DETAILS OF LOCAL OUTBREAKS OF SMALL-POX, 1882-1883.

Compiled from Reports of Correspondents.

DURING the progress of the epidemic the following circular letters (Nos. 81-82), with supplies of the blank forms (Nos. 80 and 86) were sent to each locality whence small-pox was reported-in addition, to the circular, Concerning the Prevention of Small-pox, in sufficient number for distribution among the infected and exposed; and, whenever necessary, a supply of fresh vaccine points, for use in cases of pressing emergency:

[S. B. H. No. 81.1

ILLINOIS STATE BOARD OF HEALTH,

OFFICE OF THE SECRETARY.

SPRINGFIELD,

188

DEAR SIR:

Accompanying this is a package of blanks for small-pox reports. Will you kindly undertake to see that these are furnished, in sufficient number, to every physician in your neighborhood who has recently attended small-pox patients.

It is very desirable that all possible information concerning this disease should be acquired, to the end that such knowledge may be utilized for the prevention of future epidemics.

In this connection, also, your attention is asked to the blank for statement of the cost of the diseaue to your community, and which it is hoped you will find time to fill out and return to this office.

Very respectfully.

JOHN H. RAUCH, M. D.
Secretary.

*Addressed to secretaries or presidents of local boards of health, mayors of cities, presidents of village trustees, town clerks or supervisors, county commissioners, prominent medical men; or, where none of these were known, to the postmaster or leading citizen of the infected locality.

P. O. address:

Co., Ill.

SIR:-The following tables exhibit the actual cost and estimated cost of small-pox in this community since ..., 188.., together with other data concerning

the economic features of such sickness.

Very respectfully.

(Signed):

(Official title):

To the Secretary STATE BOARD OF HEALTH, Springfield, Illinois.

TABLE No. I.

Cost of small-pox hospital:--buildings, grounds, etc.

physicians, nurses and other employés in same

medicines, subsistence, fuel, lights, transportation, coffins, repairs and
other expenses of maintenance..

extra expense of burials...

gratis vaccination:-virus, salary of physicians, etc..

disinfection:-labor, disinfectants, etc.

quarantining infected premises: -special police, barricading, etc.
subsisting quarantined persons.

property destroyed:-infected clothing, bedding, etc.

printing placards, notices, ordinances, certificates, etc.

All other items of expense defrayed out of the public funds..

Total

TABLE No. II.

Estimated losses to common carriers by interruption to travel and traffic: to railroads

to steamboats.

to stage coaches..

to street railways

to other conveyances

Estimated losses to business by panic, quarantines, etc.:

to hotel keepers

to merchants of all kinds.

to manufacturers of all kinds

to corporations of all kinds...

to laborers, artizans and mechanics

All other losses to business:-including suspension of building or other construction; interruption of labor, etc...

Total estimated losses

TABLE No. III.

Actual cost to private individuals:

etc.

Expenses incurred in care of sick:-medical attendance, nurses, medicines, Value of property destroyed on account of infection:-clothing, furniture, bedding, etc.

Cost of cleansing and disinfecting premises, clothing, furniture, bedding. etc.; whitewashing, painting, kalsomining, etc..

Cost of funerals...

Total

Other public assemblages, places of amusement, etc., interrupted during

County, Illinois.

TABLE No. V.

REMARKS.

188...

days.

[S. B. H. No. 82.1

ILLINOIS STATE BOARD OF HEALTH.

OFFICE OF THE SECRETARY.

SPRINGFIELD,

18-. DOCTOR: Aside from every other consideration, it is assuredly to the physician's interest to put an end to a disease which injures his practice, by driving other patients away from him while he is so unfortunate as to have a small-pox case on hand.

It is hoped, by securing trustworthy data concerning the present outbreak, to be able to make some progress toward eliminating this disease from our midst, at least in its epidemic form.

Accompanying this are sundry blanks so arranged, it is believed. as to require but little labor to fill out, and return to this office for publication with due credit.

I trust you may find time to do so at an early date after the last cases have been disposed of in your vicinity. Very respectfully,

JOHN H. RAUCH, M. D.,

ILLINOIS STATE BOARD OF HEALTH-SMALL-POX EPIDEMIC, 1881-82.

5. Termination of case-date of death or of discharge convalescent, and, briefly, any no'able sequelæ:

6. If others were infected by this case give names and residences, and address of attending physician;

7. Measures enforced to prevent spread of disease-including vaccination of others exposed, and result:

8. If the patient had previously had smallpox, state details, briefly:

9. Brief data of vaccinal history: If previously vaccinated-1. Where, as nearly as could be learned, with what virus, and in what country, 2. Number of vaccinal cicatrices visible, and character, typical, modified, or bad. 3. Probable effect of such vaccination on character and progress of this attack. If revaccinated, when, as nearly as could be learned, in what country, with what result:

10. If vaccination was attempted after exposure, when, with what virus, with what result:

11. If any other physician was in attendance upon this case, please furnish name and P. O. address:

[CHECK THE PROPER WORD.]

