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Title Page | |
Front Matter | |
Members of the Florida state board... | |
Directors of county health... | |
Official staff Florida state board... | |
List of Tables | |
Table of Contents | |
Tenures of state health office... | |
Organizational chart of the Florida... | |
General 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 and publications by state... |
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Cover Title Page Page i Front Matter Page ii Page iii Members of the Florida state board of health Page iv Directors of county health departments Page v Official staff Florida state board of health Page vi List of Tables Page vii Page viii Table of Contents Page ix Tenures of state health officers Page x Organizational chart of the Florida state board of health Page xi General 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 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Bureau of dental health Page 31 Page 32 Page 33 Page 34 Page 35 Bureau of entomology Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Bureau of finance and accounts Page 64 Page 65 Page 66 Page 67 Page 68 Page 69 Page 70 Page 71 Page 72 Page 73 Page 74 Page 75 Bureau of laboratories 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 Page 90 Page 91 Page 92 Bureau of local health services Page 93 Page 94 Page 95 Page 96 Page 97 Page 98 Page 99 Page 100 Page 101 Page 102 Page 103 Page 104 Page 105 Page 106 Page 107 Page 108 Page 109 Page 110 Page 111 Page 112 Page 113 Page 114 Page 115 Page 116 Page 117 Page 118 Page 119 Page 120 Page 121 Page 122 Page 123 Page 124 Page 125 Page 126 Page 127 Page 128 Page 129 Page 130 Page 131 Page 132 Page 133 Page 134 Page 135 Page 136 Page 137 Page 138 Page 139 Page 140 Page 141 Page 142 Page 143 Page 144 Page 145 Page 146 Page 147 Page 148 Page 149 Page 150 Page 151 Page 152 Bureau of maternal and child health Page 153 Page 154 Page 155 Page 156 Page 157 Page 158 Page 159 Bureau of mental health Page 160 Page 161 Page 162 Page 163 Page 164 Page 165 Page 166 Page 167 Bureau of narcotics Page 168 Page 169 Page 170 Bureau of preventable diseases Page 171 Page 172 Page 173 Page 174 Page 175 Page 176 Page 177 Page 178 Page 179 Page 180 Page 181 Page 182 Page 183 Page 184 Page 185 Page 186 Page 187 Page 188 Page 189 Page 190 Page 191 Page 192 Page 193 Page 194 Page 195 Page 196 Page 197 Page 198 Page 199 Bureau of research Page 200 Page 201 Bureau of sanitary engineering Page 202 Page 203 Page 204 Page 205 Page 206 Page 207 Page 208 Page 209 Page 210 Page 211 Page 212 Page 213 Page 214 Page 215 Page 216 Page 217 Page 218 Page 219 Page 220 Page 221 Page 222 Page 223 Page 224 Page 225 Page 226 Page 227 Page 228 Page 229 Page 230 Page 231 Page 232 Page 233 Page 234 Page 235 Bureau of special health services Page 236 Page 237 Page 238 Page 239 Page 240 Page 241 Page 242 Page 243 Page 244 Page 245 Page 246 Page 247 Page 248 Page 249 Page 250 Page 251 Page 252 Page 253 Page 254 Page 255 Page 256 Page 257 Page 258 Page 259 Page 260 Page 261 Bureau of vital statistics Page 262 Page 263 Page 264 Page 265 Page 266 Page 267 Page 268 Page 269 Page 270 Page 271 Page 272 Page 273 Page 274 Page 275 Page 276 Page 277 Articles and publications by state board of health staff members, 1965 Page 278 Page 279 Page 280 |
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'WE FLORIDA STATE BOARD OF HEALTH 1965 AN E l .NmUAL REPORT 4,enuae 72epoet State Board of Health State of 7co1ida 1965 WILSON T. SOWDER, M.D. STATE HEALTH OFFICER JACKSONVILLE, FLORIDA The Honorable Eugene G. Peek, Jr., M.D., President Florida State Board of Health Ocala, Florida Dear Dr. Peek: I herewith submit the annual report of the Florida State Board of Health for the year ending Decemnber 31, 1965. Sincerely yours, WILSON T. SOWDER, M.D., M.P.H. State Health Officer May 1, 1966 Jacksonville, Florida His Excellency, Haydon Burns Governor of Florida Tallahassee, Florida Sir: I herewith present the report of the Florida State Board of Health for the period of January 1, 1965 to December 31, 1965, inclusive. Respectfully, EUGENE G. PEEK, JR., M.D. President May 1, 1966 Ocala, Florida Members of the FLORIDA STATE BOARD OF HEALTH EUGENE G. PEEK, JR., M.D., President Ocala T. M. CUMBIE, Ph.G., Vice-President Quincy LEO M. WATCHEL, M.D. Jacksonville WILLIAM 0. SHUMPERT, D.D.S. Ft. Lauderdale W. S. HORN, D.O. Palmetto DIRECTORS OF COUNTY HEALTH DEPARTMENTS (as of December 31, 1965) Alachua .....................................Edward G. Byrne, M.D., M.P.H. Bay ............................................A. F. Ullman, M.D. Brevard .......................................T Paul Haney, M.D., Dr.PH. 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 ....................................... Patricia C. Cowdery, M.D. (Acting) Escambia ......................................E. E. Metcalfe, M.D. Hillsborough .............................John S. Neill, M.D., M.P.H. Lake ............................................J. Basil Hall, M.D., M.P.H. Leon ............................................Clifford G. Blitch, M .D. Manatee ......................................George M. Dame, M.D. Marion ......................................James B. Stapleton, M.D. Monroe ...................................Jose T. Sanchez, Jr., M.D. (Acting) 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 ................................ Mason Morris, Jr., M.D. Santa Rosa ............................ A. E. Harbeson, M.D. Sarasota .................................Elton S. Osborne, Jr., M.D., M.P.H. (Acting) 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 ..........................Elton S. Osborne, Jr., M.D., M.P.H. (Acting) Gadsden-Liberty ........................ B. D. Blackwelder, M.D., M.P.H. Jefferson-Wakulla .....................P. H. Smith, M.D. Madison-Taylor ..........................Luther A. Brendle, M.D., M.P.H. Osceola-Indian River ................C. C. Flood, M.D., M.P.H. Pasco-Sumter ........................John L. Ingham, M.D. Bradford-Clay-Union .............A. Y. Covington, M.D., M.P.H. Charlotte-Desoto-Hardee ..........Francis R. Meyers, M.D. 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 ....William G. Simpson, M.D., M.P.H. Martin-Okeechobee-St. Lucie ..Neill D. Miller, M.D. Suwannee-Dixie-Lafayette ......John S. Williams, M.D. OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH (As of December 31, 1965) 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 0. Bond, M.D., M.P.H. Coordination of Training.................... Robert V. Schultz, M.D., M.P.H. Division of Health Education................Vincent Granell, B.S., M.S., Ed.D. Librarian ..........................................Mildred T. Clark, B.A., B.S., M.A. Division of Personnel............................Miles T. Dean, B.S., 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................ Justine L. McCurdy, B.S. (Acting) West Palm Beach Regional Laboratory ..................................... Lorraine Carson Bureau of Local Health Services-.......... Elton S. Osborne, Jr., M.D., M.P.H. (Acting) Assistant Director ...............................Hubert U. King, M.D. Division of Nutrition............................Mildred Kaufman, B.S., M.S. Division of Sanitation.......................A. W. Morrison, Jr., R.S. Bureau of Maternal and Child Health....David L. Crane, M.D., M.P.H. Bureau of Mental Health..................... Elton S. Osborne, Jr., M.D., M.P.H. (Acting) 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 Occupational Health ..................Edwin G. Williams, M.D. Division of Tuberculosis Control..........Dwight Wharton, M.D. Division of Veterinary Public Health..James B. Nichols, D.V.M. Bureau of Research Assistant State Health Officer..............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 Water Supply...................John B. Miller, M.P.H. Division of Waste Water....................Ralph H. Baker, Jr., M.S.S.E. *Bureau of Special Health Services....... Malcolm J. Ford, M.D., M.P.H. (Acting) Division of Chronic Diseases..............J. E. Fulghum, M.D. Division of Hospital and Nursing 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..................Charles H. Carter * This bureau was abolished late in 1965 and the two divisions were raised to bureau status. LIST OF TABLES Number Page 1 Number of employees in the Florida State Board of Health and county health units ................................ 22 2 Distribution of personnel, Florida State Board of Health .... 23 3 Distribution of personnel in county health units .............. 25 4 Employment termination and turnover rate ..................... 27 5 Arthropod-borne virus isolations from mosquitoes ........... 43 6 Summary of pest control registration and enforcement ...... 44 7 Results of cage tests of thermal aerosols against dog fly .... 53 8 Results of tests with aerial sprays against caged dog flies .... 54 9 Effects of salinity on the kill of Culicoides larvae .............. 57 10 Funds received by county health units ............................. 74 11 Examinations performed by State Board of Health laboratories ............................................... ............. 87 12 Specimens submitted to State Board of Health laboratories ........................................ ................ ............. 89 13 Comparison of three serology test procedures for syphilis ..................................... ...... ....... ......... 91 14 Proportion of fecal specimens positive for hookworm and ascaris ................................................................. 91 15 Viral and rickettsial diagnostic findings for 1519 patients .... 92 16 Examinations performed in tuberculosis hospital laboratories .......................................................- ......-- 92 17 Permitted establishments and facilities ..............................136 18 Major activities of local health units ..................................137 19 Postgraduate obstetric-pediatric seminar registration ........159 20 Patients discharged from Child Guidance Clinics by type of service, condition on termination, referral source ......................................................................................163 21 Patients discharged from Child Guidance Clinics by age, race, sex, diagnosis ............................................... 164 22 Practitioners registered with the State Board of Health ......170 23 Distribution of sources of radiation ....................................182 24 Summary of X-ray surveys ............................................183 25 New active tuberculosis cases and tuberculosis deaths ........189 26 Number and percentage of reported active cases of tuberculosis ..................................................190 27 Results of 70mm X-ray screenings ......................................191 28 Results of state X-ray survey units ........................................192 29 Tuberculosis cases in central register ................................193 30 Tuberculosis case register statistics ....................................194 31 Number of cases of animal rabies ...................................199 32 Engineering laboratories analyses basic water quality data ......................... ............................. 206 LIST OF TABLES (Cont'd) Number Page 33 Industrial waste projects approved ........................................215 34 Incinerator projects approved ................................................ 216 35 Summary of activities relating to shellfish and crustacea plants .......................................................222 36 Number of sewerage projects approved ................................225 37 Sewage treatment plants by type and capacity ...................226 38 Number and estimated cost of waste water projects ............226 39 Number of water projects approved ......................................232 40 Permits issued for swimming pools, natural bathing places, water wells and plans approved for public swim m ing pools .......................... ..................... 233 41 Number of water plants visited ..............................................234 42 Water and sewage works operators short schools ................235 43 Sanitation of water supplies serving interstate carriers ......235 44 Total patient visits to tumor clinics ...................................... 241 45 Glaucoma screening program .....-........................ ........249 46 Major evaluation indices by type of hospitalization program s ........................... ... .. .... ................. .. 253 47 Applications processed and approved for payment by hospitalization program ........................ .............254 48 Medical Assistance to the Aged hospitalization applications processed and approved for payment ..........255 49 Hospital evaluation statistics ......................................257 50 Nursing homes licensed by county .................................... 258 51 Activities of the Division of Vital Records -----.......................270 52 Resident births and deaths with rates per 100,000 population ......... ................................270 53 Ten leading causes of death ......................................... 271 54 Resident deaths and death rates (preliminary 1965) ..........272 55 Resident deaths and death rates (final figures 1964) ..........273 56 Estimated population and resident births, deaths and infant death rates (preliminary 1965) ........................274 57 Estimated population and resident births, deaths and infant death rates (final figures 1964) .......................275 58 Marriages by race, divorce and annulments by county ........276 59 Vital statistics scoreboard ........................ ...........277 FIGURES Number Page 1 Sewage treatment plants approved .......................................227 TABLE OF CONTENTS Page Administration (including Activities of the Board; Train- ing Coordination; Scholarships; Encephalitis Research Center; Divisions of Health Education, Personnel and Public Health Nursing) ............-...-......-- .......-- .. 1 Bureau of Dental Health ................... ............... .......... ... 31 Bureau of Entomology (including Entomological Re- search C enter) ............................................... ..................... 36 Bureau of Finance and Accounts (including Purchasing and P property ) ............................................................................ 64 Bureau of Laboratories .....----------......... --.------....--........--... 76 Bureau of Local Health Services (including Accident Pre- vention and Health Mobilization; and Divisions of N nutrition and Sanitation) ......................................... ...... 93 Bureau of Maternal and Child Health ........................................153 Bureau of Mental Health (including Florida Council on Training and Research in Mental Health) ...........................160 Bureau of N narcotics ..................................... ................168 Bureau of Preventable Diseases (including Divisions of Epidemiology [Venereal Disease Control Program], Radiological and Occupational Health, Tuberculosis Control and Veterinary Public Health) ........................----..........171 Bureau of R research ....................................... ................... 200 Bureau of Sanitary Engineering (including Divisions of Industrial Waste, Special Services, Waste Water and W ater Supply) ................ ........ ...... ...........202 Bureau of Special Health Services (including Divisions of Chronic Diseases and Hospitals and Nursing Homes; and Hospital Services for the Indigent Program) ..................236 Bureau of Vital Statistics (including Divisions of Data Processing, Public Health Statistics and Vital Records) ......262 Articles by Staff M embers .......................... ....... ............278 ~ TENURES OF STATE HEALTH OFFICERS J. Y. PORTER, M.D., 1889-1917 W. H. COX, M.D., 1917-1919 R. N. GREENE, M.D., 1919-1921 R. C. TURCK, M.D., 1921-1925 B. L. ARMS, M.D., 1925-1929 HENRY HANSON, M.D., 1925-1935 W. A. McPHAUL, M.D., 1935-1939 A. B. McCREARY, M.D., 1939-1940 W. H. PICKETT, M.D., 1941-1942 HENRY HANSON, M.D., 1942-1945 W. T. SOWDER, M.D., 1945*- A. V. HARDY, M.D., 1961-1962 (Acting) W. T. SOWDER, M.D., 1963- On leave October 1961 to December 1962 dOROWtZArT/lOl N CNRT OF tri FORIDA StArE IO4RD OF HlEAiTH GOVERNOR BOARD OF Imm mm m mIm m m(5 emers) m m m m m mm mm m mmi I l I SII I II I -I e I I I MEDICAL DENTAL COUNCIL ADVISORY SCHOLARSHIP SCHOLARSHIp ON TRAINING HOSPITAL COM-TTEE OIR ADVISORY ADVISORY RESEARCH L R HOSPITAL COMMITTs EE CODITTEE IN NTAL"" SERVICE ORO CONTROL HEALTH COVCML THE INDIGENT COMISSIOV STATE HEALTH OFFICER DEPmUT STATE i~DM S HEALTH OFFICER HEALTH OFFICER PROGRAM PLANNIOPERATIONS ALYI I too DIVISION OF DIVISION OF HEALTH PERSONNEL EDUCATION (Library) I'' I ILDOORATODIEI I I RENDOC R SEA TO E C RSVADn EAl I I ADD L Jii~ Lbrt''1 COT SI BUREAU OF SANITARY ENGINEERING (Stream Sanitation, Waste Treatment ConetructiRn) DIVISION OF INDUSTRIAL WASTE (Air Pollution) DIVISION OF DIVISION 0r WASTE WATER DIVISION OF WATER SUPPLY ({Swiming Pools) I BUREAU OF VITAL STATISTICS DIVISION Or PUBLIC HEALTH STATISTICS DIVISION OF DATA PROCESSING IWNIARCH I I ROBLICE ABLTRI LENTJ I INO~r I ~ BUREAU OFB BUREAU OP RESEARCH DENTALAOTICS I I-I- m*- BUREAU OF LOCAL HEALTH BUREAU OF SERVICES MATERNAL Civil Defense, & CHILD HEALTH Accident Prevention) (Migratory Labor) DIVISION or SANITATION DIVISION OF NUTRITION ' PREVENTABLE DISEASES DIVISION OF RADIOLOGICAL OCCUPATIONAL HEALTH DIVISION OP VETERINARY PUBLIC HEALTH (Milk Sanitation) DIVISION OF TUBERCULOSIS CONTROL DIVISION OF EPIDEMIOLOGY (Venereal Disease Control) BUREAU OF SPECIAL HEALTH SERVICES DIVISION OF CHRONIC DISEASES (HeartCancer, Diabetes) DIVISION OF HOSPITALS AND NURSING HOMES (Indigent Care, Hospital & Nursing Home Licenaure) DEC. 1964 67 Cnatfy Nealth Departments BUREAU OF EHTOMOLO Y (Resea .rch Center, Weet Florida Mosquito control Districts, Aiiif -- GENERAL ADMINISTRATION WILSON T. SOWDER, M.D., M.P.H. State Health Officer Nineteen sixty-five may be long remembered as the year that gave birth to large scale, far reaching medical care programs. Unfortunately, with the onset of Medicare and other massive federal health programs, one of the most difficult problems to face the State Board of Health (SBH) this year was the grave loss of so many key personnel. Among those resigning or retiring this year were the following: Miss Elizabeth Reed, Director of the Division of Health Education, Dr. Edward L. Flemming, Assistant Director of the Bureau of Mental Health, Dr. L. L. Parks, Assistant State Health Officer and Director of the Bureau of Local Health Services, and Dr. Simon D. Doff, Assistant State Health Officer and Director of the Bureau of Special Health Services. To make matters worse, while we are faced on the one hand with a loss of experienced, key personnel, on the other hand we are having great difficulty in hiring bright, well trained young people who can be groomed to assume positions of leadership. A prime reason for this is our low current pay scale. Because of the vital and highly complex duties assigned to the SBH, we must rely on educated specialists from a multitude of disciplines; yet we must attempt to hire these people at salaries that are less than attractive. One survey completed this year showed that we are attempting to hire college graduates in engineering at a salary range that pays $162 a month less than the current industry average. As a result, we have a number of engineering positions open, with no applicants interested in filling them. Everyone agrees that clear air and pure water is vital to our state, but expanding environmental engineering problems combined with a shortage of personnel is creating a difficult situation for this bureau. Florida can have air as clean as it wishes and water as pure as it wants, but there is a price tag on both and it has to be met. While personnel shortage is a vital problem to our Bureau of Sanitary Engineering, it is by no means confined to that unit. This is probably our greatest handicap, and it is common throughout the agency. For instance, we are offering this year's graduate in business administration $130 a month less than the industry average; the liberal arts major $141 less; the chemistry major $147 less, and so on. What with more and more health programs made possible through federal funds and made necessary by an enlarging population in Florida, by the increase of state tourism, and by the growth of industry, our need for new, highly trained public health personnel is urgent and critical. On the other hand a number of important advances were made in 1965. The year saw the establishment of a State-Local Relation- ships Study Committee. The difficult and important assignment of 2 ANNUAL REPORT, 1965 this committee is to study the organizational structure and rela- tionships of county health departments (CHD) and the SBH as they relate to the effective provision of public health services throughout Florida. The committee is also examining the legal, administrative, fiscal, consultative and cooperative aspects of state- local relationships in light of current and future health needs as they are affected by population, political and economic factors in Florida. This is a large order, but we hope the results of this study will serve as valuable guidelines for future state-local relationships. This year, for the first time in the history of reportable diseases in Florida, not one case of poliomyelitis was identified. It appears that this terrible childhood disease is finally on the threshold of total eradication from the state and nation. Unfortunately, it con- tinues to rage in other portions of the world, so we must not let up on our efforts for total immunization. We are not succeeding as well in our attempts to eradicate syphilis from the state. In fact, the number of early infectious syphilis cases reported increased again this year, as has been the trend since 1959. It is becoming evident that a well informed public is necessary for the control of this disease, so we are intensi- fying our efforts at public information and education in this im- portant area. With Florida maintaining its popularity as a retirement state, we must pay a good deal of attention to heart disease, cancer, stroke and other chronic diseases. It is estimated that about 21 per cent of our population is now over 55 years of age, and chronic disease of one sort or another is responsible for most of the hospital admissions in the state. In addition to maintaining active programs in cancer, diabetes and heart disease, one of our newer programs is in prevention of blindness (glaucoma). This disease is the second most common cause of blindness in Florida, and we estimate that more than 40,000 people over 40 years of age may have glaucoma. To date, more than 61,000 persons have been screened for glaucoma, and over 1568 of these were referred to ophthalmologists for diagnosis. In most of these cases, the disease was discovered before extensive damage was done. As for radiation hazards, this was our first full year as an Atomic Energy Commission Agreement State (which means we have agreed to assume certain regulatory activities from the AEC), and as a result we have increased activity in licensing and use of radionuclides in medicine, industry and research. To date, 6300 radiation-producing machines have been registered, and we have, of course, continued all of our radiation surveillance activities. We made some fine progress in dental health this year, with that bureau participating in a number of Head Start Projects and other special dental projects conducted about the state by local GENERAL ADMINISTRATION 3 dentists. Also, a total of 35 fixed dental clinics were operated in 27 counties this year, serving underprivileged expectant mothers as well as underprivileged children. In veterinary public health we continued our study, surveillance and control of animal diseases that are transmissible to man. In this area, it's cheering to note that only 78 cases of rabies were confirmed in animals this year. This is a decline over the annual rate for the past two years. Not so cheering is the fact that our Bureau of Entomology has discovered that salt-marsh mosquitoes seem to be developing a resistance to Malathion, heretofore our most effective adulticide in mosquito control. It looks as if we are going to have to search for another pesticide to destroy resistant adult mosquitoes. In addition, this discouraging note comes at a time when personnel loss is badly hampering the activities of this bureau. These, then, are some of our problems and some of our suc- cesses of 1965 the good and bad of it. It has been a year of large problems, but larger accomplishments. For a detail by detail look at the year, we commend to you this Annual Report. STAFF ASSISTANCE The internal auditor plans, directs and coordinates the internal audit program of the SBH, including the 67 CHDs. He has one permanent assistant, and was provided with an additional account- ant for four months during 1965. The internal auditor conducts 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 34 CHDs were audited during 1965. Also, audit work papers were prepared on the accounts of six additional CHDs. The staff attorney provides legal advice on problems related to administration and operations, and participates in the formula- tion of the agency's legislative and regulatory programs. He also maintains a distribution and supplementation service to over 700 recipients of the compiled SBH regulations. This is a limited service to those persons interested in the total program activity. Distribu- tion of regulations to the general public is handled by the bureaus and divisions directly responsible for specific program activity. There is a general trend of increased legal involvement in public health programs. Litigation involving regulations for the handling of dead bodies directly resulted in extensive technical studies of burial practices and subsequent revision of regulations on the subject. The use of direct civil litigation, legal assistance to CHDs and administrative hearings have been the most successful methods of securing compliance of public health requirements when the noncompulsory methods of health education, consultation and 4 ANNUAL REPORT, 1965 persuasion have failed to correct violations. These have been utilized in the fields of air pollution control, trailer park permitting, nursing home and hospital licensure, and water pollution. During 1965, the press secretary distributed 74 press releases to news media over the state; and various media were given assist- ance 136 times by supplying information to them or by setting up and aiding their representatives to obtain their own stories, photo- graphs, radio or television interviews. PROGRAM PLANNING MALCOLM J. FORD, M.D., M.P.H. Deputy State Health Officer This was the first full year of operation for the Deputy State Health Officer for Program Planning. He is charged with the coordination and administrative review of all grants-in-aid, project grants, contracts and cooperative agreements of the State Board of Health (SBH). The agency has received 11 grant-in-aid funds, and 39 special projects have been processed to date, as well as 10 projects awarded to other agencies and eight agreements signed by the SBH. This officer also serves as the project director of a special pesti- cides study being conducted under a contract with the U.S. Public Health Service. Through studying the epidemiology and ecology relating to pesticides, combined with a statewide survey of pest control operators of morbidity and mortality and a consideration of laboratory services, this study hopes to determine the short and long term effects of pesticides on human health. In addition to these duties, the Deputy State Health Officer for Program Planning conducted exhaustive reviews on the pro- gram content and administration of the Division of Health Educa- tion and the Bureau of Special Health Services; represented either the State Health Officer or the SBH on the Florida Commission on Aging, the Governor's Committee on Employment of the Handi- capped and the Florida Joint Council on Health of the Aging; coordinated program information between the SBH and the Governor's Office of Economic Opportunity; and served as acting director of the Bureau of Special Health Services. Mr. J. N. Conger, Health Program Analyst on this staff, served as acting director of the Division of Health Education. OPERATIONS ELTON S. OSBORNE, Jr., M.D., M.P.H. Deputy State Health Officer In this first full year of operation also, the Deputy State Health Officer for Operations performed a most important function in working with the State Board of Health (SBH) Division of Per- GENERAL ADMINISTRATION sonnel and the Florida Merit System. It is believed that a better working relationship between this agency and the Merit System has been achieved as a result. Beyond serving as acting director of the Bureau of Mental Health and as acting director of the Bureau of Local Health Services, the Deputy State Health Officer for Operations repre- sented the State Health Officer at Merit System Council meetings, the Conference of Directors of State Agencies and the Annual Conference of the Surgeon General with the State and Territorial Health Officers. This position also assumed the supervision of the staff attorney and the press secretary of the SBH. ACTIVITIES OF THE BOARD February 7 Jacksonville 1. Re-elected Eugene G. Peek, Jr., M.D., as President of the Board and Mr. T. M. Cumbie as Vice President. 2. Approved the appointment of Mr. Louis O. Frost, Jr., as Counsel to replace Mr. Carlton Maddox. 