« PreviousContinue »
3 LABORATORY FACILITIES, ETC.-continued
Distribution, therapeutic outfits:
Antitoxins, diphtheria and tetanus, 10
Serums, antimeningococcus, antipneumococcus, 5
solution (ophthalmia neonatorum), 10
4 MEDICAL INSPECTION OF SCHOOL CHILDREN
(half time, allow 8; less than half time in proportion)
Nurse (full time, 1 to 6000 children, or part time, 1 to
3000 children, allow 15)
daily assembly of school..
throat, teeth, orthopedic work, etc.
mental defectives or other like activity..
5 INFANT AND MATERNAL WELFARE WORK
(a) Infant welfare station for each 25,000 people
c if public health nurse gives one-third time to in
fant and maternal welfare work
6 MILK AND FOOD INSPECTION
tional time for less than 150 dairies).
Certified with Grades A and B, bottled and pas
Grade B, bottled and not pasteurized, allow 10
dust and flies. ...
7 WATER SUPPLY
From springs and wells not subject to pollution.
Any proper source with efficient filtration and
chlorination, allow 20
(for temporary use).
8 SEWAGE, GARBAGE AND MANURE (a) Sewage.
City completely sewered, allow 20; one-half
sewered, allow 10
95 per cent, allow 10
75 per cent, allow 5
(1) Municipal, allow 12
(2) Licensed collectors, allow 8
(3) Municipal, allow 8
(4) Private, allow 4 (c) Manure.
Collection weekly during summer months and fly
breeding prevented by use of insecticides or other-
(a) Ample stenographic and clerical force..
special information is immediately available.
ceived and action taken
tion of births and deaths..
10 PUBLIC HEALTH EDUCATION
1 Homes of newborn
4 Homes of cases of communicable diseases, etc.
'Health Department auspices.
11 APPROPRIATION FOR PUBLIC HEALTH FUND.
50 cents per capita or over, allow 100
12 EFFICIENT ENFORCEMENT OF REGULATIONS RELATIVE TO
BARBER SHOPS, COMMON TOWELS AND DRINKING AND
13 SPECIAL PUBLIC HEALTH WORK OF VALUE ALONG New
OR UNUSUAL LINES OR SPECIALLY EFFICIENT AND
ties; dispensary; effective follow-up system)
Copies of the score cards have been sent to the sanitary supervisors, with the request that scores be made by city health officers and their sanitary supervisors, acting jointly.
While the score system is still experimental and while without doubt its continued application will result in desirable changes being suggested, the interest it has already aroused indicates that it will have a marked influence in stimulating local health activities in New York State cities.
On March 13, Dr. Meader, Director of the Division, addressed the Women's Club of Sidney on " Simple Methods of Controlling Communicable Diseases.” On April 1 and 15 he attended meetings in New York City of a committee, of which he was a member, appointed by the American Public Health Issociation to formulate minimum measures for the control of communicable diseases. A report of this committee was adopted by the American Public Health Association at its meeting at Washington in October. On April 20, Dr. Meader attended a meeting of the American Statistical Association held in Ner York city. It this meeting changes to be suggested in the 1920 Census were discusserl. On April 24 he presented a paper on “Diphtheria in New York State" at the meeting of the State Medical Society, at Utica. On April 27 he attended a meeting called by the Surgeon General of the Public Health Service for the discussion of public health problems. On June 1 the present acting Director assumed charge of the Division.
In October the acting Director attended the meeting of the American Public Health Association at Washington. On December 11 he addressed the Chautauqua County Medical Society, at Jamestown, on “The Control of Venereal Disease."
During the year certain of the Department's communicable disease circulars have been revised and a new circular, a copr of which follows, has been prepared upon epidemic cerebrospinal meningitis.
EPIDEMIC CEREBROSPINAL MENINGITIS
Epidemic cerebrospinal meningitis is an acute communicable disease characterized by inflammation of the meninges (covering membranes) of the brain and spinal cord. The organism which is the inciting agent of the disease, the meningococcus, enters the brain and spinal cord through the nose and throat. It is usually present in the secretions of the nose and throat of those suffering from the disease or recently recovered from it and frequently in the nose and throat of those who have been in contact with cases. It is present in the spinal fluid of those who have the disease, and is discovered upon microscopical examination of specintens of spinal fluid withdrawn by lumbar puncture.
A person who has been closely associated with one ill with the disease may acquire the germs in his own nose and throat without himself contracting the disease, thereby becoming a carrier.” It is possible for one to become a carrier from contact with another carrier.
The disease is communicated from one person to another through transfer of the discharges from the nose and throat of cases and carriers. The carrier, if undiscovered, continues to mingle with others as usual, and for this reason is a greater source of danger than one who is actually ill.
Children are most susceptible to infection, resistance increasing gradually up to middle life. Adults are equally liable to become carriers.
Overcrowding or close contact greatly favors the spread of epidemic meningitis, owing to the greater likelihood of the transfer of secretions from one person to another under these conditions. On this account it is apt to be prevalent in military camps, where men are brought together in large numbers from widely separated localities, in some of which the disease prevails.
The disease is treated by the injection of antimeningococcus serum which is most effective when administered early, and becomes less effective with each day's delay. In most cases an early diagnosis can be made only through examination of the spinal fluid. An excessive amount of fluid is frequently present, and the mere withdrawal of fluid may gire immediate temporary relief from severe headache or other so-called pressure symptoms. If the attending physician suggests lumbar puncture, therefore, this should be done promptly.
Diagnosis and treatment
The onset of cerebrospinal meningitis may be gradual or abrupt depending upon the virulence of the infective agent. Severe headache, associated with an elevation of temperature, is usually present. Frequently early in the disease an eruption appears. Vomiting, rigidity, and pain in the neck, retraction of the head, stupor or delirium, or Kernig's sign, are common. The pulse is apt to be relatively slow and in the later stages irregular while the pupils may be dilated after the first stage. Muscular twitchings or rigidity, convulsions, strabismus, and paralysis of facial muscles are among the symptoms which may appear.
Diagnosis is usually difficult and at times impossible without resort to laboratory aid. Meningeal symptoms associated with epidemic poliomyelitis