Incubative Febrile Exudative Suppurative

[CHECK THE PROPER WORD.] Discrete Confluent. Hemorrhagic grenous

Gan

UNIVERSITY OF

LIBRARY

ILLINOIS

*This letter, with the blank form, No 80, was sent direct to the physician in attendance, where his address was known; in other cases its distribution was effected by means of the preceding letter, S. B. H., No. 81.

REMARKS.

[NOTE. Here, at discretion, make comments, and give further details, or elaborate replies. It is not expected that all the data indicated can be furnished in every case. This, however, need not deter the physician from reporting any case-no matter how meagre the details. If only the name and residence of a patient be reported it will have some value in perfecting the records of the epidemic. So. also, if the case was only seen and diagnosed-subsequently passing into the hands of another physician, or removed to hospital-the name and residence of patient, together with the name and address of subsequent physician, or designation of hospital, will serve as checks to prevent duplication of cases.]

Additional copies of this blank may be obtained by addressing the Secretary of the STATE BOARD OF HEALTH, Springfield, Ill. In returning the reports to the Secretary, one stamp will be sufficient; any additional amount will be paid on receipt.

From the information obtained through these circulars and forms, and from responses to a number of supplemental circulars, and over 2,000 letters, the following details of local outbreaks have been compiled.

It has been found convenient, for reference purposes, to arrange this mass of matter alphabetically by counties, and chronologically as to date of appearance of the disease in the localities in each county.

CLAYTON:

ADAMS COUNTY.

There were two importations of the disease into Clayton, but without any spread. The first case, a railroad employé, contracted the contagion in St. Louis, of which city he was a resident. The disease was diagno-ed December 8, 1881. The other case was that of a medical student who contracted the disease in the Keokuk. Ia.. College of Physicians and Surgeons, and returned to his home sick, December 22, 1831. The railroad man presented a typical primary cicatrix (humanized virus); was unsuccessfully vaccinated after exposure-recovered. The medical student is said to have been vaccinated, but when and with what virus is not stated; presented no evidence of vaccination:-died on tenth day. The rules of the STATE BOARD were promptly and efficiently carried out, and the disease confined to these two cases. Cost not reported. Duration of outbreak, thirty days-December 8, 1881, to January 6, 1882.

Reporter: T. G. BLACK, M. D, chairman Clayton board of health.

RICHFIELD:

One of the students of the College of Physicians and Surgeons, Keokuk, Ia., returned to his home in Richfield, and soon thereafter developed a case of modified small-pox. diagnosed, in the febrile stage, January 2, 1882. From him there were 15 other cases, in three families, all of a mild type, the modification of the disease being attributable to recent vaccination and revaccination, induced by the excitement caused by the cases of small-pox in Payson township (Stone's Prairie), adjoining and along the northwestern boundary of Pike county, during the previous summer. Within 38 days after the appearance of the first case the local board reported to the STATE B ARD: That the small-pox has subsided in this district; the houses where the disease was located have all been thoroughly fumigated and purified, and all the sanitary measures recommended by the STATE BOARD OF HEALTH have been complied with, and we believe all danger from the spread of the disease is now past." No other cases resulted. Tota! cost, $3,160.

Reporters: Dr. W. C. TROTTER, attending physician and chairman board of health; J. W. BROWNING, WM. A. EVANS, members board of health.

QUINCY:

The total number of cases which occurred at Q. is officially reported as 22, among which were 3 deaths. March 18, 1882, Dr. Drude, secretary of the local board of health, reported to the STATE BOARD the existence of a mild case of varioloid. Five days later Dr. Baker, the physician in charge of small-pox cases, reported four cases, all in the exudative stage-which would carry the date of infect on back to about the 5th of March. Dr. Baker assigns the origin of the first three cases to infected rags used in a corn-planter factory; and the fourth case-which is the one first reported by Dr. Drude-to contact with the patient's brother, who was employed at this factory. The history of the rags it has been found impossible to obtain. Case No. 1 caused two more cases, Nos. 11 and 12, in his own family. Nos. 2, 3, 5 and 6 were members of the same family; as were also Nos. 4.7. 8, 9 and 10 members of one family. No. 13, a railroad brakeman, although of the same family as Nos. 2, 3, 5 and 6, is said to have contracted the disease in Trenton, Mo., and to have communicated it to his brother, No. 17, also a railroad brakeman. No. 14 lived next