ï~~ Mel }j6uAdo3:s n Aq pajzeloid eq Aew pue Aied Pa!g1 e Aq eU!Z1!PGa'\Jo Aieil euoqeeN etl 1o uoqoe1oo ei 4pJPaloseM abed siql uo Jelaaee 10 REPORT OF STATE COMMISSIONER OF HEALTH. EPIDEMICS. Thefiscal year began just at the close of the epidemic of infantile p ralysis, which subsided promptly with the coming of cold weather. Duril the winter there were more than the usual number of cases of cerebrospim meniitis These were quite widely scattered, and in many instances wer associated with soldiers from camps in which the disease prevailed. Ther o unusual prevalence of the commoner diseases. The year closed with the beginning of the influenza epidemic. In Vir gine it id not reach alarming proportions until September 30th. At that time it was apparent that the epidemic was coming, so general warning notice were sent out to all the doctors. Thirty thousand placards were mailed t postoffices (each one in the State) and to teachers, and at least 100,000 ie.eospclinunzbletswre idydsrbtd.,f copiei of specia.l influenza bulletins were widely distributda es 0000cpe COMMON COMMUNICABLE DISEASES. The morbidity returns in the accompanying table show a most gratifying to every doctor in thes are made up from return postal reports that are sent cases are reported b t ae, with the exception of those in the cities, whose y the chief health officer. Morbidity Etatistic. TYPHOID DIPHTHERIA TUBERCULOSIS SCARLET FEVER B B 71 I - October, 1917... November, 19177............... 1 5835 285 493 187 352 104. Deebr 97..........20 13 22 436 199 365 126!.. Januayme, 191-...................103 157 203 351 177 303 101 Febuary, 1918.................. 59 112 95 184 206 373 10 ebra ry, 1918............48 87 91 158 223 39 1 arl,1918.......................64 988 293 3547 4 82... aril,19188...................... 88 155 62 98 281 500 82 June, 1918...................... 109 187 32 54 217 377 66 July, 1918........ - -........ 183 287 41 68 200 331 31 August, 3918.....................321 504 108 180 59' 265 3455 5 September, 1918i3................ 344 29 -.-.-.-.-.-.-.- j 397 678 116 200 144 297 31 REPORT OF STATE COMMISSIONER OF HEALTH. 11 In October, 1916, we began the distribution of a placard containing the simple principles of personal hygiene for the prevention of diseases spread by the secretions of the mouth and nose, such as diphtheria, scarlet fever, etc. The placards' were sent to most of the teachers. The morbidity table shows that there was practically no reduction from 1909 to 1916-in fact, only a slight yearly variation-but that from 1916 to 1917 there was a reduction of more than forty per cent. and to 1918 nearly sixty per cent. This reduction seems more than a coincidence. As incidence is directly proportionate to chances, wheni the chances of getting the germs into the mouth are reduced, we should naturally expect the incidence of the cases to be reduced. INTENSIVE COMMUNITY CAMPAIGNS. Intensive community campaigns have been greatly interfered with by so many of the directors going into the army. To take the place of those who left, we were able to secure the services of Dr. W. J. Innes and Dr. W. P. Caton,-who carried on active campaigns in several counties. We are indebted to the International Health Board for their continued co-operation and assistance. The details of this work are discussed in the special reports of Dr. W. A. Brumfield and Dr. R. W. Garnett, and are summarized in the table appearing at the end of this general report. SUPERVISION OF CONVICT CAMPS. Chapter 301, Acts of Assembly 1918, places the sanitation and hygienic care of convicts in the prison camps under the supervision of the State Board of Health. To Dr. R. W. Garnett was assigned the duty' of carrying out the provisions of this act. The camps were visited and reports made thereon, and a set of regulations have been drawn up. In this work we have had the cordial co-operation of the officials of the Penitentiary and of the State High way Department. Details are fulnished in Dr. Garnett's report. CARE OF SCHOOL CHILDREN. The last legislature (chapter 233) authorized county boards of super visors to appropriate money for the employment of school nurses, and for the medical inspection of school children. It also required teachers to have a course of instruction in preventive medicine and in the medical inspection of school children, the standards and requirements of the course to be fixed by the State Health Commissioner and the Superintendent of Public Instruction. Through the co-operation of the State Superintendent of Public Instruction and the superintendents of the normal schools, our representatives were able to give a series of lectures at the summer normal schools. The lecturers were Drs. Garnett, Barringer, Brydon and Innes, who jointly prepared later on a bulletin entitled "The Health Manual for Teachers." Dr. Brydon, who for several years was resident physician at the Farnville Normal School, will continue to enlist the co-operation of the teachers in carrying out the purpose of the act. This is done by letters and addresses at teachers' insti tutes, and also by lectures at the State normal schools. T otal.........- - To...........2,374...j 1,388 2,602 883 Total estimated -48836 Totl stmatd.............. 4,16..... 2,382.j......... 4,634........ T otal, 1916-1917-..-.......3 2 63 6....... Total, 141915..........4,318 6,55 390 5,4 354 536 1,634. Total, 1913-1914..4,530 6,008 3,278 4,651 5,342 6.936 2,002. Total, 1912-1913.......... 4,012 7,430 2,901 5,179 4,515 8,297 1,849. Total, 1911-1912.............- -5,839. 10,571 2,608 4,757 4,334 8,274 2,180. Total, 1910-915..................4,608 8,470 3,440 6,544 4,803 8,681 2,231. Total, 19109-1910..............5,938 11,803 3,557 6,812 4,494 8,651..... Total, 1908-1909...6,771 11,843 3,379 6,279 5,760 10,545. Total. 7,442 14,398 3,028 5,818 6,816 12,127............ Since the State Board of Health was reorganized, special efforts haver ofen put fortyhoin fethe diseases carried by human filth, the chief example' of which is typhoid fever. To show that the campaign has not been in vain it is only necessary to say that in the first fiscal year the estimated number of typhoid cases was 14,398, and in the past year only 4,016. F,.