3. Discussed a study by a committee set up for the purpose of careful scrutiny of the regulations in the handling of dead human bodies. 4. Discussed the problem of dual licensure of hospitals and nursing homes. 5. Approved the recommendation of the Board of Governors of the Florida Medical Association that the referral of cancer patients on the Medical Assistance to the Aged Program to Tumor Clinics not be required by the State Board of Health (SBH) and that such patients have the privilege of retaining their private physician. 6. Approved in principle Standards and Operating Procedures for Family Planning Services and a Guide for County Health Departments (CHD). 7. Discussed the purchase of mental health drugs and autho- rized the use of county health unit at large funds through June 30, 1965, for this purchase up to the amount of $50,000. 8. Approved amendments to Chapter 500 Food, Drug, Cos- metic and Devices Act for submission to the Legislature. 9. Approved amendments to the Uniform Narcotic Drug Law for submission to the Legislature. 10. Disapproved proposal set forth by the Florida Air Pollu- tion Control Commission to amend Chapter 403 for the purpose of bringing the entire state under the control of the Commission and any provision for rules and regula- tions to be adopted solely by the Commission. 6 ANNUAL REPORT, 1965 11. Approved a resolution submitted by the Pinellas County Board of Health for the transfer of $40,000 from the Pinellas County Health Unit Fund to the Pinellas County Anti-Mosquito Control Program. 12. Discussed the Italian Broadsides found among the rec- ords of the SBH and advised Dr. Sowder to keep the originals and send copies to the Smithsonian Institute in Washington. 13. Discussed the donation of a surplus airplane to the State Board of Health by the Brevard Mosquito Control District to be used in the research program in the distribution of insecticides to control mosquitoes and dog flies. April 24- Miami Beach 1. Discussed the Agreement on Civil Rights. 2. Discussed the Community Medicine Study being carried on by the University of Florida and designated the State Health Officer to personally handle all relationships with the University with regard to any cooperative arrange- ments involving the SBH and the CHDs. 3. Discussed the status of a proposed bill which would sep- arate the Dade CHD from the SBH. 4. Discussed the appointment of a committee to study the various phases of CHD operations and asked the State Health Officer to submit names of possible members to the Board at a later meeting. 5. Discussed the policy regarding physicians employed in the central office engaging in private practice outside of the SBH and reiterated their long standing policy that physicians employed by SBH not be allowed to engage in private practice. 6. Approved seven candidates for medical scholarships recommended by the Advisory Committee on Medical Scholarships. 7. Adopted a statement regarding the SBH's position re- garding the placement of the Mental Health Program of the SBH under another state agency as proposed by legislation. 8. Approved amendments to regulations on septic tanks, Chapter 170C-4. 9. Approved a policy whereby SBH staff not be allowed to issue permits that are in conflict with local laws or ordi- nances unless such action is required by the results from a pending court case, or by a legal opinion from the Attorney General's Office. GENERAL ADMINISTRATION 10. Approved amendments to the Bedding Law to be sub- mitted to the Legislature. 11. Approved amendments to the Structural Pest Control Law to be submitted to the Legislature. 12. Approved the submission of a deficiency appropriation bill regarding Tampa Laboratory. 13. Approved candidates for Postgraduate Training. 14. Authorized the State Health Officer, who is the State Registrar of Vital Statistics, to settle questions of eligi- bility for the waiving of fees for particular organizations or individuals qualifying for free services under the general categories approved by the Board. 15. Referred the matter regarding the International Minerals and Chemical Corporation Plant in the Mulberry area to the Florida Air Pollution Commission for its action and recommended that a hearing be set for this matter by that group. April 25 Miami Beach 1. Discussed the action taken by the House of Delegates of the Florida Medical Association regarding the Mental Health Program and the Indigent Hospitalization Program. June 13 Jacksonville 1. Approved the appointment of Mr. Charles Carter as the director of the Division of Vital Records in the Bureau of Vital Statistics. 2. Approved the appointment of Miss Mildred Kaufman as director of the Division of Nutrition. 3. Accepted the resignation of Simon Doff, M.D., as director of the Bureau of Special Health Services. 4. Accepted the information on the resignation and retire- ment of Miss Elizabeth Reed, director of the Division of Health Education. 5. Discussed proposed rules concerning the transportation, storage and disinterment of human bodies and postponed action until further study. 6. Heard a report on the Civil Rights Agreement with respect to hospitals receiving federal funds in Florida and the necessity of their compliance by September 1, 1965. 7. Discussed proposed revisions of Chapter 170C-10, Garbage and Rubbish and a proposed section dealing with patho- logical waste. Postponed action until consultation with the Florida Hospital Association regarding this matter could be arranged. 8 ANNUAL REPORT, 1965 8. Approved the purchase of the property on Pearl Street, Jacksonville, immediately by the State Health Office out of the funds provided for this in the Legislative Budget. 9. Heard a report by Mr. Fred B. Ragland on legislation affecting the SBH. 10. Approved the release of funds from the Lake County Health Unit Fund in the amount of $1800 for the comple- tion of the Clermont Health Center. 11. Heard a report by the State Health Officer on the effect of the legislation regarding the transfer of the Mental Health Program to a separate agency. 12. Approved an extension for postgraduate training for Robert S. Wright, Sanitary Engineer. 13. Discussed the dedication of the Pensacola Laboratory Building which is to be held some time in August. 14. Discussed a report from the Florida Medical Association's Board of Governors with reference to the medical scholar- ship program. 15. Approved the use of state monies in the amount of $30,000 for use in the counties in the Vaccination Assistance Program. 16. Discussed the use of architectural firms for the construc- tion of the new building in Jacksonville. 17. Approved a leave of absence without pay for Albert B. Hardy, M.D., up to three months. August 1 -Jacksonville 1. Approved revisions of regulations in Chapter 170E-7, Transportation, Storage and Disinterment of Dead Human Bodies. 2. Heard reports from Dr. Hardy and Nathan J. Schneider, Ph.D., regarding the status of the Encephalitis Program. 3. Approved revisions in Chapter 170C-9 Air Pollution. 4. Discussed the law on phenylketonuria (PKU) testing passed by the Legislature and possible programs to be car- ried out because of its passage. 5. Discussed rules and regulations of the State Board of Cosmetology. 6. Developed a statement of policy regarding salary supple- mentation and asked the State Health Officer to circulate it to all employees of the SBH and the CHDs. 7. Established a policy whereby all printed pamphlets, book- lets, etc., by the SBH contain the names of the Board Members and the State Health Officer in them. GENERAL ADMINISTRATION 8. Appointed Malcolm J. Ford, M.D., as acting director of the Bureau of Special Health Services. 9. Appointed a Committee on State-Local Relationships. October 3 Jacksonville 1. Discussion with the Florida Tuberculosis and Respiratory Disease Association officials regarding problems in the Hillsborough County area. 2. Revised certain sections of the recently approved regula- tions regarding Chapter 170C-9 -Air Pollution. 3. Heard a report from Leo M. Watchel, M.D., on a meeting held by the Advisory Committee on PKU. 4. Discussed proposed revisions of the Pest Control Regula- tions and postponed action until a further study could be made of these revisions. 5. Approved the appointment of members to the Advisory Committee on Hospitalization for the Indigent. 6. Appointed a Committee to assist the State Health Officer in seeking candidates for the position of director of the Bureau of Local Health Services. 7. Approved the appointment of Dr. Elton Osborne, acting director of the Bureau of Local Health Services. 8. Extended the time limitation for certain physicians not yet having secured their license and asked the State Health Officer to make a complete study of the problem. 9. Approved the expenditure of $6000 to investigate the pos- sibility of cooperation of the SBH with the Florida Medical Association in the Salvador Parades Hospital Project in Trujillo, Honduras. 10. Discussed federal money to be available during the next year for a Home Health Services Program. 11. Discussed a proposed draft of a Multi-County Project and suggested that careful study be given this; and further that an advisory committee go over this proposal before being brought back before the Board. December 5 Jacksonville 1. Recognized the re-appointments of Dr. Peek, Dr. Wachtel and Mr. Cumbie as members of the Board for another four year term. 2. Abolished the Bureau of Special Health Services and created a Bureau of Chronic Diseases with James E. Ful- ghum, M.D., as director; and created a Bureau of Hospitals and Nursing Homes with Chester L. Nayfield, M.D., as director. 10 ANNUAL REPORT, 1965 3. Approved revisions of the Pest Control Regulations. 4. Confirmed action taken by mail regarding the acceptance of an airplane from the Brevard County Mosquito Control District. 5. Approved only those regulations of the Board of Cosme- tology which pertain to health and sanitation. 6. Approved a plan for the operation of a PKU Program within the SBH. 7. Approved the establishment of a central drug distribution program within the SBH and the employment of a pharma- cist to handle this. 8. Inaugurated a measles vaccination program in conform- ance with existing policies of the SBH; such as the ap- proval by the local medical society for the program in each county, the distribution of drugs to CHDs only; and the limitation or the use of vaccine by CHDs to indigents and medically indigent persons unless specific approval is ob- tained from the medical society for other groups. 9. Approved rules and regulations with reference to an amendment by the legislature of Chapter 170G-1, Drug, Cosmetic and Device Law. 10. Heard a report from Dr. Sowder on the trip to Trujillo, Honduras. 11. Discussed the employment of a physician to head up the Medicare Program. 12. Discussed the recent federal legislation passed regarding a Solid Waste Program. 13. Heard a progress report regarding the Home Health Serv- ices Program. 14. Approved the appointment of Senator Robert M. Haver- field as a member of the Advisory Committee on the Hos- pitalization for the Indigent. 15. Discussed possible methods of taking legal action regarding medical scholarship recipients. 16. Approved the appointment of Vincent Granell, Ed.D., as director of the Division of Health Education. ENCEPHALITIS RESEARCH CENTER JAMES O. BOND, M.D., M.P.H. Director California encephalitis (CE) viruses assumed a role of major importance in the studies of the Encephalitis Research Center (ERC) during 1965. Identified first in California in 1943, and again GENERAL ADMINISTRATION 11 in Florida in 1962, these arboviruses were considered relatively un- important until recently. They are now the most frequently re- covered mosquito-borne, viral agents in Florida. In the Tampa Bay area during 1965, 21 such recoveries were made; all from the Aedes genus of mosquitoes. Joint studies by the ERC virology laboratory and the University of Pittsburgh Laboratory identified two distinct serotypes; one was unlike any previously described and has been given the new name of Keystone virus. In addition to the isolation- identification of the CE viruses from mosquitoes, the two labora- tories developed more precise serologic techniques for the diagnosis of infection in humans and other mammals. Two human cases were identified during 1965; both were children and both had probable exposure in North Carolina. Each recovered from a mild meningo- encephalitis without apparent sequelae. Serologic surveys in the normal population indicate an inapparent infection rate with CE virus of five per cent. The reservoir of CE viruses in nature is presumed to be a mam- mal rather than a bird. In the Tampa Bay area, very few of the mammals examined during 1965 demonstrated HI antibodies to CE virus. However, the rabbit, raccoon and squirrel were serologically implicated as possible reservoirs. Limited studies of the preferential feeding habits of Aedes mosquitoes in the Tampa Bay area indi- cate that mammals are a preferred source of blood and, of these, the rabbit, horse and cotton rat serve as frequent blood meals for these mosquitoes. Both field and laboratory studies are currently underway to describe further the epidemiology of this interesting group of arboviruses which is becoming increasingly important in Florida. The major purpose of the ERC is to study the epidemiology of St. Louis encephalitis (SLE), but this was frustrated in 1965 by the virtual absence of this virus from the Tampa Bay environment. Serologic evidence indicated that cotton rats in Hillsborough County and backyard chickens in Hardee County may have been infected with SLE virus sometime during the spring of 1965. De- spite intensive studies, however, no further evidence of SLE virus activity was detected. The volume of material collected for viral surveillance in 1965 exceeded any previous year. Specimens tested for SLE virus, either by serology or viral isolation, included over 175,000 mosquitoes, 2832 wild birds, 747 sentinel chickens, 205 backyard chickens, 52 horses, 531 mammals, 419 human central nervous system (CNS) surveillance cases and 398 human serologic survey specimens. Significant positive contributions to our knowledge of SLE epi- demiology included a better understanding of the interpretation of human serologic responses to SLE antigens used in the hemaggluti- nation-inhibition laboratory test. The University of Pittsburgh, co- operating with ERC, found that old dengue infections, particularly in the Hillsborough and Manatee County areas, caused consider- 12 ANNUAL REPORT, 1965 able overlap in the immunological response measured by SLE anti- gens. A better interpretation of both the epidemiology and serology of SLE infections in humans in the Tampa Bay area is now possi- ble. Follow-up studies of earlier SLE cases continued in conjunc- tion with the National Institute of Child Growth and Human De- velopment Study Center in St. Petersburg. Significant, residual, emotional instability in the old SLE patients was again demon- strated, although some improvement was evident. Although no SLE virus was identified in the mosquitoes during 1965, continued studies added new knowledge on the habits of the proven vector, Culex nigripalpus. Host preference studies verified the suspected ubiquitous feeding habits of this mosquito. Donkeys, chickens, cotton rats and even box turtles were fed upon. Birds, however, are apparently the preferred host. Carbon dioxide, in com- bination with either chicken bait or light, was a powerful additional stimulant toward attracting these mosquitoes into traps. Very preliminary studies showed some correlation between the adult density of C. nigripalpus in the summer months and the levels of ground water. An artificial colony of this species was established in an insectory and maintained throughout the year. The possible vertebrate reservoirs) of SLE virus in the Tampa Bay area are varied. In laboratory infection experiments, the mockingbird was found capable of maintaining a viremia long enough to be a potential wild reservoir. Other species with this same potential include the chicken, dove and sparrow. Population studies, by ornithologists, demonstrated that urban environments favor an increased prevalence of such species as the dove, sparrow and pigeon. In contrast, swamp environments completely lack these species of birds and have a lower density of birds in general. This has important implications in the future epidemiology of SLE in Florida. New, unidentified viruses present an interesting challenge to the virology and biology sections of ERC. In the Big Bend area of Hillsborough County, over 900 rodents have been collected in a three year period, 360 of these in 1965. Viral agents have been re- covered from cotton rats in each of the three years; two during 1965. Attempts to identify these agents, both in the ERC and the University of Pittsburgh, have so far been unsuccessful. Four addi- tional tick agents, also recovered in 1965, are undergoing further identification tests at the University of Pittsburgh. Other unidenti- fied viruses from the Big Bend area have apparently occurred in C. nigripalpus mosquitoes. These findings give high importance to the continuing studies in this particular small area of Hillsborough County, although the medical and public health significance of the findings cannot be assessed at the moment. Significant new observations or activities of the various sections of the ERC during 1965 were as follows. In the human surveillance program, studies of systemic viral infections, in addition to CNS GENERAL ADMINISTRATION viral infections, were initiated in midyear. Etiologic diagnoses, which were either new or unusual, included mycoplasma pneu- moniae, herpes simplex, ECHO 7, and parainfluenza 3. Western encephalitis (WE) antibodies were detected in two humans; how- ever, these were acquired from previous infection outside of the state of Florida. An unusual prevalence of Group B arbovirus anti- bodies in patients referred by neurosurgeons for viral diagnostic studies was observed in Hillsborough County. Special serologic surveys for EE, WE, SLE and CE arbovirus antibodies were car- ried out in children in the Sunland Training Hospital, Orlando, the MacDonald Training Center, Tampa, and in old cases of epidemic neuromyasthenia in Punta Gorda. No significant antibodies to those arboviruses were observed. The virology laboratory embarked on a new program of producing arbovirus antigens and antisera which involved an expenditure of an unusual amount of time and resources. The entomology section instituted new programs or ex- periments to study host-feeding preferences of mosquitoes, and the attractant efficiency of various types of collecting devices. An insectory was established for artificial rearing of mosquito colonies. The biology section instituted new, large-scale studies of migra- tory birds, both in the Tampa Bay area and on the southern most tip of Florida in the Dry Tortugas Islands. In conjunction with ornithologists from the University of South Florida, a large program of banding and bleeding members of the heron families throughout south Florida was initiated. 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 functions under the general direction of the Deputy State Health Officer for Operations and its activities are primarily concerned with providing assistance in planning and conducting meetings, seminars, symposia, workshops and other forms of in-service train- ing; with administrating the academic training program; with ar- ranging for short and long term courses and other training pro- grams supported by grants from the United States Public Health Service (USPHS) or other sources, and with the conduct and ad- ministration of the special programs listed below. Student Traineeship Program For a number of years, Florida residents who are medical, dental, veterinary, sanitary engineering, graduate science or under- graduate students, have been employed for a period of three months in the State Board of Health (SBH) or county health de- partments (CHD), to assist in ongoing projects which are related to the student's indicated interest in these fields. Selection is based on financial need and the students' potential for continuing careers 14 ANNUAL REPORT, 1965 in public health. To this end, they receive special training and supervision designed to acquaint them with the inter-relationships and overall functions and activities of the SBH and CHDs. Most students are employed during the summer months, but the program is not restricted to this period. In 1965, there were 177 applications for this program. Of these, 54 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: Brevard, Dade, Duval, Hillsborough, Leon, Marion, Orange, Palm Beach, Pinellas and Polk. SCHOLARSHIPS FOR PROFESSIONAL EDUCATION The scholarship programs created by the 1955 Florida State 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 based on the recommendation of a seven-man advisory committee authorized by law. The seven members were: David W. Goddard, M.D., Chair- man, Daytona Beach; James T. Cook, Jr., M.D., Marianna; John C. Finerty, Ph.D., Associate Dean of the School of Medicine, Uni- versity of Miami, Miami; E. B. Hardee, Jr., M.D., Vero Beach; Hugh M. Hill, M.D., Assistant Dean for Students, College of Medicine, University of Florida, Gainesville; Homer L. Pearson, Jr., M.D., Executive Director, Florida State Board of Medical Ex- aminers, Miami; and Arthur J. Wallace, M.D., Tampa. 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 Research in Mental Health. Through the Federal Social Security Act of 1935, the SBH re- ceives federal funds which are used to provide scholarships for its employees and those in affiliated CHDs for specialized professional training. These scholarships are awarded to career employees who evidence a potential for growth and service in specialized areas of public health. GENERAL ADMINISTRATION 15 MEDICAL Scholarships Awarded in 1965: **Gordon Charles Finlayson ........ ............ ...... ......Broward Louis B. St. Petery ............... ....... ............Orange Park Monica Anne Minyard .................... ....Ft. Lauderdale William Clark Morgan ......................... ..........Gainesville *Donald L. M cBath ... .... ......................... ..... ...... Hollywood George L. Sanders ................... ..................Pompano Beach Julia Carolyn Revell ..............................Tallahassee Harrison Denison Williams ............ ....... ................Tallahassee Wayne Raymond Johnson ................--.---- ..........Miami Continuing Scholarships Awarded Prior to 1965: 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 Wilson Awarded 1964: ***Daniel Leslie Benboe **Clarence M. Harris III Jack Benson Owen Elena Suzanne Rose *Orville Leon Barks, Jr. James Patrick O'Leary Elizabeth Orene Vaughan Charles Edward Walbroel Rosetta Mae Bush Edmond Delaney Roinson Awarded 1963: Kenneth L. Beckett Calvin Collins, Jr. **Beatrice Alfreda Denefield Samuel Boykin Hunter Ronica Mahoney Kluge Bodo Eidel Pyko Kathleen Mary Santi Ira Harmon Wenze Phillip Eugene Wright *Osteopathic scholarship **Scholarship surrendered ***Dropped from school DENTAL Scholarships Awarded in 1965: Melvin C. Beard II ....Escambia David W. Rawson .................Santa Rosa Albert J. Endruschat ..........Dade John L. Ricks, Jr. ....................Jackson Richard L. Finkbeiner ........Polk Drew H. Turner, Jr. ..................Duval Nathan A. Graddy .............Polk Richard H. Waldbart, Jr. ....Hillsborough Leonard W. Peterson ....Monroe John W. Shannon .............. Duval Continuing Scholarships Awarded Prior to 1965: Awarded 1962: George W. Boring, Jr. *James V. Ferdinand William W. Motley, Jr. Alvan C. Smith Emory T. Cain 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 16 ANNUAL REPORT, 1965 Awarded 1964: Wayne D. Bradley Roger E. Gibson S* Charles L. Graves III James R. Hoover Ronald J. Marien Conrad A. Mora James E. Owens William A. Thompson * *Scholarship surrendered ***Dropped from school PUBLIC HEALTH PERSONNEL Ernestine S. Boswell ..............Public Health Nurse II ............................Duval Collette Davidson .................Public Health Nurse Supvr. I ...............Dixie Martha V. Long .................... Asst. County Nurse Director .......Hillsborough Doris B. Jones ........................Public Health Nurse I .......................Manatee M. H. Speakman ....................Public Health Nurse II ........................Highlands Vernon Buttram .................Health Field Worker II .............................SBH Oliver H. Boorde ..................Chief PH Statistics ...............................SBH Leroy C. Doughty ....................Sanitary Engineer III ..................................SBH C. W. Sheffield ......................Sanitary Engineer III ..............................Orange R. S. Wright ..........................Sanitary Engineer IV .................................SBH O. J. Baker ....... ...........Sanitarian IV ...................................... Broward James Walter Mason II ......Sanitarian ................ ........................... Brevard Harry Zarcadoolas ..................Sanitarian I ....................................................Dade James L. Hulbert ....................Sanitarian ....................................................Orange MENTAL HEALTH Clinical Psychology Marjorie A. Bayes ....................Miami Steven P. Rievman ....................Miami Carol W. Cardoza ....................Miami Dorothy B. Ward ..............Gainesville William T. Dillon ........St. Petersburg Psychiatric Nursing Alice B. Atkins ..........................Miami Shirley M. Bloodworth ....Gainesville Sandra H. Swicord ..........Gainesville Psychiatric Social Work First Year: Gerald J. Buchert ...........Port St. Joe Gail Dee Chadwick ..............Sarasota David F. Dillon ....West Palm Beach Joseph R. Dills ................Jacksonville Jack I. Knight ............Winter Haven Joan Kogelschatz ...............Inverness Ruth McCartt ............Chattahoochee Jan C. McGurk ..................Miami Marian Schneider ............Opa Locka Richard J. Sheldon ........Tallahassee A. Julius Sontag, Jr. ......Tallahassee Donald F. White ............Jacksonville Catherine L. Zulauf ..........Rockledge Second Year: John W. Terlouw ............Tallahassee Florida Program for Residency Training in Public Health The Council on Medical Education, American College of Pre- ventive Medicine, has approved the Florida program and the fol- GENERAL ADMINISTRATION lowing five Florida CHDs for residency training in public health: Dade, Alachua, Hillsborough, Pinellas and Palm Beach. This residency in public health offers qualified physicians one year of postgraduate training and up to two years of indoctrination under the guidance of the director of the CHD to which the resi- dent is assigned, in preparation for recruitment in public health activities in Florida. It is jointly administered by the Council and by the coordinator, who for this purpose, is designated as program director by the State Health Officer and functions in this capacity under his supervision. John J. Woodward, M.D., completed his first year as Resident in Public Health in Hillsborough County, October 1, 1965. The coordinator assists the Division of Health Education in program planning and evaluation of a four and one half day orien- tation course for new employees. (See Division of Health Educa- tion elsewhere in this report.) He provides individual orientation for trainees from the USPHS and other agencies, small group orientation for special guests and dignitaries from other sections of the United States or from foreign countries who are visiting the SBH. The coordinator is -responsible for appropriate distribution of information brochures, pamphlets and announcements concerned with training available in all parts of the United States. The SBH assumes no responsibility or obligation to provide for fees, per diem or travel, incident to attendance. This is considered a matter for local decision by the directors of the departments concerned. For reference purposes this office maintains a file of catalogues of Schools of Public Health, other institutions, and USPHS publica- tions concerned with training. In addition, the coordinator is currently assisting the Bureau of Local Health Services in recruitment and was appointed by the State Health Officer to represent the SBH on the Health Task Group on State Emergency Resource Management Plans (Civil Defense). DIVISION OF HEALTH EDUCATION ELIZABETH REED, R.N., B.S. Director (to May 14) J. N. CONGER, M.P.H. Acting Director (May 14 to December 1) VINCENT GRANELL, Ed.D. Director (from December 1) As in the past, the division continues to serve all other bureaus and divisions, county health departments (CDH), voluntary health agencies, PTAs, public and parochial schools, health-related pro- 18 ANNUAL REPORT, 1965 fessions and the general public. Thirteen health educators are em- ployed in CHDs, with four more positions vacant. There is an acute need for more health educators as many CHDs are considering adding such a position to their budgets. Audio-Visual Library In 1965 the Audio-Visual Library continued its steady growth. Circulation, as well as the number of booking orders processed, reached an all-time high. The number of films and other aids cir- culated increased 19.8 per cent, for the first time going over the 10,000 mark. The actual figure was 10,465 compared with 8748 in 1964. The number of booking orders processed increased 13.7 per cent. The number of times all aids were used showed a marked increase. In 1964 they were used 17,935 times compared with 21,326 in 1965, an 