortality. The next
and final step is the determination of precise amounts of food required
under concrete-trough conditions to produce mosquitoes at either end of
the nutritional scale.














ERC Research Grants-1964 Summary
Source Investigator Investigation Sum
PHS..............Harrington..............Biology of larvivorous fish......................$ 19,072
PHS..............Lea...........................Autogeny in mosquitoes ........................ 26,450
PHS..............Rathburn...................Insecticide aerosols .................................. 9,043
PHS................Yount.......................Lake limnology ...................................... 36,035
PHS..............Lum...........................Mosquito larval nurture ........................ 32,528
PHS..............Provost......................Field production of mosquitoes ......... 22,195
PHS.............Bidlingmayer.............Mosquito populations .............................. 25,295
PHS........ Van Handel..............Lipid synthesis in insects ........................ 45,103
FWS.............Trost/Provost............Wildlife effects of salt-marsh flooding.... 3,000

$218,721


Applied for in 1964 and approved for 1965
PHS................................................ Continuing grants ....................................$ 56,829
PHS----........................................ New grant (program) ............................ 225,608

Approved 1965 Total ......$282,437
Pending ............................ (none)


Time Status
7th year, 3 to go
5th year, end
4th year, 1 to go
4th year, 2 to go
3rd year, 2 to go
3rd year, end
2nd year, 3 to go
2nd year, 3 to go
4th year, end








ENTOMOLOGY 49


Techniques for estimating numbers of pupae produced and numbers
of adults emerged for release in dispersal studies were refined. A light
tray was developed within which pupae can be weighed dry and the
total number calculated very accurately. These trays, each with a 50,000
capacity, can be stored on moist toweling at cold temperatures so that any
desired emergence time can be manipulated and calculated. A monogram
was developed for calculating the emergence time of pupae at several
temperatures. At a predetermined hour the pupae (on trays) are trans-
ferred to the emergence site. Here they are submerged in specially de-
signed water vats and emergence cages placed over them. After emer-
gence, the cages of mosquitoes can be marked with fluorescent dyes and
transported to the exodus site for release.
Three releases of A. taeniorhynchus were made this year to study the
initial take-off during twilight. Special attention was given the factors of
light, wind and temperature, and a photographic method of monitoring
both adult emergence and exodus was developed. It was demonstrated
that adults as young as four hours could take part in the twilight exodus,
while individual departures during the night involved only mosquitoes
over eight hours old.

Culex nigripalpus Research
A special study of the cylindrical bait trap with funnel entrances was
made to learn whether this trap would perform more efficiently if aligned
with the wind. The interior of the experimental traps was divided into
two compartments to show which end the mosquitoes had entered. The
fact that mosquitoes approach these traps by flying upwind was abun-
dantly confirmed. Analysis of the data also showed that in four different
orientations (held at 0 or 90 from the wind direction; set in a fixed,
randomly selected direction; or continuously revolved), the traps caught
very similar numbers of C. nigripalpus. Most interesting was the fact that
pointing a trap in the direction of the wind not only reduced the total
catch, but increased its variability. This is fortunate because there appears
to be no economical way to construct a trap that is self-orientating at low
wind velocities.
It is sometimes necessary to identify large numbers of mosquitoes,
leaving them in the same physiological condition as before; for example,
equally ready to take a blood meal. Previous work had demonstrated
that subsequent biting activity would be affected both by CO2 anesthesia
and by exposure to cold after chloroform knockdown. Attempts have been
made this year to develop a method of immobilizing C. nigripalpus by
chilling alone. No satisfactory results have yet been achieved. It may be
that even minimum chilling will delay the return of normal blood-feeding
activity far beyond the period required for the mosquito to warm up.
The energy reserves of C. nigripalpus, both field-collected and fed on
various diets, were tested by their survival in humid incubators set at
27 C. Water, but no food, was available during the holding period.
Females reared from pupae taken in two different habitats differed







50 ANNUAL REPORT, 1964

slightly in their survival; females raised in the laboratory lived somewhat
longer. Reared females given sugar at different intervals after emergence
exhibited very low mortality after they had been fed. Reared females that
were kept on a diet of 10 per cent sugar for one, two or three days after
emergence reached 50 per cent survival levels at four, 12 and 15 days
respectively. In another test, reared females were offered blood but no
sugar. Regardless of the age at which they fed, the 50 per cent survival
level was reached in three to four days, approximately the period required
to mature eggs. These tests have affirmed the great importance of sugar
in the diet of adult mosquitoes, also the inadequacy of blood as a sub-
sistence food.
Collections made in bird-baited traps from November to March were
tested in the same way. They had a 50 per cent survival period ranging
from 70 to 92 hours. No reason could be found for the wide spread in
survival times. Survival was apparently not related either to the size of
the holding container or the age of the females. It might have been due
to the availability of sugar sources in the field.
Oviposition by C. nigripalpus in prepared infusions of oak leaves con-
tinued throughout the winter of 1963-64. After December, the observed
rate of oviposition was much lower, possibly due to a change in the
infusions which were being prepared outdoors. In connection with this
study, characters were found in first-instar larvae of the four prevalent
species of Culex that permitted rapid identification of live material.
Observation of the oviposition behavior of wild adults of C. nigri-
palpus brought to the laboratory was concerned mainly with the recogni-
tion of infusions. The results of testing an infusion at full, two-thirds and
one-thirds strength were nearly identical with those of an earlier test made
in the field. The largest numbers of egg rafts (41 and 55) were laid on
the undiluted infusions, about half as many were laid on each of the two
dilutions, and very few (three and nine) on dishes of water. Indoors,
C. nigripalpus seemed in general less capable of distinguishing infusions
from water, even laying as many as 20 per cent of its rafts on water in-
stead of an infusion. The female oviposited similarly on infusions in Petri
dishes and in solid hexagonal clumps of shell vials with approximately the
same surface of exposed fluid. When nine vials filled with infusion and
nine vials filled with water were arranged in regular patterns, as many
as 15 per cent of the rafts were laid on water. When shell vials similarly
prepared and arranged were separated from each other by their diameter,
the per cent of rafts laid on water was only six per cent. This suggests that
accurate recognition of infusions is improved by their spacing, and has
important implications for laboratory studies of this type.
Spacing has also been investigated with respect to concentrations of
salt, thus far without conclusive results. In the field, C. nigripalpus de-
posited egg rafts on an infusion containing one-half per cent sodium
chloride, but not one or two per cent sodium chloride. In small cages
in the laboratory a few rafts were deposited on each of these higher
concentrations.








ENTOMOLOGY


Comparative Biology of Mosquitoes
Colonization studies have continued with C. nigripalpus, Aedes infir-
matus and Aedes atlanticus three species implicated in virus transmis-
sion in the Tampa Bay area. A. atlanticus was found to mate as readily as
A. aegypti in small cages, while A. infirmatus is very refractory to mating
even in a four-foot cage. A. atlanticus lay only 40-60 eggs, but these are
very large and much more desiccation resistant than the 100 or more eggs
laid by A. infirmatus. C. nigripalpus, on the other hand, lay 150 to 325
eggs per raft and at 27 C these hatch 30 hours after laying. All three
species survive in fair numbers up to 60 days at 270 C on 10 per cent
sugar solution. Techniques for egg hatching and larval rearing of A. at-
lanticus and A. infirmatus have been only partially worked out, but C.
nigripalpus now frequently give a 95 per cent return of pupa from the
number of larvae hatched. The stimulation of C. nigripalpus mating by
the sound of A. taeniorhynchus male swarms broke the initial refractori-
ness to mating. The C. nigripalpus colony is now in its 14th generation
and is still very vigorous.
The Caribbean Culex bahamensis, common in the Florida Keys, was
studied because of its possible disease-spreading properties. It was found
the easiest species of the subgenus Culex to colonize. It mates in both
daylight and twilight, with or without swarming, in small cages. Larvae
thrive in either fresh water or 25 per cent sea water, and adequate larval
diets have been worked out.
Observations of mosquito behavior during two total lunar eclipses and
one solar eclipse were made this year, the latter during a vacation at Mt.
Desert Island, Maine. The results are still under study. A new light meter
has been developed which can be used for measuring twilight and moon-
light illumination in the field or low light intensities in laboratory experi-
ments.

ECOLOGY SECTION
Biology of Larvivorous Fish
The extensive data on food habits and seasonal reproductive cycle of
the important mosquito-eating marsh killifish, Fundulus confluentus, cited
in the preceding report, have been fully analyzed and are available for
reference pending their preparation for formal publication.
Preliminaries to the investigation of the other end of this problem,
viz. marsh productivity, have advanced to the selection of the study area,
its subdivision by stakes into a grid corresponding to that marked on a
completed vegetation map of the area, and include determination of
contour lines with regard to progressive flooding or dewatering, according
to season. A sod-sampler has been designed and fabricated that will cut
unit areas of marsh of one-liter volume. These can be flooded to learn the
productivity of subregions of the marsh in terms of numbers and kinds
of organisms hatching, with reference to vegetation, soil-solution salinity,
marsh profile and dewatering timetable.








52 ANNUAL REPORT, 1964

The above projects have been kept in abeyance, however, by the
demands of maintenance and systematic recording of vast amounts of
observational and experimental data resulting from the continuing study
of the hermaphroditic killifish, Rivulus marmoratus. A paper has been
published reporting results of tissue-transplantation tests made on this
material. A generating series of integrated observations and experiments
have been and are being carried out on material seldom, if ever before,
equalled in genetic homegeneity. The most recent experiments used ani-
mals all from the same genetic clone (group of organisms all having the
same genotype, i.e., heredity make-up, as do identical twins). A low per-
centage of males among laboratory populations of hermaphrodites raised
the question of the cause or causes of their sudden appearance, in view
of the fact that out of hundreds of fish examined no females were
found. A preliminary experiment testing the possible effect of several
environmental factors on sex determination or differentiation gave strong
presumptive evidence of a critical temperature effect. Such experiments
on fishes are of long duration over a year, sometimes unlike those
on insects. Owing to mortality under the rigorous conditions, it was im-
possible to decide with finality between a selective mortality of opposing
sex types and a differential induction of males. To remove this dilemma,
these experiments were repeated the following year with variations to pro-
vide additional information, and there can no longer be doubt that by
manipulation of rearing temperature a statistically significant preponder-
ance of males can be produced at will. Concurrent studies of histological
serial sections of hermaphrodites and males have been made. An addi-
tional series of observations supplemented by experiments have been
conducted on a group of fish hatched late in 1961 and still with survivors,
because some of these underwent a "sex inversion" from hermaphrodites
to secondary male gonochorists (separate male or female animals, antonyn
of hermaphrodite). This study has required the daily monitoring of these
fish since 1961. It has proved most rewarding and when completed (prob-
ably during 1965) will provide the first clear-cut evidence of the effects
of extrinsic factors on sex inversion in a vertebrate animal. The fruitful-
ness of the above series of interrelated researches may be apprehended
by the estimate that it will take approximately 10 to 14 separate journal
articles to adequately report them, and will, of course, take considerable
time and effort to examine in the context of present biological knowledge.

Mosquito Sampling Studies
The mosquito flight study described in the Annual Report for 1963
was continued through 1964. The two field stations were operated from
April through October. As the different collecting methods will yield
collections more rapidly than they can be processed, the mosquitoes are
stored in a freezer so that no deterioration of the internal organs will
occur. These collections are then dissected and examined during the
winter months. Preparations are being made to continue the program
during the coming year.
The power aspirator developed the previous year was operated on a








ENTOMOLOGY 53


regular schedule during the current season. It has confirmed its earlier
promise of becoming a valuable tool for obtaining a random sample of
the constituents of a mosquito population.
Since this unit is an integral part of a jeep, the jeep cannot sample
every type of habitat because of its size. In order to develop a more
versatile power aspirator, a miniature tractor has been secured and it is
planned to adapt the power aspirator to this vehicle.

Research on Control of Lake Productivity
The two methods of reducing lake productivity under study, aeration
and nutrient removal, were investigated further in 1964. Excessive pro-
ductivity is a limnological disease, in a sense, and it is responsible for
many unhealthy and unwanted lake conditions in Florida, of particular
concern here being the over-abundance of chironomid midges. The cure
can only be some drastic measure which will reduce the basic richness or
productivity.
Background studies on Lake St. Clair and the two Lakes Tangerine
were continued in preparation for the aeration experiment planned for
early spring 1965. The aeration equipment compressors, plastic air
lines, etc. have been assembled and placed and will be ready for use
on Big Tangerine. Lake St. Clair will be used as a control for this study,
while Little Tangerine was slated for the hyacinth nutrient-removal
study.
More than a ton of water hyacinths were placed at various intervals
in an enclosure in Little Tangerine as a preliminary experiment in nu-
trient removal, with hopes of fast growth. The work, however, was
vitiated by damage to the plants eventually traced to the feeding of pond
turtles. Nurtrient-removal studies on small, plastic-lined pools were also
plagued with trouble from wild animals. Nevertheless the methodology
for such studies involving the removal of lake nutrients by hyacinths was
worked out in considerable detail and the investigations of 1965 should
not be as frustrating as the exploratory studies.

