REPORT OF THE DIVISION OF PREVENTABLE DISEASES State Health Department of West Virginia From July 1, 1916, to June 30, 1917 Dr. C. R. Weirich, Director Dr. S. L. Jepson, State Health Commissioner. DEAR SIR: I have the honor of submitting to you the following report of the work done in the Division of Preventable Diseases from July 1, 1916, to May 1, 1917: The year's work in this division has been varied, and includes visits to county medical societies. the investigation of county records and various reported nuisances, the formulating of standard circulars of information on the care and prevention of the common contagious diseases for use in the family, copies of which are attached to this report, visits to the schools in Fairmont, Morgantown and Wellsburg, and the rural schools of Hancock county, and assistance rendered to the local health authorities in the control of the winter epidemic of poliomyelitis at Elkins, Grafton and Fairmont, and a lesser outbreak of the same disease at Morgantown-by direction of the Health Commissioner. A Health Conference at Washington was also attended and reported by the director of this division, followed by further investigation and study of poliomyelitis in New York City during the months of August and September, 1916. A number of public health talks have been given during the year. During tuberculosis week, lantern slide talks were given in Wellsburg at the Presbyterian church, the colored M. E. church, the Knights of the Maccabees lodge and the public schools, with a Sunday address in the M. E. church. Upon request an address was prepared and given before the State convention of undertakers and embalmers held in Wellsburg in July, 1916. Talks on general public health matters were given before the three parentteachers' associations of Wellsburg, at a public meeting in Berkeley Springs and before the teachers' association of Morgan county. A paper on poliomyelitis was prepared and read before the Medical Societies of Brooke, Marion, Lewis, Monongalia, and the Grant-Hampshire-Hardy-Mineral society. The dairies of Monongalia county were visited in company with Dr. Core, a veterinarian, and copies of the State rules and regulations for dairies were distributed. A proposed school-site in the Richland school district in Ohio county was investigated upon the receipt of the following letter, dated February 6, 1917: Dr. C. R. Weirich, MY DEAR DOCTOR: Richland school district in Ohio county has selected a site to establish a central school. The Superintendent of Schools seems to think it comes within the prohibitive rule of the State board of health on account of a stable or barn that is across the creek, near to the site. I would like very much to have you come down and look over the situation, and either approve or disapprove of the site under this rule of the State board. Will you please write Prof. J. E. Evans of Warwood and advise him what afternoon it will suit your convenience to go out and look at the site? I am told that the place can be reached in a machine. Cordially yours, DAVID A. MCKEE, Prosecuting Attorney. On February 9, 1917. I wrote to Mr. McKee in reply: I have investigated the McCulloch and Ridgley sites for the proposed central school in Richland Schocl District of Ohio county, and beg to report as follows: The McCulloch site is ideal as to drainage and location, providing the building is placed well up toward the hill; but in order to comply with section 12 of the public health rules and regulations, it will be necessary to remove a barn which is located across a creek and not more than 250 feet from the proposed site of the building. It is my opinion that the Ridgley site, because of lack of proper drainage and the closeness of a blacksmith shop, will not meet the requirements of said section 12 of the health rules and regulations. Therefore, if the barn above mentioned be removed from its present location near the McCulloch site, this site would then be a suitable location for a building to be used for school purposes. Cordially and respectfully yours, DR. C. R. WEIRICH, Director. Division of Preventable Diseases, State Board of Health. In March I was again requested by Mr. McKee to investigate some additional sites in the same district, and reported to him as follows: Mr. D. A. McKee, Wheeling, W. Va. MY DEAR MR. MCKEE: On March 19th I visited, in company with Prof. Evans, the four proposed school sites in Richland district. As indicated by my letter of February 9th, the McCulloch site is the best of the four, as it comes nearest to fulfilling the requirements of the public health rules and regulations. As to further recommendations, please