18.9 per cent increase. The number of times equipment was used outside the Audio-Visual Library increased from 287 in 1964 to 317 in 1965, an increase of 10.4 per cent. The use of motion pictures alone increased 20.5 per cent. In 1964, 8438 prints were circulated compared with 10,072 in 1965. The use of all other aids combined also showed an increase, but of all audio-visual aids motion pictures accounted for about 97 per cent of the circulation with slides, filmstrips and tape recordings comprising the remaining three per cent. One film was televised to an estimated audience of 3400 per- sons. Seven television spot announcements were booked. Eleven 35 mm tuberculosis trailers were shown approximately 92 times. Forty-nine prints of motion pictures were removed from circula- tion because of obsolescence or damage. Two other aids were re- moved because of damage. Two motion pictures and one filmstrip were lost in transit. Inventory as of January, 1966 included 1242 prints of motion pictures. There were 563 separate titles and 255 other aids. Pur- chases consisted of 93 prints of motion pictures. No equipment was purchased. A catalog and a supplement were printed and dis- tributed during the year. A circulation survey was compiled, printed and distributed. Medical Library New books added in 1965 totaled 1312, while 686 outdated or worn-out volumes were withdrawn bringing the total number of books and bound journals in the collection to 21,548 on December 31. The vertical file of unbound material was increased by the ad- dition of 940 pamphlets. By far the most extensive use of the library was made by the personnel of the State Board of Health (SBH) in Jacksonville and those in the CHDs. The number of loans made to the libraries GENERAL ADMINISTRATION of the Jacksonville Hospitals Educational Program was next. Local physicians, nurses, lawyers and students also were borrowers. Of the 2555 books checked out, 752 were issued on indefinite loan. Journals circulated both in Jacksonville and out-of-town numbered 10,059. Day loans (books and journals used in the li- brary) came to a total of 2446. Other statistics included 97 inter- library loans, 34 bibliographies compiled and 1666 photocopies made. In 1965, the library continued to publish the leaflet, "Book Bulletin," which gives the titles of the new books received. This was circulated to SBH personnel, CHDs and other local libraries. The library participated in the program of the Medical Library Association Exchange through which medical libraries may request the missing issues of journals and in return supply the needs of other libraries by mailing out its duplicates. The SBH library re- ceived 180 requests and was able to fill 135, of which 13 were from foreign libraries. This represents 2545 duplicates mailed. Pamphlets The total amount of pamphlets distributed in 1965 was 324,475. The decrease from the 1964 distribution figures was due to the discontinuation of many pamphlets while others were being revised, reviewed or in the process of printing. The Spanish pamphlets were sent to the Dade County Department of Public Health for use. A new procedure has been initiated to accumulate information on each pamphlet. A card is completed giving the following data: name of pamphlet, publisher and address, price, budget number of bureau or division financing purchase, number of copies ordered, date ordered and date delivered. The procedure will permit an in- telligent answer to the purchaser who wishes to determine the effectiveness of a pamphlet. Based on requests, there is need for more pamphlets on child growth and development, sex education, good grooming, caloric charts, careers, insects, water pollution, air pollution, bacteria and viruses. Publications, Radio and Television The circulation of the Florida Health Notes (published 10 months a year) continued to climb in 1965 with 20,500 copies a month being printed. Subjects covered in 1965 were: air pollution, mental health, dental health, day care centers for children, the Aedes aegypti Eradication Project, health of migrant laborers, smoking and health, nursing homes, a condensation of an environ- mental health survey of Gainesville and a condensed annual report. Monograph Number 8, Developmental Evaluation Clinic, was published. Assistance was given to the editing and publishing of 20 ANNUAL REPORT, 1965 40 other books and pamphlets, as well as the Annual Report. In- cluding slides, over 158 photographic assignments were completed. Approximately 200 radio stations received 37 new spot an- nouncements on various health topics. Filmed spot announcements on general immunization and measles prepared by the Federal Government were received and distributed to state television stations. Exhibits and Illustrations The exhibits consultant developed 40 exhibits and displays dur- ing the year and made 78 reproductions and 50 illustrations. A total of 150 charts, graphs and maps were made, plus 160 signs, 89 slides and 28 miscellaneous illustrations. Forty conferences were conducted and 12 trips made for consultation on exhibits, displays and other creative productions. Educational Activities The staff health educator participated in a variety of health education activities with many groups and agencies. Activities included attendance at the PTA State Conference, Florida Associa- tion for Health, Physical Education and Recreation annual work- shop, Florida Education Association State Conference, Southern Branch of the American Public Health Association, State School Supervisors Conference and National Association of Sanitarians Conference. The consultant participated in the Health Project in Teacher Education (see report of the Bureau of Maternal and Child Health elsewhere in this report) and assisted as a consultant in the de- velopment of a workshop on school health at Florida State University. The consultant assisted the CHDs in the development of health education activities. Similar services were given to the public health educators employed in the CHDs. He served as a consultant to principals' workshops on health matters, conducted three SBH Orientation Programs and served as adviser to community health councils as requested. The services of the health educator are being requested more and more to assist in developing programs that focus on the pov- erty aspects of society. The emphasis on health indicates that more personnel will be necessary to meet the demand for services requested. GENERAL ADMINISTRATION DIVISION OF PERSONNEL MILES T. DEAN, M.A. Director Under the general direction of the State Health Officer, this division is responsible for the administration of the personnel pro- gram of the State Board of Health (SBH). This includes advising administrative officers concerning personnel practices and develop- ment; putting into effect procedures for carrying out approved per- sonnel policies; participating in the preparation and administration of the approved Classification and Compensation Plan; administer- ing the leave regulations; maintaining adequate personnel records on all persons employed in the agency; acting as liaison official with the Florida Merit System involving requests for certificates and reporting on the selection of eligibles, promotions, salary advance- ments, 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 oper- ation, also a responsibility of this division, includes the administra- tion of leave accounting, the employee insurance program, retire- ment and Social Security, as well as the preparation of the admin- istrative payroll and distribution of warrants. Preparation of the salary portion of the Legislative Requesting and the Operational Budgets is also a responsibility of this division. The total number of employees of the SBH increased signifi- cantly during the past year. There were 1398 employment. Most of these additional personnel were in programs included in the Grants and Donations category. In April 1965, there was a major change in our personnel and payroll procedure. The payroll was changed to an add and delete operation, and the procedure for reporting personnel actions was changed so that such actions were made with the minimum amount of necessary work in the field on new IBM printed forms. A major change was made in the classifications used by the SBH. This included a revision in the classes of health officers, dentists, nurses, sanitarians and nutritionists. A large percentage of the classes used by the SBH received a pay range increase, but the full implementation of the Merit System pay plan was not made. There was a considerable change in the pay plan rules effective August 1, which allowed considerably more flexibility on pay mat- ters within the agency. Turnover of personnel continued to be a real problem. There was a marked increase in turnover for higher-paid employees dur- ing this year. Difficulties in recruitment and retention of employees in- creased. In the field of Sanitary Engineering, even after concerted efforts, only about 75 per cent of vacancies were filled. Retention of 22 ANNUAL REPORT, 1965 physicians, although the salary ranges for physician classes were revised upward, became a real problem. Recruitment of the entire spectrum of health workers became so difficult that employment above the minimum salary was on a considerable increase over previous years. TABLE 1 NUMBER OF EMPLOYEES IN THE FLORIDA STATE BOARD OF HEALTH AND COUNTY HEALTH UNITS AS OF DECEMBER 31, 1956-1965 State County Health Total Year Office Departments Employees 1965 ... ................ ........... 914 2647 3561 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 1321 1879 1957. .. .............. ........... 528 1234 1762 1956 ............................ 481 1127 1608 TABLE 2 DISTRIBUTION OF PERSONNEL, FLORIDA STATE BOARD OF HEALTH (OTHER THAN COUNTY HEALTH DEPARTMENTS) DECEMBER 31, 1965 .. "00 ADMINISTRATIVE UNIT g -- o -. o ) 5 -E- Grand Total ...................................................... 914 28 11 81 33 27 202 7 121 277 127 Administration Research....................................... .......... 20 2 ..... ..... ..... ..... 6 1 4 6 1 Training................................... 18 1 ..... 5 1 4 ..... 2 2 3 State Health Officer. ................... ......... ... .... ... 35 8 ..... ..... ..... I "3 ..... 7 16 Health Education ........................................... 14 ..... ..... ..... ..... ..... ..... .... 6 6 2 Personnel ................... .............................. 14 ..... ..... ....... ..... ..... ..... 4 10 Nursing ..........12 ..... 10 ..... ... ... ..... ..... .... 2 Encephalitis Research Center.................... .........8 2 ..... ..... ..... ..... 2 ..... 1 3 Dental Health ................... ................... ......... 15 ..... 10 ..... ..... ..... ..... ..... 2 3 Entomology State and Regional Offices ..................................... 23 ..... ..... ..... 1 ..... 11 ..... 1 4 6 Research Center-Vero Beach ................... ..........53 ..... ..... ..... ..... ..... 29 ..... 1 3 20 Arthropod Laboratory in West Florida .................. ............ 8 ..... ..... ....... 8... .. .... .. 4 ..... ..... 1 3 Finance and Accounts Fiscal ................................................... 14 ..... ..... ..... ..... ..... ..... ..... 6 8 Purchasing and Property................... ................... 7 ..... ..... ..... ..... ..... ..... ..... 2 4 1 Building and Facilities ...................... ................ .. 35 ..... ..... ..... ..... ..... ..... ..... 1 6 28 Laboratories Central-Jacksonville ................... ...................... 66 ..... ...... .... ..... 1 47 ..... ..... 7 11 Miami ............................. ........... ......... 22 ..... ..... ..... ..... ..... 17 ..... ... 2 3 Orlando ................... ................... ......... 10 ..... ..... ..... ..... ..... 6 .. .... I 3 Pensacola............................ ....... ............. 9 ..... ..... ..... ..... ...... 5 ..... ..... 1 3 Tallahassee ................................................. 7 ..... ..... ..... ..... ..... 4 .. .1... 1 2 Tampa ...................................... ..... 21 ..... ..... ..... ..... ..... 13 ..... ..... 3 5 West Palm Beach ......... ........7 ...... ..... ..... ..... ..... 6 .... ..... 1 Epidemiology of St. Louis Encephalitis ..................... ........ 19 .......... 1 19 .1. .. .... 11 ..... ..... 3 4 Local Health Services Bureau of Local Health Services. ................... ......... ...... 9 1 ..... ..... ..... 1 ..... .... 2 5 Sanitation.................................................. 6 ..... ..... ..... ..... 5 ..... ... 1 .. Nutrition ................... ................. ........... 10 ..... ..... ..... ..... ..... ..... ..... 8 2 Civil Defense ................... ................ ........ 2 ..... ..... ..... ..... ..... ..... ..... I 1 Accident Prevention ...................... ............... 2 ......... .... .. ..... ..... .. .. .... 1 ... TABLE 2 (Continued) DISTRIBUTION OF PERSONNEL, FLORIDA STATE BOARD OF HEALTH (OTHER THAN COUNTY HEALTH DEPARTMENTS) DECEMBER 31, 1965 ADMINISTRATIVE UNIT a c Maternal and Child Health ....................................... 60 4 ..... 22 ..... 9 ..... 3 4 13 5 Mental Health .......... 8 ..... ..... 2 ..... ..... ..... 1 1 4 ... Narcotics .............. 19 ..... ..... ..... ..... ..... ..... ..... 13 6 .... Preventable Diseases Bureau of Preventable Diseases ................................... 11 3 ..... ..... ..... ..... 2 ..... 1 5 Radiological and Occupational Health .............................. 20 1 ..... "1 4 ..... 6 6 "2 Tuberculosis Control ...................................... 68 4 ..... 22 ..... ..... 14 ..... 3 24 1 Venereal Disease Control .... .......................... ......... 19 ..... ..... .... ..... ..... ..... .... 15 4 Veterinary Public Health.. .......... .. 5 ..... ..... ..... .... .. ..... ..... 13 2 Vaccination Assistance Project .... ............ ... ............... 1 ... ..... 18 ....... ..... ..... 4 15 14 Sanitary Engineering and Air Pollution Control ....... .............. 86 .... ..... ..... 31 2 16 ..... 5 23 9 Special Health Services Bureau of Special Health Services ................ .................... ... .2 ..... ..... 1 Hospitals and Nursing Homes..................................... 16 1 ..... 1 ... ..... 1 ..... 6 8 Chronic Diseases ......................................... .. 14 .... .... ..... 1 ..... 2 9 .. Community Cancer Demonstrations ......... ...... ................ 3 ..... ..... ..... ..... ......... .... 1 2 .. Vital Statistics Bureau and Division of Vital Records. ................... ......... . 47 ...... ..... ..... ..... ..... ..... ..... 5 42 Statistics .................... ................. ......... 5 3..... ..... ..... ..... ..... ..... ..... 3 2 Data Processing ................... .......................... 13 ..... ..... ..... ..... ..... ..... ..... 2 10 1 GENERAL ADMINISTRATION 25 TABLE 3 DISTRIBUTION OF PERSONNEL IN COUNTY HEALTH UNITS, FLORIDA, DECEMBER 31, 1965 COUNTY 4 2 1 6 1 Bradford ........ ..... 7 ........ 1 ...... ...... ...... 1 1 Grand Total.........1 2647 122 21 724 17 339 46 92 61 484 741 Alchua ...................... 6 1....... 6 1 10 5 Bay ..... . . .. 17 I ...... 6 ...... 3 ...... 2 ...... 3 2 Brevard ............ 45 1 ...... 15 2 10 1 2 ...... 13 1 Broward............ .. 105 3 2 30 3 18 4 3 3 29 10 Calhoun ........... 4 ...... ...... 1......... ..... .... .. .. 1 1 Charlotte ........... 11 1 ...... 5 ...... 3 ... ...... ...... 1 1 Citrus .............. 6 1 ...... 2 ...... 1 ...... . Clay. ............... 10 ...... ...... 5 ...... 2 ...... ...... ...... 2 1 Co.ller . . . 14 1 .. .... 3 ...... 3 ...... 2 .... 4 1 Columbia........... 9 I ...... 3 ...... 3 ...... ...... ...... I 1 Dade ............ .. 434 45 9 161 4 58 19 13 17 87 21 DeSoto ............ 7 ...... ...... 3 ...... 1 ...... ...... 2 Dixie ......... 3 ...... ...... 1 ...... ...... ...... ...... ...... 1 1I Duval............. 52 2 1 17 ...... 9 1 6 ...... 10 6 Escambia........... 75 4 ...... 25 ...... 14 2 3 2 18 7 Flagler............. 3 ...... ...... 2 ...... ...... ...... ...... ...... 1 .. Franklin ............ 4 ...... ...... 1 ...... 1 ...... ...... ...... 1 Gadsden........... 13 1 ...... 6 ...... 3 ...... ...... ...... 2 1 Gilchrist. .......... 3 ...... 3...... 2 ...... ...... ...... ...... ...... 1. . G lades ............ 1 ..... ... ...... ........ .. ...... 1 ... Gulf.............. 5 ...... ...... 2 ...... 1 ...... ...... ...... 2 . Hamilton........... 5 ...... ...... 2 ...... 1 ...... ...... ...... 1 Hardee............ .. 6 ...... ...... 3 ...... 1 ...... .. .. 1 Hendry ............ 12 ...... ...... 5 ...... 1 ...... ...... ...... 3 3 Hernondo ........ .. 3 ...... ...... I ...... 1 ...... ...... ...... I . Highlands ........... 9 1 ...... 3 ...... 2 ...... 1 ...... 2 Hillsborough ........ ..188 6 2 7 2 35 3 4 8 38 20 Holmes ............ 6 ...... ...... 2 ...... 1 ...... ...... ...... 1 2 Indian River......... 11 ...... 5 1 1 ...... ...... ..... : 2 1 Jackson ...... 14 .... ......1 2 ...... 1 ...... 2 4 Jefferson. ........... 6 1 ...... 2 ...... 1 ...... ...... ...... 1 Lafayette. .......... 4 ...... ...... 1 I ..... 1 . Lake.............. ... 18 1 1 7 ...... 3 ... ...... 4 2 Lee ............... 17 1 ...... 6 ...... 3 1 1 ...... 5 ...... Lean. ............ 41 2 ...... 11 ...... 6 ...... 6 1 11 4 Levy .. ........... 5 ..... ...... 2 ...... 1 ...... ...... ...... 1 Liberty . . .... ...... 2 .. .... ...... ...... ...... ...... ...... ...... Madison ........ .... 6 1 ...... 2 ...... 1 ...... ...... ...... 1 1 Manatee ............ 32 1 ...... 11 ...... 7 ...... 3 1 7 2 Marion ............ 18 1 ...... 7 ...... 2 ...... 1 1 4 2 Martin ............. 5 ...... ...... 2 ...... 2 ...... ...... ...... ..... Monroe.............. 16 1 ...... 5 ...... 2 ...... ...... ...... 4 4 Nassau ............. 13 1 ...... 4 ...... 2 ...... ...... ...... 3 3 Okaloosa............ 20 1 ...... 7 ...... 4 1 1 1 3 2 Okeechobee .5 ...... ... 1 ...... 1 ...... ...... I 1 Orange............. 95 4 1 26 ...... 17 1 4 5 23 14 Osceola ........... .. 6 ...... ...... 2 ...... 1 ...... ...... ...... 2 1 PalmBeach ......... 126 9 2 36 2 21 2 8 6 28 12 Pasco ............. 8 1 ...... 3 ...... 2 ...... ...... ...... 1 1 Pinellas ........... 184 9 1 72 1 29 8 5 7 43 9 Polk .............. 96 3 1 40 2 11 2 2 2 19 14 Putnam ............. 15 1 ...... 5 ...... 4 ...... 1 ...... 3 1 St. Johns............ 10 1 ...... 4 ...... 2 ...... ...... ...... 2 1 St. Lucie........... 21 1 ...... 4 ...... 5 ...... 5 ...... 5 1 Santa Rosa......... 12 1 ...... 5 ...... 2 ...... ...... ...... 2 2 Sarasota ........... 45 1 ...... 15 ...... 8 ...... 3 ...... 16 2 Seminole........... 17 1 ...... 8 ...... 2 ...... 1 ...... 3 2 Sumter ............. 4 ...... ...... 1 ...... 1 .... ...... ...... 1 1 Suwannee ........... 9 1 ...... 3 ...... 1 ...... ...... ...... 2 2 Taylor.............. 5 ...... ...... 2 ...... 1 ...... ...... ...... 1 1 Union.............. 3 ...... .. I 1 ...... 1 ...... ...... ...... 1 . Volusia.............. 58 3 1 21 ...... 9 ...... 5 ...... 10 9 Wakulla .. ....... 3 ...... ...... I ...... ...... ...... 1 1 Walton .. ......... 9 2 ...... 2 ...... 1 1 ...... ...... 2 1 Washington .. ...... 5 ...... ...... 2 ...... 1 ...... ...... ...... 1 1 26 ANNUAL REPORT, 1965 TABLE 3 (Continued) DISTRIBUTION OF PERSONNEL IN COUNTY HEALTH UNITS, FLORIDA, DECEMBER 31, 1965 E -.: - d r .2 a . S- 'o J Eradication of Aedes aegypti Alac uaA. : : : : : 11 ...... ...... ................ .... .. .. 1 60 Brevard A. A.......... 12 ...... ...... ...... ...... ...... ...... 1 11 Broward A. A.......... 51 1 50 Dade A.A ............ 157 ...... ...... ...... ...... ..... 2 155 Duval A.A.. . .. 26 4 10 12 Escambia A.A. . . 15 ...... ...... ...... ...... ...... .... 1 14 Hillsborough A.A....... 67 ... ...... ...... ... 65 Lee A.A............. 20 ...... ...... ... 1 19 Leon A.A............. 8 ...... ...... ....... .....7...... ..... ...... ..... 1 Manatee A.A.......... 27 ...... ...... ......2............. ....... ....1 Monroe A.A .......... 15 ......1...... ...... ...... ..... ..... 14 Orange A.A......... 28 ...... ...... ...... ...... ...... ...... 1 27 Palm Beach A.A........ 45 ...... ...... ...... ...... .. .. .... .. ...... 1 44 Pinellas A.A......... 53 ...... ...... ...... ...... .... ...... .. ..... 1 52 Polk A.A. .......... 15 ...... ...... .......... .. .... ... .... ... 14 St. Lucie A.A ...... .. 10 ...... ... ..... .. .. 10 Sarasota A.A......... 13 ...... ...... ........ .... ...... .. 13 Volusia A.A.......... 6 ...... ............ .................. ...... 1 5 GENERAL ADMINISTRATION TABLE 4 EMPLOYMENT TERMINATIONS AND TURNOVER RATES BY CLASSIFICATION AND SALARY, FLORIDA STATE BOARD OF HEALTH AND COUNTY HEALTH UNITS, 1965 (FULL-TIME EMPLOYEES ONLY) SALARY CLASSIFICATION Under 200- 300- 400- 500- 600- 700- 800- 900- 1,000 Total 199 299 399 499 599 699 799 899 999 Over TERMINATIONS 1965 Total-All employees ..... 916 47 221 416 121 30 43 10 8 3 17 Physicians ............ 22 .... .... .... .... .... 3 1 2 1 15 Dentists................... 20 ............ 5 .... 15 ............. Sanitarians ............ 35 .... .... 8 21 5 .... .... 1 .... ... Sanitary Engineers....... 8 .... ........... 5 1 1 .... .... 1 Public Health Nurses ... 126 .. 5 65 53 1 2 .... ... Laboratory Workers proff. & tech.)........ 36 .... 8 11 7 3 3 3 .... 1 .... Mental Health......... 52 .... .... 3 10 9 19 5 4 I 1 Other professional and technical ........... 18 .... .... .... 10 7 .... .... 1 .... ... Clerical ............. 189 1 133 51 4 .... .... .... All others ............ 410 46 75 278 11 .... .... .... . TURNOVER RATE* Total-All employees .... 25.7 38.2 42.0 37.4 11.6 9.3 22.5 15.2 16.7 15.8 15.3 Physicians............ 14.7 .... .... ......... ... 37.5 100.0 100.0 14.3 16.9 Dentists .............. 68.5 .... ..... .. 62.5 .... 100.0 .... .... .... .... Sanitarians ............ 9.6 . .. 266.7 12.1 3.9 . 50.0 .... . Sanitary Engineers....... 16.0 .. ... .... ..... 100.0 9.1 16.7 ....... 9.1 Public Health Nurses ..... 15.7 ... 20.8 69.9 9.0 1.5 7.4 .... .... .... .... Laboratory Workers proff. and tech.). ....... 14.5 . 20.8 18.6 12.3 7.1 10.3 25.0 .. 100.0 .... Mental Health ......... 52.5 .... .. ... 150.0 52.6 30.0 82.6 71.4 40.0 100.0 .... Other professional and technical ........... 9.9 .... ........ 17.5 15.9 .... .... 11.1 .... .... Clerical ............. 24.8 4.8 44.8 13.6 5.9 .... .... .... .... .... .... All others ............ 47.2 51.7 47.5 48.8 22.9 .... .... .... .... .... .... *Per cent of full time employees terminating by classification during 1965. DIVISION OF PUBLIC HEALTH NURSING ENID MATHISON, R.N., M.P.H. Director A primary function of this division is to coordinate and to con- sult with all other units of the State Board of Health (SBH) con- cerning programs and projects which require nursing services. Guidance and assistance is given to public health nursing at the local levels in the planning and development of the various public health programs. Special efforts are made to recruit nurses from the colleges of nursing, since this is the only public health preparation available at the undergraduate level. As nursing services expand and become more complex it is imperative that well qualified nurses give leader- ship and supervision to staff nurses and to the increasing numbers 28 ANNUAL REPORT, 1965 of nonprofessional people who will be involved with providing care for patients in their homes. The nursing consultants participate in planning conferences with bureau and division directors, and interpret to the county health department (CHD) personnel the policies of the SBH and the newer trends in nursing programs. Upon request they work with local nursing directors and supervisors to improve the ad- ministrative and supervisory services within the nursing unit. Assistance is given in the planning and implementation of com- munity health activities, workshops and continuing education programs for all nurses. The consultants who gave special emphasis to the vaccination assistance program in the state worked with many of the counties to orient them in the initial procedures necessary for participation in the program. A great deal of time and effort went into the preparation of a time equivalency reporting form which makes it possible for the nursing personnel assigned on the special project funds to function in a generalized public health program. A short-term traineeship grant from the U.S. Public Health Service made possible a one-week seminar on public health nursing administration in November. Nursing directors and supervisors from 28 CHDs, two visiting nurse associations, public health fac- ulty from three colleges of nursing and nursing administrators from four other states participated in the course. The continuing education committee, under the leadership of the nursing education consultant, has prepared an orientation guide for use in the four field training centers. All newly employed nurses who have not had preparation or experience in public health nursing are required to have a planned eight weeks orientation before permanent status is granted. In cooperation with the director of the Division of Tuberculosis Control, a guide for the Tuberculosis Control Program was com- pleted. This will constitute one unit in the public health nursing manual now under revision. There are now 42 voluntary nursing organizations, incorporated as nonprofit bodies, which contribute to or provide nursing care to the sick at home. With the exception of the seven independent visiting nurse associations, the service is combined with the CHD to provide a generalized nursing service to the community. In these 42 agencies, fees collected for nursing services are administered by the agency, the monies reverting back into nursing service. Fees are collected on a sliding scale, according to the ability of the patient to pay; however, no one goes without nursing care because of a lack of funds. A number of CHDs have enabling acts which permit them to receive money for services rendered. All counties accept referrals for Medical Assistance to the Aged patients, and in some of the smaller counties, where there is no organized nursing GENERAL ADMINISTRATION 29 care of the sick at home program, additional services are given on a limited basis. Additional nursing staff will be necessary before the service can be expanded in most areas of the state. The de- mands for nursing care of the sick at home are expected to increase markedly with the inception of the medicare program. Unfor- tunately, lack of nursing staff curtails many services badly needed by the CHDs. The division has developed a survey form which will be used to determine the readiness of agencies--both official and non- official for certification as providers for Home Health Services, as defined in Public Law 89-97. All consultants will give these top priority in January and February, 1966, so that the agencies ready for certification can participate in funds now available to the state. Studies to determine the time and cost of units of nursing activities have been completed in 17 counties. The following are examples of the cost per visit and average time in minutes spent giving care to the patient on disease and disability visits: Cost Time Clay CHD $6.56 36 Manatee CHD 5.83 49 Jacksonville VNA 5.58 67 Okaloosa CHD 4.44 35 Sarasota CHD 6.79 53 In recent years the number of midwives has been decreasing at about 10 per year; 179 were licensed in 1965. A definite need for the services of a midwife is established before a woman is selected for training. Before licensure a new applicant must complete a three weeks training program, sponsored by a maternity home and the CHD (Seminole). A grant of $3000 was secured from the Florida Council on Training and Research in Mental Health for a detailed study to determine the mental health engendering concepts in the Florida Midwife Program. Data have been collected and will be published when the material has been analyzed and conclusions reached. The three orientation programs at the Gainesville Sunland Training Center were attended by 71 people; two at Fort Myers by 47; two at Marianna by 63; and two at Orlando by 66. These programs make it possible for professional workers, rehabilitation personnel, special teachers and social workers to see the facilities available within the state for the care of selected mentally retarded children. Many of the training programs at the institution can be adapted for use in the local communities. Communications among agencies have improved considerably as a result of the orientation programs at the institutions. The consultant in this program is also promoting community action programs so that maximum serv- ices will be available to the non-institutionalized retarded in com- munities throughout the state. 