PHSYSIOLOGY SECTION
Pupation Studies
Studies on the factors affecting larval development were continued
with particular emphasis on the phenomenon of daily synchronous pupa-
tion. Experiments were made at 320C to determine how light of various
intensities, wave lengths and duration stimulated the photoperiodic re-
sponse resulting in a 24-hour rhythm of larval pupation. The experi-
ments showed: 1) A five-second light period, at an intensity of 9000
lux, repeated every 24 hours, was sufficient to cause slight synchrony of
pupation. Synchrony became sharper as the duration of the light period
was extended up to 12 hours out of every 24 hours. Tests with longer
light periods showed that a minimum four-hour dark period was also
necessary; 2) Light in the blue region was responsible for the synchronous








54 ANNUAL REPORT, 1964


pupation, so that light in the green, yellow and red portion of the spec-
trum was comparable to a dark period; 3) A reduction of the light
intensity from 9000 to 300 lux was shown to be equivalent to complete
darkness.

Endocrine Studies
The main objective of this work has been to investigate the hormonal
regulation of egg development, and to date experiments have shown that
two hormones are involved, one produced by a pair of glands in the
neck (the corpora allata) and the other by groups of cells in the brain
(the neurosecretory cells). During the past year an attempt has been
made to find reliable hosts into which these organs could be implanted in
order to test the activity of the organs from mosquitoes of different species,
ages and phases of the reproductive cycle. The histological studies, men-
tioned earlier, will give clues as to the most appropriate animals to test,
as well as when to test in order to show the greatest differences.
Experiments with A. aegypti showed that even a female which was
observed to copulate must have attained a certain age before she will
become inseminated. Young females will mate repeatedly but fail to re-
ceive sperm. The age at which females will be inseminated is temperature
dependent and varies between strains of aegypti. A hormone from the
corpora allata influences the insemination of females. Older females which
had their corpora allata removed fail to receive sperm during mating,
whereas the implantation of corpora allata into such females restored their
ability to become inseminated. This provides another criterion by which
to judge the activity of the corpora allata, and may lead to other experi-
ments showing a relationship between the behavior of mosquitoes and
their physiological state.

BIOCHEMISTRY SECTION
During the year 1964 two projects in technique development were
concluded and accepted for publication: the determination of small
amounts of glycogen and the separation of glycogen, lipids and sugar.
The work on the effect of increasing sugar doses on fat and glycogen
storage at constant temperature has been concluded and submitted for
publication. The work on the effect of temperature on sugar disappear-
ance, fat storage and glycogen storage has been continued and is now
being mapped for seven temperatures between 100C and 350C. With
these two studies (the temperature and the nutrition factor) it will be
possible to predict, from a known set of conditions, the life expectancy
of any brood of any mosquito species in the resting stage, for males and
females separately. To round off this program, it will be necessary to
study the energetic of the mosquito in flight and the energy derived
from proteins. With the aid of an unbiased sample (a problem studied
by the ecology section) some behavior characteristics (studies by the
ethology section), some simple analysis described in the above-mentioned
method papers, and available weather data, life expectancy of a brood
can be calculated with a simple empirical formula.








ENTOMOLOGY 55


Studies of blood-fed mosquitoes have shown that almost all of the
blood protein is used for egg development and after egg laying very little
energy is left to prolong metabolic life expectancy.
Of course, mosquito broods are also affected by non-metabolic death,
(studied in other projects), but the metabolic and non-metabolic death
will always be intimately related: In other words, more precise informa-
tion will become available anent the most efficient moment to institute
adulticiding.

WEST FLORIDA ARTHROPOD RESEARCH LABORATORY
The West Florida Arthropod Research Laboratory of the Bureau of
Entomology was established at Panama City in August 1964. The research
staff of this laboratory formerly comprised the Control Research Section
of the Entomological Research Center at Vero Beach.
The 1963 Legislature provided funds for the construction of this
laboratory for the purpose of investigating public health insect problems
in the West Florida area and developing effective abatement methods.
The stable fly, Stomoxys calcitrans, known as the dog fly in West
Florida, is the principal problem insect. However, since West Florida
also is confronted with the other public health insect problems that occur
throughout the state, i.e., mosquitoes, sand flies, deerflies, etc., it was
decided for reasons of economy to consolidate the research on control
of all insects in this new laboratory.
During 1964 the laboratory was housed in temporary quarters leased
from the U. S. Navy Mine Defense Laboratory at Panama City. New
buildings will be constructed on 10 acres of land located on North Bay,
Panama City, during the first half of 1965. The land was located by the
Panama City-Bay County Airport Authority. Matching funds in the
amount of $45,600 for the construction of the laboratory were secured
from the USPHS.
Because of the limitations imposed by temporary quarters and pres-
ently budgeted funds, the laboratory will not be fully staffed and pro-
grammed until late in 1965. The 1964 Annual Report covers the period
January to August, during which time the staff was at the Vero Beach
laboratory, and the short period at Panama City near the end of 1964.

Dog Fly Studies
The biting stable fly, S. calcitrans, is a severe pest of the human
population and domestic animals along the coastal area between Pensa-
cola and Cedar Key. The problem is especially severe along the 200 miles
of Gulf Coast between Carrabelle and Pensacola. This fly, known as the
dog fly in West Florida, is a vicious blood-sucking parasite which is
responsible for large economic losses both to stockmen and the tourist
industry in the affected areas.
Intermittent studies of the problem by various research workers since
about 1934 have established that the windows of marine grasses (com-








56 ANNUAL REPORT, 1964


only called seaweed) which are deposited by high tides on the beaches
of inland bays and sounds is the principal source of the flies in West
Florida.
Studies by the U. S. Department of Agriculture and the USPHS from
1939 to 1946 resulted in the development of abatement measures to pro-
tect military personnel stationed in the West Florida area during World
War II. The most effective control method developed by this group was
the application of DDT residual sprays on the marine grasses to kill
emerging adult flies. This program was terminated by the federal agencies
in 1946, and there has been no sustained research program since that
time. Local abatement districts were organized in the several counties
concerned beginning in the early 1950's. Basically, these local abatement
programs have utilized the control procedures established by the federal
agencies about 20 years ago.
Results of the local control programs have been less than satisfactory.
The first objective of this laboratory will be to evaluate present control
procedures, and the long-range objective will be to develop improved
methods of control.

The dog fly problem normally is most severe from August to Novem-
ber. A moderate outbreak of flies occurred along much of the West Florida
coastal area in late August and early September 1964. Field observations
by laboratory staff members were begun in September. Infestations of
dog flies in advanced stages of development were found in marine grass
deposits at three locations in Bay County on September 21, 22 and 26
respectively. The latter infestation was in a grass deposit which measured
over 1800 feet in length and averaged five feet in width. This grass
probably was washed ashore by high winds of Hurricane Dora, which
passed near Panama City on September 10, 11 and 12. This infestation
was used in the first attempt by this laboratory to evaluate current
methods of spraying with DDT.

The infested grass was sprayed on September 29 by the spray crew of
the Bay County Pest Control District, using five per cent DDT emulsion
at the rate of about 50 gallons per mile. Emergence cages were placed
over the treated grass and a short portion that was left untreated. Un-
fortunately, Hurricane Hilda uprooted the cages and scattered the grass
on October 3, thus ending the observations. Results during the three days
after spraying showed, however, that the treatment was not effective.
Observations indicate that the volume of spray and the type of spray
nozzle used might have resulted in inadequate coverage of the infested
grass.

On December 17 pupae from a colony of dog flies established in the
laboratory were "planted" in old grass deposits along the shore of West
Bay, Bay County, and treated with DDT at two rates of application. This
test was not completed in 1964 but results indicate that dog flies in the
West Florida area are still susceptible to DDT sprays.








ENTOMOLOGY 57

Mosquito Adulticiding Studies
The principal area of investigation in 1964 was research dealing with
the aerial application of insecticide sprays for adult mosquito control.
From these studies it was determined that a dosage of 0.05 pounds per
acre of Dibrom (naled) applied at a gross volume of one quart per
acre in No. 2 diesel oil using a 200-foot swath, produced an excellent
kill of both the salt-marsh mosquito, A. taeniorhynchus, and the enceph-
alitis vector, C. nigripalpus, in grass areas. In brush areas, 0.1 pounds per
acre Dibrom at the same gross volume and swath produced excellent kill
of both species of adult mosquitoes; however, neither application proved
to be effective in heavily wooded areas. Results obtained in 1963 indicated
that a gross volume of one to 1-/2 gallons per acre was necessary to
give satisfactory kill in heavily wooded areas.
In 1963 satisfactory kill of adult mosquitoes with aerial fog was ob-
tained only in open areas, indicating that the fog did not reach the ground
in areas with overhead cover. Therefore, tests were conducted in 1964
with a high viscosity fog oil with the hope that larger and heavier particles
would be produced which would penetrate tree canopies and reach the
ground. However, based on comparative kills of caged mosquitoes placed
on the ground, the fog oil was no more effective than diesel oil.
In aerial fog tests comparing discharge rates of 150 and 320 gallons
per hour, significantly better kills were obtained with the 320 gallon
per hour rate. However, even at the higher rate of application satisfactory
kills of caged mosquitoes placed in grass in open areas were not obtained
at 165 feet from the line of flight. Aerial fog tests with Malathion and
Dibrom at a discharge rate of 600 gallons per hour failed to give satis-
factory kill of caged mosquitoes on the ground or at a height of six
feet from the ground in heavily wooded areas. Research with both aerial
spraying and aerial fogging will continue in the coming year. Large scale
tests are planned using natural populations as well as caged mosquitoes.
Research on ground fogging in 1964 was primarily confined to a series
of tests designed to compare the effectiveness of diesel oil and fog oil
as diluents in insecticide formulations. Many claims have been made by
both manufacturers and users as to the superiority of fog oil as a diluent
for insecticides in ground fogging. However, tests designed to demonstrate
any difference between fog oil and diesel oil indicated that: fog oil
and diesel oil were equally effective in killing caged adult mosquitoes
placed above the ground at distances up to 1320 feet; neither fog oil
nor diesel oil gave satisfactory kill at ground level or in low grass;
neither fog oil nor diesel oil gave satisfactory kill at a 20-gallons per hour
discharge rate; fog oil was no more effective than diesel oil against
A. taeniorhynchus or C. nigripalpus with either six ounces per gallon or
eight ounces per gallon formulations of Malathion; and there was no
difference between the two oils in regard to the formation of sludge
when formulated with Malathion or Dibrom in the absence of sludge
inhibitors. Since both A. taeniorhynchus and C. nigripalpus rest on the
ground during daylight hours and poor results were obtained with both








58 ANNUAL REPORT, 1964


oils where caged mosquitoes were exposed at ground level, neither oil
would be effective for fogging during daylight hours.
Results of ground thermal aerosol tests with Baytex to determine ef-
fective dosage for use against C. nigripalpus were complicated by low
temperatures. It is planned to continue these tests with Baytex and some
new insecticides in 1965.
A test was conducted in 1964 in the Tampa Bay region of Florida to
determine the effectiveness of residual insecticide spray applications
against the encephalitis vector, C. nigripalpus. Individual premises, in-
cluding the lawns, shrubs and houses to a height of four to five feet, were
sprayed to run-off with a two per cent solution of Malathion. Only one
premise per city block was sprayed since it was desired to determine the
degree of control obtained if a single homeowner sprayed his property
while the rest of the block remained unsprayed.
The effectiveness was determined by counts of adult C. nigripalpus
taken in chick-baited traps before and after treatment. No reduction in
the population of adult mosquitoes was noted in the sprayed premises as
compared to unsprayed premises located in the same block. Therefore,
it was concluded that residual spraying of this type would not be effective
in protecting individual homes from encephalitis mosquitoes.
Basic Research on Particle Size
In 1964 much time was spent developing a laboratory thermal aerosol
generator and wind tunnel which could be used in particle size investi-
gations. The amount of liquid and the rate of injection of the insecticide
formulation, the temperature at which the formulation is vaporized as
well as the wind velocity at which the aerosol particles are transported
can be varied to meet test conditions. Through the use of this generator in
1964, it was demonstrated that there is: an increase in the number of
large particles produced with a decrease in generator temperature; an
increase in the number of large particles produced with an increase in
viscosity and density of the spray solution; an increase in the deposition
of aerosol particles on flying insects as compared to dead or non-flying
insects; and an increase in particle deposition with an increase in
particle size.
The laboratory thermal aerosol generator also offers the additional
advantage of a quick and accurate method of screening insecticides
against adult mosquitoes which will eliminate much of the time-
consuming field testing of new insecticides as presently conducted.
The spectacular appearance of the density of thermal aerosols of fog
oil (oils of high viscosity and density) as compared to diesel oil is being
investigated. This difference has been measured photo-electrically by
light transmission and is currently being investigated relative to the dif-
ferences in particle number and spectrum, optical density and refractive
index, and density and viscosity between the two oils. It appears that this
study may be able to define the importance of some of the physical factors
involved in thermal aerosol formation.








