MAYO TOLMAN, B.S., Director and Chief Engineer.. ANDREW N. WARDLE, B.S., Assistant Engineer.. MRS. NINA V. HIVELY, Stenographer. MISS ETHEL POPP, Stenographer..... Hygienic Laboratory ARTHUR LEDERER, M.D., C. P. H., Chem. Eng., Director. MISS LILLIAN NICHOLAS, Chemist. WILLIAM H. SCHULTZ, Ph.D., Consulting Pharmacologist Morgantown, W. Va. Morgantown, W. Va. REPORT OF HEALTH COMMISSIONER Great delay has been occasioned in the publication of our annual report by the loss of several of our office force occasioned by the war. Therefore the report is necessarily abbreviated in our haste to have it appear as soon as possible. DISEASES REPORTED In Dr. Wood's report may be seen a list of the principal diseases reported to this department during the past year as compared with the year 1916. His summary does not indicate that we are receiving any fuller reports from physicians than in former years. Several physicians have been fined during the year for violating the law requiring these reports. This is always an unpleasant duty for the department officials, and unless a good part of one man's time be spent in the field engaged in this special duty, not a great deal can be accomplished. Since the war has considerably reduced our office force, never equal to the duties of the department, not much improvement can be hoped for until the war has ended and our appropriation increased so that additional necessary aid can be secured. The comments of Dr. Wood can be read with interest. The vital statistics of the state have never been reported with sufficient fullness and accuracy to make them of great value. We fear that they are this year even more imperfect than ever, since the county clerks have been led into an error by a former employee of the department who notified them that it would not longer be necessary to send complete records at the end of each year. This, however, is still a legal requirement although we are making an effort to secure the original birth and death certificates, and expect to receive weekly morbibity reports when practitioners come to learn the value of such reports. As an example we may refer to a quite extensive epidemic of typhoid fever from which we had no report whatever until a hundred cases and a number of deaths had occurred. This fault was largely due to the health officer's neglect to make us acquainted with the facts. We made an earnest effort for his removal and are glad to report that the desired result was reached. Soon after the information reached us the epidemic was brought to an end by correcting the water supply which was ascertained to be the cause of the outbreak. This should be a lesson to all physicians and health officers as to the value of prompt morbidity reports. POLIOMYELTIS After the winter epidemic of 1916 and 1917 that occurred chiefly in Elkins, but extended also to Grafton and Fairmont, it was predicted that the disease would again appear in the summer of 1917, and efforts were made to secure from the legislature an increased appropriation to meet the expected emergency. But five thousand dollars, however, was added to the appropriation of the former two years. The emergency arrived as predicted, and during the year 1917, poliomyelitis cases were reported to this department as follows by counties, many cases no doubt remaining unreported because undiagnosed. Marion 58, Randolph 50, Taylor 30, Wood 22, Harrison 21, Braxton 14, Tucker 14, Ohio 13, Upshur 12, Jackson 11, Lewis 9, Marshall 7, Mineral 7, Preston 7, Cabell 6, Mason 6, Hancock 6, Gilmer 4, Kanawha 4, Ritchie 4, Doddridge 3, Barbour 2, Berkeley 2, Calhoun 2, Hampshire 2, Hardy 2, Monongalia 2, Monroe 2, Wetzel 2, Fayette 1, Greenbrier 1, Lincoln 1, Logan 1, Mingo 1, Pendleton 1, Raleigh 1, Roane 1. Total 332. From eighteen counties no report of any case of the disease was received. Of 101 cases reported with full data, 75 of the patients were under 6 years of age. The oldest was 29 and the youngest 4 months old. The means suggested for the control of the disease were strict isolation of the patient, disinfection of body discharges, and of everything used for or by the patient, confinement to home of all children in infected families, quarantine for three weeks after the inception of the disease and two weeks after a funeral which must be private, restriction of railroad and trolley line travel to those over 16 years of age. The railroad companies were always willing to follow the directions of the state health department, and as far as able to control travel in the interest of the public health. It will be noted that Marion county had the largest number of cases, many of them being in the summer and at and near Monongah, one of the great centers of the coal mining industry, with a very large foreign population, It became necessary for the commissioner to make several visits to this region during the prevalence of the disease. The Consolidation Coal Company very generously fitted up an emergency hospital which was under the direction of Dr. Noe of New York. At one of the commissioner's visits an entire day was spent in getting all of the patients of the community into the hospital. This was not done without the greatest difficulty. Since many of the mothers could not understand English, it was necessary to secure the assistance of the Polish and Italian priests whose services were freely rendered and were most valuable. But for the willing aid of the coal company the disease would have been much more difficult of control. At no other point were such excellent facilities afforded for its treatment and management. This epidemic left very many cripples, and efforts were made especially by the Marion county physicians to which this department gave its influence, to secure expert treatment for the unfortunate ones. An appeal was made to the legislature for a special appropriation for this purpose, but all efforts failed, presumably because it was thought that the State Hospital at Fairmont could be utilized for this purpose. Many state legislatures, however, have been very liberal in appropriations of money for the skilled care of children crippled by this dread disease, since it has been demonstrated that proper treatment continued for a sufficient length of time often so mitigates the unfortunate results of the disease that its victims are so greatly bettered in physical condition that they are in no danger of being a burden on the state or community. DIVISION OF SANITARY ENGINEERING Special attention is called to the report of this division of our work. We are fortunate in having three well equipped engineers, all greatly interested in their work, and the report shows that a large amount of very interesting work has been |