30 ANNUAL REPORT, 1965 The consultant in rehabilitation nursing had the major role in the preparation of a book BLUEPRINT FOR STROKE RE- HABILITATION THROUGH COMMUNITY ACTION. This was a joint project of the SBH and Florida Heart Association. Educational programs in rehabilitation nursing were conducted for public health nurses, institutional nurses and nursing home per- sonnel. The requests and need for these programs in nursing homes can not be met. The Advisory Committee on Public Health Nursing, appointed by the SBH in 1963, published its first report in 1964. This dealt with the study of the role, problems and direction of public health nursing in Florida. The committee gave invaluable assistance to the division this year in the revision of the Merit System Nurse Classification Series. BUREAU OF DENTAL HEALTH 31 FLOYD H. DeCAMP, D.D.S. Director DELMAR R. MILLER, D.D.S., M.P.H. Assistant Director The dental health program expanded this year due to an in- crease of funds made available through the Children's Bureau, the U.S. Public Health Service (USPHS), at the state level and by the interest of county health department (CHD) directors in the establishment of well planned and equipped dental clinics in many of the new health centers built this year. The clinics are staffed with at least one full-time dentist and a dental assistant. Some counties have several well equipped dental clinics in areas throughout the county. During the year, the bureau participated in a number of Head- start Projects and also in other special dental health projects con- ducted throughout the state by local dentists. The bureau is greatly assisted in the conduct and planning of programs through the efforts of the dental member of the State Board of Health (SBH). The state law in Florida provides that one of the five members be a dentist. This action assists in form- ing much closer cooperation between the bureau and the members of the Florida State Dental Society. The Dental Scholarship Program and the Dental Preceptorship Program being administered jointly by the Florida State Board of Dental Examiners and this bureau has resulted in an excellent association and cooperation between these two state agencies. PRECEPTORSHIP PROGRAM Since its beginning in 1957, this program has provided an ef- fective method of recruiting dentists to staff dental clinics in CHDs. Preceptees are selected by the Florida State Board of Dental Examiners and supervision of their work is provided by a dental consultant from this bureau, a committee of dentists from the local dental society and the director of CHDs in their re- spective areas. Some 125 highly qualified young dentists have served in the program during the nine years of its operation. Most of these men have entered private practice in the state on completion of their assignments and continue to maintain great interest in public health matters of their communities. Counties served by dental preceptees during all or a portion of 1965 were: Alachua, Broward, Collier, DeSoto, Duval, Flagler, Glades, Hardee, Hendry, Highlands, Hillsborough, Lake, Manatee, Marion, Palm Beach, Polk, Putnam, Sarasota, Santa Rosa and Volusia. Preceptees also served in the Jacksonville City Health Department and as operators of the two mobile dental clinics of the Bureau of Dental Health. 32 ANNUAL REPORT, 1965 In addition to preceptees serving throughout the state of Florida in CHDs, there are 12 dentists engaged full time in dental public health on the county and state level. DENTAL SCHOLARSHIPS Ten dental scholarships were awarded in 1965. These were granted in accordance with the dental scholarship law which pro- vides a stipend of up to $1000 per year for as many as four years for recipients who agree to practice in "areas of need" (where there are few or no dentists) for 12 months for each $1000 received. Stu- dents may repay the funds received under certain circumstances. Since 1955, a total of 111 scholarships have been awarded, four of which were cancelled before becoming effective. Disposition of the 69 graduates to date: Serving in "areas of need" ..................................... ...... 23 Repaid scholarship in full (cash) ..................................... 17 In military service ....................... .................. .............. .. 10 Completed compensatory practice .................................... 14 Repaying stipends received .......................................... 4 Obligated to repay but not qualified for Florida licensure 1 69 DENTAL CLINICS During the year, a total of 35 fixed dental clinics were operat- ing in 27 counties. All served only underprivileged children in ele- mentary grades or underprivileged expectant mothers. Full-time licensed public health dentists served all or a portion of the year in the dental clinics of the following counties: Broward, Dade, Jack- son, Liberty, Orange, Palm Beach, Pinellas, St. Johns and Volusia. In addition, the bureau assigned two completely equipped mobile dental clinics to various counties. These mobile clinics are main- tained to serve underpriviledged elementary school children in counties having few or no practicing dentists. Financing and super- vision of mobile clinic operators is provided by this bureau, the preceptorship committees and the county health officers in the counties or areas where the clinics are assigned. One mobile clinic operated for four months and the other operated for 10 months during the year. A summary of the services performed follows: School dental inspections .................................. ...... .... 95 New Patients ........................................ 1192 Repeat Patients ................................ ........................... 325 Prophylaxis ....................................................................... 266 Fillings (all types) ....................................... .................... 3037 E xtractions ..................................................................... 1592 M miscellaneous treatments ............................................... 289 Topical fluoride applications ........................................ 20 Talks given to school and civic groups .......................... 5 Pamphlets distributed ..................................................... 200 As a continuance of previous efforts to develop ways of provid- ing dental services to handicapped children, a mobile clinic was DENTAL HEALTH assigned for one month to a special school for the handicapped. Preventive dental services and treatments were provided for the underprivileged children attending the school. A new dental clinic began operation in Hardee County. Charlotte County completed installation of dental equipment in a new clinic. DeSoto County acquired a portion of the equipment necessary to begin a dental treatment program. Clay CHD com- pleted installation of equipment in the dental clinic of a new building. A full-time dental hygienist was employed during the entire year. Her efforts made it possible to increase the amount of assistance given to the growing number of requests for aid to school dental health programs. The hygienist gave dental inspections to 6009 children in 19 different schools in 11 counties. A total of 69 lectures were presented to students, teachers and PTA groups. Approximately 250 stannous flouride treatments were performed by the dental hygienist at the Florida School for the Deaf and Blind at St. Augustine and at the girls' 4-H encampment at Doe Lake in Marion County. The hygienist served as a coordinator for the Florida Health Project in Teacher Education at one of the participating universities. FLUORIDATION Many communities expressed interest in the matter of water fluoridation during the year. Pensacola ceased fluoridation as a result of city commission action. Daytona Beach, in a referendum, voted heavily in favor of fluoridation and is proceeding with the necessary plans. Fluoridation was approved by city commission action in Sanford and Eau Gallie. A negative decision resulted from a fluoridation referendum held in DeLand. At the end of 1965, 26 Florida cities, with a combined popula- tion of over 756,132, were fluoridating water supplies. An addi- tional population of more than 300,446 residing in 26 other cities, including Jacksonville and Sarasota, is served by water supplies containing approximately the correct amount of fluoride as a natural component. In all areas, a total population exceeding 1,056,578 is receiving the benefits of water containing fluoride at near optimal level to control dental decay. Oral Cytology Project In 1964, this bureau, in cooperation with the Florida State Dental Society and Florida Northeast District Dental Society, initiated an oral exfoliative cytology project in a 17-county area of northeast Florida. It was funded by the USPHS with the under- standing that at the end of one year it would be evaluated and considered for expansion statewide. 34 ANNUAL REPORT, 1965 The evaluation committee consisting of four dentists, a physi- cian, an oral surgeon and pathologist, met May 26, 1965. The de- cision was made to expand the program. Sufficient funds from the first year's fund grant were available to permit the expansion to a statewide program for an additional year. The four other dental districts agreed to participate in the program. Plans were immediately made to organize an oral cytology committee in various local dental societies throughout the state, and to conduct orientation programs for all participating dentists. These orientation programs are now being conducted and will eventually include all local dental societies within each district. Local participating pathologists in each area examine the smears and biopsies submitted by the dentists, and are paid from project funds by the Bureau of Dental Health. One dentist in south Florida, who holds a fellowship in the American Academy of Oral Pathology, is examining smears and biopsies for dentists in the Miami area. In other areas throughout the state, the local dentists are inviting medical pathologists in their area to partici- pate in evaluating cytological slides and biopsies. So far, there have been approximately 60 dentists throughout the state who have submitted specimens for examination, and the number is steadily growing as new areas are included in the program. LACTOBACILLUS LABORATORY PROGRAM A few years ago this bureau, in cooperation with the Bureau of Laboratories, adopted a simple diagnostic test of saliva from young patients who had an excessive amount of dental caries. An increased number of dentists throughout the state have utilized this service during the past year because it is an approved scien- tific fact that a change in the diet, in which other foods are sub- stituted for carbohydrates and sweets with proper control, will markedly reduce the dental decay rate. In 1965, 106 dentists par- ticipated in this program, and each year the program is increasing in scope. HEALTH EDUCATION A variety of dental health activities were carried on in Florida during the year. The ultimate objective is to decrease the vast amount of dental decay and tooth loss among the children of this state. Parents and teachers have been encouraged to make more effective use of known dental health measures to reduce the high rate of dental decay and early loss of permanent teeth of young children. The Florida State Dental Society has adopted a unique policy in which local dentists through official action of the Florida State DENTAL HEALTH Dental Society are encouraged to serve as dental health con- sultants to elementary and high schools in the various counties. Through the interest of the Florida State Department of Education and many county boards of public instruction, this new program has provided a close liaison between school principals and school health coordinators on a statewide basis. It is estimated that in 1965, 1100 dentists served in this capacity. Not only were there many thousands of school dental inspec- tions performed by these dentists, but they lectured on dental health to civic groups, and they assisted in the introduction of DESIGN FOR TEACHING DENTAL HEALTH IN FLORIDA SCHOOLS, Bulletin 7. Dental health education in local 4-H clubs was improved, and distribution of dental health educational materials for the members has increased. The major portion of the health educator's time was spent in public and private schools, meeting with administrators and teachers to promote effective dental health education from primary grades through college level. Some of these activities were to assist in teacher preplanning conferences at the beginning of the school year, as well as for groups of health coordinators during the year. Lectures on the value of dental health were given in most of the 50 junior colleges and universities each term. In addition, presentations on dental public health were given at least once a year in each of the three Florida schools of dental hygiene. Meetings were held in six urban areas with dental advisors (private dentists serving elementary schools in the company of consultants) and school supervisors to show the latest audio visual aids and new teaching materials available from the SBH. The health educator also served as a SBH consultant on the Florida Health Project in Teacher Education. (See report of Bureau of Maternal and Child Health elsewhere in this report.) 36 ANNUAL REPORT, 1965 BUREAU OF ENTOMOLOGY J. A. MULRENNAN, B.S.A. Director A most discouraging note for 1965 in the field of public health entomology was the finding that salt-marsh mosquitoes were show- ing a terrific resistance to the fogging application of Malathion for adult mosquito control. This excellent insecticide was first used in the state on wide-scale application in the mosquito control dis- tricts in 1957. The chemical has been an extremely effective adulti- cide, the only method of use in mosquito control. This now means that many counties will be required to turn to another insecticide to destroy resistant adult mosquitoes. The encephalitis surveillance program appears to be working quite well since it has been able to show, by collecting mosquitoes from different sections of the state and examining them for arbo- virus, that St. Louis encephalitis (which caused the epidemic in the Tampa Bay area in 1962) was not present in mosquitoes ex- amined in 1965. However, many other strains of arbovirus were circulating, as is shown in this report. The federally-supported Aedes aegypti Eradication Program continued operations throughout the year with expansion to other counties in addition to the seven original counties reported upon last year. The funds were increased to $3,066,000 during 1965. Two years operation is not sufficient to provide definite conclusions, but it is apparent that excellent reduction in breeding is being ac- complished in the Tampa Bay counties. Unfortunately, with the exception of Monroe County, the same cannot be said for the three other southeastern counties. In fact, resistance to DDT is in evi- dence in Dade County. Many other methods of control are being carried out in hopes of finding a method which will be effective in this area. In addition to extensive container breeding, the area presents a unique problem of breeding in cultivated bromiliads found by the thousands on many premises. ARTHROPOD CONTROL Source Reduction Accomplishments The number of counties and/or mosquito control districts par- ticipating in the state aid program for the control of arthropods remained the same as during 1964. Fifty-seven programs were operated in 53 counties; 26 programs being directed by county health departments (CHD), six by boards of county commissioners and 25 by boards of mosquito commissioners. Holmes County resumed participating in state aid after with- drawing for a year due to legal difficulties, and Calhoun County was dropped, due to the failure to meet state aid requirements for receiving state aid. Two separate programs continue to be operated in Bay, Duval, Lee and Walton Counties. ENTOMOLOGY 37 The state fund matching rate for source reduction measures averaged 20.75 per cent for the year; however, at the end of the year the matching rate was only 17.60 per cent. This reduction in the state matching rate each year appears to cause many counties and/or districts to increase their local annual budgets to offset the loss in state funds, which further reduces the percentage rate of state funds that can be given. In 1963 the local funds budgeted amounted to $4,865,700, and in 1965 the amount was $5,805,700, an increase of $940,000 in two years. Hydraulic dredging was discontinued in Brevard County in February, 1965. Only one dredge is now operating (Indian River County), and it will likely be discontinued in 1966. Some new dragline ditches were constructed; however, the greater portion of machine work performed was in maintenance of ditches constructed several years ago. The construction of dikes, for impounding salt-marsh mosquito breeding areas, continued in Brevard and St. Lucie Counties. The disposal of solid waste material poses an ever increasing statewide problem. Considerable time was, spent during the year in consulting with local officials, and making surveys pertaining to garbage and rubbish disposal. The 38 counties conducting sanitary landfills under the state program reported direct field costs for garbage disposal to amount to $659,482. There follows a summary of the source reduction work accom- plished throughout the state during 1965: Machine Ditching and Maintenance 1964 1965 Number of counties participating ............................ 33 34 Miles of ditches dug or maintained .......................... 447.164 427.741 Cubic yards earth excavated ......................................3,604,286 3,662.598 Average labor cost per cubic yard .............................. $0.1032 $0.1110 Construction and Maintenance of Dikes Number of counties participating .......................... 4 4 Miles of dike constructed or rebuilt ...................... 47.54 34.06 Cubic yards earth placed in dikes ........................ 937,037 694,343 Average labor cost per cubic yard ........................ $0.0615 $0.0810 Hydraulic Dredging (10-inch Dredges) Number of counties participating ............................ 2 2 Number of dredges used ........................... ............. 2 2 Cubic yards earth fill placed ......................................1,023,298 206,252 Average labor cost per cubic yard .......................... $0.0575 $0.1720 Deepening and Filling (Draglines and Bulldozers) Number of acres improved ...................................... 97.63 113.3 Average labor cost per acre ...................................... $132.21 $92.47 Sanitary Landfills Number of counties operating landfills .................... 35 38 Total number of landfill sites operated ....... ...... 121 143 Total field costs in all counties ................................ $659,482 Cubic yards of garbage disposed of ......................4,989,121 5,673,595 Total field costs per cubic yard ................................ $0.121 $0.1162 *Figures not available. 38 ANNUAL REPORT, 1965 Temporary Control Measures The temporary control of arthropods is accomplished by the ap- plication of insecticidal formulations, applied either as a larvicide or as an adulticide. The material is dispersed by either/or both ground and air equipment. Airplane applications of insecticides were made, on a contract basis, in Dade, Broward, Martin and Indian River Counties. Counties owning and operating their aircraft for temporary control measures are Collier, Lee, Volusia, Monroe and Brevard. Dibrom and Malathion were the principal insecticides used for adulticidal work. A small amount of Baytex formulation was suc- cessfully used on Sanibel Island in Lee County, following obtain- ing poor results with Malathion. The West Florida Arthropod Research Laboratory is conducting resistance studies, which is re- ported under its section. The following is a summary of the ground adulticiding work performed during the calendar year. The costs shown are direct field costs, and do not include capital investment costs, deprecia- tion of equipment, or supervision and overhead expenses. 1964 1965 Number of counties or districts doing ground fogging .............. ............ ............ 46 54 Total number of hours fog machines operated...... 62,511 57,737 Total number of miles fogged ................................ 372,537 389,571 Gallons of insecticidal formulation used.............. 2,559,085 2,806,887 Total field costs in all counties and districts.......... $1,271,100 Average cost per hour for fogging ......................... $22.02 Average cost per mile for fogging .............................. $3.26 *These figures not available for 1964. Reporting procedures revised on October 1, 1964. Airplanes were used in eight counties for adulticiding and/or larviciding work. Hillsborough County received a surplus C-47 air- plane, which at the end of the year was nearly ready for a restricted license for mosquito control work. Polk County purchased a new Piper Pawnee, which will be used in midge control work and herbiciding. Volusia County completed building a Bell helicopter, which was licensed and operating late in the year. Adulticiding and Larviciding with Airplanes: 1964 1965 (1) Airplane Fogging (with Malathion and Baytex in 1965) Number of counties and districts doing fogging ................................. ...... .. .......... 3 4 Gallons of insecticidal formulation applied...... 227,041 303,408 Acres treated ........................................................2,706,840 2,641,833 Gallons applied per acre (average).................. 0.10235 0.11485 Labor cost per acre treated ......................... $0.0112 Incomplete (2) Airplane Spraying: Number of counties and districts doing spraying ............. .... ......................... 5 5 Gallons of spray formulation used ................... 160,124 214,459 Acres treated ................................. ....... 221,864 308,512 Gallons applied per acre ...---................................ 0.7217 0.6951 Labor cost per acre treated ......................... .. $0.125 Incomplete ENTOMOLOGY Adulticiding and Larviciding with Airplanes: (continued) 1964 (3) Airplane Larviciding with Paris green: Number of counties doing larviciding............ 3 Pounds of Paris green pellets used ............... 236,463 Acres treated ..................... ............................. 22,779 Pounds applied per acre (Aver. 5% mix) ........ 10.38 Labor cost per acre treated ........................... $0.4945 1965 4 313,490 18,541 16.90 Incomplete Dog Fly Control Emulsifiable DDT, mixed with sea water, continued to be used by the most western Florida counties bordering on the Gulf of Mexico for controlling dog flies. The program was continued on the same basis and manner as in previous years. No spraying was per- mitted by the U. S. Fish and Wildlife Department on their reserva- tion in Wakulla County, and no work was reported as being done in Escambia County. The following is a summary of the dog fly control work per- formed in the seven remaining counties: 1964 1965 Total miles of shoreline treated ...................... .................... 962 963 Gallons of 35 per cent DDT concentrate used.................. 12,634 12,219 Average labor cost per mile ....................................... .. $8.33 $9.47 Number of man-hours labor required ............................ 5,686 7,774 The control work continued to be effective, with only a very few small and localized outbreaks of short duration being reported. Counties Participating and Local Fund Budgets The following counties participated in the State Arthropod Control Program during the year. The amounts of local funds bud- geted for arthropod control activities during the fiscal year October 1, 1965 through September 30, 1966 are (as of December 31, 1965) as follows: County Alachua ........................$ Bay (Comm.) ......... Bay (Gulf) .................... Bradford ............... Brevard .................. Broward ...................... Charlotte .................... Citrus .......................... Collier ........................ Columbia .................. Dade ............................ Duval (East) ............. Duval (Northeast) ...... Escambia ................. Flagler .......................... Franklin ................... Gadsden ...................... Gulf .............................. Hardee ....................... Local Amount 88,194.00 100,906.00 51,857.13 16,334.11 346,966.17 82,743.86 80,938.33 123,099.51 179,974.26 14,728.06 241,599.00 108,467.33 134,000.00 125,199.95 14,191.28 15,000.00 12,710.00 41,255.44 4,700.00 County Hernando .................. Highlands ..................... Hillsborough ................ Holmes ............-........ Indian River .............. Jackson .................... Jefferson .................. Lake ................... Lee (District) .............. Lee (Beach) ................ Leon ..-.... .........$ Levy ........................ Madison .................. Manatee .................. Marion ................... Martin .................... Monroe ..................... Nassau .................... Okaloosa ............-.... Local Amount 15,009.46 4,625.00 342,120.00 11,000.00 353,637.69 5,036.89 10,727.23 88,500.00 502,306.95 63,011.00 80,000.00 15,000.00 1,150.00 87,421.75 30,000.00 43,237.89 283,215.27 61,549.00 42,243.50 40 ANNUAL REPORT, 1965 Local Local County Amount County Amount Orange .......................... 107,143.00 Sarasota ......... ...... .... 158,601.94 Osceola .................. 45,147.44 Seminole ........................ 15,000.00 Palm Beach .................. 340,946.00 Suwanee ................ 15,930.00 Pasco ....................... 80,210.91 Taylor .................... 4,850.00 Pinellas ................. .. 315,274.73 Volusia .............. 319,081.64 Polk ....................... 228,003.00 Wakulla ................ 18,000.00 Putnam ................. 25,000.00 Walton ................. 7,500.00 St. Johns ........ ....... 90,493.26 Walton (South) .......... 22,262.20 St. Lucie .................. 147,026.82 Washington ................ 2,500.00 Santa Rosa ...........:........ 40,071.00 Total local funds appropriated .... ................$5,805,698.00 Total state funds appropriated .............................. 1,650,000.00 TOTAL BUDGETED FUNDS FOR ARTHROPOD CONTROL ................... .........$7,455,698.00 Engineering The engineering section continued its assistance to counties and districts through assisting the directors, commissioners and health officers with the many aspects related to their particular area and program. Assistance in the field was given through pro- gram planning, equipment needs, project plans and proposals, se- lection of landfill sites, preparation of budgets, specifications for purchase of heavy equipment, record keeping procedures, and preparation of monthly report forms. The office staff maintained records pertaining to financial ac- counts of all 57 counties and districts; checked monthly report forms for accuracy, and tabulated progress and costs by activities. Regional Entomologists Five entomologists and one assistant continue to serve the state from locations in Panama City, Marianna, Jacksonville, Orlando, Tampa and Miami. They have continued to advise and give entomological assistance to counties and districts from these head- quarters (except for Marianna, which is primarily concerned with encephalitis mosquito collections), while coordinating all regular phases of state and local activities, including the functions of plan- ning, budgeting, operating, approving control projects, evaluating and reporting the progress of 57 mosquito control and landfill programs in 53 counties of the state. A sample list of other duties, taking more or less time accord- ing to region, season and necessity, include meeting with county and district commissioners to discuss mosquito operations and procurement of personnel; participation in State Board of Health (SBH) orientation and sanitarian training classes; conducting tours for World Health Organization personnel and foreign stu- dents; addressing and showing films to various civil clubs and com- munity groups, promoting and extending landfill programs in inter- ested counties; assisting and training personnel of counties and ENTOMOLOGY 41 districts to prepare progress and financial reports; field work in calibrating equipment for Paris green pellet application by air- planes and helicopter; assisting in pest control problems and in- vestigating insecticide poisonings (heaviest in Miami, Tampa and Orlando); testifying in conjunction with pest control and fly prob- lems; locating, relocating, terminating, arranging for new construc- tion or repairs and securing cooperators in the mosquito light trapping program; collecting, developing techniques and arranging for collection of mosquitoes in suspected encephalitis areas (119,364 specimens details elsewhere), and generally serving as a clearing house for information several times daily for people who telephone or visit the regional or central offices with their insect and pest problems. Arthropod Identification Laboratory The identification of arthopods of public health importance con- tinues to be an increasing need for the citizens of Florida, both from a personal standpoint and also in conjunction with wide- spread control activities and research. The season just finished has been near normal for the most part, with a sizable increase in the encephalitis mosquito identification work. "Salt-Marsh Mosquito- grams" have been published weekly to advise districts, counties and others interested of the current status of salt-marsh mos- quotes in 43 coastal locations spaced evently around the state. The "Weekly Bird Baited Trap Collections" were published through October 30 as an aid to encephalitis research, and then discon- tinued. These traps, except for specific collections, are being re- placed by more efficient and practical CDC traps. Freshwater collections from 63 interior locations, Woodruff Dam, North Bay and Shell Creek impoundments, have been con- tinued on a routine or seasonal basis throughout the period of this report. As usual, the general public has kept this bureau abundantly supplied with arthropods and miscellaneous pests for identifica- tion. The technicians have rendered this service for so many years that they are becoming proficient with many arthropod groups out- side their normal field. The identification and pooling of live mosquitoes collected for encephalitis research in conjunction with work in the Jacksonville SBH virus laboratory has increased substantially during this year as a result of the improved trapping and CO, baiting techniques. Due to the close relationship of certain species commonly found in encephalitis collections and the fact that the anesthetized mos- quitoes must be identified and preserved on ice within 30 minutes, the work is extremely painstaking in comparison to routine salt- marsh mosquito identification. At times of heavy collections the laboratory is taxed to the limit. The laboratory identified 9514 adult and 4 larval collections 42 ANNUAL REPORT, 1965 containing a total of 680,046 adult and 49 larval specimens re- spectively for the regular light trap program. Although the bird baited trap program was gradually curtailed, as previously ex- plained, a total of 12,892 specimens from 960 collections were identified from samples taken in 24 counties from January to December. The identification, pooling and processing of live mosquitoes for encephalitis virus studies was continued this year. A total of 794 collections from 729 CDC light trap nights, 56 bird-baited trap nights and 9 sweep net collections containing 119,364 live mos- quitoes (the dead discarded) was collected from 25 counties. The mosquitoes collected were brought into the entomology laboratory alive, identified and grouped into pools of usually 26 to 60 speci- mens of a single species. Eleven of the counties had no pools positive for encephalitis. These counties and the number of mosquitoes identified were as follows: Dade, 3155; Hardee, 2464; Highlands, 2359; Jackson, 196; Levy, 4570; Okaloosa, 272; Orange, 1388; Osceola, 498; Putnam, 691; St. Johns, 121; and Wakulla, 142. At the time this report goes to press 2170 pools have been processed by the Jacksonville SBH virus laboratory, and 61 posi- tive virus isolations in 14 counties obtained. The counties with positive pools and the details concerning the virus type, species of mosquito concerned, number of live mos- quitoes identified, and geographical locations of each virus are pre- sented in Table No. 5. This is a cooperative project involving both Entomology and the Jacksonville virus laboratory. (See section on Laboratory Serv- ices elsewhere in this report.) Midge Studies During 1965 33 collections containing 2961 live chironomid larvae were taken. Each larva was placed into an individual vial to rear, and a total of 678 adults emerged. This work is a continuation of a study of the life history and ecology of the Chironomidae of Florida, supported by a research grant from the National Institutes of Health. Twenty collections, containing approximately 1150 insects, chiefly Culicoides, were identified to species for the West Florida Arthropod Research Laboratory. The Midge Research Laboratory at Winter Haven, submitted 96 collections with more than 205,000 insects, mostly Glyptoteipes paripes and Chaoborinae. These were identified by checking an aliquot of each collection. In addition, 21 collections of miscellaneous Diptera were identi- fied for private individuals, Bureau of Plant Industry, U. S. Quar- antine Station at Miami, and the University of Florida. TABLE 5 ARTHROPOD-BORNE VIRUS ISOLATIONS FROM MOSQUITOES, FLORIDA, 1965 COUNTIES -5 o Mosquito species 4 0 _ o n > oo An. crucians. .................... 