ENTOMOLOGY 59


Additional meteorological data acquired in 1964 by means of the
portable 40-foot meteorological tower developed in 1963 demonstrate the
great importance of wind in the satisfactory application of thermal aero-
sols. The rise of the fog cloud to a height of 10 to 50 feet resulting in
no fog and therefore no mosquito kill up to this height is a condition
that prevails during the summer months in many areas of the state. Con-
cerning this condition, it appears from observations made in 1964, that
the fog cloud will not rise vertically as long as the speed of the lateral air
movement is uniform with height. However, if there is a pronounced
increase in the speed of the lateral air movement at a certain height, the
fog cloud will rise and form a layer, the base of which is at the intersec-
tion of the slow moving and fast moving air currents. These observa-
tions do not preclude the importance of temperature in this phenomenon.
More research of this type is necessary to define the meteorological
factors responsible for poor fogging conditions resulting in poor mosquito
control. The accumulation of data on meteorological factors affecting fog
behavior will be continued during the coming year. In 1965 it is planned
to test in the field some of the hypotheses formulated as a result of the
laboratory experimentation on particle size and kill of adult mosquitoes.
Laboratory studies of the relationship of particle size to deposition on
insects also will be continued.
Water-Management Studies
The long-range water management plots at Vero Beach were main-
tained for experimental purposes until August 1964, at which time the
project was terminated. Although most of the original objectives of the
project were attained by the end of 1963, studies were extended into 1964
to investigate the effectiveness of salinity on controlling the growth of
certain aquatic plants, and to determine the feasibility of delayed artificial
flooding of the seasonal plots.
Unfortunately, rainfall during the period of study was well below
normal; however, it was shown that under abnormally dry conditions
flooding of the seasonal plots could be delayed until June with no serious
threat of producing a brood of salt-marsh mosquitoes from rainfall.
Flooding of plots (overgrown with cattails) with salt water showed
that this weed can be controlled in managed plots by varying the salinity.
It was noted also that cattails were severely damaged in plots from which
flooding was withheld for long periods. Salinity of the soil water increased
in the latter plots but whether or not the increased salinity or lack of
flooding, or both, damaged the cattail growth is not known.
Results of the water-management studies conducted at Vero Beach
are applicable only to the east coast of Florida. Additional studies will
be necessary to evaluate impounding as a method for controlling salt-
marsh mosquitoes on the west coast of Florida.
Sand Fly Control Studies
This project was continued in 1964 at Vero Beach with the field
testing of several formulations of creosote and aromatic solvents as sand








60 ANNUAL REPORT, 1964


fly larvicides. In selecting compounds for testing, an effort was made to
select only those chemicals that seemed less likely to create a resistance
problem in the sand fly and mosquito populations. A total of 25 test
plots were arranged to test the larvicidal effectiveness of creosote and
aromatic solvent formulations applied at the rate of four and eight
gallons per acre in calm and rough water conditions at low and half
tides. Results showed that the creosote formulation applied at a four
gallons per acre dosage will control sand fly larvae for five weeks in soil
heavily washed by waves and eight weeks in calm water. In calm water,
emulsions of aromatic solvents AR-60 and Panasol AN-5 were effective
for two and five weeks respectively. But in plots heavily washed by
wave action the AR-60 lost its effectiveness in one week and the Panasol
AN-5 in two weeks.
Before recommendations are made, additional testing will be con-
ducted in the Panama City (Bay County) area. These tests will include
large plots in order to evaluate the effectiveness of the creosote formula-
tion when applied under operational conditions.

WINTER HAVEN MIDGE CONTROL LABORATORY
Most of the work in control research during 1964 was devoted to the
further development of larvicides for chironomid midge control. Of the
numerous chemicals tested as potential midge larvicides, a one per cent
granular formulation of American Cyanamid 52,160 and a three per cent
granular formulation of BHC showed the most promise. Applied at the
dosage rate necessary to control midge larvae, both of these insecticides
are safe to fish.
Baytex applied at the rate of 0.25 pound per acre in a one per cent
granular formulation gave excellent control of midges for at least eight
weeks in four large lakes. Population studies indicate that it may take
from six months to a year for the chironomid population to stabilize itself
again in a lake following an application. No detrimental effects were
noted to the common aquatic biota following the insecticide treatments.
Since most of the midge larvae are concentrated in the peripheral
areas of the lake bottom, an attempt was made to apply granular Baytex
only to these heavily infested areas; it proved to be very successful. While
the duration of larval control was not as long as when the entire body of
water was treated, there was a large reduction in the amount of material
and man-hours used in application.
A research project has been set up to determine if there is a definite
correlation between the kind and amount of plankton available in the
lake to that found in the gut of midges throughout the year, also to
establish if there is a relationship between the amount of plankton avail-
able in a lake to the level of midge breeding in a lake. The data ac-
cumulated thus far are insufficient to show any seasonal food preference in
the larvae; however, it does show that the algal content of the gut does
not fluctuate exactly the same as that of the lake water.








ENTOMOLOGY 61

Laboratory rearing experiments were tried this past year. Unfortunate-
ly, little success was noted. A culture of Chironomus fulvipilus was es-
tablished through two generations. Also, a few successful emergences of
Tendipes decorus were recorded. All the experiments trying to establish
a laboratory culture of Glyptotendipes paripes were negative.
Chemical analyses were run on algae to determine if they were capable
of tying up insecticides in the lakes rendering them ineffective as midge
larvicides. While the results are not conclusive, it would appear that
algae does absorb a noticeable amount of the phosphates from insecticides
in a relatively short time.








62 ANNUAL REPORT, 1964


BUREAU OF FINANCE AND ACCOUNTS
FRED B. RAGLAND, B.S.
Director
PAUL R. TIDWELL, B.B.A.
Assistant Director

Major responsibility rests with this bureau for the business and finan-
cial management of the agency, and includes: accounting, budgeting,
purchasing, property control, duplicating services, mail, shipping, receiv-
ing, automobile control and assignment and buildings and grounds main-
tenance. The business and financial management requires a close work-
ing relationship with the State Board of Health (SBH) program di-
rectors in planning maximum utilization of funds that have been pro-
vided. This means sound budget preparation of the various health pro-
grams designed to cover a future period of time. Once the funds are
provided and properly budgeted, then a logical system of accounting for
these funds and issuance of reports concerning their expenditure is
necessary. This, along with the dissemination of proper budget control
information, is accomplished by the bureau. Sometimes this becomes quite
involved due to the complexity of the various sources of funds: federal,
state, county, private, etc. Each of these sources bears its own set of rules,
laws and regulations as to the administration of expenditure of the funds.
The fiscal year end June 30, 1964 was the first year of the 1963-65
biennium for which the 1963 Legislature made available to the agency
state funds through the General Appropriations Act. These appropria-
tions were generally based upon maintaining present programs at the
same level; however, there were a few instances where additional financial
support was included. These additions were:
1. State fund grants to county health units were increased from
$3,320,000 to $4,070,000 and represented the first increase to
counties since 1958.
2. Appropriated for statewide encephalitis research and control,
$200,000. This is a new program and complements work pre-
viously started by a federal grant in the Tampa Bay area.
3. Provided a lump sum appropriation of $116,600 for an air pollu-
tion control team in central Florida. This complements the current
air pollution program.
4. General Public Health appropriation provided for 26 new posi-
tions and, also, implementation of the Florida Merit System
biennial pay survey 1963-65.
5. Provided for arthropod research laboratory in West Florida-
$65,000 (to match federal funds).
6. Provided for regional laboratory in Tampa-$300,000 (to match
federal funds). Architectural planning is underway and contract
will probably be let in February 1965.








FINANCE AND ACCOUNTS 63

7. Provided for regional laboratory in Pensacola-$120,000 (to
match federal funds). This project is under contract, having been
let in September 1964.
8. Provided for an appropriation for Medical Assistance for the
Aged (MAA). The appropriation may be used for hospital serv-
ices and visiting nurse care.
Of major importance to the agency was the legislative act passed to
exempt the disbursement of county health units trust funds from the
limitations on salary, positions and Budget Commission approval required
by Chapter 282.051, Florida Statutes.
Total program expenditures fiscal year ended June 30, 1964, amounted
to $27,800,000; this was $3,400,000 over previous fiscal year. This in-
crease can be accounted for in three program areas. Half of it was in the
Indigent Hospital Program due to the hospitalization for Public Assistance
Recipients and MAA. County health department (CHD) expenditures
accounted for one-fourth of the increase and finally the general increased
cost of ongoing programs and some increase in special grants and dona-
tions accounted for the remainder.
It is important to note the ever-increasing number of special projects
and grants from the federal agencies. The most significant one during
1964 was the "best efforts" contract for eradication of the Aedes aegypti
mosquito. This contract is at a level of about one and one-fourth million
dollars per year. The duration of the project will be approximately
five years.
At the close of the fiscal year June 30, 1964, the number of state-
owned and operated automobiles was 97. These were driven approxi-
mately 1,500,000 miles during the year. In addition, the agency owned
35 trucks or special-purpose vehicles. These units traveled approximately
275,000 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's travel responsibilities.
During 1964, 18 old vehicles were traded and 24 new units acquired.
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
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 cer-
tain conditions, printing regulations, etc. Requests for equipment and
supplies are reviewed by the purchasing section and purchases are made
under contracts and maximum price regulations negotiated by the State
Purchasing Commission where applicable. The purchasing section con-
tinues to cooperate with other state agencies in the exchange of informa-
tion pertaining to contracts for volume purchases which enables this








64 ANNUAL REPORT, 1964

agency to purchase certain items under contracts negotiated by other
state agencies and to arrange for purchases under SBH contracts by others.
The property division of this section carries out the responsibility of
recording, marking and inventorying of all property owned by this
agency (desks, chairs, office equipment, scientific equipment, etc.). The
Florida Statutes prescribe records that must be maintained and the
frequency of physical inventories.
During 1964 the purchasing office issued 4361 separate purchase
orders which totaled $1,262,048.48. CHDs normally handle purchases
locally within their organizational framework; however, their purchasing
procedures must also conform to the Florida Statutes governing pur-
chases, such as obtaining bids and advertising for bids where required.
The following of good business practices in procuring materials through
competitive bids is advocated. The purchasing agent at the SBH assists
the CHD wherever possible with their purchasing requirements.
Property Control
The responsibility of this section is to see that capital outlay items
are assigned property numbers, maintain records, process annual physical
inventories on over 160 locations and handle fire insurance coverage on
buildings and contents.
Property value reflected by the SBH Plant Ledger as of June 30, 1964
was as follows:
Real property ....................................................... $2,824,795
Furniture and equipment ................................... 1,280,732
Automotive equipment and trailers .................... 277,920
Books and films ...................................................... 321,514

Total ........................................................... $4,704,962
One new steel building was constructed for the Encephalitis Research
Center, Tampa.
Control of property and maintenance of records as required by Florida
Statutes continues to be a job of considerable magnitude, not only because
of the dollar increase but as the SBH continues to grow and depart-
ment acquire new quarters, property cards have to be changed or cor-
rected 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-
mission. 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, dental equipment and X-ray equipment
in various mobile units is insured under a "Floater" or "Transportation"








FINANCE AND ACCOUNTS


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-insuror for collision damage. Boats and outboard motors owned
by the agency are insured under marine policies to include public liability
and property damage as well as protection against damage or loss of
the boats and motors. 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 position
bond; Workmen's Compensation.
During 1964 nine claims amounting to $1,871.77 were settled under
the agency's fleet automobile liability policy. Damages to SBH vehicles
caused by others were settled for $2,736.74. Claims amounting to $533.87
for repairing damages to SBH vehicles under the comprehensive clause
were paid by the agency's insurance company. The SBH as self-insuror
for damages caused by collision paid $502.35 for repairs. This figure is
considerably less than the cost of carrying collision coverage in the fleet
liability policy.
This agency received $346.71 as reimbursement for losses under the
marine insurance coverage during 1964.
BUILDINGS AND FACILITIES SECTION
Maintenance-During the year 728 written work requests were
received. Of these 17 were uncompleted at the end of the year. The
uncompleted requests are divided as follows: two cancelled, two await-
ing funds, one awaiting material, four in work, three held in abeyance
and five in planning status. Due to sickness and annual leave requirements
only 11,250 "maintenance" man hours were available this year. Of these
hours 10,630 were expended in connection with the work requests; the
remaining 620 man hours were expended in the preventive maintenance
program.
During the year an additional and parallel electrical primary feed
circuit was installed to obviate the electrical overloads in the Bureau of
Laboratories and Division of Data Processing. In addition, an extensive
and larger emergency power system was installed. Branch circuits are
being installed in the Laboratory. Structural and utility alterations were
made in the greater portion of the Laboratory's second and third floors.
In addition, a new "Butler" type building was erected on the east side of
and as an addition to the animal house. This new building was air condi-
tioned, electrified and equipped by this section.
The preventive maintenance program is not in full operation. This
deficiency is largely due to the pressure of work requests upon a limited
staff.
A new concrete floor was installed in the shop area of the Julia
Street Building. The old floor was damaged by Hurricane Dora.
Shipping and Receiving-The remarks made in last year's report con-
tinue to apply regarding working and storage space. The following