refer to my letter of February 9th. Respectfully yours, DR. C. R. WEIRICH, Director. Division of Preventable Diseases, State Board of Health. On November 3, 1916, an investigation of insanitary conditions then existing in a building used for school purposes at Warwood, W. Va., was directed by the commissioner of health in a letter dated October 30th as follows: The enclosed is a copy of a petition in my hands sent to the superintendent of schools and by him sent to me for reply. I have since received a letter from Mr. J. H. Lazear, county superintendent of schools, whose home is in Fulton, Wheeling, W. Va. Will you kindly investigate the matter at your earliest convenience, compare the situation with the requirements of cur regulations governing school sanitation, and if you deem it advisable, issue an order for the correction of the conditions you find existing, sending a copy of it to Mr. Lazear and one to me. The order, I presume, should be directed to the board of education of the district. I advise that you confer with the local health officer, Dr. Walden, before taking action. S. L. JEPSON, State Health Commissioner. The result of this investigation is contained in the following letter: Mr. J. E. Evans, Secretary Board of Education, Warwood, W. Va. DEAR SIR: Acting upon a complaint received by the State health department from the citizens of Warwood, asking the Department to investigate conditions existing in the basement of the Christian church, now in use as a school room, I visited the said school in Warwood on November 3, 1916, and find that the petitioners have some ground for their complaint; but I also found, upon inquiry, that it is apparently impossible for the school board to find any more suitable quarters; therefore I beg to call your attention to the rules and regulations of the State health department, a marked copy of which I am sending you, and request that the following sections of the same be complied with at once: 1-Sec. 16: Regarding the height and placing of desks. 2-Sec. 18: A urinal trough should be provided, the toilets kept in a more sanitary condition, and be better lighted and ventilated. 3-Sec. 19: The part regarding the jacketing of stoves should be attended to, and a thermometer provided. 4-Sec. 20: Better artificial lighting should be provided for in the room. 5-I find also that the room is situated about three feet under ground, and suggest that a roof-conduit be built, so as to prevent dampness in the walls caused by the seepage of water around the foundation. 6-I also noticed that there is no provision for cloak rooms, and suggest that you comply with Sec. 15. On December 11, 1916, the following letter was received from Dr. Kelly, city health officer at Morgantown: Dr. C. R. Weirich, DEAR DOCTOR: I desire to ask you what your opinion is as to the requirements of vaccinating the teachers and pupils of the public schools of this state. Can we be sustained in the enforcement of the laws of the Public Health Council? Have you had any trouble in this line or has it been required throughout the state, or has any effort been made to carry out the regulations? I have called the attention of the local school board to the legal requirements. Please advise me at once on the subject. Very respectfully yours, W. C. KELLY, M. D., Health Officer. The following answer was sent to this communication: Dr. W. C. Kelly, Health Officer, Morgantown, W. Va. DEAR DOCTOR: The section, No. 29, of the rules and regulations of the State health department. regarding vaccination, cannot be enforced, as it is inconsistent with the law, section 3, chapter 11. Acts of 1915. While in Morgantown in September, 1916, I wrote for an opinion of the attorney general, on this matter, and the opinion given by Assistant Lilly on this matter is as follows: "There being no epidemic of smallpox in this state. I am of the opinion that the regulation under consideration cannot be enforced, and that a health officer cannot require the compulsory vaccination or the presentation of vaccination certificates of pupils, teacher, and janitor in this state." Fraternally yours, DR. C. R. WEIRICH, Director. At various times during the year conferences were held with the following health officers of the state: Drs. Kelly, McLane and Phillips of Monongalia county; Drs. Ramage, Yost and Ice, of Marion county; Drs. Warder and Shafer of Taylor county; Drs. Daniels and Harper of Randolph county; Drs. Hamilton and Reger of Lewis county; Dr. Beer of Upshur county; Dr. Murphy, of Phillipi; Drs. Miller and Pittman, of Jefferson county; Dr. Love, of Hardy county; Drs. Babb, Long and Bell, of Mineral county; Dr. Grubb, of