1B 6B 18 68 2B 16 15236 A. atlanticus ................... 3C 2C 2C 7C 3C 1C 3C 21 5650 A. infirmatus. ................. I C 1C 2 6017 A. taeniorhynchus. ............... 1C 1 2407 Aedes spp ................ ...... 1C 1 1547 C. nigripalpus .................. 1H 1H 1C 3 54608 1W 1B 1W Cs. melanura ................... 1H 1H 2E 1E 1E 1C 2E 1E 16 7371 2H 1H P. confinnis ............ ..... B 1 1654 Total positive pools by county ......... 6 3 1 1 2 19 1 4 2 1 9 1 8 3 61 Number of mosquitoes identified by county .............. Letter and number designate positive pools: W = Western Encephalitis E = Eastern Encephalitis C = California Complex B = Bunyamera Group (probably Tensaw) H = Hart Park like virus 1825 1456 2744 2608 1500 16842 815 9420 3719 9066 3876 47519 1320 m Z -4 0 0 I- 0 0 44 ANNUAL REPORT, 1965 TABLE 6 SUMMARY OF PEST CONTROL REGISTRATION AND ENFORCEMENT, FLORIDA, 1961-65 Registration 1961 1962 1963 1964 1965 State Board of Health Licenses issued.............. 274 296 311 329 338 State Board of Health Change of Address Licenses issued.. 29 33 34 44 41 State Board of Health Licenses revoked* .......... .. 0 0 2 1 0 State Board of Health Licenses placed on probation* .... 1 0 0 3 2 Pest control certificates revoked, suspended or placed on probation* ........ ... ...... .......... ...... ... . . 3 2 Employees' Identification Cards issued ............. 2,818 2,996 3,391 3,588 3,910 Employees' Change of Address Identification Cards issued ............ ... ..... .. 136 145 160 237 283 Employees' Identification Cards revoked or stopped* o... 0 7 15 10 12 Employees' Identification Cards on probation* ........ 5 0 2 2 2 Thermal-Aerosol Certificates of Authorization renewed*. 12 9 8 6 5 Enforcement Homeowner complaints investigated ............... 94 81 82** 83 92 Unlicensed illegal pest control operators investigated ... 35 21 11 19 31 Warrants filed against unlicensed operators .......... 15 5 5 9 6 Letters of warning issued to unlicensed operators ....... 10 9 4 9 14 Enforcement miles traveled (Jacksonville office only) .. 18,222 16,865 17,107 18,608 19,427 *By Pest Control Commission of Florida **Corrected from 1963 report Licenses, identification cards and thermal-aerosol certificates issued are based on 1964-65 licensing year. All other entried are based on calendar year 1965. PEST CONTROL The bureau continued for the 18th consecutive year its respon- sibility for licensing and issuing employee identification cards to firms engaged in the business of pest control, and enforcing the law and regulations governing this industry (see Table No. 6). In April the State Legislature amended Chapter 482, formerly the Struc- tural Pest Control Act, enacting the Pest Control Act and provid- ing for a new category known as "lawn and ornamental pest con- trol." Other significant changes effected by the act include increas- ing the license fee; changing the name of the commission from Structural to Pest Control Commission; increasing penalties for violation of both the law and regulations; directing the board to promulgate regulations for the protection of health and safety of pest control employees and the general public, in conformity with the act, by requiring that all pesticides be used only in accordance with the registered label; and, at long last, fixing certain criteria for certified operators "in charge of" pest control activities of a busi- ness. As required by law, public hearings were held on September 13 and November 12 to consider complete revision of Pest Control Regulations. New regulations were adopted by the board on December 5, filed with the Secretary of State on December 10, and will become effective January 21, 1966. ENTOMOLOGY The number of regular licensees and employees' identification cards issued increased by 2.7 and 8.9 per cent respectively over 1964. The number of investigations of property owners' complaints, involving licensees, increased 10.8 per cent over 1964, while investi- gations of unlicensed operators increased by 63.2 per cent. The Pest Control Commission recorded 864 certificates in force and issuance of 386 new certificates during the year. ENTOMOLOGICAL RESEARCH CENTER The supplementation of state funds by U. S. Public Health Service research grants took a new administrative direction in 1965. This year was the first in which all entomological research at this center was supported by a program-project grant (Al - 06587) from the National Institute of Allergy and Infectious Diseases. This broad program is entitled "The Natural History of Mosquitoes" and is subdivided into seven projects, each of which is treated separately in the following report. The one remaining in- dividual Public Health Service research grant is CC 00101, en- titled "The Biology of Salt Marsh Larvivorous Fishes" and its progress is reported under Project 8. PROJECT 1: BITING CHARACTERISTICS This project will explore the biting behavior of mosquitoes by performing precipitin tests on the blood meals of specimens col- lected in areas where the land vertebrates are routinely censused. It was started by collecting fresh vertebrate sera and preparing antisera in rabbits and chickens. Antisera for the recognition of the principal groups of Florida mammals were easily accumulated, but a similar bank of antisera to identify the various orders of birds has been delayed by difficulties in obtaining enough live specimens of representative species. Precipitin tests which have been made with the prepared antisera indicate that the techniques being used are entirely satisfactory. Progress in the field work has required the development of new traps and methods of collecting. This knowledge will be especially useful when it is necessary to obtain more specimens of the same animals. A special test of methods of storing mosquito blood meals has been undertaken to study the following factors: time since feeding, pinning versus sealing in gelatin capsules, various conditions of temperature and humidity, and, especially, duration of storage. PROJECT 2: POPULATION DYNAMICS Comparisons were made between collections of mosquitoes taken by non-attractant (truck trap, suction trap and power aspi- rator) and attractant (New Jersey light trap, bait trap and human landing rate) samplers. The data from the non-attractant samplers were used as a base to establish levels of light activity. Compari- 46 ANNUAL REPORT, 1965 sons with attractant methods showed that Aedes taeniorhynchus and Psorophora confinnis prefer to fly in open areas while Aedes infirmatus prefers wooded areas. Culex nigripalpus occurs freely in both types of areas. Ovarian examinations were made on all collected material. Most C. nigripalpus and P. confinnis taken were found to be in egg stage I, while most A. taeniorhynchus were in stage II. Stages III and IV were taken in largest numbers by the power aspirator (as were most blood-engorged), operated only by day over the ground-litter resting places. This implies that little flying is done during these stages when eggs are maturing after the blood meal. Truck traps and suction traps took more gravid (stage V) females than at- tractant traps, indicating that neither hosts nor light are especially attractive to gravids. Gravids were taken primarily during the twi- light periods, few being taken during the middle of the night, sug- gesting a preference for oviposition at those times. The parous rate among females did not appear to vary during the night. However, larger numbers of nulliparous females of both A. taeniorhynchus and C. nigripalpus were taken by the truck trap and the landing rate station than by other methods. This suggests that nullipars range more freely and attack more readily than older females. PROJECT 3: DISPERSAL CHARACTERISTICS (a) A migratory species The care and management of the nursery plots for salt-marsh egg production has proceeded as usual. A very high egg deposition had been maintained throughout most of the summer by scheduled flooding the swales with brackish water. The electric pumping sys- tem for water level control (in relation to attraction for oviposit- ing females) has been improved by installation of automatic float switches to control rain and tide seepage. The dikes at some points need raising to prevent hurricane tides from flooding out egg supply. The hurricane in September flooded out the egg supply but a large brood of females has replaced it. Three towers have been installed for raising nets to a height of 50 feet for exodus studies. Also improvements were made in the heat-controlled rearing trough. Attempts were made at controlling fiddler crabs, Uca Spp., and minnows in the plots. The greatest aid towards this end will be an artesian well which will provide water of a lower salinity. No actual experimentation with A. taeniorhynchus dispersal was undertaken during the year because of lack of supervisory per- sonnel. Analysis of data from an as-yet unreported exodus experi- ment in mid-March 1964 yielded several meaningful conclusions. This was primarily a technology-testing experiment and several departures in exodus-recording technology were proven effective. (1) Feeding a colored sugar-solution to the newly-emerged adults ENTOMOLOGY worked well and gave strong evidence that more of the fed than the unfed take part in the twilight migratory exodus and that the unfed took off earlier. (2) Time-lapse photography with newly designed exodus cages succeeded in pin-pointing the twilight migra- tory exodus to from 10 to 25 minutes after sunset. (3) Stationary nets demonstrated their high selectivity for migrants and proved that at wind speeds under three miles per hour the exodus is up- wind while at wind speeds over three miles per hour the exodus is down wind and over a narrower sector the greater the wind velocity. (b) A non-migratory species In July and August of 1965, the dispersal and longevity of C. nigripalpus, a non-migratory species, were studied by marking reared specimens with radioactive phosphorus and externally ap- plied dusts. Each different dust or combination of two dusts was used for the releases made on two successive nights and was not repeated within three weeks. An average of more than 3000 fe- males with internal and external marking was released each night for 36 days, and then, on the two days following, there were final releases consisting of about 14,000 females marked only with phosphorus and about 15,000 marked only with dust. Collections to recover the marked mosquitoes were made with CDC miniature light traps placed in pairs at half-mile intervals on three radii each extending three miles from the release point. Some of the findings are still tentative because the markings, both internal and external, were not entirely satisfactory, and be- cause the examination of the collections is not yet complete. The released specimens spread at least three miles in each direction, and the rate of dispersal, as shown by the day on which the col- lecting sites first became positive for recoveries, was 0.57 miles per day. The problem with regard to the internal marking arose from the use of too high concentrations of the radioisotope. The dosages which were selected to offset a 29 per cent loss in radioactivity observed when females oviposited in the laboratory, apparently prevented normal development of the ovaries and delayed ovi- position. The problem with regard to the external marking was the exces- sive loss of dust before recapture and the resulting possibility that, in many cases, a mosquito had lost its second marking. On the other hand, the amount of information provided by the external markings justifies a thorough study of the best way to attach them to a mosquito. It is through the recovery of specimens of known age that longevity data are best obtained, and this knowledge will lead to a better understanding of the infectivity of populations in the field. 48 ANNUAL REPORT, 1965 (c) Migratory versus non-migratory dispersal Four large-scale investigations conducted in 1951-55 on the dispersal of the migratory salt-marsh mosquito, Aedes taeniorhyn- chus, were made the subject of a comparative study. There were found to be marked differences in the displacement of the released populations as well as in their maximum spread. There was also a wide range in the rate of dispersal. Investigations of Culex tarsalis and C. nigripalpus exhibited relatively slight displacement com- pared to that of A. taeniorhynchus. An analysis of dispersal based on the unmarked specimens in the recovery collections provided strong evidence that A. taeniorhynchus ceased to migrate within a week of adult emergence. PROJECT 4: COMPARATIVE BIOLOGY Investigations conducted during 1965 were directed towards basic behavioral patterns of reproduction in Culex nigripalpus (Florida's SLE vector) and how these corresponded or differed from those of Culex pipiens quinquefasciatus and Culex bahamen- sis. The latter, an abundant species in the Florida Keys, was colo- nized during the year and found to lend itself readily to laboratory manipulation. Principal points of Culex studies were: insemination of female and its effect on avidity for the blood meal, effect of in- semination on oviposition and space and light requirements for mating. Copulation was stimulated in refractory species by intro- ducing another species which mates readily in flight under labora- tory conditions. Tests with C. nigripalpus, using A. taeniorhynchus as the "stimulating species," resulted in increased mating. Other species were ineffective as stimulators for C. nigripalpus. Diets were developed for rearing maximum numbers of C. nigripalpus larvae with maximum synchrony of pupation. Late in the fourth instar, it was found that three times the usual number of larvae could be crowded together for radioisotope (p") marking without appreciably reducing the synchrony of pupation. Larval diets were also developed in relation to effective crowding for con- servation of space and time in manipulation for: Culex pipiens quinquefasciatus, C. bahamensis, Aedes sollicitans and A. vexans. Survival studies on stored reserves at emergence were initiated for wild grown A. taeniorhynchus. The investigation will be ex- panded to include several other species. Seasonal vector sources were studied in relation to mosquito population survival in the field. Further ethnological observations were made on the crab-hole mosquito, Deinocerites cancer, in anticipation of early publication of studies on this species made during the past several years. A catalogue of the 35 mosquito species reared in this laboratory was prepared, with an analysis of progress in the various steps lead- ing to eventual colonization. The analysis stressed the points of procedural weakness, with a view to leading as early as possible to efficient colonization. ENTOMOLOGY PROJECT 5: REPRODUCTION Comparative studies on the endocrine system of Aedes have shown that the medial neurosecretory cells (mnc) and the corpora allata are both essential for egg maturation. Transplantation of corpora allata into a host mosquito from which the mnc had been surgically removed or implantation of mnc into an allatectomized female showed that the mnc and corpora allata were not inter- changeable. Therefore, each must have some essential function un- related to the other. The timing of mnc-ablation was as critical as that of allatectomy. The percentage of taeniorhynchus and triseri- atus which matured eggs after mnc-ablation increased when the operation was performed on older females. Extirpation of the mnc did not prevent digestion or absorption of the blood meal because as much triglycerides were synthesized by mnc-ablated females as by unoperated controls which were fed the same amount of blood. Several species took notably larger blood meals from unoperated animals. The lack of effect of mnc-ablation on protein ingestion and on digestion in mosquitoes appears to differ from what is re- ported for blowflies and other insects. An anatomical study of the neuroendocrine system of Aedes is underway utilizing both dissection and histological staining tech- niques, specific for the neurosecretory cells. The objective is to trace the axons of the mnc and observe their content of neuro- secretory material in different animals and under controlled physiological conditions. In addition to its influence on egg maturation, the endocrine system has been shown to control insemination. The age at which a normal A. aegypti female becomes inseminated during mating has been established and compared among four strains. Extirpation and implantation experiments have demonstrated that the corpora allata in some way regulate insemination. PROJECT 6: GROWTH In addition to temperature and food, larval development in A. taeniorhynchus is affected by the photoperiod acting through an endogenous 22-hour rhythm in terminating it as a synchronized daily rhythm of pupation. A series of experiments were performed to elucidate the photoperiod-related rhythm. It was found that maximum synchronization of a brood or population occurred on a "full ration," at a 12L:12D photoperiod, and between 29C and 31C; under these conditions there was but one day's burst of pupation for the whole population. Under a variety of other condi- tions, pupation occurred as a short to long series of daily burst or "peaks." The main findings concerning the complex of factors affecting pupation were: (a) Minimum larval duration, at any constant 50 ANNUAL REPORT, 1965 temperature, was the same on full or quarter rations, feeding at 24- hour or two-hour intervals, in continuous darkness or on a 12L:12D photoperiod, but was five to six hours longer in continuous light. (b) Different photoperiods have only a slight effect on the first three larval molts, as the intervals between successive molts vary with temperature only. (c) Under continuous darkness or contin- uous light and on full rations, only one long skewed peak of pupa- tion occurs. (d) Under continuous darkness, at quarter ration, and with feeding at two-hour intervals, pupation occurs in a series of peaks at 22-hour intervals; this is the first demonstration in an in- sect of an endogenous circadian rhythm expressed without environ- mental cue or entraining. (e) At quarter ration and 12L:12D photoperiod, three to four pupation peaks occur at 22-hour inter- vals, and these occur even when all light is excluded from the time pupation first appears. The morphological and physiological status of mosquitoes at emergence is the result of larval nurture. Studies to relate larval diet, density, temperature and photoperiod to adult characteristics at emergence showed that adults obtained from larvae reared under 12L: 12D on full ration but having different larval rearing tempera- ture (24-34oC) were different in their physical and chemical compositions, at the different temperatures and between emergence peaks at the same temperature. Dry body weights, total fats, glycogen, trehalose and autogeny were maximum at 30C, showing an apparent correlation with the maximum synchronous develop- ment of pupae. However, thorax length, wing length and hind femur length were completely temperature dependent showing a low decrease in their measurements from 24-34oC. The effects of different temperatures on the physical and chem- ical constitutions of the newly emerged adults show that tremen- dous changes take place during the pupal stage. In males, total lipids, glycogen and dry weights were maximum at 30C, but some distinct differences in these constituents were observed at different temperatures in the females. PROJECT 7: ENERGETIC For the isolation of total glycogen from animal tissues, most investigators favor a modification of Pfluger's method. The pro- cedure, however, yielded low and unreproducible results when ap- plied to small quantities of glycogen. Therefore, each step of the procedure was reinvestigated. Quantitative isolation of as little as 1 ug of glycogen has been achieved. Furthermore, although analyti- cal methods exist for determination of small amounts of sugar, glycogen and lipids, no methods appear to be available for separa- tion of these materials when present in the same biological system. For studies of the metabolism of glycogen and triglycerides in car- bohydrate-fed insects, a method was devised to separate mixtures of sugars, glycogen and lipids. ENTOMOLOGY 51 Certain cold-blooded animals take meals in excess of their body weight and, without obligation to maintain constant body temperature, may convert a measurable portion of the chemical energy in a single meal into caloric reserves. Mosquitoes appear to be uniquely suited for such energy-balance studies. This problem was investigated by determining the growth and decline of the total glycogen and fat pools, produced at constant temperature by dif- ferent quantities of sugar-fed individual mosquitoes. It was found that the fat pool grows in proportion to the sugar meal, but that glycogen reaches a maximum in 8-12 hours, independent of the amount of sugar fed. The rate of fat synthesis was similar whether sugar or calorically equivalent amount of protein was fed, but glycogen was synthesized ten times faster from sugar than from protein. This information was used to study the role of the neurose- cretory system in glycogen and triglyceride metabolism. It was concluded that in the female fed sugar, the medial neurosecretory cells of the brain restrict synthesis of glycogen from sugar and stimulate fat synthesis. Surgical removal of these cells greatly increased the storage capacity for glycogen at the expense of fat storage. In cold-blooded animals, the rate of many physiological pro- cesses is temperature dependent. A measurable chemical reaction was followed, i.e., the rate of synthesis of glycogen and fat from a single dose of sugar, in a temperature range (10C to 350C) where no excessive mortality was caused by heat or cold exposure. The rate of fat synthesis was temperature dependent at all experi- mental temperatures. Glycogen synthesis was temperature de- pendent between 35 and 22.50, but independent of temperature between 10 and 22.5. In another experiment designed to study the effect of tempera- ture on the composition of newly synthesized triglyceride fatty acids, the results in mosquitoes did not support the hypothesis that depot fat is more unsaturated when synthesized at low temperatures. PROJECT 8: BIOLOGY OF LARVIVOROUS FISHES This project has to date concerned itself with the biology of the larvivorus fishes of the salt marsh. Studies of the feeding habits of these fishes, including their predation on mosquito larvae, have pointed up the necessity to understand the whole ecology of the salt marsh. Such an ecological understanding would, of course, not only give the context for predation by fishes but would give the context for mosquito larval feeding habits as well, and also depict the environment within which mosquito parasites, diseases and predators must also operate. The current year's work therefore comprised (1) the launching of a new study on the productivity of the high subtropical marsh, 52 ANNUAL REPORT, 1965 (2) the bringing to near-completion of a study of the reproductive biology of the larvivorous fish, Rivulus marmoratus, and (3) the preparation of several manuscripts for publication on Rivulus and on the food habits and reproductive cycles of other larvivorous species. WEST FLORIDA ARTHROPOD RESEARCH LABORATORY Owing to delays in the building of new facilities not anticipated when the 1964 Annual Report was prepared, this laboratory was still in temporary quarter at the U. S. Navy Mine Defense Labora- tory, Panama City, at the end of 1965. It is now anticipated that the new facilities will not be ready until February 1966. Although the limitation of temporary quarters and unfilled staff positions were significant handicaps, some progress toward the objectives of the laboratory was made during 1965 which are discussed below: DOG FLY STUDIES During late 1964 and early 1965 personnel made an evaluation study of the equipment and procedures used for the control of the stable fly or dog fly, Stomoxys calcitrans, in West Florida. The objective of this evaluation and of the research on this insect during 1965 was to provide local authorities with more effective tools for control of this pest at the earliest possible time. This vicious, bloodsucking fly is prevalent on the shores of bays and on the Gulf beaches in West Florida during late summer and early fall, which is the principal tourist season in this area. A meeting of all fly control districts was held at the laboratory on January 28, 1965, at which time detailed recommendations were made for improving the effectiveness of methods currently used for control of this pest. Extensive tests with insecticidal thermal aerosols (fogs) for control of adult dog flies were initiated in April, 1965. These tests, which utilized flies from the laboratory colony, quickly revealed that the formulations of Dibrom used effectively for mosquito control were not adequate for control of dog flies. Subsequently, it was found that 31/2 ounces of Dibrom per gallon of diesel oil applied in the standard operation of 40 gallons per hour, five miles per hour or at 80 gallons per hour at 10 miles per hour, gave good kills of adult dog flies. The data are shown in Table 7. This information was made available to all dog fly control districts via a memorandum issued by the Bureau of Entomology on June 1, 1965. The standard method for control of dog flies in West Florida during the past 20 years has been the spraying of DDT emulsion on windows of marine grasses along the shores of the large bays. These grass deposits comprise the principal known source of dog ENTOMOLOGY 53 TABLE 7 RESULTS OF CAGE TESTS OF THERMAL AEROSOLS OF DIBROM AGAINST THE DOG FLY, STOMOXYS CALCITRANS, FOUR REPLICATIONS EACH TREATMENT, FLORIDA, 1965 Formulation1 Volume Vehicle Per cent kill in (Oz./gal.) (gol./hr.) Speed 24 hours 1-3/42 40 5 55 1-3/4 40 5 70 1-3/4 80 5 90 3-1/2 40 5 96 3-1/2 80 10 96 1Ounces of actual Dibrom per gallon of diesel oil. 2These tests conducted from 10:00 a.m. to 4:15 p.m.; all other tests conducted from 4:30 p.m. to 8:00 p.m. flies in this area. All available information indicates that DDT emulsion spray is still effective in reducing the numbers of dog flies produced in these grass deposits, if done according to recom- mendations. One of the planned objectives of the dog fly studies during 1965 was to evaluate the effects of rainfall on DDT sprays applied to marine grass deposits. It was requested that officials