66 ANNUAL REPORT, 1964


figures illustrate some of the work performed in this section. General
requests filled: regional laboratories 250, CHDs 2000, tuberculosis hos-
pitals 600 and private physicians 3000.
Seventy-two hundred (7200) items were picked up within the agency,
wrapped and mailed. More than 300 vehicle trips were made to local bus
stations for pickup and delivery service.
There were 4560 drug and 3815 form requisition written requests
honored. No record is maintained on local telephone orders. A total of
3400 waybills were executed in the year's business. Storage space is
critically overloaded.
Mailing-A signature log is maintained on all registered, certified
and insured mail. This office handled the following quantities of mail
during the year: outgoing U.S. Mail 218,799 pieces, incoming U.S. mail
383,000 pieces and interoffice mail 93,500 pieces.
The annual postage meter expenditure approximates $54,000. Mail
distribution is hampered by both the increased requirements imposed at
the agency's local rental spaces and of inadequate space in the central
office.
Ditto Room-The output of this activity amounted to: addresso-
graph impressions 612,242, addressograph plates embossed 9497 and total
of operations 621,739. This figure represents an increase of 60,922 opera-
tions over that of the previous year.
Duplicating-This department is charged with fulfilling the dupli-
cating requirements of the central office, branch laboratories and research
centers. The offset duplicating section, composed of three machines, all
of which are over or near 13 years in age, bear the bulk of the workload.
A transfer unit was purchased during the year. The cost of the machine
has been greatly offset by the savings in labor and materials over previous
methods. The department performs the additional duty of stocking and
supplying envelopes, plain and copy paper, index cards and interoffice
material of the above nature. The bindery section continues to operate
economically in jobs requiring the use of machinery such as the folder,
stitcher, cutter, punch and perforator, thereby reducing outside costs.
As required by Florida Statutes, a cost record is maintained relative
to the individual requisitions for production. Supplies necessary for the
functioning of this department are obtained through the purchasing agent
on a bid basis or through state contracts.
The department output this year was: 2286 job requisitions for a
total cost of $39,967.46. These requisitions involved the handling of
4431 offset plates and 3138 stencils. Total machine impressions were
9,574,526.
Security-Vandalism of buildings and equipment continues to be a
problem in this area. More than 1700 parcels, of which 40 were
considered legal evidence, were received during nonworking hours. In
addition, there were 20 emergency issues of vaccine or serum. Testimony
in seven court cases was given by members of the security force.








FINANCE AND ACCOUNTS


FISCAL SECTION
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, 1964, 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, 1964, has been prepared and distributed
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, 1964 were from the following sources:


State appropriations and funds ....................$
From local agencies for county
health departments ...... ......................
From federal grants-in-aid .........................
From research grants .........................
From hospital services for the indigent
*Local sources ..................................
State Department of Public Welfare......
From state for building ....... ...................


9,375,180.00

7,338,399.84
3,752,864.15
1,640,862.58

352,083.07
7,060,301.49
420,000.00


$29,939,691.13


31.3%

24.5%
12.5%
5.5%

1.2%
23.6%
1.4%

100.0%


*These funds deposited with and disbursed through the State Treas-
ury. Does not include $2,457,402.91 disbursed locally.


The operating and capital expenditures by the SBH were for:


Personal Services (salaries and
professional fees) .................. .....
Contractual Services (repairs, utilities,
travel expenses, hospital program)..........
Materials and Supplies (office, medical,
laboratory, mosquito control,
educational) ......................... ..-..-
Current Charges (rent, insurance, merit
system cost, registrar fees) ...................
Capital Outlay
(equipment and fixed assets) ................
Grants to Counties and Mosquito
Control Districts ...........................................
Miscellaneous (education aids and
subsidies) ........................................


$13,387,758.82

10,769,675.33


1,289,871.54

403,187.71


48.1%

38.7%


4.6%

1.7%


471,053.60 1.7%

1,359,735.87 4.9%

130,766.90 .3%


$27,812,049.77 100.0%









68 ANNUAL REPORT, 1964

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 USPHS
personnel on loan to the Board in the Bureaus of Preventable Diseases
and Special Health Services.
Fiscal operation followed a budget plan of 196 departmental budgets.
These budgets were periodically revised as required.

SUMMARY OF RECEIPTS AND DISBURSEMENTS AND BALANCES
FOR THE FISCAL YEAR ENDED JUNE 30, 1964


RECEIPTS

FROM STATE APPROPRIATIONS
General Public Health:
Salaries .................................. .... .........................$ 2,855,890.00
Other Personal Services ............................................................ 10,250.00
Expenses .................................. ..... ........................ 1,156,310.00
Operating Capital Outlay ........................................................ 68,360.00
Grants to Localities .................................................................... 1,650,000.00
Encephalitis Research and Control .................................. 100,000.00
Purchase of Polio and Combined Vaccines ....................... 125,000.00
Dental Scholarships .................................................................. 40,000.00
Medical Scholarships ................................................................ 40,000.00
Arthropod Laboratory in West Florida ................................ 65,000.00
Air Pollution Control ....................................... 196,110.00
Mental Health Council .................................. ............. 147,360.00
Hospital Services for the Indigent .............................................. 885,900.00
County Health Units .................................................................. 2,035,000.00
Total State Appropriations....................................................$ 9,375,180.00


FROM FEDERAL GRANTS-IN-AID
Public Health Service:
General Health ............. .................. .....................$ 423,222.00
Chronic Illness and Care of Aged ................................... 433,552.84
Venereal Disease ........................................................................ 199,420.00
Tuberculosis Control ................................................................ 70,335.00
Heart Disease ........................................................... 197,116.00
Cancer Control .......................................................................... 99,912.90
Mental Health .......................................................................... 177,422.50
Water Pollution ............ .................................... 127,111.00
Radiological Health .................................... ........ ............ 59,205.00
Mental Health Planning ............................................................ 71,400.00
Cuban Health Services .................................. ............ 917,502.10
Children's Bureau
Maternal and Child Health...................................................... 976,664.81
Total Federal Grants-in-Aid ....................................................$ 3,752,864.15









FINANCE AND ACCOUNTS 69

FROM GRANTS AND DONATIONS........................................................ $ 1,640,862.58

FROM LOCAL AGENCIES FOR COUNTY HEALTH UNITS...........................$ 7,338,399.84

FROM HOSPITAL SERVICES FOR INDIGENTS
Local Sources ..........................................------ ----.... .$ 352,083.07
State Welfare Board .................................................................. 7,060,301.49

Total Hospital Services for Indigent .......................................$ 7,412,384.56

FROM STATE FOR BUILDINGS ............................ .......................... $ 420,000.00

TOTAL RECEIPTS ......................................-.......--..............---$29,939,691.13

Balance July 1, 1963, $3,405,294.34 (Less
expired appropriation of $304,454.95)..............................$ 3,100,839.39
Total Receipts and Balances ------------.........-$33,040,530.52

DISBURSEMENTS
OPERATING EXPENSES
Personal Services:
Salaries ....................................................................................$12,648,247.75
Other personal services-individual ........................................ 584,149.00
Other personal services-other ........................................ 155,362.07
Contractual Services:
Travel expenses, including subsistence and lodging ................ 1,433,348.97
Communication and transportation of things ....------.................... 389,608.69
U utilities ........................................ ...... .......... 146,151.42
Repairs and maintenance ........................................................ 167,545.55
General printing and reproduction services ............................ 73,181.37
Subsistence and support of persons ........................................ 8,370,127.20
Other contractual services ..................................................... 189,712.13
Commodities:
Bedding, clothing and other textile products ...........------............... 3,419.90
Building and construction material and supplies.................... 9,982.73
Coal, fuel oil and other heating supplies .............................. 11,675.03
Educational, medical, scientific and mosquito control
materials and supplies ........................................................ 942,877.34
Maintenance materials and supplies ...................................... 79,856.59
Motor fuel and lubricants ....................................--- .... .. --- 51,274.66
Office materials and supplies ........................................-----......... 184,221.18
Other materials and supplies .................................................... 6,564.11
Current Charges:
Insurance and surety bonds ................................................... 37,110.15
Rental of buildings .................................................................... 147,622.77
Rental of equipment .............................................. 43,889.11
Other current charges and obligations ..................................... 99,858.18
M erit System ............................................. ... ............... 74,707.50

Total Operating Expenses.................................................. $25,850,493.40
CAPITAL EXPENSES
Books ........................................ ............................................... $ 15,882.90
Buildings and fixed equipment .............................................. 26,092.16
Educational, medical, scientific and mosquito
control equipment ........................................................... 220,175.49









70 ANNUAL REPORT, 1964

Motor vehicles-passenger ........................................................ 58,420.58
Motor vehicles-other .......................................................... 142.00
Office furniture and equipment ..................................... 148,295.50
Other capital outlay ................................................................. 2,044.97

Total Capital Expense........................................................... $ 471,053.60

GRANTS, SUBSIDIES AND CONTRIBUTIONS
Grants to counties and mosquito control districts....................$ 1,359,735.87
Other educational aids and subsidies ...................................... 130,766.90

Total Grants, Subsidies and Contributions..............................$ 1,490,502.77
Total Program Expenses ............................ ............ $27,812,049.77
NON-OPERATING DISBURSEMENTS
Transfers ..................................... ......... $ 127,111.00
Refunds ........................................ ................................. 108,013.17

Total Non-Operating Disbursements ............. ..... .............$ 235,124.17

Total Disbursements ............................... ............... $28,047,173.94

Balance June 30, 1964............................. ---...... ........$ 4,993,356.58

Total Disbursements and Balances.............. ........ ..............$33,040,530.52

SCHEDULE OF EXPENSES
BY PUBLIC HEALTH PROGRAM ACTIVITY
Health Services to mothers, infants, preschool and school children....$ 3,690,000.00
Statewide venereal disease control, diagnosis and referral of
infectious venereal disease patients to treatment clinics-
also operation of program .......................................................... 1,153,200.00
Mosquito and pest control programs, including pest control
law enforcement ....................................... ... 3,353,334.95
Indigent hospitalization .................. ........................................................ 7,796,544.42
Statewide sanitary engineering and environment sanitation ................ 2,342,955.64
Statewide cancer control program ................................... 604,800.00
Statewide tuberculosis control, X-Ray survey and follow-up work...... 1,145,500.00
Mental health program ................................................................... 1,341,400.00
Statewide narcotic drug, medical practice law enforcement........... 216,320.48
Chronic illness and care of the aged ......................................... 1,532,835.00
Heart disease program ...................................... .... ........... 498,250.00
Other health programs and administration ...................................... 4,136,909.28

Total Expenses ............................. .................................. $27,812,049.77

SCHEDULE OF EXPENSES
BY FUNCTIONAL ACTIVITY
General public health (also includes miscellaneous health activities
and training) .................................. ...... ..... $ 1,550,516.98
Vital statistics ................................................................ 346,904.19
Health education ................................... ........................................... 98,171.15
Sanitary engineering .............................. ..................................... 682,184.74
Entomology and mosquito control ....................................... ......... 2,246,154.31
Tuberculosis control ................................................ 284,273.86
Laboratories ........................................................... 944,261.19









FINANCE AND ACCOUNTS 71

Preventable disease (excluding tuberculosis control) ........................ 733,822.27
Mental health ........................................................................................ 408,875.88
Narcotics .................................................................................................. 169,107.42
Maternal and child health .................................................................... 560,158.38
Hospital service for the indigent ........................................................ 7,796,544.42
Local health service .............................................................................. 463,460.42
Chronic diseases .................................................................................... 455,808.10
County health units .............................................................................. 11,071,806.46
Total Ex enses .... ............. .................................................. $27.812.049.77











TABLE 11

FUNDS RECEIVED BY COUNTY HEALTH UNITS FROM THE FLORIDA STATE BOARD OF HEALTH AND
LOCAL SOURCES FOR THE FISCAL YEAR ENDED JUNE 30, 1964


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................. ........
Collier .......................
Columbia.....................
Dade... ..... ...............
DeSoto........ ................
Dixie...........................
Duval............... .......
Escambia.................. ....
Flagler ......................
Franklin........... ............
Gadsden.......................
Gilchrist ......................
Glades........................
Gulf...........................
Hamilton .... ..................
Hardee ........................
Hendry.........................
Hernando .... .................
Highlands.....................
Hillsborough ..................
Holmes ......................
Indian River ...................
Jackson............... .......
Jefferson ... ....................
Lafayette ... ...................
Lake.........................


