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Widal Tests For Typhoid.

Positive. Negative. Atypical. Total.

Month

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TYPHOW DIAGNOSIS: WIDAL REACTION

Direction for Taking the Blood. 1. Cleanse the skin of the lobe of the ear, or the tip of the finger, avoiding the use of bichloride of mercury, carbolic acid or other strong reagent. Soap and water, followed by alcohol and ether, is recommended.

2. Prick deeply to ensure a free escape of blood, manipulating with the fingers, if necessary, to secure a sufficient amount. A surgical needle or pointed tentome may be used for the puncture.

3. Avoiding the first two or three drops which exude, touch the freshy escaped blood several times with the loop of wire accompanying the outfit in order to secure one full drop. Since the Widal method is quantitative, care should be taken to fill the loop completely, but no more than one such loopful is required.

4. Deposit the whole drop of blood on the paraffined paper accompanying the outfit, and allow it to dry completely; do not use heat to hasten the drying.

5. Cleanse the wire loop, fill out the accompanying card and repack the outfit, placing the filled-out card over the paper; enclose the whole in the envelope and mail to the Hygienic Laboratories, West Virginia State Board of Health. (Postage 2 cents.)

A report will be mailed on the day following receipt of the preparation, or a telegraphic report will be sent at the physician's expense, if requested.

Communications concerning specimens should be addressed to

DATA CARD FOR TYPHOID.

Hygienic Laboratories—West Virginia State Board of Health.

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Physician's Name ..... ................... Ag.......
Physician's Address .....

...L. M....
Patient's Name .......... ....... Age...... Time......
Patient's Address ........ ......... Sex.......Dil. ......
Date of earliest symptoms....
Has Patient ever had Typhoid?......When.......Mailed.....
Has Patient had Typhoid Vaccine....... ..... Rec'd......
Supposed Source of Infection......

ection....................Ex. by..... Clinical Diag .....

... Rept. by Date of Collection of Blood ................... Date... Do you wish telegraphic report, at your expense..............

(Further details may be given on reverse side)

REPORT BLANKS FOR TYPHOID.

West Virginia State Board of Health

Hygienic Laboratories.
Morgantown, W. Va.

DACTERIOLOGICAL DEPARTMENT.

Dr. .......................................

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shows the presence of the serum reaction for typhoid fever.

Very truly yours,
A. ARKIN, Ph. D., M. D., Chief Bacteriologist.

A positive reaction indicates that the patient yielding the blood has typhoid fever or has recently recovered from it, or has been given the typhoid vaccine, or has some localized affection in which typhoid bacilli are present. All excreta from the case should be carefully disinfected. Laboratory outfits MUST be used, otherwise specimens

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does not give the serum reaction for typhoid fever.

Very truly yours,
A. ARKIN, Ph. D., M. D., Chief Bacteriologist.

A single negative result should not be considered decisive, especially if the case is clinically suspicious. The reaction rarely appears before the fifth day of the disease, and may appear and disappear on successive days. In a small percentage of cases of typhoid fever the reaction does not occur at any stage of the disease. A single negative result does not exclude typhoid fever but renders its existence doubtful. Laboratory outfits MUST be used, otherwise specimens will not be examined.

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does NOT give a typical reaction, a partial action only occurring. The result is therefore of no value. Kindly submit another specimen.

Very truly yours,
A. ARKIN, Ph., D., M. D., Chief Bacteriologist.

An atypical result means nothing. Further tests may result either DATA CARD FOR RABIES.

Hygienic Laboratories.
West Virginia State Board of Health,

Morgantown, W. Va.

BACTERIOLOGICAL DEPARTMENT.

RABIES.

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Case No.................... Received .........
DIAGNOSIS: Negri Bodies, Animal Inoc.
Preliminary Report ....

...... Final Report.

(See other side also.) From (city or town) .....

......... Co. .....
Reported by ..
Patient's Name .......
Patient's address ........
Number of persons bitten.

Date.....
Number of animals bitten .....

Date..... Breed and color of animal, etc. ...

..................

(See over)

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Date and manner of death of animal
Was animal bitten? .....

................ Date.. Date of first symptoms ................................ Character of symptoms ......

(To be filled out by bacteriologist only)
Condition of Brain ......
Result of examination—smear ................ Horn.......
Cerebellum ....................

....... Gasserian....... Date animal's inoc ..................... Result

....... Result ...........

(See over)

REPORT BLANKS FOR RABIES.

West Virginia State Board of Health,

Hygienic Laboratories,
Morgantown, W. Va.

BACTERIOLOGICAL DEPARTMENT.

Dear Sir:

The brain of the ............... submitted by you on .......

..... shows presence of Negri bodies. We therefore report the case as positive for rabies.

Very truly,

A. ARKIN, Ph. D., M. D.

West Virginia State Board of Health,

Hygienic Laboratories,
Morgantown, W. Va.

BACTERIOLOGICAL DEPARTMENT.
Dear Sir:

The brain of the ........
submitted by you on .....
...............................

......... does not show the presence of Negri bodies. The report on this specimen is therefore negative for rabies.

Very truly,

A. ARKIN, Ph. D., M. D., Chief Bacteriologist. Case No. ........ .

Examinations For Rabies.

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Of the eight brains submitted for the diagnosis of rabies all were negative. The 'bulletin of information emphasizes the importance of keeping the animal under observation rather than killing it before symptoms have developed.

THE EXAMINATION OF WATER. We have examined 256 samples of water for the year ending November 30, 1914. The bacteriological examination of each sample as carried out at the laboratory is as follows:

1. Plating of samples on Standard agar, for determining bacterial count.

2. Plating of samples on Standard agar containing 1 per cent lactose and 1 per cent litmus, for determination of acid-forming bacteria.

3. Inoculation of lactose bile fermentation tubes, for determination of the presence of bacillus coli.

The samples are shipped in containers furnished by the laboratory. These containers keep the water samples at a low temperature, about 10° C., during transportation.

The bacteriological examination requires four to five days, at the end of which time report is sent.

Of the 256 samples of water collected during the year we found 98 to be unsafe for drinking purposes, or 38 per cent. The complete report of this work will soon be published. The results indicate the great need of a careful bacteriological survey of the water supplies of the state. This the laboratory is prepared to do. Such a survey

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