of the con- trol districts advise the laboratory when grass deposits suitable for testing were found in their respective areas. But as the season progressed, no grass deposits were reported for this purpose. Therefore, laboratory personnel started surveys in August to find suitable sites for these tests. Between August 13 and October 15, field plots were estab- lished five times either in natural grass deposits or in grass that was gathered for this purpose. In each instance, hurricane or storm tides destroyed or damaged the plots before significant data were secured. Much of the misfortune encountered with this type of testing in 1965 was due to inexperience with local conditions and cooperative working arrangements with local authorities. With experience gained in these areas during 1965, it is expected that research on the spraying of grass deposits will be more fruitful during 1966. There is a desperate need for a fast, effective method of abate- ment when hordes of adult dog flies suddenly invade many miles of the Gulf resort beaches in West Florida. The airplane seems to offer the only hope of providing a solution to the problem under these circumstances. With this objective in mind, tests were begun in August, 1965, to determine an effective aerial spray operation against this pest. 54 ANNUAL REPORT, Initial tests were conducted on the municipal airport at Mari- anna, using caged flies from the laboratory colony. Dibrom was applied in emulsion formulation with a 235 h.p. Piper Pawnee air- plane. Caged flies were placed in two plots, one on an open grass strip and one in an adjacent wooded area. Results of these tests are shown in Table 8. TABLE 8 RESULTS OF TESTS WITH AERIAL SPRAYS OF DIBROM AGAINST CAGED ADULT DOG FLIES, FLORIDA, 1965 Dosage/acre Per cent kill Swath in Feet Volume Ib. toxicant No. Tests Open Wooded 200 1 qt. .14 2 100 99 400 1 pt. .07 3 97 85 Owing to the high rate of kill in the open plot with the 400-foot swath, this operation was tested against natural populations of dog flies on the beaches at Panama City, one test in October and one in November, 1965. In the first of these tests, conducted Octo- ber 22, caged flies were used in addition to the natural population, the latter being sampled with traps before and after treatment. In this test, 88 per cent of the caged flies were killed by the treat- ment but no valid data were obtained on the effect of the spray against the natural population. Northerly winds bring dog flies to the beaches along the Florida Panhandle and southerly winds apparently cause the flies to disappear rather suddenly; presum- ably the southerly winds take the flies back to the bays, or beyond, which lie north of the beaches. Within a few hours after the tests, both in October and in November, the wind changed from a north- erly to a southerly direction and flies disappeared or were greatly reduced in numbers, both in untreated plots and treated plots. Therefore, no meaningful data were obtained from either of these tests as to the effects of the spray on natural populations. During July, 1965, the West Florida Arthropod Research Lab- oratory was awarded a research contract by the U. S. Department of Agriculture in the amount of $85,000 for conducting tests with insecticides against dog flies. Owing to administrative delays in authorizing employment of personnel and acquisition of equip- ment, this contract work was not fully activated during 1965. It is hoped that a full complement of personnel and required equip- ment will be available to permit this project to reach maximum activity during 1966. In general, the dog fly problem was reported to be less severe in 1965 than in any previous recent year. There were no significant 1965 ENTOMOLOGY outbreaks of this pest on the Gulf beaches of Bay County until October, which is past the peak tourist season. However, reports from some of the other counties indicate that small outbreaks did occur as early as August in some areas. There was a small outbreak in August on the shores of St. Andrews Bay, but these flies never reached the Gulf beaches in significant numbers. The efforts of the fly control districts in following the recom- mendations of the laboratory ranged from good to poor, some reporting inadequate budgets for purchase of recommended equip- ment. It is estimated that the overall budget for control of dog flies in West Florida should be three times the present amount of $36,000. Under these circumstances, it would be difficult to assess the effects of the control effort on the generally favorable fly situa- tion in 1965 prior to October. The spraying of marine grass deposits was discontinued on or about October 1, 1965, by the control districts. Investigation re- vealed that it is "traditional" to terminate the spraying of the marine grasses on October 1. The only major outbreak of dog flies during the 1965 season commenced during the third week in Octo- ber and continued into November. On October 25, one trap oper- ated by this laboratory caught 543 dog flies on the Bay County Gulf beaches in two hours 48 minutes. It is not possible to state firmly that this major outbreak re- sulted from the termination of control activities on October 1. However, the weather was mild during October and the outbreak started about two to three weeks after control operations ceased, which is the normal development period for dog flies. This is strong supportive evidence that this outbreak might have resulted from the cessation of control activities, but no other data are available to confirm this. This laboratory was not consulted about the term- ination date for spraying marine grasses in 1965, but a memoran- dum was issued through the Bureau of Entomology in late October recommending that control operations continue at least until No- vember in future years. MOSQUITO STUDIES During the summer of 1965 the first apparently bona fide re- port of mosquito resistance to Malathion in Florida was received from Lee County. An immediate collection of adults and larvae from several areas in this county was made and the subsequent tests conducted with these mosquitoes revealed a 10 to 30-fold resistance in A. taeniorhynchus larvae. Therefore, over a period of the next few months adult mosqui- toes were collected from 20 different areas in eight different coun- ties. Although the tests are still in progress, the results indicate a definite resistance to Malathion on Sanibel and Captiva Islands in Lee County, on the Keys in Sarasota County and possibly on the mainland of Lee and Brevard Counties. Tests completed 56 ANNUAL REPORT, 1965 to date do not indicate any significant change in susceptibility of A. taeniorhynchus larvae from Indian River, Martin, Volusia or Hillsborough Counties. This past year considerable time was spent in an attempt to establish laboratory colonies of A. taeniorhynchus and C. nigripal- pus by means of techniques presently used at the Entomological Research Center. Since A. taeniorhynchus is the most important pest species and C. nigripalpus is the most important vector of St. Louis encephalitis in Florida, establishment of colonies of these two species is necessary to insure sufficient numbers of these mosquitoes for research requirements. There was a continuation of the study designed to further the knowledge of particle size as it relates to insect control. Both laboratory and field studies were conducted. The laboratory studies are concerned with the deposition of particles on insects through the use of a laboratory thermal aerosol generator developed as a result of this study. Recent results have shown that the droplet deposition on insects is affected by the type of oil used in produ- cing the aerosol. The field studies are concerned with the effects of wind, discharge rate, distance from discharge, and so forth, on particle size as produced by commercial thermal aerosol gener- ators. Recent studies have shown a reduction in the size and num- ber of particles larger than five microns with distance and inside screen cages of the type used in adulticide studies. Although it has been demonstrated previously that the major portion of the droplets in insecticidal fogs is made up of droplets smaller than five microns, the relative importance of the large and small droplets has yet to be proven. Attempts were made at calibrating a rental aircraft for the dispersal of concentrate sprays against adult mosquitoes. Much time, effort and funds were expended traveling to and from Mari- anna where the airplane used in this work is based. Efforts to calibrate this plane were unsuccessful because the discharge rate was not consistent between tests. This presumably was due to the equipment on the airplane, which was not satisfactory for dis- persing such small quantities as one-half to three ounces per acre. It is expected that this laboratory will acquire its own airplane soon. This will greatly facilitate the research and development work with aerial sprays, including concentrate sprays. Sand Fly Studies Based upon successful control of sand fly (Culicoides furens) larvae in small-plot tests at Vero Beach with coal tar creosote emulsion (See 1964 Annual Report), this chemical was tested on a larger scale against Culicoides in the Panama City area during 1965. The creosote emulsion was applied with power equipment to a bay shore, canal banks, and a small salt marsh at the rate of ENTOMOLOGY 57 eight gallons of toxicant in a gross volume of 220 gallons per acre. The test plots totaled 3.8 acres in size. Larval counts and light trap collections of adults before and after treatment showed poor results. Since the dosage of creosote emulsion used in this test was effective against C. furens at Vero Beach in similar habitats, it was reasoned that the failure of this material in West Florida might be due to a difference in species susceptibility and/or conditions of the habitat. Accordingly, laboratory tests were conducted to study effects of salinity, which appeared to be less in St. Andrews Bay than in the Indian River, and species differences. Results of the salinity tests are shown in Table 9. TABLE 9 EFFECTS OF SALINITY ON THE KILL OF CULICOIDES LARVAE WITH COAL TAR CREOSOTE EMULSION, THREE REPLICATIONS EACH TREATMENT, FLORIDA, 1965 Per cent larval mortality at Toxicant Indicated water salinity (parts per thousand) Concentration (Parts per Million) 17.8 19.3 34.8 10 23 47 100 30 60 97 100 60 100 100 100 Check 0 0 0 In these tests, there was a definite trend toward a higher kill with increased salinity at the lower dosages. Whether or not this factor is as important under field conditions as these limited data indicate remains to be confirmed. In the species tests, larvae of C. furens were collected at Vero Beach and compared with larvae of C. hollensis, the dominant species in Bay County. Results showed no significant difference in kills of the two species with the creosote emulsion; therefore, species difference in susceptibility, at least between these two dominant species, is not considered an important factor in the results of the 1965 field tests. Species identification in these tests, as in all tests of sand flies, were made by rearing samples of the larvae to adult stage. Coal tar creosote emulsion and other prospective larvicides will be tested in small plots at Panama City during 1966. Two light traps were operated during most of 1965 in the Panama City area. Species collected were: C. hollensis, C. haema- 58 ANNUAL REPORT, 1965 topotus, C. crepuscularis, C. villosipennis, C. stellifer, C. biqut- tatus, C. piliferus, C. mellus and C. furens. WINTER HAVEN MIDGE CONTROL LABORATORY This year has been the most fruitful one as far as research is concerned since the laboratory's inception nine years ago. Because of the success achieved in controlling Glyptotendipes paripes Eds. through the use of insecticides, more emphasis has been placed on basic life history studies of chironomid midges. Tentative studies were initiated in the area of pathology of chironomids as a possible ultimate means of biologically controlling these insects. Continuation of the limnological studies of lake hypereutrophica- tion were carried out this past year aided by a PHS grant. RESEARCH ON CONTROL OF LAKE PRODUCTIVITY A. Nutrient Reduction by Water Hyacinth Harvest As a continuation of the hyacinth experiments 10 commercial swimming pools, 10 feet in diameter and 30 inches deep with vinyl liners, were set up in the Lake Alfred-Minute Maid area. These pools were used due to the ease of installation and maintenance following the difficulties encountered with the use of polyethylene sheets in ground excavations. Each pool was filled with water from a shallow well, treated with four pounds of Milorganite and 20 grams of hydrated lime; three days later, four pounds of hyacinths were introduced within a tygon-tubing ring encompass- ing one square meter. The ring was used as visual aid in estimating growth for harvesting purposes. Three days after fertilization chironomid egg masses were common in all polls (Chironomus fulvipilus and Chironomus at- tenuatus). Seven days after fertilization Culex egg rafts and num- bers of Culex larvae were noticed in all pools except those which were rich green and full of bubbles. On this date several Gambusia were added to each pool. Within three days no Culex larvae could be found. The hyacinths were harvested when they had multiplied to fill the tygon ring in each pond. On July 28 one-half of the hya- cinths were removed, drain-dried and weighed. Following further air drying, aliquots of the hyacinths were analyzed for nitrogen and potassium. The remaining dried hyacinths from the ponds used as controls were ground in a Wiley Mill and returned to their respective ponds so that the nutrient level in these ponds would remain constant. The harvest and removal of hyacinths apparently decreases the hyacinth productivity. Temperature and/or light changes dur- ing the season also may influence the plant productivity. Analysis of the plant tissue indicate that the cessation of hyacinth growth ENTOMOLOGY 59 was accomplished by the removal of only one-fifth of the nitrogen and potassium originally introduced. Starting in the middle of September, pools No. 1 and 3 each received 10 gm. of Milorganite per day to stimulate nutrient addi- tion to natural waters. This was an attempt to see to what extent the hyacinths could remove nutrients from the water. So far there has been no apparent effect, perhaps due to seasonal changes. B. Nutrient Reduction by Aeration (to Keep Nutrients From Cycling Within the Lake) The aeration of Big Lake Tangerine was continued during this period and Little Lake Tangerine and Lake St. Claire were con- tinued as control studies. The selected factors studied were pH, acidity, alkalinity and productivity (light-dark bottle method) bi-weekly, conductivity and DO weekly, and secchi and temperature three times a week. The greatest difference appears to be in the dissolved oxygen distri- bution; the DO is more equally distributed after aeration without the extremes generally encountered in the other lakes. However, the extremes were not as great for any factor in 1965 as in 1964 in any of the three lakes. CONTROL STUDIES Through the cooperation of the officials of Polk County, the realization of a successful midge or "blind mosquito" control pro- gram is much closer. From the $30,000 allocated to the County Arthropod Control Department to work in cooperation with this laboratory for the development of a practical control program a tremendous amount of data has been obtained. The following is a brief summation of the more important findings. Fenthion (Baytex), the one per cent sand granular formulation which had been tested successfully in previous years, was found to give an excellent initial larval control under a wide range of condi- tions with no overt detrimental side effects to other aquatic organ- isms. Unfortunately, due to apparent limnological changes in the lakes during the summer and changes in the rate of development of the midge G. paripes in the warmer seasons, the residual effec- tiveness of the fenthion treatments varied a great deal depending on the time of application. When the material was applied in March, adult midge control was achieved for almost two and one- half months. In June this same application gave adult midge con- trol for less than one month. The October treatment applied at the same dosage rate gave control for approximately a month and a half. Thus, it now appears that for the cost involved, it is imprac- tical to use fenthion as a midge larvicide in the summer and proba- bly in the fall. In the spring the rate of development per genera- tion of G. paripes is approximately 40-45 days, while in the sum- 60 ANNUAL REPORT, 1965 mer it is less than 21 days. The bloom of blue green filamentous algae during the summer months also appears to interfere with the residual effectiveness of all larvicides. Aerial applications of the granular insecticide were found to be the most practical for large lakes. For smaller lakes or spot treat- ments the material can be applied by a Buffalo turbine mounted on a boat, although this method is not as accurate as the aerial one. By carefully marking the lake for the plane's swaths, the amount of formulated insecticide necessary to achieve satisfactory midge control can be reduced to ten pounds per acre from the original recommendations of 20-25 pounds per acre. This cut seems to shorten the residual effectiveness of fenthion by about a week. Further reductions in the amount of toxicant used can be made in some lakes and still maintain satisfactory midge control by treat- ing only those portions of the lake bottom which breed midge larvae in large numbers. This type of treatment calls for a careful larval survey of each lake and an adequate marking system which can be easily distinguishable from the air. In most of the lakes in Polk County, unfortunately, the larvae are found breeding in all the sand and sandy-muck bottom areas of the lake; therefore, it was found, in many such cases, less expensive to treat the entire body of water than to try to mark out and treat only the breeding areas of the lake. It was also found that treating groups of inter- connected lakes at one time did not greatly prolong midge repopu- lation. All the lakes in this area breed G. paripes to some extent and it would be impractical to try and treat all the lakes just be- cause they might serve as a possible source of midges for re-infesta- tion. Abate (Am. Cy. 52, 160) was applied to four lakes during the year; it gave excellent control of G. paripes larvae at dosages as low as 0.05 pounds per acre of the technical material. This com- pound was applied in a one per cent sand granular formulation. There were no detrimental side effects to the aquatic biota from these lake treatments with Abate. This chemical has not been given federal clearance for use as a midge larvicide at this time. A series of toxicological studies were conducted on various aquatic organisms in the laboratory with fenthion and Abate. It was found that neither fenthion nor Abate were toxic to fish at a dosage rate necessary to control the larvae of the chironomid midge G. paripes. Fenthion was toxic to shrimp and amphipods at a dosage of 11 ppb which is below the level for chironomid larvae however, in the field enough of the shrimp and amphipods were able to survive the fenthion applications to repopulate the lakes. Microcrustacea and protozoa were not affected by the dosage rate required to con- trol midge larvae. ENTOMOLOGY 61 Abate at 0.1 ppm was safe to all of the organisms tested. In the field there was no notice of mortality of any aquatic organisms such as Odonata, copepods, ostracods, Chaoborus or shrimp following a 0.25 pound per acre technical Abate treatment to control G. paripes larvae. Lake treatments with BHC in a wettable powder formulation applied at the rate of 1.25 pounds per acre gave fair control of midge larvae in one lake and very poor control in another. Since residues of this compound were detected in the flesh of fish follow- ing analysis, no further work was carried out on this chemical. A new granular formulation of one per cent EPN gave good initial larval control of G. paripes applied at the rate of 20 pounds per acre, but it did not have the residual effectiveness of fenthion. It will serve as a good back-up larvicide. Three new larvicides were tested: Malathion, Paris green and Dow M-2854. In the case of Paris green and Dow M-2854, a new formulation must be developed which will carry the chemical to the lake bottom. All preliminary tests with these three chemicals indi- cate that they are good midge larvicides. Toxicity studies will have to be run on them before being tried in the field. Aerial fogging tests were conducted with Malathion as a midge adulticide. It was a complete success. In the early morning hours control was achieved within one hour. When the material was applied at 11 a.m., the rate of knockdown was slower but a hundred per cent control was achieved within three hours. A great deal of time and effort was spent this year developing the use of low volume Malathion sprays as a midge adulticide. It was found that aerial applications of low volume concentrate sprays of Malathion when applied at the rate of two and four ounces per acre gave excellent control of G. paripes adults. At the four-ounce dosage rate, control was achieved within three hours and the resi- dual effect of the spray gave control for four days. At the two- ounce dosage rate, it took almost six hours to achieve a satisfactory kill; however, the residual effect usually lasted three days. It ap- pears that there is no difference in the initial kill when one, two or three swaths are laid down; however, there are indications that the residual action is slightly less with one swath. Of the aquatic organisms tested against the four-ounce dosage rate, none were significantly affected when the concentration was approximately 0.14 ppm. There was complete mortality of mosquito larvae and good control of midge larvae, but no mortality of the mosquito pupae at a concentration of 0.5 and 1.6 ppm of Malathion. In the field following the sprays, there was mortality of Hippelates eye gnats, muscoid flies, small beetles and wasps. Calibration studies of low volume sprays indicate that four tee jet nozzles (800067 at 40 psi flown at a height of 40 feet) gave a slightly better spray pattern than two mini-spin nozzles (0.29 and 62 ANNUAL REPORT, 1965 0.37) at the same pressure and flown at the same height. With tee jet nozzles a single swath width was about 320 feet in a cross wind of 4-5 mph. In a cross wind of 10 mph, the effective swath was almost 400 feet when the material was applied by mini-spin noz- zles. There appears to be little change in the spray pattern when the pressure was raised from 40-48 psi or when the plane was flown at a height of 20 or 40 feet. All the midge control research was done in cooperation with the Polk County Arthropod Control Department. BIOLOGICAL STUDIES OF GLYPTOTENDIPES PARIPES Five funnel-type emergence traps were continued in Lake St. Claire, two each in Big and Little Lake Tangerine to estimate daily and seasonal abundance, and in Lake St. Claire emergence by depth and bottom type. Seasonally, spring and fall contained the greatest emergences followed by summer and then winter. For specific areas or lakes there are exceptions; for example, the traps in Little Lake Tangerine contained their greatest numbers for one month in January 1965. These studies continue to show bottom types containing predominantly sand and depths intermediate in the bottom profile are most productive of G. paripes. A study comparing moon age with daily catches indicates most catches occurred during the last quarter and over the new moon period. The fewest catches were recorded the week prior to full moon. The use of 10 egg traps in Little Lake Tangerine was con- tinued to study daily, seasonal and depth patterns. The daily and seasonal patterns related to the emergence studies. The study of depth distribution showed the greatest majority of egg masses were recovered within 50 feet of the shoreline. Larval samples taken in conjunction with the emergence traps related the larval numbers to emergence periods. Dissolved oxygen studies were continued to see if low DO was related to a migration of larvae which was noted in Lake Cannon several years ago. Since in the area of study no low DO was found, and no large number of larvae was found in the emergence traps, this aspect could not be proved nor disproved. Throughout this year the research project on the relationship between the plankton available in the lake to that found in the gut of chironomid larvae was carried out. The results of these studies indicate that basically 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. The two main factors which seem to influence high productivity of G. paripes is a plenti- ful supply of algae and a sandy bottom lake necessary for tube building. ENTOMOLOGY 63 Laboratory and field rearing experiments were tried with vari- ous degrees of success with the midge. Chironomus holoprasinatus, which was formerly called C. fulvipilus. Life history studies indi- cate that this species can complete its development within a two- week period under favorable conditions. It is an algal tube builder and thus requires no substrate to sustain itself. It is found com- monly in small temporary pools or in artificial containers in con- junction with Culex larvae. Although the pathology studies were initiated last January, they have been neglected throughout the year due to changes in personnel. A partial survey has been made of the diseases and parasites endemic to the local midge population. Two new species of mermethid worms or nematods were identified from G. paripes larvae. Microsporidia of the genera Thelohania and Stempellia were isolated from midge larvae. Both fungus and bacterial infec- tions have been observed in the larvae. At present an attempt is being made to isolate and identify the different types of bacterial diseases which are commonly found in midges. 64 ANNUAL REPORT, 1965 BUREAU OF FINANCE AND ACCOUNTS FRED R. RAGLAND, B.S. Director PAUL R. TIDWELL, B.B.A. Assistant Director Major responsibility rests with this bureau for the business and financial management of the agency, and includes: accounting, budgeting, purchasing, property control, duplicating services, mail, shipping, receiving, automobile control and assignment and build- ings and grounds maintenance. The business and financial man- agement requires a close working relationship with the State Board of Health (SBH) program directors in planning maximum utilization of funds that have been provided. This means sound budget preparation of the various health programs 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 function, along with the dissemination of proper budget control information, is accomplished by the bureau. Some- times this activity becomes quite involved due to the complexity of the various sources of funds: federal, state, county, private, etc. Each of these fund sources bears its own set of rules, laws and reg- ulations as to the administration of expenditure of the money. The fiscal year ended June 30, 1965, was the second year of the 1963-65 biennium for which the 1963 Legislature made avail- able to the agency state funds through the General Appropriations Act. These appropriations were generally based upon maintaining present programs at the same level. Total program expenditures for fiscal year ended June 30, 1965, amounted to $32,500,000; this was $4,700,000 over the previous fiscal year. This increase 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 Medical Assistance for the Aged. County health department (CHD) ex- penditures accounted for one-fourth of the increase and finally, the general increased cost of ongoing programs and some increase in special grants and donations 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 of these continues to be the "best efforts" contract for eradication of the Aedes aegypti mosquito. This contract is now at a level of about $3 million per year. The duration of the project will be approximately five years. At the close of fiscal year June 30, 1965, the number of state- owned and operated automobiles was 107. These were driven ap- FINANCE AND ACCOUNTS 65 proximately 1,650,000 miles during the year. In addition, the agency owned 31 trucks or special-purpose vehicles. These units traveled approximately 235,000 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 1965, 23 old vehicles were traded and 29 new units acquired. The bureau director and his staff continue to give assistance to the overall planning of the health department activities, partic- ularly 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 accordance with rules and regulations issued by the State Pur- chasing Commission covering the solicitation of bids, advertising for bids under certain conditions, printing regulations, et cetera. Requests for equipment and supplies are reviewed by the purchas- ing department and purchases are made under contracts and maxi- mum price regulations negotiated by the State Purchasing Com- mission where applicable. The purchasing department continues to cooperate with other state agencies in the exchange of information pertaining to contracts for volume purchases which enable this agency to purchase certain items under contracts negotiated by other state agencies and to arrange for purchases under our con- tracts 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, and scientific equipment). The state statutes prescribe records that must be maintained and the frequency of physical inventories. During 1965 the purchasing office issued 4312 separate purchase orders which totaled in excess of $1,400,000. CHDs normally handle purchases locally within their organizational framework; however, their purchasing procedures must also conform to the Florida Statutes governing purchases, such as obtaining bids and advertis- ing for bids where required. The following of good business prac- tices in procuring materials through competitive bids is advocated. The purchasing agent at the SBH assists the CHD wherever pos- sible with their purchasing requirement. Property Control The responsibility of this section is to see that capital outlay items are assigned property numbers, maintain records, process annual inventories on over 170 locations and handle fire insurance on buildings and contents. A total of 650 new pieces of equipment valued at $131,485 was added to the inventory. Four small buildings were completed valued at $19,000. 