$ 215,886
22,682
96,230
35,003
266,026
476,894
23,416
79,573
33,745
46,690
81,026
53,473
1,691,885
36,385
17,153
314,617
338,830
18,406
25,707
79,000
13,657
16,118
30,149
23,810
45,642
51,970
26,017
57,823
785,508
29,463
60,364
83,009
26,078
17,247
98,951


$ 75,730
10,194
46,506
15,496
73,973
131,042
10,929
20,335
20,157
21,634
33,229
24,704
332,494
21,433
7,490
150,055
102,517
7,328
9,400
37,766
4,575
5,242
12,445
10,194
15,496
12,710
11,877
29,172
166,401
14,404
28,450
47,682
12,180
7,237
35,262


$ 68,525
10,194
43,866
15,496
69,713
126,658
10,929
20,335
20,157
21,634
33,229
24,704
168,855
21,433
7,490
101,840
83,456
7,328
9,400
37,766
4,575
5,242
12,445
10,194
15,496
12,710
11,877
29,172
79,244
14,404
28,450
39,162
12,180
7,237
35,262


$ 7,205
2,640

4,260
4,384




1636.........39...


""4'8',2i6
19,061









87,157

48,520


............


$ 140,156
12,488
49,724
19,507
192,053
345,852
12,487
59,238
13,588
25,056
47,797
28,769
1,359,391
14,952
9,663
164,562
236,313
11,078
16,307
41,234
9,082
10,876
17,704
13,616
30,146
39,260
14,140
28,651
619,107
15,059
31,914
35,327
13,898
10,010
63,689


$ 108,099
12,237
48,306
14,199
185,644
340,159
10,925
55,018
9,775
22,513
39,768
28,100
1,241,525
13,503
7,655
131,200
156,670
10,941
16,248
35,186
4,438
10,836
14,608
12,167
27,929
17,150
11,976
27,887
404,949
7,500
20,141
30,969
3,500
10,000
61,669


$ 7,650
. .. . .
2,86'


600
4,600
3,600









4,000
............
3,000
....... 666..







3,000
3,000
6,000


$ 15,760



2,740
............,
............'



............
2,400




4,210
35,000
............
1,250
600








600
1,000
1,650


z
C2


$ 8,647 4
251
1,418
108
6,409
2,953
962
4,220
213 0
143 O
8,029
669 -
117,866
1,449
8
29,152
44,643 10
137
59 O<
540 4
44
40
96
189
1,717
22,110
414
764
214,158
59
4,273
758
3,398
10
520








TABLE 11 (Continued)

FUNDS RECEIVED BY COUNTY HEALTH UNITS FROM THE FLORIDA STATE BOARD OF HEALTH AND
LOCAL SOURCES FOR THE FISCAL YEAR ENDED JUNE 30, 1964


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


Lee ...........................
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 ........................
U union ..........................
Volusia .........................
Wakulla .......................
Walton ... .....................
Washington......................
County Health Units, State at Large
Totals .................


$ 91,314
246,675
32,982
16,350
34,827
182,558
101,064
41,285
107,481
63,704
85,563
24,237
475,744
41,559
852,323
42,325
1,045,234
423,022
82,201
54,407
226,653
92,189
58,836
108,313
30,369
37,345
29,873
17,812
344,400
26,117
36,372
30,583
95,440


$ 39,732
90,011
14,616
7,104
18,429
63,157
45,332
21,742
45,999
22,030
33,311
10,194
132,542
21,841
135,890
21,562
188,633
114,500
37,782
25,675
61,603
39,025
31,343
46,939
15,360
18,861
16,200
10,273
120,440
13,882
19,170
14,828
95,440


$ 39,732
78,825
14,616
7,104
18,429
63,157
45,332
21,742
40,719
22,030
33,311
10,194
112,722
21,841
112,048
21,562
111,641
89,480
37,782
25,675
58,363
39,025
31,343
46,939
15,360
18,861
16,200
10,273
112,880
13,882
19,170
14,828
95,440


$ ... .....
11,186





5,280


19,820

23,842
76,992"
25,020

3,240






7,560
. ... .. .. .


$ 51,582
156,664
18,366
9,246
16,398
119,401
55,732
19,543
61,482
41,674
52,252
14,043
343,202
19,718
716,433
20,763
856,601
308,522
44,419
28,732
165,050
53,164
27,493
61,374
15,009
18,484
13,673
7,539
223,960
12,235
17,202
15,755
. ... .. ...


$ 50,992
83,973
11,194
9,239
16,313
102,052
44,320
17,644
45,716
41,496
45,000
13,873
256,607
16,650
587,477
18,465
702,681
247,337
42,506
24,175
144,582
40,148
24,092
39,186
14,405
17,355
12,750
7,515
167,937
12,000
7,700
15,694
. .. .


$. ..........
10,786
5,700

......4,066
4,000
750
6,000


22,000
2,600
29,415
1,744
30,000


10,084
1,920

1,000
800

12,900
7,0006


$..........
5,000



5,600
3,667


8,470



7,200



1,250
10,000





2,400


$10,497,590 $3,159,185 $2,641,164 $ 518,021 $7,338,405 $6,034,464 $ 196,357 $ 116,807


hi
1-1


$ 590
56,905
1,472
7 z
85
17,349 C'
1,812 tl
1,149
6,099
178
7,252
170
56,125
468
99,541
2,298
152,176
23,985
1,913
4,557
20,468 0
2,932
231 0
12,188
604
129
123
24
43,123
235 E/n
102
61


$ 990,777 1
1 W








74 ANNUAL REPORT, 1964


BUREAU OF LABORATORIES

NATHAN J. SCHNEIDER, Ph.D., M.P.H.
Director
WARREN R. HOFFERT, Ph.D., M.P.H.
Assistant Director

This bureau has the responsibility to provide laboratory services to
the local county health departments (CHD) and to the bureaus and
divisions at the state level relating to their broad and varied public health
programs. In addition, assistance is provided to licensed practitioners
of the healing arts to diagnose and treat infectious diseases. There are also
the 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 in the regulation of medical technology in laboratories
owned and operated by lay (nonmedical) personnel and to provide
services in the regulation of the sale of drugs, cosmetics and devices in
Florida.
It was reported in the Annual Report of last year that the legislature
had appropriated money for construction of replacement laboratory
facilities in Pensacola and Tampa. Construction of the Pensacola labora-
tory was begun in September. When completed early next year, it will
have 8000 square feet of laboratory space. More time has been required
to complete the plans of the Tampa laboratory, a larger facility of ap-
proximately 16,000 square feet.
Elsewhere, 800 square feet of additional space was allocated to the
Jacksonville laboratory for expanded virological facilities. New animal
facilities were provided by the erection of a prefabricated building to
house a small mouse-breeding colony. Further, it was possible to re-
arrange space for a much needed dehumidified room to house certain
electronic instruments for the chemistry section.
There were several important personnel changes made during the
year under review. Warren R. Hoffert, Ph.D., was designated as assist-
ant director of this bureau and given the specific responsibility of plan-
ning and directing the special laboratory studies in encephalitis sur-
veillance and routine operation of the virology section. Replacing Dr.
Hoffert as director of the Miami Regional Laboratory was Dwight E.
Frazier.
Two main administrative changes were made which affected some-
what the responsibilities of the bureau. Jurisdiction of the Marine Labora-
tory in Apalachicola (Franklin County) was transferred to the Bureau
of Sanitary Engineering and the clinical laboratory operated in the
Jefferson CHD was placed administratively under the Healthyways
Foundation. The bureau continued to provide technical consultation to
both of these laboratories when requested.








LABORATORY SERVICES


DIAGNOSTIC SERVICES
The nature and extent of diagnostic laboratory services offered during
the year under review were essentially similar to those in previous years.
Considering the general public health services only as shown in Table
12, there was a total of 2,809,275 examinations performed in 1964 as
compared to 2,802,583 (excluding Franklin and Jefferson County labora-
tories) examinations in the preceding year. Overall increases in workload
in Jacksonville, Miami, West Palm Beach and Pinellas County laboratories
offset a small reduction in the Tampa, Tallahassee, Pensacola and Or-
lando regional laboratories. The major increase was noted in the number
of examinations of throat specimens for diphtheria and streptococcal
infections, sputum specimens for mycobacteria, cervical and urethral
microscopic smears for gonococci, blood specimens for leptospiral anti-
bodies, miscellaneous bacteriological cultures for isolation and identifica-
tion and food specimens involved in food poisoning episodes and chemistry
specimens for blood sugar and toxicology and narcotics.
The trend of increased demands for sanitary bacteriology in the
examination of dairy products and drinking and swimming pool water
continued as in past years. Milk and dairy products examined in 1964
numbered 165,274, as compared to 164,796 in 1963; much of this
increase was due to a closer surveillance of tanker milk shipped from
within the state or imported from milk producers outside of Florida.
Drinking water and swimming pool specimens increased considerably
from 183,914 samples in 1963 to 193,400 during the year under review.
By using the membrane filter procedure to test these specimens and by
establishing the capability of carrying out this procedure in certain of
the CHDs, the demand for this service from the bureau has been some-
what alleviated. Nevertheless, this service continued to be widely used
throughout the state. The number of bacteriological pollution surveys
declined from 83,060 samples in 1963 to 71,070 during 1964. This
decrease was noted in the Tampa, Orlando, Pinellas County and Pensa-
cola laboratories. The remaining laboratories experienced an increase in
the number of samples tested, and it is anticipated that this trend will
carry over to all of the laboratories as the population and the use of
recreational areas increase.
The results of examinations by findings are presented in Table 13;
a total of 715,662 blood specimens was examined for syphilis of which
31,029 were found to be reactive. Excluding the specimens unsatisfactory
for testing, the proportion reactive was 4.4 per cent, as compared to 5.6
per cent in 1963. This continued a downward trend from a high of 6.2
per cent in 1962. Special attention was given to blood specimens from
problem cases of suspected syphilis and/or biologic false positives. Each
of 96 specimens were examined by five standard serologic tests and the
findings compared. In order of reactivity, the results were as follows:
VDRL 88.5 per cent, Kolmer (1/5 vol.) 87.5 per cent, Treponema
Pallidum Immobilization (TPI) 58.3 per cent, Fluorescent Treponema
Antibody (FTA-200) 56.2 per cent and the Kolmer Reiter Protein
(KRP) 50 per cent. The findings confirm those obtained by others in








76 ANNUAL REPORT, 1964


that the VDRL and Kolmer (1/5 vol.) are comparably the most sen-
sitive, and next the TIP and FTA (200). The KRP was found to be so
undersensitive that serious consideration to abandon this procedure is
indicated. This bureau participated in a nationwide study to evaluate
a modified fluorescent antibody procedure (FTA-abs) which shows
promise of having greater sensitivity and specificity comparable to that
of the TPI.
The number of diagnostic specimens found positive for diphtheria
in 1964 was 66; this continued the downward trend in proportion of
positives which was 4.5 per cent in 1963 and 1.0 per cent in 1964. In
contrast, there appeared to be a slightly higher percentage of associated
throat infections, particularly streptococcal. In the year under review
there were 1205 positives (17.9 per cent) as compared to 901 (17.3 per
cent) in 1963.
A total of 46,498 specimens was examined for tuberculosis during
1964. Excluding the unsatisfactory specimens, there was a total of 3300
or 7.4 per cent positive cultures of M. tuberculosis or atypical mycobac-
teria found as compared to 2491 or 5.9 per cent positives in 1963. The
numerical increase of isolations in 1964 was particularly striking as the
number of positive specimens for the preceding five-year period from
1959 through 1963 averaged only 2421 positives. During that period there
appeared to be a gradual reduction in the number of specimens found
positive. The reversal of this trend in 1964 may be explained, in part, on
the introduction of a modification of the digestion procedure for process-
ing tuberculosis specimens. For the past 15 years, sputum specimens have
been subjected to an incubation procedure with equal parts of 23 per cent
trisodium phosphate (TSP) solution for a period of 18-24 hours at
37 degrees centigrade. This lengthy incubation seemed appropriate to
digest the mucoid specimens and eliminate most of the contaminants
normally found in most sputum specimens. It has been appreciated that
this procedure was somewhat toxic to the acid-fast bacilli, but this could
be tolerated because of the large number found in most positive speci-
mens. In recent years, it had been noted that tuberculosis infections were
being found in earlier stages of the disease before large numbers of or-
ganisms might be shed. In May 1964 a modification of the digestion
procedure was introduced which called for the use of 23 per cent solu-
tion of TSP containing 1:3000 concentration of zephiran chloride. In
addition, the digestion time was reduced to two hours at 25 degrees
centigrade. The findings are tabulated for six comparable months in 1963
and 1964 in Table 14. Approximately 15,000 specimens were examined
in each of these two periods. There were 836 cultures positive for M.
tuberculosis and 938 atypical organisms in 1964 as compared to 451 and
153, respectively, in 1963. This is almost a twofold increase in positive
M. tuberculosis and sixfold increase for the atypicals. Admittedly, this
comparison was based on findings from different specimens submitted
during the two different time periods; nevertheless, the apparent increased
sensitivity of the modified digestion procedure makes it worthwhile to
continue its use. It is noted that there was a 50 per cent increase in
cultures lost through contamination by using the new technique. This loss








