December 30th, J. Payne Lowe, D.V.S., reported a case of glanders at 65 Second street, Passaic. The animal was destroyed and the stable was disinfeeted. Summary of cases receiving attention during the year: Anthrax-Three cases reported but diagnosis was not confirmed. Number of cases. 52 18 4 6 Laboratory of Hygiene. REPORT OF BACTERIOLOGIST. To the Board of Health of the State of New Jersey: GENTLEMEN-I have the honor to make the following report on the work of this laboratory during the year ending October 1st, 1901. The management of the laboratory and the conduct of the work have continued in general as in previous years. The methods of making reports to physicians and keeping records have not been materially changed. The mailing cases used for sending specimens to the laboratory for examination in suspected cases of diphtheria and tuberculosis have not been changed, except that an improvement was obtained at the beginning of the year in the sputum jar used in the tubercle mailing cases. They are now eminently satisfactory, except that a reduction in size might be made with advantage. The packages formerly used for blood for Widal's test for typhoid fever were found unsatisfactory, and a change was made at the beginning of the year. Instead of paper, glass slides inclosed in wooden boxes and heavy envelopes are now used. This has proved a great advantage over the former method, but is still unsatisfactory in some cases. We hope in the near future to send out plasters and glass tubes for blister serum for these tests. Specimens are occasionally received without the clinical report properly filled out. In some cases no data whatever is given, or the post-office address of the sender of the specimen is omitted. Such cases are located and reports sent when it is possible to do so; but where no data are given or the physician is unknown, it is impossible to report unless a complaint or inquiry is received, which does not always occur. There were thirteen such cases during the year, which are included in the table (Table`I.) under "County unknown." It is our aim to make the services of the laboratory conveniently accessible to every physician and health officer in the State who desires our aid. Repositories have been established at drug stores, hospitals, board of health offices and private physicians' offices in nearly every town of considerable size in the State, as well as in many of the smaller towns and country villages. New repositories are established whenever and wherever we find a demand for our mailing-cases. During the year eighty new stations were established and a few changes were made in the old list of repositories. The list which follows is corrected and complete to October 1st, 1901. As in previous years, the work of the laboratory has consisted in bacteriological examination of specimens sent in by the physicians and health officers of the State. The diseases for which examinations are made most frequently are diphtheria, tuberculosis, typhoid fever, malaria and gonorrhoea, in the order named. They are described in detail in the tables that follow. The examinations for diphtheria are for two purposes-first, for diagnosis, and, second, to determine the discontinuance of the presence of the infection. The majority of the primary examinations may be assumed to be for the former purpose, and of the secondary for the latter. In many cases, however, the physicians rely upon the clinical evidence for diagnosis and treatment, and depend upon bacteriological examination only to determine when the patients may safely be released from isolation. Nearly all of the examinations for the other diseases are for the purpose of diagnosis. In the vast majority of cases the methods employed and the results obtained are eminently satisfactory when the directions given are accurately followed in preparing and sending specimens. But this is not always done. Careless preparation of specimens occasions much inconvenience in the laboratory work, and many failures to obtain good results are attributable to this cause. Physicians occasionally send, or allow their patients to send, specimens, with no regard to the direction nor the requirements for a satisfactory examination. More or less inaccuracy is inevitable even when fairly good specimens are furnished. In cases of diphtheria, unless great care is taken to get a thorough swabbing of false membrane itself, good cultures may not be obtained, and for this reason, or because mixed infection with other bacteria predominating, a few bacilli may escape detection. In cases of tuberculosis, where the sputum is not highly infectious, the few bacilli present may escape detection if a sufficient amount of bronchial excreta is not furnished, or if it is mixed with an excessive amount of saliva or pharyngeal excreta. In cases of typhoid fever the blood often fails to react during the first days of the disease, and sometimes will not react until well along toward convalescence. In several cases reactions have been obtained on the second or third examination, when the first or second examination failed to give a reaction. Hence, negative results, especially within the first five or six days of the disease, should not be regarded as proof that the case is not one of typhoid fever. Specimens for malaria especially require very careful preparation. A few examinations have been made for diseases and infections other than those above mentioned. They are too few in number and too various in character to be well classified or included in the tables which follow. They include examinations for anthrax, streptococcus, staphylococcus and various other bacterial infections, &c. A few articles and some dust were examined from rooms supposed to be infected with diphtheria and tubercle bacilli, with negative results. The following tables describe in detail the work in connection with the five diseases most frequently examined. Table I. shows the number of examinations for the several diseases from each county and the entire State for each month and during the year, with items and totals. It will be seen that specimens are examined from every county, but that there are great differences in the numbers examined from the several counties. It will also be seen that at no time during the year has there been a let up in the work of the laboratory. During the month of the year when the fewest examinations were made there was an average of about ten a day, excluding Sundays, and during the busiest month there was a similar average of about sixteen a day. Table II. shows the numbers of primary and secondary examinations for the several diseases, and also the numbers of positive, negative and doubtful results. Of the positive results, it shows how many occurred during the several months of the year. Table III. shows the number of examinations made for the several diseases and the totals for each of the last four years. It will be seen that the number of examinations is increasing from year to year, and that each year shows an increasing ratio. |