APPENDIXES

TO THE

REPORT OF THE HEALTH OFFICER

OF THE

DISTRICT OF COLUMBIA.

The publication of these reports as appendixes to the report of the health officer is not to be construed to mean that the opinions and recommendations set forth in them have been adopted by the health department.

D C 1906-VOL 3- -4

49

APPENDIX A.

REPORT OF THE INSPECTOR IN CHARGE OF THE CONTAGIOUSDISEASE SERVICE.

WASHINGTON, D. C., October 9, 1906. SIR: I have the honor to submit the following report of the contagious-disease service for the year ending June 30, 1906:

From January 1 to December 31, 1905, 469 cases of diphtheria were reported to the health department, 410 white and 59 colored, as against 489 for the year 1904, a decrease in the total number of cases of 20. This decrease was limited entirely to the colored population, which furnished a total of 59 cases (a decrease of 23 from the previous year). Of the 469 cases, 44 resulted fatally, 29 being white and 15 colored, giving a death rate of 7.07 for the whites and 25.42 for the colored, the total death rate being 9.38. A comparison of these figures with those of last year shows an increased death rate among the whites and a decrease among the colored.

The prevalence of the disease among the whites was in the proportion of 1.80 for each 1,000 of the population and 0.61 per 1,000 among the colored, while the proportion to the total population was 1.45.

From January 1 to June 30, 1906, 210 cases of diphtheria were reported, an increase of 46 over the corresponding period of 1905. Of this number, 17 died, making a mortality of 8.09. While there were a greater number of cases reported in 1905, the general death rate for the same period was somewhat lower. The white population furnished 82.86 and the colored 17.14 per cent of the cases reported.

During the calendar year 1905, 2,344 cultures from the throats of patients suffering from diphtheria, or who were suspected to be suffering from that disease, were submitted to the Department for examination. Of this number 1,166 were primary cultures, and in 327, or 28.04 per cent, the diphtheria bacillus was found.

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SCARLET FEVER.

It is gratifying to note a considerable reduction in the number of cases of scarlet fever reported to the health department during the year 1905. The total number of cases reported was 284-244 white and 40 colored-with 11 deaths, while 454 cases were reported in 1904402 whites and 52 colored, with 11 deaths. The great reduction in the cases occurred in the white population, which showed a decrease of 158, the decrease among the colored being 12.

The death rate in the year just closed would, however, indicate a more severe form of disease, as of the 244 white cases reported 7 died, a percentage of 2.86, while of the 40 cases reported among the colored population 4 died, giving a mortality of 10 per cent. The total mortality was 3.87, as against 2.42 for the preceding year.

The prevalence of the disease among the white population was in the proportion of 1.07 per 1,000, and in the colored of 0.41 per 1,000, with a total of 0.88 for each 1,000 of the entire population.

From January 1 to June 30, 1906, 164 cases of this disease were reported, 129 being white and 35 colored. Of this number 8 died. The mortality among the whites was 4.65, and of the colored 5.71. The total mortality was 4.81.

The white population furnished 78.66, and the colored 21.34 per cent of the cases reported. A comparison of these figures with the corresponding period of 1905 shows a reduction of the number of cases reported of 27. This reduction was among the white population. The colored cases increased during the same period from 23 in 1905 to 35 in 1906. The total death rate for this portion of 1906 was 4.81, as against 4.71 for 1905.

TYPHOID FEVER.

Typhoid fever continues to prevail. In October, 1905, the filtration plant was completed, and it was hoped and expected that with this plant in full operation this disease would seldom be heard of in the District of Columbia. These hopes and expectations have, however, not been realized. Instead of the expected decrease, the disease has increased to a considerable extent.

The calendar year 1905 furnished 1,097 cases of this disease with 142 deaths; 797, or 72.65 per cent of the cases, were white, and 300, or 27.35 per cent, colored, the death rate of the former being 11.66 per cent, while that of the latter was 16.33 per cent, the total mortality being 12.94. The death rate of the whites increased and that of the colored decreased over that of the previous year. The general death rate was reduced from 14.01 in 1904 to 12.94 in 1905. Of the total cases reported 3 died from causes other than that disease as follows: 1 miliary tuberculosis, 2 intestinal obstruction. These cases are not included in the deaths from typhoid fever.

The case rate for each 1,000 of population was 3.50 white, 3.13 colored, and 3.39 for the total population.

During the period from January 1 to June 30, 1906, when, in view of the fact that all the public water supply was being filtered, it was confidently expected that the number of cases of this disease would show a marked decrease over previous years, the cases on the contrary increased from 157 in 1905 to 205 in the present year. Not only did the number of cases increase but the mortality also. The number of cases reported during the 1906 period was 146 white with 21 fatalities, and 59 colored, of which 16 died.

An investigation of the cases reported during the calendar year 1905 shows the following:

Of the 973 cases in which information was obtainable 648 or 66.6 per cent used Potomac water exclusively. There were very few instances in which the water was either boiled or filtered prior to the installation of the filtration plant.

The occupations of those affected with the disease were as follows:

While it is generally believed that the Potomac water was the cause of most of the cases of typhoid fever, other causes have also contributed a certain number of cases. Twenty-three cases were due to milk infection. The first of these cases occurred in a family of a dairy farmer living at Oxenhill, Md., and from this focus of infection 22 other cases developed. A number of cases occurred among the soldiers in the Washington Barracks. The original case or cases it is believed were brought here from some military camp and the other cases were contracted through contact with these cases.