LABORATORY SERVICES


could be minimized by submission of freshly collected specimens on a daily
basis rather than to hold such specimens until a series of three more 24-
hour specimens have been collected. This latter practice is used to save
on postage but in actual fact, it often results in the overgrowth of con-
taminants which mask the presence of acid-fast bacilli.
Microscopic smear specimens submitted for the presence of gonococci
and associated infections increased moderately from 40,690 in 1963 to
43,617 specimens in 1964.
In contrast, the number of specimens cultured and/or studied by the
fluorescent antibody technique for N. gonorrhea decreased during the
year as compared to 1963. A modified chocolate agar culture media
(Thayer-Martin) was used for the culture examination in the regional
laboratories; the fluorescent antibody procedure was used in the Jackson-
ville laboratory only.
Although there was only a moderate increase in the number of fecal
specimens submitted for examination for enteric pathogens, the number
isolated increased substantially. A total of 1067 Salmonella other than
typhoid and 218 Shigella were found in 1964 as compared to 867 and
164, respectively, in the preceding year.
Among the miscellaneous examinations, there was an increase in the
number of positive darkfields found. In 1964, a total of 81 lesion speci-
mens was found to contain T. pallidum as compared to only 64 for the
previous year.
A total of 2626 miscellaneous bacteriological cultures was submitted
to the laboratory for identification and characterization. This service is of
value to hospital and private clinical laboratories which, because of
limited facilities or lack of specialized reagents, request assistance in
identifying or confirmation of identification of bacterial cultures made in
their laboratories. Apparently this service has been considered useful
judging from the increase in submission of such specimens totaling 1176
in 1960 as compared to 2626 in 1964.
Included in the miscellaneous special diagnostic services totaling 2684
specimens with positive findings were coagulase positive straphylococci of
patients involved in food poisoning, urine counts from patients with
chronic urinary infections, cultures of animal tissues and environmental
sources submitted in connection with the Division of Veterinary Public
Health and tests for sterility of biological reagents or solutions.
There was little change in the number of saliva specimens examined
for lactobacillus counts. The dentists in Florida have used this service in
close consultation with the Bureau of Dental Health which provided pro-
fessional interpretation of findings on all specimens as reported.
The number of stool specimens examined for intestinal parasites de-
creased moderately during the year. Positive findings for hookworm,
ascaris and trichuris decreased; enterobius pinwormm) findings increased
slightly. There were no positive malaria smears found in 1964.
In the chemistry section, a total of 35,352 blood specimens was
examined for various determinations including blood sugar, cholesterol,








78 ANNUAL REPORT, 1964


hemoglobin, cholinesterase inhibition, phenylalanine, barbiturates, am-
phetamines and alcohol. Urine specimens were examined in the Miami
Regional Laboratory for pesticide intoxication as a special service to the
Dade County Department of Public Health. The number of water chemis-
tries increased markedly; from 1292 specimens in 1963 to 2750 in 1964.
These chemical analyses of water from municipal supplies included an
assay of the sodium ion content. The latter determinations were carried
as part of a nationwide study to determine the association of heart disease
and hypertension with the presence of the sodium ion in drinking water
supplies. Toxicology and narcotic specimens examined in 1964 totaled
1998 specimens as compared to 1710 in the previous year.
The radiological chemistry laboratory in the Orlando laboratory
carried out analyses of water, air, milk and selected tissue and other
environmental specimens for radioactive nuclides. The responsibilities
assigned to this section were related to the radiological surveillance pro-
gram of the Division of Radiological and Occupational Health. Two
U.S. Public Health Service (USPHS) research projects which were con-
cerned with background radiation in Florida and the relative proportion
of Cesium-137 and Strontium-90 in milk were included in the specimen
load reported herewith. Findings from these projects are of concern to
the general public as an indication of the amount of radiation exposure
present in the environment.
Diagnostic services for viral and rickettsial infections were provided
on a statewide basis from the Jacksonville laboratory. As compared to the
preceding year, there was a moderate decrease in the number of specimens
on which viral serology was performed. This was due, in part, to the ap-
parent reduced incidence of encephalitis during the current year and a
more careful screening of specimens submitted from the Encephalitis Re-
search Center Laboratory in Tampa. Close liaison was maintained be-
tween the two laboratories to minimize duplication of diagnostic tests on
suspect encephalitis cases. Specimens found negative for St. Louis en-
cephalitis and certain other selected arboviruses were examined in Jack-
sonville for the enteroviruses and other appropriate central nervous system
viral agents.
The number of animals examined for rabies increased from 2965 in
1963 to 3669, representing an increase of 23.8 per cent. There were also
more animals found positive, particularly raccoons and bats. The fluores-
cent rabies antibody (FRA) procedure for diagnosing rabies virus in
animal brain tissue was carried out in the Jacksonville, Tampa, Miami
and Tallahassee laboratories.
Viral and rickettsial diagnostic findings on 1220 patients examined in
1964 are presented in Table 15. A total of 158 patients was found with
positive laboratory diagnostic evidence of viral infections which included
mumps, dengue, Eastern encephalomyelitis, Herpes simplex, measles, polio
and other enteroviruses. There were an additional 237 patients who were
found to have antibodies against certain viral agents, but these findings
were considered equivocal; due to the submission of a single blood speci-








LABORATORY SERVICES


men or paired convalescent sera in which evidence of a fourfold rise or
decrease in titers of paired sera were not demonstrable.
The cooperative laboratory diagnostic and special study program
established between the State Board of Health (SBH) and the State
Tuberculosis Board completed its ninth successful year. This arrangement
has contributed immeasurably to the success of the control of tuberculosis
in Florida by providing a coordinated laboratory program which made
possible more standardized diagnostic procedures for the diagnosis and
treatment of tuberculosis. It also served to strengthen the follow-up given
to each patient upon being discharged from the hospital to return to his
home community. The nature and extent of the studies performed in the
hospital laboratories are given in Table 16. A total of 40,834 bacteriologi-
cal examinations for tuberculosis was performed and 3803 cultures of
M. tuberculosis and atypical mycobacteria were tested for drug suscepti-
bilities. This is a 10.9 per cent decrease over last year. The other labora-
tory sections of the hospitals also performed large numbers of other
bacteriological, mycological, chemical and hematological examinations,
as requested by the medical staff.

SPECIAL STUDIES
The bureau continued its active program in special studies as listed
in Tables 12 and 13. Identification of bacteriological cultures belonging to
the Salmonella arizona family was carried out on a total of 1254 isola-
tions, as compared to only 432 cultures in 1959. An increased interest
and awareness of the widespread incidence of Salmonella infections in
man and animals have contributed to the continuing rise of such cultures
being submitted for identification to the central Salmonella typing center
in Jacksonville. It is recorded with pride that a new serotype, subsequently
named Salmonella seminole, was found by the bureau and subsequently
reported in the scientific literature. The laboratory participated in the
nationwide Salmonella surveillance program by furnishing listings of the
Salmonella typed each week to the USPHS, Communicable Disease Cen-
ter (CDC), in Atlanta.
The diarrheal disease studies were carried out in the Miami Regional
Laboratory in this terminal year of a contract with the Armed Forces
Epidemiological Board. They were concerned with observations made
in determining the potentiality of utilizing the marmoset monkey as a
test animal for the study of experimental Shigella infections.
Enterovirus studies in Jacksonville and in Miami were concerned with
the collection and examination of sewage as a means of determining the
enteroviral flora in Dade County and selected communities in Florida.
Both of these studies have been completed during the current year. Report
of the statewide project was published during the year under review.
Statewide surveillance for arthropod-borne viral infections was ini-
tiated during 1964. These studies, supported by state funds, were carried
out in the panhandle and peninsular part of Florida to complement the
surveillance carried out by the Encephalitis Research Center Laboratory








80 ANNUAL REPORT, 1964

(ERC) in Tampa. A total of 714 pools of mosquitoes and selected animal
tissues was inoculated into suckling mice; also human and animal blood
specimens were examined for hemaglutinating antibodies against viral
antigens prepared from St. Louis Encephalitis, Eastern Encephalitis
(EE) and Western Encephalitis (WE) agents. Results of virus isola-
tion attempts from 681 pools of mosquitoes, six horse brains and tissues
from a duck and a dove are presented in Table 17. A total of 47
arboviral agents was isolated from the mosquitoes and two agents
identified as EE from horse tissues. Among the mosquito isolations, 40
agents were identified to include EE, WE, two different agents belonging
to the California complex and five serologically similar agents belonging
to the Bunyamwera group (Cache Valley). There were nine arboviral
agents not identified. These isolations do not include agents recovered
from collections made by the ERC in Tampa. The mosquito collections
made for the Jacksonville laboratory were carried out by the Bureau of
Entomology and the human and animal sera were collected by the Divi-
sions of Epidemiology and Veterinary Public Health. Counties yielding
arboviral isolates included Duval, Madison, Jefferson, Levy, Wakulla,
Leon, Franklin, Marion and Polk. The total number of counties wherein
collections were made numbered 20.
A new three-year research grant by the USPHS concerned with a
study of the Sanitary Quality of Salad Type Foods was initiated in 1964,
in cooperation with the Division of Sanitation. The first year of the study
was concerned with establishing standardized bacteriological procedures
and to obtain baseline data as to the quality of salad type foods being
marketed in Duval County. Simultaneously with the laboratory studies, the
Division of Sanitation initiated plans to study the sanitation facilities
associated wth the processing and marketing of these salad type foods.
The USPHS supported a study to determine the usefulness of the
Sabin-Feldman Toxoplasmosis dye test in diagnosing chronic eye disease
was continued during the year under review. A total of 279 serum speci-
mens was tested for toxoplasma antibodies. Findings seems to indicate
that the dye test results are difficult to interpret because of the wide-
spread presence of antibodies in apparently healthy adults. To further
complicate the interpretation, the absence of antibodies or very low titers
cannot be taken as an indication that the Toxoplasma gondii may not
be the causative agent in producing chronic eye disease. Very often the
parasite may be present and produce a damaging lesion in the eye but fail
to stimulate antibody production because of the relative paucity of vas-
cularization in the eye. The fluorescent inhibition procedure was also
investigated as another diagnostic tool in toxoplasmosis infections. This
part of the study was carried out in cooperation with CDC in Atlanta.
Studies of the atypical mycobacteria were carried out during the year,
under the guidance and direction of the Division of Epidemiology (See
report of that division for report of findings).
The Miami Regional Laboratory established the capability of perform-
ing the Guthrie technique to screen sera and urine specimens from new-
born infants to detect early cases of phenylketonuria (PKU). This study,








LABORATORY SERVICES


carried out by the Dade County Department of Public Health, has
provided for the screening of over 80 per cent of the births in Dade
County. Quantitative determinations of serum phenylalanine in the PKU
cases under treatment were carried out in the chemistry section of the
Jacksonville laboratory.
A special study to determine the extent of Q fever infection present
in apparently healthy dairy workers was carried out in cooperation with
the Division of Veterinary Public Health. A total of 1938 test and control
sera was collected and examined for Q fever antibodies. A total of 59
of 1874 sera tested by the capillary agglutination test and 12 of 64 sera
tested by the complement fixation test or 3.6 per cent was positive for Q
fever.
Special studies to determine toxin in oysters and airborne pollen
were carried on a small scale during the year. Both of these activities
will be continued in order to maintain the capability of carrying out these
special tests as needed.
Although they are not enumerated separately in the tables, each of
the regional public health laboratories carried out limited special studies
during the year. These included evaluations of various laboratory proce-
dures and/or bacteriological culture techniques, such as the direct sen-
sitivity test for tubercle bacilli in the Tallahassee laboratory and a
comparison of the Thayer-Martin gonococcus (GC) media with the
routine GC media in the Tampa, Miami and Pensacola laboratories.
Also, studies on the use of the membrane filter for testing of drinking
water were carried out in the West Palm Beach and Pensacola regional
laboratories. In addition, all of the laboratories carried out special Q
fever studies on raw milk collected from dairy farms.