66 ANNUAL REPORT, 1965 Property values reflected by the SBH Plant Ledger as of June 30, 1965, were as follows: Real property ........................ ................ $2,856,042 Furniture and equipment............................... 1,385,546 Automotive equipment and trailers ........... 291,684 Books and films ........................................ 343,784 Total ......... ...... .................$4,877,056 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 departments acquire new quarters, property cards have to be changed or corrected for insurance purposes on any change of location. The importance of correct maintenance and control of property is continually stressed within the agency to insure that the records reflect the current status of all property items owned by this agency. Insurance Fire insurance on buildings and contents is carried in the State Fire Insurance Fund under the supervision of the State Fire In- surance Commission. Coverage on boilers and heating equipment is carried in a master policy supervised in the office of the State Fire Insurance Commissioner. Scientific equipment, dental equipment and X-ray equipment in various mobile units is insured under a "Floater" or "Transportation" policy. Automobiles, trucks and other special-purpose motor vehicles owned by this agency are covered by a fleet policy to include public liability, property dam- age, fire, theft and comprehensive. The agency acts as self-insurors 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 em- ployees honesty blanket position; Workmen's Compensation. During 1965 we were notified by the insurance companies that claims amounting to $16,843.30 were settled under the agency's fleet automobile liability policies. This includes claims for acci- dents during 1964 and 1965 which were settled during 1965, and includes accidents involving vehicles on loan from the Federal Gov- ernment for use in the Aedes aegypti Eradication Program, as well as SBH vehicles. Damages to SBH vehicles caused by others were settled for $2,044.17. Claims amounting to $2,730.27 for damages to SBH and Federal vehicles under the Comprehensive clause were paid by the insurance company. The SBH as self-insuror for dam- FINANCE AND ACCOUNTS ages caused by collision paid $1,469.38 for repairs. This figure is less than the cost of carrying collision coverage in the fleet automo- bile policy. BUILDINGS AND FACILITIES SECTION Maintenance During the year 762 work requests were re- ceived of which 712 were completed. Forty of the uncompleted requests are active and in process of completion; the remaining 10 have been cancelled or are being held in abeyance. In consum- mating this work, $15,220.40 was expended in labor and materials; an additional $1,525.50 was expended in labor and material to provide preventive maintenance and to honor verbal requests for assistance. Some of the major accomplishments of the year were: almost complete waterproofing and caulking of the exterior of the build- ings along with recovering a large portion of the painted surfaces. About one-half of the interiors have been refinished in a standard- ized color; the media and wash rooms have been completely modernized with shelving, sinks and specialty area setups. Many additional electrical branch circuits were established for both the laboratories and Vital Statistics, plus the updating of 39 ceiling light fixtures. In addition, all fluorescent lighting fixture tubes were replaced during the year. The preventive maintenance pro- gram is not in full effect because of limited staff. Since the position of boiler operator-repairman was filled in mid-December, boiler outage complaints have been nil. Shipping and Receiving Lack of operating and storage space handicap this section severely. Business transactions continue to increase at an accelerated pace over that of previous years. The following figures illustrate some of the work performed in this sec- tion: 300 orders filled for regional laboratories, 3500 for private physicians, 2500 for CHDs and 300 for tuberculosis hospitals. Fifteen hundred milk and water boxes were repacked with empty cartons and return shipped; 6500 items were picked up within the agency, wrapped and mailed; more than 400 vehicle trips were made to local bus stations for pickup and delivery service; 5000 drug and 4115 form requests were received and filled, and 3600 rail- way, truck and express waybills were executed during the year. Mailing This office is also severely handicapped by lack of space and reserve manpower. The following quantities of mail were handled during the year: 1,078,456 pieces of outgoing and 489,340 pieces of incoming mail as well as 182,500 pieces of interoffice mail. The annual postage meter expenditure was approximately $70,000. Ditto Room The output of this activity is also indicative of the large population increase within the state. In general, the out- 68 ANNUAL REPORT, 1965 put in this section has been increased because of the necessity of zip coding, plus a purge of the addressee lists conducted during the year. Part-time training of a reserve operator is being con- ducted. A modern Xerox dry copy machine was installed during the year. The number of plates embossed on the graphotype ma- chine was 12,870; total addressograph impressions were 642,058 and the total number of Health Notes addressed and mailed was 177,319. Duplicating The three, 14 year old offset machines, con- tinue to bear the brunt of the shop work. This department con- tinues to perform the duty of stocking the bulk paper stationery. The output during the past year consisted of: 2117 job requisitions for a total charge of $38,635.89. The total machine impressions were 8,980,426. The decrease in output reflects the influence created by greater use of contractual printing firms for manu- scripts, and other printing. Security The work of the Security Force continues at about the level reported in 1964 with a slight increase in the number of court cases requiring testimony of a security officer. FISCAL SECTION The essential function of this section is the determination of the legality and propriety of payments under the various programs of the agency, processing all bills and vouchers for payment, the financial record keeping and preparation of required financial reports. The financial transactions of the SBH for the fiscal year ended June 30, 1965, as reflected by the records of the bureau, are pre- sented in a condensed form at the end of this section. A detailed financial report for the fiscal year ended June 30, 1965, has been prepared and distributed to the Governor, members of the Board of Health and all bureaus, divisions and CHDs. The funds received (or appropriated) for the fiscal year ended June 30, 1965, were from the following sources: State appropriations ............................$ 9,367,955.00 28.6% From local agencies for county health units .................................... 8,310,506.30 25.4% From federal grants-in-aid ............. 3,619,046.91 11.1% From research grants .......................... 2,308,306.80 7.1% From local and state agencies - hospital services for the indigent.. 8,627,265.62 26.2% From state and federal for building .. 515,693.81 1.6% $32,748,774.44 100.0% FINANCE AND ACCOUNTS 69 The expenditures by the SBH, in summary, were for: Personal services (salaries and other personal services) ................$15,337,358.91 47.1% Contractual services (repairs, utilities, travel expense, hospitalization) ...................... 13,113,058.85 40.2% Commodities (office, medical, laboratory, and mosquito control supplies) ...................... 1,422,293.35 4.4% Current charges (rent, insurance, registrar fees) .......................... 544,253.92 1.7% Capital outlay (equipment and fixed assets) .................................... 603,308.78 1.8% Grants to counties and mosquito districts ......................................... 1,425,612.46 4.4% Miscellaneous (education aids and subsidies) ...................................... 144,409.16 .4% $32,590,295.43 100.0% In addition to funds reported in the annual financial report and summarized above, certain other funds and services were made available by the 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 189 departmental budgets. These budgets were periodically revised as required. SUMMARY OF RECEIPTS AND DISBURSEMENTS AND BALANCES FOR THE FISCAL YEAR ENDED JUNE 30, 1965 FROM STATE APPROPRIATIONS General Public Health: Salaries .............................. $ 2,971,560.00 Other personal services. ................... 10,250.00 Expenses ................................. 1,158,820.00 Operating capital outlay. ................ .. 59,410.00 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 70 ANNUAL REPORT, 1965 Air pollution control . . . Mental health council . . Hospital services for the indigent. . Deficiency fund . . . County health units . . . Total state appropriations . . . . 81,060.00 S. 149,360.00 S. 918,900.00 S. 28,595.00 . 2,035,000.00 .. $ 9,367,955.00 FROM FEDERAL GRANTS-IN-AID Public Health Service: General health....... Chronic illness and care Venereal disease . Tuberculosis control. . Heart disease ....... Cancer control ...... Mental health....... Water pollution . . Radiological health . Mental health planning. Cuban health services.. Dental health....... ............ ......eeo.... .........ee.. .....ee..... of.aged. e..e . ......e.e... ............ ........o... ............ ............ ............ Children's Bureau: Maternal and child health. . . . . Total federal grants-in-aid . . . 305,954.00 398,035.40 166,964.53 69,957.00 184,063.00 94,720.00 177,423.00 121,698.00 57,740.00 99,702.26 726,027.30 10,000.00 1,206,762.42 . $ 3,619,046.91 FROM GRANTS AND DONATIONS .. ............ $ 2,308,306.80 FROM LOCAL AGENCIES FOR COUNTY HEALTH UNITS ................... ........$ 8,310,506.30 FROM HOSPITAL SERVICES FOR INDIGENT Local sources ........................... $ 338,570.11 State welfare board ....................... 8,288,695.51 Total hospital services for indigent ......... .$ 8,627,265.62 FROM STATE AND FEDERAL FOR BUILDINGS ....... $ 515,693.81 TOTAL RECEIPTS ..................... $32,748,774.44 I f. If. I.. FINANCE AND ACCOUNTS Balance July 1, 1964, $4,993,356.58 (Less expired appropriation of $2,141.14) . . ... $ 4,991,215.44 Total receipts and balances . . . ..... $37,739,989.88 DISBURSEMENTS OPERATING EXPENSES Personal services: Salaries................................ Other personal services-individual ......... Other personal services-other . . . Contractual services: Travel expenses, including subsistence and lodging .. Communication and transportation of things . . Utilities ............................. Repairs and maintenance . . . . . General printing and reproduction services . . Subsistence and support of persons . . .. Other contractual services . . . . . Commodities: Bedding, clothing and other textile products . . Building and construction material and supplies . Coal, fuel oil and other heating supplies . . Educational, medical, scientific and mosquito control supplies and materials . . . . Maintenance materials and supplies. . . . Motor fuel and lubricants . . . . . Office materials and supplies . . . . Other material and supplies. . . . . Current charges: Insurance and surety bonds. . . . . Rental of buildings ................... .. Rental of equipment .................... Other current charges and obligations . . Merit System ........................ Total operating expenses . . .. .... $14,623,976.03 .... 548,114.42 .... 165,268.46 1,505,190.97 448,022.19 164,396.05 145,760.57 104,817.48 10,535,148.80 209,722.79 3,612.36 9,689.00 8,724.31 1,029,967.56 102,976.46 57,203.49 202,578.21 7,541.96 73,930.68 .. 158,553.43 .. 101,042.32 . 185,612.37 25,115.12 . $30,416,965.03 72 ANNUAL REPORT, 1965 CAPITAL EXPENSES Books ................................ $ Buildings and fixed equipment ............... Educational, medical, scientific and mosquito con Motor Motor Office Other 10,414.95 246,207.30 trol equipment ..................... 152,772.31 vehicles-passenger . . . ..... 64,739.99 vehicles-other ................... 1,037.80 furniture and equipment ...... . .. .. 126,008.52 capital outlay ...................... 2,127.91 Total capital expense . . . ... ..$ 603,308.78 GRANTS, SUBSIDIES AND CONTRIBUTIONS Grants to counties and mosquito control districts . $ 1,425,612.46 Other educational aids and subsidies .. . ... 144,409.16 Total grants, subsidies and contributions . $ 1,570,021.62 Total program expenses. . . . ... $32,590,295.43 NON-OPERATING DISBURSEMENTS Transfers ..............................$ 526,704.31 Refunds .............................. 80,162.17 Total non-operating disbursements . .... $ 606,866.48 Total disbursements . . . .... $33,197,161.91 Balance June 30, 1965 ..................... $ 4,542,827.97 Total disbursements and balances. . . ... $37,739,989.88 FINANCE AND ACCOUNTS SCHEDULE OF EXPENSES BY PUBLIC HEALTH PROGRAM ACTIVITY Health services to mothers, infants, preschool and school children .................... .......... $ 4,469,000.00 Statewide venereal disease control, diagnosis and referral of infections venereal disease patients to treatment clinics-also operation of program ....... 1,228,500.00 Mosquito and pest control programs, including pest control law enforcement. . . . ..... 4,551,569.50 Indigent hospitalization . . . . . ... 9,900,170.02 Statewide sanitary engineering and environment sanitation 2,596,923.17 Statewide cancer control program . . . ..... 656,000.00 Statewide tuberculosis control, X-ray survey and follow-up work ........... ..... ..... ..... .. 1,228,000.00 Mental health program .. ...................... 1,462,600.00 Statewide narcotic drug, medical practice law enforcement. 229,426.99 Chronic illness and care of the aged . . ..... 1,594,600.00 Heart disease program.. ...................... 492,200.00 Other health programs and administration . . ... 4,181,305.75 Total expenses .......................... $32,590,295.43 SCHEDULE OF EXPENSES BY FUNCTIONAL ACTIVITY General public health (also includes miscellaneous health activities and training). . . . . . Vital statistics ............................. Health education ................... ........ Sanitary engineering ......................... Entomology and mosquito control. . . . . . Tuberculosis control .......................... Laboratories ............................... Preventable disease (excluding tuberculosis control) . . Mental health.............................. Narcotics ................................ Maternal and child health ................... .. Hospital Service for the indigent. ................ Local health service.......................... Chronic diseases ............................ County health units .......................... Building construction . . . ..... . ... Total expenses ...................... $ 2,435,801.93 407,325.63 99,302.84 667,536.74 3,457,162.71 325,720.74 934,328.04 954,870.25 412,978.72 182,710.60 631,946.84 9,900,170.02 476,299.31 528,393.87 10,944,067.96 231,679.23 $32,590,295.43 TABLE 10 FUNDS RECEIVED BY COUNTY HEALTH UNITS FROM STATE BOARD OF HEALTH AND LOCAL SOURCES FOR THE FISCAL YEAR ENDED JUNE 30, 1965 STATE BOARD OF HEALTH LOCAL FUNDS COUNTY Total Board Funds Total State Federal Total of County Board of Fees and Commis- Public Cities Miscella- sioners Instruction neous Alachua ............................. $ 237,759 $ 82,234 $ 70,278 $ 11,956 $ 155,525 $ 118,227 $ 6,000 $ 22,220 $ 9,078 Baker .............................. 22,560 9,573 9,573 12,987 12,625 ........ ......... 362 Bay ...... ... ......................... 102,319 49,316 46,135 3,181 53,003 50,383 ........ .... .... 2,620 Bradford .......... ....... ........... 36,101 15,417 15,417 20,684 15,374 2,800 2,400 110 Brevard ......... ..................... .. 278,854 78,028 73,548 4,480 200,826 188,212 ...... ........ 12,614 Broward. ............... .............. 566,018 137,979 133,899 4,080 428,039 420,712 ...... 2,740 4,587 Calhoun ............................. 23,766 10,958 10,958 ........ 12,808 11,000 600 ..... 1,208 Charlotte. ................... ......... 71,586 21,185 21,185 ..... 50,401 43,811 1,000 ... 5,590 Citrus. .............................. 34,495 20,629 20,629 .... 13,866 9,961 3,600 .. 305 Clay............ ....... .... ......... 51,995 21,492 21,492 ........ 30,503 27,973 ........ 2,400 130 Collier.............................. 85,586 35,112 35,112 ........ 50,474 44,082 ........ ........ 6,392 Columbia....................... .......... 52,049 23,746 23,746 ....... 28,303 26,786 ........ ........ 1,517 Dade .................... .. ......... 1,992,526 354,436 182,572 171,864 1,638,090 1,510,375 ....... ........ 127,715 DeSoto ............................ 41,303 22,933 22,933 ........ 18,370 16,980 ........ ........ 1,390 Dixie .............. .... .......... 19,431 7,151 7,151 ........ 12,280 9,670 2,600 ... 10 Duval ................. ............ 336,397 156,577 102,361 54,216 179,820 134,470 ........ 3,960 41,390 Escombia .................. .......... 332,430 103,210 85,880 17,330 229,220 162,202 ... 25,000 42,018 Flagler .......... ......... .......... 20,766 8,836 8,836 ........ 11,930 11,747 ............... 183 Franklin ............. .............. 26,985 9,853 9,853 ........ 17,132 17,068 ........ .. ........ 64 Gadsden ................ ............ 78,498 38,872 38,872 ....... 39,626 34,226 3,930 1,000 470 Gilchrist............................... 14,831 5,795 5,795 ........ 9,036 4,620 4,300 ........ 116 Glades ................................ 16,770 4,188 4,188 ....... 12,582 12,491 ........ ........ 91 Gulf. ................................ 40,155 14,263 14,263 ........ 25,892 22,714 3,000 .. ... 178 Hamilton ......... .... .. .. ........... 24,849 11,008 11,008 ........ 13,841 12,167 ........ 1,365 309 Hardee ............... .... .. ........ 46,907 15,815 15,815 ........ 31,092 28,934 500 .... .. 1,658 Hendry ....... ........... .......... .. 51,375 13,715 13,715 ........ 37,660 19,173 ........ ........ 18,487 Hernando. ............................. 26,228 11,549 11,549 ....... 14,679 7,156 7,000 .. .. 523 Highlands ......... .... .. .. .......... 63,477 33,180 33,180 ........ 30,297 29,314 ..... .......... 983 Hillsborough. ............ ............... 1,141,362 176,071 81,201 94,870 965,291 756,134 ...... ........ 209,157 Holmes ................... ......... 29,894 14,839 14,839 ........ 15,055 7,500 7,500 ... 55 Indian River. ............... ........... 62,306 29,696 29,696 ........ 32,610 20,462 3,000 4,500 4,648 Jackson. .............................. 84,526 47,689 38,989 8,700 36,837 32,079 3,000 600 1,158 Jefferson ................ .. ......... 27,522 13,401 13,401 ..... .. 14,121 7,000 6,000 1,000 121 Lafayette ........... ........ ......... 15,063 5,057 5,057 ........ 10,006 10,000 ........ ........ 6 Lake. ...................... ......... 102,685 36,739 36,739 ........ 65,946 63,811 ........ 1,625 510 N Z Z C r 0 -I 0 TABLE 10 (Continued) FUNDS RECEIVED BY COUNTY HEALTH UNITS FROM STATE BOARD OF HEALTH AND LOCAL SOURCES FOR THE FISCAL YEAR ENDED JUNE 30, 1965 STATE BOARD OF HEALTH LOCAL FUNDS COUNTY Total I Board Funds Total State Federal Total of County Board of Fees and Commis- Public Cities Miscella- -n sioners Instruction neous Lee ............................... $ 115,085 $ 40,500 $ 40,500 $....... $ 74,585 $ 74,063 $....... $... $ 522 Leon ............ .................... 249,517 84,263 71,390 12,873 165,254 109,344 11,393 5,000 39,517 Levy .. .............. . . 33,022 14,448 14,448 .. 18,574 11,313 5,700 1,561 Liberty.......... 16,272 6,926 6,926 .... 9,346 9,330 ........ ........ 16 Z Madison ............... ... ............ 34,495 17,306 17,306 .. .. 17,189 17,101 ........ ........ 88 Manatee .................... 178,024 56,297 56,297 121,727 103,085 1....8,642 Marion........................... 103,321 44,905 44,905 58,416 46,652 4,000 5,600 2,164 m Martin ............................ 44,056 23,609 23,609 ........ 20,447 18,439 750 1,258 Monroe............ .............. .. 113,390 47,171 41,891 5,280 66,219 47,862 7,333 4,000 7,024 Nassau ...... ............... ........ 68,997 22,510 22,510 .. .. 46,487 46,090 .......... .397 Okaloosa .............................. 109,678 32,320 32,320 ........ 77,358 53,106 12,000 12,252 Okeechobee. .......................... 24,716 10,194 10,194 ... 14,522 14,199 .323 Z Orange............................... 520,773 143,957 115,007 28,950 376,816 269,429 20,167 4,220 83,000 Osceola ......... .......... ........ 41,312 21,833 21,833 ... .. 19,479 16,650 2,200 ..629 Palm Beach ........................... 768,869 137,188 110,512 26,676 631,681 509,687 29,415 .. 92,579 Pasco ............................... 45,797 21,316 21,316 ... ... 24,481 21,606 ....... .. ...2,875 Pinellas .............................. 1,124,073 185,474 109,144 76,330 938,599 749,232 .. ......... 189,367 Polk ................................ 468,744 111,811 86,397 25,414 356,933 280,538 43,340 4,800 28,255 Putnam .................................. 83,864 37,788 37,788 ........ 46,076 42,826 ... .............. 3,250 ( Santa Rosa ............................ 60,296 26,345 26,345 ........ 33,951 27,738 ........ 6,213 Sarasota .......... ............... ... 245,958 65,433 62,013 3,420 180,525 151,107 ........ .. 29,418 Seminole ...... .. .......... 96,923 40,195 40,195 .. .. 56,728 38,810 13,749 4,169 St. Johns .......... ............. 54,883 28,585 28,585 ........ 26,298 24,151 1,920 ....... 227 St. Lucie ............. ............... 118,051 47,074 47,074 .... .. 70,977 43,528 .... .. 10,000 17,449 C Sumter ............................ 31,653 16,647 16,647 ........ 15,006 14,322 ........ ........ 684 Suwannee ...................... ... 36,630 20,520 20,520 ... .. 16,110 15,947 ....... ........ 163 Z Taylor. .............. ............... 29,441 16,070 16,070 ... .... 13,371 12,750 500 121 Union........... ............ 18,719 8,376 8,376 ........ 10,343 10,319 ........ ...... 24 Volusia ..................... ........ 341,812 115,326 107,766 7,560 226,486 163,652 12,900 ..... 49,934 tj Wakull ................... ... .... ... 27,543 13,536 13,536 ........ 14,007 14,000 ....... ......... 7 Walton .............................. 47,204 20,073 20,073 ........ 27,131 17,616 7,000 2,400 115 Washington ......... .... .. ...... .. 31,627 15,076 15,076 ..... .. 16,551 16,485 ........ ........ 66 County Health Units, State at Large............ 69,680 69,680 69,680 ....... ..... ........ Totals..................... $11,513,799 $ 3,203,294 $ 2,646,114 $ 557,180 $ 8,310,505 $ 6,890,416 $ 227,197 $ 104,830 $1,088,062 I I I I I I 1,8041 27,9 114,30 1,08W2 C 76 ANNUAL REPORT, 1965 BUREAU OF LABORATORIES NATHAN J. SCHNEIDER, Ph.D., M.P.H., Director WARREN R. HOFFERT, Ph.D., M.P.H., Assistant Director Laboratory services were provided to the county health depart- ments (CHD) and to other bureaus and divisions of the State Board of Health (SBH) in support of their broad and varied public health programs. Similarly, diagnostic and epidemiologic assistance was provided to licensed practitioners of the healing arts. The bureau discharged its responsibilities in approving qualified private and hospital laboratories for performing serological tests for syphilis on prenatal and premarital patients; it assisted the Bureau of Narcotics in regulating the sale of narcotics, drugs, cosmetics and devices in Florida. The new $240,000 facility for the Pensacola Regional Labora- tory was completed and occupied in June, and formally dedicated on August 15, 1965, as the Herbert L. Bryans Building in memory of the late eminent Pensacola physician and member of the Florida State Board of Health for over 18 years. Availability of this modern laboratory enables the redirection of certain procedures such as tuberculosis bacteriology for the West Florida area, thus speeding up laboratory findings. Construction of the new Tampa Regional Laboratory building was initiated in July, after the 1965 State Legislature had ap- propriated $75,000 to supplement the $300,000 appropriation of the previous legislature. The total cost of constructing and equip- ping this facility will amount to $750,000. Anticipated completion date is May 1966. Elsewhere, approximately 1500 square feet of space was allo- cated to the Miami Regional Laboratory to permit expansion of the chemistry section for pesticide research studies. This was needed to provide laboratory support for the Community Studies on Pesticides in Dade County. With contract funds from the U. S. Public Health Service (USPHS), a modern pesticide laboratory was established in the Dade County Annex building. This section shares quarters with the Dade County Air Pollution Laboratory, thus complementing the activities of that unit. It must be noted, however, that despite additional space, the Miami Regional Labo- ratory remains crowded because of expansion of public health activities to meet demands of highly urbanized south Florida. There is an urgent need for a larger and more adequately equipped facility in Dade County to replace the present Miami Regional Laboratory building. Sadly, the year under review saw the passing of Mr. Homer D. Venters, director of the Tampa Regional Laboratory. Mr. Venters LABORATORIES observed the 50th anniversary of his employment with the State Board of Health on November 1, in apparent good health. The fol- lowing day, a fulminating pneumococcal infection, which was in- cubating insidiously even as he was receiving good wishes and plaudits from his friends and coworkers, struck him down. He did not live to see the fruition of his heart's desire, viz., completion of the new Tampa Regional Laboratory facility. Nevertheless, his was the good fortune of realizing part of an ambition in planning this facility, as well as knowing that the new building will memorialize his name. A diamond pin, signifying 50 years of meritorious service was presented posthumously to his widow on November 18, 1965. DIAGNOSTIC SERVICES The nature and extent of diagnostic laboratory services offered during 1965 are presented in Table 11. A total of 2,637,279 exami- nations was performed in 1965 as compared to 2,809,275 for the preceding year. This decrease in number of examinations does not reflect a lessening in workload because 39,370 more specimens were submitted in 1965. What seemed an apparent discrepancy, i.e. more specimens yet fewer examinations, is due to the fact that cer- tain procedures in syphilis serology were streamlined. In contrast, increased specimens in bacteriology and virology resulted in a greater workload because of the added complexity of more sensi- tive technics. Major increases were noted in the number of exami- nations of throat swabs for diphtheria and streptococcal infections, sputum specimens for tuberculosis, cervical and urethral smears for gonococci, fecal specimens for enteric pathogens, foods for sanitary quality, chemistry specimens for blood sugar, toxicology, narcotics, radioactivity and pesticides, and tissues for viral agents. In sanitary bacteriology, the decrease in the number of dairy products submitted for examination was due primarily to a reduc- tion in the number of replicate samples from CHDs. Since Florida milksheds cut across county lines, every effort has been made to encourage the sharing of laboratory information as to the quality of milk distributed to multiple counties. These efforts have resulted in reducing the number of finished milk samples considered adequate to maintain surveillance of milk reaching the consumer. There was a high level of surveillance of raw milk, both Florida produced and out-of-state shipped milk. This was evidenced by an increase in the number of raw milk samples tested in 1965. There was a moderate increase in the number of examinations of drinking water and that from swimming pools, 209,906 in 1965 as compared to 193,400 in 1964. A total of 13 CHDs has been approved for testing private water supplies by the membrane filter (MF) technic; six of these, viz. St. Lucie, Manatee, Charlotte, Sarasota, Pinellas and Alachua, have also been approved for testing public waters and swimming pools. Thus the number of potable samples submitted to the bureau represented only a portion of the 78 ANNUAL REPORT, 1965 total examined by public health authorities in Florida. The num- ber of pollution water examinations continued at virtually the same level in 1965 with 70,985 tests performed as compared to 71,070 in 1964. Tampa, Miami and Orlando laboratories experienced mod- erate increases in pollution waters tests. It is anticipated that there will be more demands for bacteriological and chemical examina- tions of streams, lakes and water areas used for recreational and industrial purposes. The productivity of the radiological chemistry section reached its full