Morgan county; Drs. Varner and Post, of Harrison county; Drs. Stone and Crooks, of Wood county; Drs. Thornton and Etzler, of Ohio county; Dr. Beaumont, of Hancock county; Drs. Walkinshaw, Booher and Megahan, of Brooke county. After an examination of the vital statistics record in various counties of the state, the following circular letter was sent to each physician who had been found as not reporting births and deaths: DEAR DOCTORS In examining the records regarding the reporting of births and deaths by the physicians of county. I found that you had failed to report any deaths (births). It may be possible that you have had no deaths (births) to report; but if you have. I wish to call your attention to the law which requires all physicians to report all births and deaths to the county clerk within thirty (30) days. It is very necessary, Doctor, that the State health department should have a more accurate record of the vital statistics in the state; and in crder to have such a record, it is necessary to have your co-operation. The State department of health proposes to examine, from time to time, the records in each county; and so, Doctor, please see that these reports are made promptly hereafter, and avoid the necessity for any unpleasantness which might arise from a continued neglect in this matter. Sincerely and fraternally yours, C. R. WEIRICH, M. D., Director. Division of Preventable Diseases, EPIDEMICS. Rabies. The findings in two investigations of rabies outbreaks are contained in the two following letters to the health commissioner: Dr. S. L. Jepson, Commissioner of Health, Charleston, W. Va. DEAR DOCTOR: According to your instructions by telegram, I visited Mannington on December 20th, and conferred with Dr. Ice and Dr. Moore in regard to the cases of hydrophobia in that city, and beg to report as follows: On November 16, between the town of Downs and the city of Mannington, a dog suffering from rabies attacked six persons and several dogs of that community, three of the persons being adults and three children. All dogs which had been bitten were destroyed, with the exception of one which was only slightly scratched upon the nose. The fact that this one dog was not killed was the reason for the call upon the State Health Department. I found that Dr. Ice had treated with serum all but one of the persons bitten, and the other person had taken treatment at Pittsburg, Pa., and at the time of my visit all of these persons were well. I interviewed Mr. Graham, the postmaster at Downs (Broomfield), and he informed me that Dr. L. N. Yost, county health officer of Marion county, and Sheriff Conway had held a meeting on Sunday, November 18th, and ordered all dogs and cats to be locked up for a period of 14 days, posting a written notice to that effect in the postoffice. Mr. Graham said that the citizens carried out the order, and did all they could to prevent a spread of rabies. I also went by auto to the home of Mr. Huff, the owner of the dog which was supposed to have been bitten and not killed, and found the animal chained and locked inside a building, where it had been kept for 28 days. I left orders for him to keep the dog chained at all times for a period of three months, unless it was under his personal observance, and to have the dog shot at the least sign of sickness. Mr. Huff has promised to comply with the orders. I could see no reason for killing the dog at this time. I saw Dr. Yost at Fairmont, and visited the Mannington schools with Prof. Ward. Respectfully yours, DR. C. R. WEIRICH, Director. Division of Preventable Diseases, Dr. S. L. Jepson. Commissioner of Health, Charleston, W. Va. DEAR DOCTOR: As instructed by you on December 23d, I visited Belleville and report the following conditions existing at that time: On or about November 28th, a dog in the lower end of Harris district became sick and showed signs of having rabies. It bit one adult person and two boys, named Frank Wegal, C. F. Smith and Lon Smith. This dog was killed. On Decembed 2nd a dog belonging to Perry Shaffer, who lives on a farm, showed signs of having rabies and bit several other animals belonging to Mr. Shaffer-another dog, two cats, a pig and a heifer. The dog then made a circuit, taking in several farms, but it is not known whether other stock was bitten. It later returned to Mr. Shaffer's farm and was killed. The head of this dog was sent at once to the state hygienic laboratory, but the examination gave negative results. The other dogs and cats on the Shaffer farm were killed. On December 18th the heifer died from a disease which was pronounced by veterinarians to be rabies, and Mr. Shaffer's own |