CONSULTATIVE AND EDUCATIONAL SERVICES
Four technical workshops were held during the year; these consisted
of a parasitology and a darkfield microscopy workshop in Jacksonville and
parasitology and mycology workshops in Miami. A total of 73 medical
technologists and 15 venereal disease investigators attended these classes.
Technical and consultative guidance was provided to four health
officers, three physicians (residents), one veterinarian, 10 medical tech-
nologists and 32 sanitarians in the form of short periods of training and/or
orientation in the laboratory.
The Venereal Disease Research Laboratory (VDRL), CDC, USPHS,
carried out a visitation and program review of the syphilis serology sec-
tions in the Jacksonville, Orlando, West Palm Beach and Miami labora-
tories. This is done periodically in all of the state laboratories in order
to assure standardization of reagents and test procedures for syphilis. The
Jacksonville laboratory examined 200 sera sent from the VDRL for
syphilis test procedures as a comparison with all other state laboratories
and many federal laboratories. It is on this basis that the bureau at-
tempted to provide similar technical guidance to local governmental and
private laboratories in Florida.








82 ANNUAL REPORT, 1964


A total of 17 additional clinical laboratories was approved to perform
serological tests for syphilis for premarital and prenatal patients. There
was a total of 290 approved laboratories as of the close of 1964.
The bureau carried out the registration of 57 medical laboratories and
assisted the Board of Examiners in the Basic Sciences to license 432
medical technologists and 141 medical technologist directors as provided
by Chapter 483 of the Florida Statutes.
Continuing visits and inspections were made to 23 commercial and
public health dairy laboratories to certify the performance of bacteriologi-
cal and related tests in accordance with Standard Methods and USPHS
requirements for interstate shipment of milk. Similarly, the senior sanitary
bacteriologist performed certification of water testing procedures per-
formed in six regional public health laboratories, seven county labora-
tories and 25 municipal water plant laboratories in the state.
Evaluations of parasitology specimens were sent out to medical labora-
tories in an attempt to improve the level of proficiency in the recognition
and identification of parasitological ova and cysts. Following this series
of unknowns, technicians needing assistance were provided with special
training by means of workshops or visitations to the central and regional
public health laboratories.
Similarly, a series of evaluation specimens in blood glucose determina-
tions were sent out to 60 public health and private clinical laboratories
registered under Chapter 483 of the Florida Statutes. The comparative
findings were circulated among the participating laboratories. Technical
assistance was provided when this was needed.
A total of nine members of the staff took training and refresher courses
in medical bacteriology, anaerobic bacteriology, botulism, toxicology of
pesticides, milk laboratory procedures, syphilis serology, shellfish water
testing, salmonellosis, virology and radiological chemistry, offered by
the USPHS in Atlanta, Washington, D. C., and Cincinnati.

Revision 1964 of previously published list of laboratories approved
for premarital and prenatal serology:
ADDED
Bio-Med Clinical Laboratory, 815 W. Flagler Street, Miami
Christian Hospital, 4700 N. W. 32nd Avenue, Miami
Pan-American Hospital, 5959 N. W. 7th Street, Miami
Caldwell Medical Laboratories, 555 Biltmore Way, Coral Gables
Osteopathic General Hospital, 1750 N. E. 167th Street, North Miami
Beach
Professional Medical Laboratory, Euclid at McGregor, Fort Myers
Tice Medical Clinic, 4909 Palm Beach Boulevard, Fort Myers
Drs. Gibson and Gibson, 680 South Broadway, Bartow
Venice Medical Center Laboratory, 620 The Rialto, Venice
Clark and Daughtry Medical Group, 130 Pablo Street, Lakeland
St. Cloud Hospital Laboratory, 1501 Columbia Avenue, St. Cloud








LABORATORY SERVICES 83

Marion County Blood Bank, 1410 S. Orange Street, Ocala
Holly Hill Hospital Laboratory, Holly Hill
Trollie Lane Medical Laboratory, 2732 Trollie Lane, Jacksonville
Paul Duffe, D. O., Medical Center Laboratory, 2811 Riverside Avenue,
Jacksonville
Gadsden County Hospital Laboratory, 339 E. Jefferson Street, Quincy
Elga B. Waite, M.D., Blountstown
REMOVED
Sterns Medical and Research Laboratory, 1110 N. E. 163rd Street, Miami
Hymen Merlin, M.D., 2933 S. W. 3rd Avenue, Miami
Little River Medical Laboratory, 8340 N. E. 2nd Avenue, Miami
Coral Gables General Hospital, P. O. Box 610, Coral Gables
New Port Richey Medical Laboratory, New Port Richey
Forsyth Memorial Sanitarium & Hospital, 805 N. Gadsden Street,
Tallahassee














TABLE 12

EXAMINATIONS PERFORMED BY FLORIDA STATE BOARD OF HEALTH LABORATORIES, 1964


Jackson- West Palm Pinellas
Examination ville Tampa Miami Pensacola Tallahassee Orlando Beach County TOTALS

GRAND TOTALS ... .................. 1,013,619 593,375 600,411 127,969 114,623 167,789 139,974 51,515 2,809,275


SEROLOGY
Syphilis .............................
Agglutinated & related tests.............
Blood typing (Rh) ......................
DIAGNOSTIC BACTERIOLOGY
Diphtheria & associated infections........
Tuberculosis. .......... ............
G.C.--smear................ ......
-culture .......................
-fluorescent antibody.............
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 ....................
Water .................................
Other ...............................


386,174
2,209
4,726

25,180
104,511
18,448
32
9,360
75,318
576
2,576
104,895

19,956
33,256
20,530
3,040
698
89
5,820

52,346
28
12,447

14,975
580

2,144
47
5,039
2,272


348,873
117
3,302

1,982
. .. ....." ..
25,146
11,459
...........2 6
52,550
. .. .... ...,

22,611

46,890
35,522
7,940
. .. .... .. .
320
219

22,578
18
69

8,711




..... ......


378,075
649
3,147

3,025
18,186
23,090
4,161
24,888
32

4,106

24,828
27,146
12,760
854
1,048


12,325
26
129

2,287
115
574
1,549
247
....462
9,462


49,245
53
1,448

2
.... .......
5,746
2,630

13,414
408

805

16,744
12,282
5,280
56
284
40


30,090
145
742

. 10,684'
10,428
1,761

21,208
64

1,274"

13,914
11,050
2,840
224
108
93


61,241
98
819

97
..... ......
3,054

28,864
192
."18,338"

8,664
22,248
1,005
518
2,122
1,102


13,702 8,013 12,188
S. ........12.. 42...... 6


5,323
..........
... .
.. .. .
... .
... .


976
13
. ...........


919
........ i

11... .


53,632
18
933

877
9,774
760

8,396
240

2,616

20,214
26,772
10,335
. ..........



1,923
2
15

3,001

464


14,064
25,124
10,380

.. ... .. ..









1..... 224
619


1,307,330
3,289
15,117

31,163
143,155
86,672
20,043
9,360
224,638
1,512
2,576
154,645

165,274
193,400
71,070
4,692
4,542
1,647
5,820

123,075
74
13,179

36,192
708
1,039
3,693
47
6,510
12,353













TABLE 12 (Continued)

EXAMINATIONS PERFORMED BY FLORIDA STATE BOARD OF HEALTH LABORATORIES, 1964


Jackson- West Palm Pinellas
Examination ville Tampa Miami Pensacola Tallahassee Orlando Beach County TOTALS

RADIOLOGICAL CHEMISTRY
Water (ground precipitation) ............. .......... .......... ......... .. 1238 ......... 1,238
Air.............................. ..... 2,898 ...................... 2,898
Milk (Sr90, Ce137,I131, etc.)............. 643 ..................... ............................... 643
Other ..................................410 ........ ............ 410
VIRAL SEROLOGY
Hemagglutination-inhibition .............. 3,516 .................................... ................... 3,516
Neutralizations......................... 20 ...................................................... ................... 20
Complement fixation .................... 19,148.... ...... ....... 19,148
VIRAL ISOLATIONS (except rabies)....... 4,434 .... .. 662,204 638
Rabies-microscopic ................... 2,720 2,086 706 476 178 694 ........6,860
-fluorescent antibody.............. 6,951 2,982 516 81 .......... ......... ........... 10,530
-mouse inoculation................ 1,441 .................................... .......... .......... 1,441
SPECIAL PROJECTS
Salmonella typing ....................... 7,524 ........... ........................ 7,524
Diarrheal disease studies (AFEB)...... ..... 1,370 ...................... ........... .. 15,370
Enterovirus studies ..................... 2,680 ........... 15,394 ............................. ........ 18,074
Arthropod-borne surveillance
Isolations ............................ 3,710 .. ....... ........... ........... ......... ........... ........... ........... 3,710
Serology ............................. 36,452 .......... 36,452
Sanitary quality salad-type foods ......... 3,840 ........ ........ .. .......3,840
Toxoplasmosis dye test .................. 4,185 ...... ....1................... 4,185
Mycobacterium studies .................. 959 .................... .......... 725......... ......... ......... 1,684
PKU infant screening study..... ....... .. ...... ............ 18,512 .................................. .................... 13,512
Q fever study............................ 7,704.. ......... 7,704
Toxin in oysters........................ .. 99 .................................... ....................99
Airborne pollen studies .................. 964 ........... ........... ............. .... 964











86 ANNUAL REPORT, 1964


TABLE 13

SPECIMENS SUBMITTED TO FLORIDA STATE BOARD OF HEALTH
LABORATORIES BY TYPE OF EXAMINATION, 1964


Number of Specimens


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

SEROLOGY
Syphilis ......................... 31,029 .......... 674,994 9,639 715,662
Agglutinated & related tests......... 349 .......... 2,591 104 3,044
Typhoid........................ ........... 41 ........ ... .......
Typhus...................... ....... ...............................
Brucellosis................... .... .......... ............................
Tularem ia...................... .......... 2 ................
Heterpohile................................. 299 .....................
Blood typing (Rh).................. ....... ... .... .. .......... .......... 14,113
DIAGNOSTIC BACTERIOLOGY
Diphtheria & associated infections.... 2,887 .......... 3,859 3 6,749
C. diphtheria................... .......... 66 ............................
Vincents ............ 2 ...............................
Streptococci ........ .. .... .... ........ 1,205 .............................
Other ............... .. .... ......... 2,402 ......... ...........
Tuberculosis ................... ... 3,300 ......... 41,130 2,068 46,498
Sputum ........ ........... .......... ..... 2,980 .............................
Aerosol............. ....... .......... 250 ............................
Urine. .................... .. ... ..... 8 ........ ...........
Gastric........................... ....... 37 .. ...........
Other fluids & exudates........... ......... 21 .............................
Animal inoculations (G.P.) .................. 0.
Gonorrhea-smears ................. 25,127 .......... 18,209 281 43,617
Intracellular Gram negative
diplococci............... ........... 7,189 .............................
Extracellular Gram negative
diplococci...................... ........... 341 ..............................
Trichomonad .................... .......... 4,489 .....
Yeasts............................... ..... 2,272 .............................
Vincents organisms............... ........... 361 .............................
Many pus cells.................. ..... 11,646 ....
Gonorrhea-cultures............... 1,121 ....... 17,744 376 19,241
Fluorescent antibody ............. 61 ......... 1,811 ......... 1,872
Enteric infections .................. 1,487 .......... 52,442 179 54,108
S. typhosa.................. .......... .. .111..
Other Salmonella................. .......... 1,067 ...
Shigella (flexneri & sonnei)....... ....... .. ... 218 ..
Other........................... .......... .. 83
Blood cultures ................. .. 3 ......... 156 ....189
B rucella ......................... .......... 0 ...... ....
O their ........................... ........... 45 ...... ...
Leptospirosis................... 11 .......... 633 644
Miscellaneous .................... 12,513 ......... 7,413 50 19,976
Darkfield-T. pallidum ........... .......... 81.......... .......... .......
Chancroid-Ducrey's. ............ ..5.........
Granuloma-Donovan bodies ...... ......... 21 ......... .............
Gonococcus in eye............ .... .......... 11 ............................
Other eye smears........... ........... 107 ... ....................
Other eye cultures ......... ................. 67 .................
Urine cultures ............................ 1,205 .................
Other fluids & exudates ........ ......... .. 4,707 .............................
M ycological examinations......... .......... 1,180 .............................
Organisms for identification........ .......... 2,626 .............................
Sensitivity testing ............... .......... 309 ................
Other examinations............... .......... 675 ................
Miscellaneous special services ...... .......... 2,684 ...........................
SANITARY BACTERIOLOGY
Dairy products .......... ......................27,150
Water, drinking & pools........ .. ... ............ ....... ... 96,963
Water, pollution surveys........ ..... .. ........... .......... 14,657
Foods (sanitary quality tests) ..... .......... .......... ............ ... 747
Food poisoning ..... .......... .......... ................ ..... 725
Utensil swabs ......... .. ........ .... ......... ............... .... 1,685











LABORATORY SERVICES 87


TABLE 13 (Continued)