potential during 1965. This section, housed in the Orlando Regional Laboratory building, served statewide needs. Selected specimens were tested for content of radionuclides as evidence of radiation in the environment. These studies were part of a radio- logical surveillance program carried out by the Division of Radio- logical and Occupational Health and by the Bureau of Sanitary Engineering. There was a 6.5-fold increase in output over the preceding year. Continued productivity at the 1965 level will de- pend on availability of research funds which have provided salaries for personnel. Because state and federal public health agencies must be prepared for the eventuality of increased industrial and military use of radioactive materials, the capability of the radio- logical laboratory must be maintained regardless of the present low levels of radiation in the environment. The technical capabil- ity of the laboratory was assured by interchanging quality control specimens with the USPHS Radiological Laboratories. The results of examinations in SBH laboratories are presented in Table 12. A total of 737,830 specimens was examined for syphilis and 32,052 were reactive. Excluding specimens unsatis- factory for testing, the per cent reactive was 4.4, the same as in 1964, but 6.1 in 1962 and 4.9 in 1960. Continued attention was given to blood specimens from problem cases of suspected syphilis and/or biologic false positives. Specimens from 115 problem pa- tients whose clinical status had been determined were subjected to the VDRL, Fluorescent Treponemal Antibody (FTA-ABS) and Treponemal Pallidum Immobilization (TPI) tests. Comparison of the relative sensitivity and specificity of each test procedure as presented in Table 13 tend to confirm the experience of others. A total of 182 sera was submitted to the USPHS laboratories in Atlanta for TPI testing from the bureau during 1965. The number of diagnostic specimens found positive for diph- theria in 1965 was 64 or 0.9 per cent (Table 12). This continues a downward trend: in 1960, 4.5 per cent; in 1962, 2.6 per cent; and in 1964, 1.0 per cent. The decline in positives emphasizes the difficulty in completely eradicating diphtheria and/or other similar diseases. The proportion of throat specimens positive for strepto- coccal infections remained about the same as the preceding year, 17.5 per cent. There was a marked increase in the number of throat specimens positive for other potentially pathogenic organisms, par- LABORATORIES 79 ticularly staphylococci, pneumococci and H. influenzae. In 1965, 62 per cent yielded such isolations, as compared to only 25 per cent in 1964. The reason for this high rate is not apparent. When found in healthy individuals, such organisms are considered normal flora. Many of the throat swabs examined are from sick persons and re- ports of findings are sent to the physician for interpretation of clinical significance. A total of 53,408 sputum and associated specimens was sub- mitted to the laboratory for tuberculosis and other mycobacterial cultures. Compared with 46,498 specimens submitted in 1964, this represented an increase of 15 per cent; due in part to a stepped-up casefinding and surveillance program by CHDs and the Division of Tuberculosis Control. Excluding unsatisfactory specimens, there was a total of 5051 or 9.9 per cent cultures positive for M. tuber- culosis or atypical mycobacteria, as compared to 7.4 per cent in 1964 and 5.9 per cent positives in 1963. It is believed that a modifi- cation in the digestion procedure reported in the 1964 annual re- port accounts for the increased sensitivity of the cultural procedure. Smear specimens examined for the presence of gonococci (GC) and associated infections increased from 43,617 in 1964 to 48,058 in 1965. In contrast, there was a decrease in the number of GC cultures of fluorescent antibody tests from 21,113 specimens in 1964 to 19,345 in 1965. The per cent positive for GC by smear was 16.1 and by culture 8.0. The reliability of the smear test is ques- tionable, particularly when examining urethral or cervical speci- mens from females; however, because of the relative ease with which this type of specimen is taken and mailed to the laboratory, many physicians continue to depend upon it for diagnosis because the culture test can only be provided to clinics located in close proximity to the laboratory. The number of fecal specimens cultured for enteric pathogens increased from 54,108 in 1964 to 57,758 in 1965. There were 84 positives for S. typhosa, a decrease from 111 in 1964, and 1330 Salmonellae and 261 Shigellae were isolated in 1965 as compared to 1067 and 218, respectively, for 1964. This increase may be due to a greater awareness on the part of physicians. A total of 190 other enteric pathogens were cultured in 1965 as compared to only 83 in 1964. These "other" pathogens included six different entero- pathogenic serotypes of E. coli as well as members from the Ari- zona and Edwardsella groups. A total of 628 blood specimens was examined serologically for leptospiral agglutinins; 18 or 2.87 per cent were positive. In addi- tion to specimens from suspect cases, paired sera from patients with aseptic meningitis of suspected viral etiology, were tested for a rise in agglutination titer. Among the miscellaneous examinations, there was a total of 84 darkfield specimens positive for T. pallidum as found in the Dade County Department of Public Health V.D. Clinic. Results of dark- 80 ANNUAL REPORT, 1965 field examinations performed in other CHD clinics were not re- ported to this bureau. The finding of motile spirochaetes charac- teristic of T. pallidum in lesions is diagnostic evidence of syphilis. A total of 2670 miscellaneous bacteriological cultures were sub- mitted to the laboratory for identification and characterization. This service is beneficial to smaller laboratories which, because of limited facilities or lack of specialized reagents, seek assistance in identifying bacterial isolates. There were numerous special bacteriological services offered by the bureau, including bacteriological plate counts on urine speci- mens, sterility testing on drugs and biologicals, staphylococcal cul- tures from hospital acquired infections and culturing of imported novelties (water filled ice balls and stuffed baby chicks) for bac- terial pathogens. A moderate increase in the number of saliva specimens sub- mitted for lactobacillus plate counts was noted. Dentists have used this service in close consultation with the Bureau of Dental Health which provided professional interpretation of findings on all speci- mens reported. The number of stool specimens examined for intestinal para- sites decreased moderately during the year. Positive findings for hookworm, ascaris, enterobius pinwormm) and trichuria decreased. Table 14 summarizes the trend in findings for two parasitic dis- eases during the past 15 years. From 1950 to 1965, the overall proportion of specimens positive for hookworm declined from 18.8 per cent to 4.1 per cent. Most of the decline occurred in West Florida and the peninsular areas of the state north of West Palm Beach. For some unexplained reason, the area served by the West Palm Beach (WPB) laboratory showed a moderate decline from 1955 to 1965 (data for 1950 was unavailable). The observations on ascariasis differs significantly. In 1950, there were 3.3 per cent positives statewide and after 15 years, this high level of positivity remains at 3.6 per cent. In the chemistry section, 36,808 blood specimens were exam- ined for various determinations including blood sugar, cholesterol, hemoglobin, cholinesterase inhibition, phenylalanine, barbiturates, amphetamines and alcohol. Urine specimens were examined in the Miami Regional Laboratory for P-nitrophenol, a metabolite of parathion poisoning, as part of the Community Pesticide studies being carried out in Dade County. There was a marked increase in the number of toxicological and narcotics specimens examined in Jacksonville and Miami laboratories. These specimens represent a large amount of time since the chemists involved must appear in court to testify as expert witnesses. There were quite a number of such specimens from the Tampa area making it highly important to establish a chemistry section in the new Tampa Regional Lab- oratory building now under construction. LABORATORIES 81 The radiological chemistry laboratory carried out analyses of ground and rain water, air, milk, shellfish, selected tissues and en- vironmental specimens for radionuclides. There was a marked in- crease in the number of specimens examined. Utilization of auto- matic data processing speeded up the needed calculations making it possible to report final results with a minimum time lag. The responsibilities assigned to this section were related to the radio- logical surveillance program of the Division of Radiological and Occupational Health presented elsewhere in this report. A USPHS research project concerned with a study of the ratio of Cesium-137 and Strontium-90 in milk was included in the workload of the laboratory. Diagnostic services for viral and rickettsial diseases were pro- vided on a statewide basis from the Jacksonville laboratory. How- ever, such services were coordinated with studies carried out in the Tampa Bay area by the Encephalitis Research Center, (See Bu- reau of Research elsewhere in this report) and in the Dade County area by the Department of Medicine, University of Miami School of Medicine. The diagnostic laboratory in Jacksonville accepted such specimens as were found negative for arboviral agents by both research laboratories and tested them for other viral agents associated with central nervous system (CNS) disease. These tests included animal inoculations and various serological examinations such as hemagglutination-inhibition, neutralization and comple- ment-fixation tests. Close liaison was maintained between the several laboratories to minimize duplication of diagnostic pro- cedures on suspect encephalitis cases. Viral and rickettsial findings on 1519 patients examined in 1965 are presented in Table 15. A total of 119 cases, representing 7.8 per cent of the patients studied, yielded positive diagnostic find- ings of viral etiology and 376 or 21.5 per cent gave equivocal re- sults. This compares favorably with the experience of most public health virology laboratories. The efficacy of providing good virologi- cal service is dependent in part on the astuteness of the clinician in correctly suspecting disease of viral etiology in his patient and the submission of adequate specimens collected at the proper stage of disease for the laboratory to examine. Thus, many of the previ- ously mentioned equivocal findings did not lend themselves to in- terpretation because no tissues were submitted for viral isolation; nor could a rise in antibody titer be demonstrated either because only a single serum was submitted or because paired sera were collected too late in the course of illness. In regard to the positive findings, there was a marked increase in the number of respiratory infections found; 58 cases in 1965 as compared to only two in 1964. In contrast, there was a marked decrease in the number of labora- tory confirmed cases of CNS infections; 49 cases in 1965 as com- pared to 128 the previous year. Most of this decrease was due to fewer cases of mumps and Coxsackie infections. The complement 82 ANNUAL REPORT, 1965 fixation test study for Mycoplasma pneumoniae (Eaton agent) was instituted in September and a total of 115 patients was exam- ined serologically; 10 were found to be positive. The number of animals examined for rabies totalled 3667; two less than the previous year. There were fewer positives in 1965; 79 as compared to 105 in 1964. As in the past, most of the positives were found in wildlife, i.e. raccoons, skunks and bats. There were only four positive dogs and one cat. The cooperative laboratory diagnostic and special study pro- gram established between the SBH and the State Tuberculosis Board completed the tenth successful year. This arrangement has contributed immeasurably to the success of the tuberculosis control program in Florida by providing standardized procedures for the diagnosis and treatment of the disease. The nature and extent of the studies performed in the state hospital laboratories are pre- sented in Table 16. A total of 125,173 laboratory examinations in 1965 as compared to 104,160 in 1964 indicates the trend in tuber- culosis control in Florida. There was an increase of 15.2 per cent in the number of diagnostic tuberculosis cultures examined from patients in the hospitals. Improvements in diagnostic and con- comitant therapeutic measures have resulted in more cases diag- nosed and more patients hospitalized and discharged to return to their homes for final recovery. SPECIAL STUDIES The bureau continued its active program of special studies as listed in Tables 11 and 12, indicative of the wide variety of projects with which it was concerned. The identification of enteric pathogens belonging to the Sal- monella group was continued. A total of 1439 cultures was typed during 1965 as compared to 1254 in 1964 and 786 in 1960. It is apparent that there has been an increase in the level of surveil- lance. According to USPHS data, Florida ranked within the top 10 in incidence of Salmonella reported to the National Salmonella Surveillance Network. Greater awareness of the role of Salmonella infections in enteric disease and more sensitive enrichment pro- cedures may have accounted for this increase in laboratory con- firmation of Salmonellosis. While Shigellae are also commonly found in enteric diseases, there is a need to improve bacteriological technics, particularly by providing more adequate means of pre- serving the viability of Shigella during shipment of specimens to the laboratory and a better enrichment procedure more comparable to that used for Salmonella. Special studies on diarrheal diseases were conducted in the Miami Regional Laboratory as part of a research contract between the Division of Gastroenterology, Department of Medicine, Uni- versity of Miami School of Medicine, and the U. S. Armed Forces Epidemiological Board. Specimens collected from the intestinal LABORATORIES tract of normal and sick patients were examined for bacterial and viral flora. This work is in the terminal year of a three year contract. Statewide surveillance for arthropod-borne viral infections was continued during 1965. These studies, supported by state funds, complemented the surveillance carried out by ERC Laboratory in Tampa. A total of 2085 pools of mosquitoes and selected animal tissues was processed and inoculated into suckling mice; also hu- man and animal blood specimens were examined for hemaggluti- nating and/or complement-fixing antibodies against antigens pre- pared from St. Louis Encephalitis, Eastern Encephalitis (EE), Western Encephalitis (WE) and California Encephalitis (CE) viruses. Of two agents identified as EE, one was isolated from horse tissue and one from chukar partridges. From the 119 se- lected animal tissues, a Bunyamwera Group (Tensaw-like) agent was isolated from the brain of a fox collected in Marion County. There were 59 arboviral agents isolated from 1965 mosquito pools. Among the mosquito isolations, 26 agents were identified as Cali- fornia complex, 18 Bunyamwera Group, 7 Hart Park-Like, 6 EE and 2 WE viruses. In addition, there were 12 agents not yet iden- tified. These isolations do not include agents recovered from col- lections made by ERC in Tampa. The mosquito collections sub- mitted to the Jacksonville laboratory were collected by the Bureau of Entomology and animal sera by the Division of Veterinary Pub- lic Health. Counties yielding arboviral isolates included Duval, Madison, Jefferson, Marion, Gulf, Leon, Polk, Charlotte, Clay, Alachua, Bay, Walton, Franklin and Citrus. Continuing studies on the sanitary quality of salad type foods, a three year research grant funded by the USPHS, was carried out in cooperation with the Division of Sanitation. Standardized bac- teriological procedures were established and baseline data as to the quality of market and processing plant samples were determined. Quantitative tests included enumeration of total and fecal coli- forms, coagulase positive staphylococci, anaerobic Clostridium perfringens and the aerobic standard plate count. In addition, each specimen was tested for the presence of Salmonellae. Simultane- ously with the laboratory testing, the Division of Sanitation studied the sanitation factors associated with processing and mar- keting of salad type foods since the numbers and kinds of bacteria are directly related to proper preparation and storage. Prelimi- nary findings indicated that the general sanitation and quality of salads studied were good but that bacteria present in small num- bers could multiply and become pathogenic if such salads were mis- handled by lack of refrigeration or improper storage. Acceptability and shelf-life of salads may also be reduced when large numbers of bacteria are allowed to multiply. The laboratory was in the final year of a three year study supported by the USPHS to determine the usefulness of the Sabin- 84 ANNUAL REPORT, 1965 Feldman dye test in diagnosing chronic eye diseases by demon- strating for toxoplasmosis antibody. A total of 386 serum speci- mens was tested. As reported last year, findings seem to indicate that dye test results are difficult to interpret because of the wide- spread presence of antibodies found in apparently healthy adults. Also, the absence of antibodies or very low titers cannot be re- garded as ruling out Toxoplasma gondii as the etiologic agent. Be- cause of the relatively poor vascularization inherent in the eye, an exacerbation of the dormant parasite may produce tissue damage but fail to stimulate antibody production. The fluorescent anti- body procedure was investigated and found to be unsatisfactory in providing dependable and reproduceable results. Plans were made to investigate the usefulness of a hemagglutination test as an ad- junct for diagnosing toxoplasmosis. This part of the study will be carried out in cooperation with the USPHS Communicable Disease Center Laboratory in Atlanta. Mycobacterium studies were supported in part by a research grant funded by the USPHS. (See Division of Epidemiology re- port). Aside from the study and characterization of atypical myco- bacteria cultures from human infections, soil and other environ- mental specimens obtained in the vicinity of households of index cases also were cultured. Isolates were studied by several biochem- ical and bacteriological tests to determine their relationship to hu- man strains. Unfortunately the available tests were not specific enough to provide definitive information as to the exact similarity of human to soil isolates. Further efforts utilizing a newly developed agglutination test need to be studied to determine the usefulness of the test in characterizing mycobacteria. Last year, it was reported that the Miami Regional Laboratory had established the capability of performing and offering the Guthrie test to screen newborn infants for detection of early cases of phenylketonuria (PKU). Stimulated by legislation passed in 1965 authorizing the SBH to promote testing of all newborns, the number of tests increased from 14,042 in 1964 to 24,923 in 1965. Plans were made to provide this test procedure in the Jacksonville laboratory as well as in Miami. When fully developed, this service will be provided by the Miami laboratory for the southern part of Florida and by the Jacksonville laboratory for the remainder of the state. It is anticipated that testing will be carried out also in most large hospital and private laboratories. The bureau will pro- vide this service to the medically indigent and where the needs are not met by private laboratories. It must be emphasized that re- gardless of where the screening tests are performed, all laboratories are now required by Florida Statute to report findings of positives and the total babies tested to the Bureau of Maternal and Child Health. More importantly, newly detected patients should have proper therapy as soon as possible in order to minimize brain damage to the developing infant. LABORATORIES Special studies to determine toxin in oysters and airborne pol- len were carried out on a small scale during the year. Both studies will be continued as the need and interest remains. Although not listed separately in the tabular data, each of the regional laboratories and, in turn, each of the sections within the central laboratory performed limited special projects during 1965. These included evaluations of various laboratory procedures and/or bacteriological cultured technics. Jacksonville, Miami, Tal- lahassee and West Palm Beach laboratories compared several di- gestion procedures for culturing M. tuberculosis. The Tampa lab- oratory was particularly active in evaluating the Thayer-Martin GC culture medium. The Pensacola laboratory has been occupied with the move into a new facility and the subsequent adaptation of the routine procedures; however, tuberculosis bacteriological culturing was initiated. The Orlando laboratory has been active in developing and evaluating radiological chemistry methodology as well as testing for the sanitary quality of foods. CONSULTATIVE AND EDUCATIONAL SERVICES Assisted by the USPHS, three technological workshops were conducted as follows: (1) Enteric bacteriology held at the Teaching Hospital, University of Florida, College of Medicine, Gainesville. Five days in length and attended by 20 bacteriologists and/or medical technologists. (2) Syphilis serology held at the Teaching Hospital, University of Florida, College of Medicine, Gainesville. Three days in length and attended by 13 students from hospital laboratories throughout the state. (3) Clinical chemistry - held at Barry College, Miami. Three days in length and at- tended by 21 senior medical technologists from hospital and pri- vate laboratories. Technical and consultative guidance were provided to four county health officers, two hospital staff physicians, nine medical technicians and 56 sanitarians and water plant operators in the form of short periods of training in specific laboratory procedures. A total of 14 additional clinical laboratories was approved to per- form serological tests for syphilis for premarital and prenatal pa- tients bringing the overall total to 278 as of the close of 1965. The bureau carried out registration of 59 medical laboratories and assisted the Board of Examiners in the Basic Sciences to license 422 medical technologists and 137 medical technologist di- rectors as provided by Chapter 483 of the Florida Statutes. Continuing visits and inspections were made to 18 public health and commercial dairy laboratories to certify the performance of bacteriological and related tests in accordance with Standard Methods and the USPHS requirements for interstate shipments of milk. In addition, visitation and certification of water testing facili- ties in five regional public health laboratories, four CHDs and five municipal water plants were performed. 86 ANNUAL REPORT, 1965 Evaluation specimens for hemoglobin determinations were sent to 220 public health, hospital and private clinical laboratories. The comparative findings were circulated among participating labora- tories and technical assistance was provided when needed. During the past several years, senior laboratory personnel have given guidance to several outstanding high school students engaged in scientific projects. Since 1962, four of these students have re- ceived national recognition for their work in biochemistry and enzymology. Revision 1965 of previously published list of laboratories approved for premarital and prenatal serology: ADDED Analytical Laboratories of Florida, 34711 N. Federal Highway, Ft. Lauderdale L. G. Landrum, M.D., 2300 South First Street, Lake City Palm Springs Medical Laboratory, 801 West 49th Street, Hialeah James Archer Smith Hospital, Inc., 1220 N. W. 1st Avenue, Homestead Gadsden County Hospital, 339 E. Jefferson Street, Quincy Wauchula General Hospital, 528 N. Main Street, Wauchula Good Samaritan Osteopathic Hospital, 7171 N. Dale Mabry, Tampa Walter R. McCook, M.D., 615-B United Street, Key West Fisherman's Hospital Laboratory, U. S. Highway I, Marathon Fred F. Crews, M.D., 300 South Avenue, Ft. Walton Beach Winter Park Memorial Hospital, 200 N. Lakemont Avenue, Winter Park Lake Alfred Medical Center, P. O. Box 1295, Lake Alfred QRS Laboratory, 500 North 1st Street, Winter Haven Medical Arts Laboratory, North Causeway, New Smyrna Beach REMOVED Professional Laboratories, Medical Arts Building, Cocoa 1333 Medical Laboratory, 1333 S. Miami Avenue, Miami Bio-Medical Clinical Laboratory, 815 Flagler Street, W., Miami Christian Hospital Laboratory, 4700 N. W. 32nd Avenue, Miami TABLE 11 EXAMINATIONS PERFORMED BY FLORIDA STATE BOARD OF HEALTH LABORATORIES, 1965 Jackson- West Palm Pinellas Examination ville Tampa Miami Pensacola Tallahassee Orlando Beach County TOTALS GRAND TOTALS ......................... 947,735 494,871 521,389 116,006 122,512 231,659 150,107 53,000 2,637,279 SEROLOGY Syphilis ............................. 252,066 232,316 280,990 45,753 32,337 71,675 61,747 ..... 976,884 Agglutination & related tests ................ 1,558 309 717 74 105 91 16 ..... 2,870 Blood typing (Rh) ................. ........ 4,468 4,359 3,957 1,289 945 2,136 1,083 ..... 18,237 DIAGNOSTIC BACTERIOLOGY Diphtheria & associated infections ......... 32,886 1,196 4,122 200 ..... 50 696 ..... 39,150 Tuberculosis ......... .... ......... 152,700 .24,796 ... 12,416 .. 14,127 .. 204,039 G.C.-smear ............................ 19,200 28,132 27,394 5,324 10,666 3,374 1,346 .. 95,436 --culture ................. ......... ..... 12,500 3,269 1,293 1,912 .. ..... ..... 18,974 -fluorescent antibody.................. 7,250 ..... ... .... ... 7,250 Enteric ................. .............. 80,402 55,008 25,472 13,832 24,708 34,858 6,894 .. 241,174 Blood culture. .................. ....... 568 8 16 192 48 112 200 ..... 1,144 Leptospirosis ........................... 2,488 ..... ...... ..... 2,488 Miscellaneous ............................ 89,553 27,761 5,010 861 1,219 14,160 "4576 143,140 > SANITARY BACTERIOLOGY Dairy products ...... .................... 20,796 42,168 23,622 12,510 12,780 11,424 16,716 13,626 153,642 Water, drinking & pools .................... 37,190 38,646 27,088 11,978 11,134 29,390 28,768 25,712 209,906 Pollution ............................. 19,540 8,790 15,795 3,505 2,575 2,795 6,275 11,710 70,985 Food (sanitary quality tests) ................. 2,19 .... 1,043 14 84 3,787 21 7,139 Food poisoning ............................ 302 412 880 180 414 270 .... 16 2,474 Utensils............................. 68 246 .. ..... 40 1,098 51 42 1,545 DENTAL CARIES BACTERIOLOGY. .............. 5,906 ... .... ..... ... ...... ... 5,906 PARASITOLOGY --I Intestinal parasites ......... .............. 49,556 21,896 9,402 12,098 8,515 11,887 3,419 ..... 116,773 Malaria ............................. 34 20 10 8 4 ..... 76 O MYCOLOGY .......... ................. 13,347 33 141 69 12 228 63 ..... 13,893 CHEMISTRY Blood ............... ............... 13,894 10,133 3,500 5,869 1,439 1,438 3,690 ..... 39,963 - Spinal fluid ............................ 812 ..... 217 1 5 ... ,.. 1,035 r Urine. 597 ..... ..... 39 420 ..... 1,056 Toxicology & narcotics ............ 223 2 6,718 ..... .... ..... ... 9,141 Drugs & cosmetics ........................ 47 ..... .. 47 Water ................... ........... 3,050 .. 273 .. 3 ..... 1,237 4,563 Other .................................. 4,143 ..... 10,956 ..... ..... ..... 652 15,751 0o ",- 00 00 Co TABLE 11 (Continued) EXAMINATIONS PERFORMED BY FLORIDA STATE BOARD OF HEALTH LABORATORIES, 1965 EXAMINATIONS PERFORMED BY FLORIDA STATE BOARD OF HEALTH LABORATORIES, 1965 "7 Jackson- West Palm Pinellas Examination ville Tampa Miami Pensacola Tallahassee Orlando Beach County TOTALS C RADIOLOGICAL CHEMISTRY Water (ground & precipitation) ............... ..... ..... ..... ..... ..... 10,032 .10,032 Air ............................ .. .. ........ ........ ..... 3,180 .. .. 3,180 Milk ........................ ........ ...... ... ..... ..... ..... ..... 7,912 7,912 M Other ................................ ............ ..... 20,104 20,104 VIRAL SEROLOGY -2 Hemagglutination-inhibition ................. 6,024 ......................... ...6,024 Neutralizations......................... 460 460 0 Complement-fixation ............. ...... 24,168 .......... .... .....24,168 VIRAL ISOLATIONS (except rabies) ............. 4,866 .....4,866 Rabies-microscopic ....................... 3,908 4,356 1,760 964 460 1,616 .. ... 13,064 -fluorescent antibody ................. 10,644 6,582 1,908 ..... 690 .. .. 19,824 -mouse inoculation .... ........... 560 ..... .. ..... ..... .... 560 SPECIAL PROJECTS Salmonella typing ........................ 8,634 ...... .... 8,634 Diarrheal disease studies (AFEB). .............. ...... ...16,258..... 16,258 0 Enterovirus studies .. . ................. .... ..... 1,007 1,007 Arthropod-borne surveillance Isolations ............................. 10,711 10,711 Ur, Serology ................................ 45,571 45,571 Sanitary quality salad-type foods .............. 7,060 .. .. ... 7,060 Toxoplasmosis dye test ..................... 5,790 .. .. .. ...... ..... ..... 5,790 Mycobacterium studies. ..................... 1,950 .. .. 1,950 PKU infant screening study ................ .. 192 ... 24,471..... 24,663 Toxin in oysters ......................... 52 .. .. .. .. .. ...... 52 Airborne pollen studies .................... 708 ... ...... ..... ..... ..... .... .. 708 |