SPECIMENS SUBMITTED TO FLORIDA STATE BOARD OF HEALTH
LABORATORIES BY TYPE OF EXAMINATION, 1964



Number of Specimens


Positive Specimens
EXAMINATION
Negative Unsat. Total
One or Positive
More for
Positive Findings
Findings Indicated
DENTAL CARIES BACTERIOLOGY. .................... .................. 3,029
PARASITOLOGY
Intestinal parasites ................. 20,774 .......... 102,301 1,722 124,797
Hookworm................................ 5,609 ...........................
Ascaris................................... 4,999 .............................
Enterobius....................... .......... ,733 ..............
Trichuria ................... ..... .......... 1,647 ................
Other helminths................... ......... 157 .............................
E. histolytica. ... ............... ........... 125 .............................
Nonpathogenic amoeba............ ........ 5,079 .............................
Flagellates ...................... .......... 3,176 ...............
O their ........................... .......... 17 ...............
Malaria............................ ........ .... ...... ......... 37
CHEMISTRY
Blood .......................... ......................................... 35,352
Spinal fluid ............................... .......... .......... .......... 412
U rine................ .......... ... ...... ............. ......... .... ... 1,039
W after .................. ....... ......... ........... ......... .......... 2,750
Toxicology & narcotics ............ .......... .......... .......... .......... 1,998
Drugs & cosmetics ............... .......... .......... ........... ......... 12
Other........................ ........... ......... .......... .......... 2,091
Radiological chemistry
W ater (ground & precipitation)... .......... .......... .......... .......... 608
Air......................... .. ..... ............................ 1,050
M ilk (Sr90, Ce137, 1131, etc.).... .......... .......... .......... .......... 308
Other. ................ .................... ............ ............. 196
VIRAL SEROLOGY
Hemagglutination-inhibition ........ .......... .......... .......... .......... 879
N eutralizations..................... .......... .......... ... ...... .......... 2
Complement- fixation.............. .......... .................... .......... 4,925
VIRAL ISOLATIONS (except rabies)... .......... .......... .......... 1,958
Rabies (microscopic) ................ 10 ............ 3,509 55 3,669
D og..................... ....... .......... 1 .............................
Cat............................. .......... 5 .............................
R accoon ......................... .......... 48 .............................
Skunk ......................... .......... 6 .............................
Bat ............................. .......... 42 ............................
W ildcat ......................... .......... 2 ..............
B obcat.................................. 1 .................
Mouse inoculations .............. ... ...................................... 1,441
SPECIAL PROJECTS
Salmonella typing.................. .................... ........... ......... 1,254
Diarrheal disease studies (AFEB)..... .......... ..................... ......... 3,943
Enterovirus studies ................. .......... .......... .......... ......... 8,035
Arthropod-borne surveillance
Isolations....................... .......... ......... .......... .......... 714
Serology...... .................. ......... ................... ........... 9,113
Sanitary quality salad-type foods..... .......... .......... .......... .......... 384
Toxoplasmosis dye test .............. .......... .......... .......... ........ 279
M ycobacterium studies.............. .......... .......... ... ...... .......... 175
PKU Infant screening study.......... .......... .......... .......... .......... 14,042
Q fever study ...................... ......... .......... .......... .......... 1,938
Toxin in oysters ................... .......... .......... ..................... 99
Airborne pollen studies .............. ......... .......... ........ ........... 36
TOTAL ........................................................ 1,294,205










88 ANNUAL REPORT, 1964


TABLE 14

FINDINGS ON SPECIMENS CULTURED FOR M. TUBERCULOSIS
BY MODIFIED TRISODIUM PHOSPHATE TECHNIQUES,
FLORIDA STATE BOARD OF HEALTH LABORATORIES, COMPARABLE
SIX-MONTHS PERIOD DURING 1963 AND 1964


1963* 1964**

Number Per cent Number Per cent

Positive cultures
M. tuberculosis ............... ........... 451 8.0 886 5.4
Unclassified mycobacteria ...................... 153 1.0 938 6.0
Negative cultures .............................. 13,811 91.9 12,890 82.4
Contaminated cultures.......................... 621 4.1 972 6.2

Total specimens cultured........................ 15,036 100.00 15,636 100.00

* Digestion with 23% Trisodium Phosphate for 18-24 hours at 37C.
** Digestion with 23% Trisodium Phosphate plus Zephiran chloride 1:3000 for 2 hours at 250C.




TABLE 15

VIRAL AND RICKETTSIAL DIAGNOSTIC FINDINGS FOR 1220
PATIENTS EXAMINED BY FLORIDA STATE BOARD OF
HEALTH LABORATORIES, 1964


Etiology Positive Equivocal* Total

Lymphocytic chorlomeningltis........................ ........ ...... ... ..
Mumps... ...... ....................... 82 87 169
Dengue. .. ................................ 2 ............ 2
Eastern encephalomyelitis ............................ 3 3 6
Western encephalomyelitis .............................................................
St. Louis encephalitis.............. ...... ... ......... 2 2
Herpes simplex. ................... .............. 4 12 16
Measles...... ........ ...... ............... 8 26 34
Vaccinia-variola. ................. .......... ...
Psittacosis-LGV......... ............ ....... ....... 1 18 14
Murine typhus............... .............. ........ 2 4 6
Rickettsialpox-Rocky Mt. spotted fever....................... .......................
Q fever......................... ........ .. ........... .... ..
Influenza A...................................................... 60 60
Influenza B ......................................... ........ ...........
Parainfluenza 1 & 3.................................. ..... .... ............
Respiratory syncytial......... .................................
Adenovirus ...................................... 2 14 16
Poliovirus 1. ......................................... 13 8 21
Poliovirus 2 ......................................... 6 2 8
Poliovirous 3 ........................................ 7 6 18
ECHO virustypes2,3,7, 8, 11..............11 ........... 11
Coxsackie virus types A9, Bl, B4 and B5.... ......... 12 ........... 12
Other undetermined viral agents .......................5 ........... 5

TOTALS ..................................... 158 237 395

* In the case of a single serum submitted, or in the absence of a rise or fall in the antibody titers of
paired sera, no interpretation possible as to etiology.










LABORATORY SERVICES 89


TABLE 16

EXAMINATIONS PERFORMED IN TUBERCULOSIS
HOSPITAL LABORATORIES,* FLORIDA, 1964


Tampa Lantana** Tallahassee** Totals
Totals-excluding special studies.......... 48,716 81,865 23,570 104,160

Tuberculosis
Diagnostic........................... 16,565 12,820 11,449 40,834
Drug susceptibility .................... 2,010 794 999 3,803
Mycology .............................. 382 133 79 594
Miscellaneous bacteriology ............. 2,153 1,726 2,026 5,905
Hematology............................ 11,852 6,932 4,615 23,899
Chemistry............................. 11,300 7,515 2,434 21,249
Urine analysis.......................... 3,583 1,942 1,607 7,132
Other................................. 876 7 361 1,244


Special studies and reference tests......... 3,000
Unclassified mycobacteria (human)....
Unclassified mycobacteria (soil).......
Mouse infection experiments:
Dual infections with M. tuberculosis
and UM III-A....................
Effect of UM infection on alcoholic mice
Comparison of various UM III-A
strains isolated from different sources
Comparison of H37RU and UM III-A
strains in INAH treated mice.......

*Operated under direction of Bureau of Laboratories; budgetarily supported by State Tuberculosis
Board.
** Combined regional public health and hospital laboratories.






TABLE 17

ARBOVIRUS ISOLATIONS FROM SPECIMENS COLLECTED IN
STATEWIDE ENCEPHALITIS PROGRAM, BY SOURCE OF SPECIMEN,
FLORIDA STATE BOARD OF HEALTH LABORATORIES,* 1964


SOURCE OF SPECIMENS
Mosquito
Findings Total Pools Horse Other
TOTAL .................................... 691 683 6 2
Number of Positives............................. 49 47 2 0
Eastern Encephalitis .......................... 10 8 2 0
W western Encephalitis .......................... 1 1 0 0
St. Louis Encephalitis......................... 0 0 0 0
California Complex........................... 20 20 0 0
Bunyamwera Group......................... 6 5 0 0
Hart Park ................................... 4 4 0 0
Unidentified........................... ...... 9 9 0 0
Number of Negatives............................ 642 636 4 2

* Does not include isolations made at Encephalitis Research Center, Tampa, which are reported
elsewhere.








90 ANNUAL REPORT, 1964


BUREAU OF LOCAL HEALTH SERVICES

L. L. PARKS, M.D., M.P.H.
Director
HUBERT U. KING, M.D.
Assistant Director

Included within the organizational structure of this bureau are the
Divisions of Sanitation and Nutrition, the Accident Prevention Program
and Health Mobilization (Civil Defense) Program. In addition, the
bureau has a small staff of clerical consultants who give consultation and
assistance to the counties.
There was little change during 1964 in the major responsibilities and
functions of the bureau. However, considerably more emphasis was
placed on field visits to county health departments (CHD) to give
administrative advice and assistance. In keeping with this change in
program emphasis, there were 151 visits made to all but four of the
county health units (CHU) in the state.
The bureau was responsible for the direct supervision of CHD pro-
grams without a health officer of which there was a large number
during the year. This responsibility was considerably facilitated by the
appointment of a health officer, to the standby staff in July. He visited
and gave medical direction to departments without health officers.
Among other important activities of the bureau are included con-
sultation to local health officers and staffs on general administrative
problems; assistance in the preparation of budgets and budget control; in
the recruiting of personnel, processing of personnel papers and training
of new employees; in local program planning and evaluation; and
coordination of local programs throughout the state with the cooperation
of other bureaus and divisions.
CLERICAL SECTION
Fifty-two (52) visits were made to 42 counties for general consultation
and 27 visits were made to 21 counties primarily for the purpose of assist-
ing with budget preparation and control. Activities included consultation
and assistance in training new clerical personnel especially in smaller
CHDs; reorganization of filing systems; assistance with establishing and
maintaining bookkeeping ledgers, personnel manuals, etc.; help on vital
statistics, payroll and personnel problems; special assistance in budget
preparation and control; processing of indigent hospitalization forms;
and related matters. Considerable time was spent in the central office
in checking Monthly Reports of Activities and securing corrections. Much
time was also devoted to review and revision of records with one con-
sultant serving as coordinator of these activities and as secretary to the
Health Officers Records Committee. During the year, 20 records and
instructions were reviewed with 16 approved for adoption. The Monthly
Report of Activities and Instructions was revised and reprinted. Con-








LOCAL HEALTH SERVICES


tinuous work and plans have gone into development of an up-to-date
Records Manual.

COUNTY HEALTH DEPARTMENTS
There were no changes in the basic organization of CHUs during
the year. There were 25 single county departments, nine bi-county units
and eight tri-county units for a total of 42 county health units for the
67 counties.
During the year, there were some 72 physicians employed full-time
in CHDs. Three local directors resigned, one retired, five new local
directors were appointed, and one director transferred to another unit.
At the end of the year, there were five health officer (director) vacancies
in the state.
Financing: Budgets for fiscal year 1964-65 total $11,574,014 with
$8,186,418 from local contributions, $1,957,660 from state formula funds,
$664,224 from other state funds, $600,349 from federal funds and
$165,363 from local budgeted reserve funds. Although the increase in
state funds appropriated by the State Legislature in 1963 of $750,000
for the biennium ($375,000 increase per year) improved the financing of
CHD programs, there is still a real need for additional state appropria-
tions to restore the balance in joint state-local financing and to provide
adequate funds for further program development. (For details, see
Bureau of Finance and Accounts elsewhere in this Report.)
Health Center Construction: New headquarters centers were com-
pleted in the following counties during 1964: Clay (Green Cove Springs),
Gadsden (Quincy), Highlands (Sebring), Putnam (Palatka) and Her-
nando (Brooksville) Auxiliary health centers were constructed or ac-
quired in Alachua (Newberry), Dade (North Miami and Miami Beach
Centers), Gadsden (Gretna), Duval (Woodland Acres area), Lake
(auxiliary health center at Clermont and Arthropod Control, Tavares),
Nassau (Yulee) and Okaloosa (Niceville-Valparaiso area).
HIGHLIGHTS OF LOCAL PROGRAMS
Table 19 gives a complete statistical report of CHD activities and
indicates the number and. type of various services provided by these
departments. However, the summary which follows is designed to
present some of the more unusual or outstanding program developments
of these CHD during 1964:
Alachua-Highlights of this department include a full year's ex-
perience in the home nursing care program, expansion of the child-
spacing program, construction begun on the headquarters annex at
Gainesville to provide some 2700 square feet of additional office space
and the acquisition of a newly remodeled rural clinic at Newberry
through efforts of the local Lions Club.
Baker-The nursing program was expanded to include the Vaccina-
tion Assistance Program (VAP). Local doctors have been very coopera-
tive. On visits in this program, other unimmunized children have been