Public Health Reports Vol

PUBLIC HEALTH REPORTS VOL. 35 FEBRUARY 27, 1Wi) No. 9 INFLUENZA-PREVALENCE IN THE UNITED STATES. The peak of the present wave of epidemic influeinza definitely has passed in practically all sections of the United States. According to morbidity reports furnished to the Public Health Service by State health depart.ments, in only 3 of the 40 States for which fairly regular reports are available, were increases reported for the week ended February 21. The States for which no decreases in the number of cases were reported were Georgia, Vermont, and Oregon; while in Maine, New York (exclusive of New York City), and Louisiana the decreases indicated were relatively small. T.ABLE 1.-Influenza case reports. Number of cases of inafluenza occurring in various Stata as reported to the Public Health Service by State healtha departments. (States omitted are those from which no reports have been received. Blank spaces Indicate that no report was received for the week. These reports are preliminary and subject to change.] Average State. per week Cases reported week ended January- Casen reborted week cember, ,,______1919.' 3 1 10 1 17 24 31 7 14 21

25 ...... 8 -203 1,296 3,236 2,366 Arkansash...... ;.; ...... 52 35 53. 179 595 5,666 6,599 2,793 -24 14 32 322 1,604 -7,133- 13,660 11,887 7,420 Connecticut...... 5 1 1 14 1,123 4,664 5.,,666 4,868 2,771 Delaware...... 3- * 1 1 I....ii 5 21 78 43 District ofC-lumbia...... 4 23 9 I *liS 1,216 1,616 557 298 104 Florida. 6 14 2 10 484 1,547 1,735 1,420 Gergia...... 25 10 27 27 95 617 3,256 5,411 7,809 Idaho...... 88 1 270 922 2,783 2,304 ...... I ois...... 55 60 73 3,251 14,805 29,156 30,330 23,03 7,237 Indiana ... '. 41 31 18 44 1,714 ...... 7,811 7,13 Iowa...... 3 1 10 30 3,960 5,070 1,081 Kansas...... 11 22 17 45. 1,130 8,-582 16,960 17,69- 10,02FL Kentucky...... 44 41 45 75 170 878 2,536 Louisiana...... 13 32 52 27 123 763 1,901 Maine...... 2 7 1 4...... 387 Maryland X...... I--.I ...... 4,.935 8,4 4,758 Massachusetts...... 31J 41~ 40j SI-- 3,730 9,731 12,38 24,875 MIchigan...... 13 470 6,672 14,'201 555 Mlnnesata...... 5, 770- 11,397 7, 4,213 Missouri...... 4,043 5,359 466 sissippi...... 32,761 4,014 3,832 Montana...... 3 2 ...... i 67 1,022 1,4 1,650 1,400 Nebraska...... 1 I...... 2 1 154 1,815 3,99 3,272 New Hampshire...... i...... 610 1 New Jersey...... 75s3 7,365 9,603 1ot 2,798 New Mexico...... 3 22 8 4 61 260 1,576 632 NewYork (exclusive ofNew 52 1 A478 York ...... 3S 31 61 555 4, 55 11,616 13 259 11,304 New York City...... 58 42 100 384 5,60 30,456 21,388 8,691 3,030 North Carolina...... 3,356 12,892 2,571 14,439 North Dakota...... 946 497 Ohio...... '178 Oregon...... 1.... 042 1,318 1,971 Pennsylvania...... I...... 1,090 13,324 9,365 South Carolina...... i...... 1,661 3,17-9 3,916 2,846 South Dakota...... 3 118...... 5,042 4,976 3,047 2 Tennessee...... 1...... 2...... 2'331 1,432 Texas...... 11,265 6,788 1,035 ta...... 1,489 228 96 Vermont...... 25....- 89 272 96 1,314 Virginla...... 3,097 6,318 2,934 1,512 Washington ...... 12 1902 6,451 6,426 4,596 ...... 1,667 4'732 6,308 3 1,848 WiconsinW Virgnsi...... 3 6 67!1,944 6,739 14,328 10,310 6,274 Wyomng ...... ao00 ...... 0* e ...... 1,372. -Total.' 433 476 618 4,971 33,601 }41 oO 295 584 1266 942 152,390 NumnberN otat...... eof States reportinga 25 20 22 22 '241 '311 431 '40 38 Week ended Friday. 2Fi3e days only. J Six days only. 161090°-20-1,*, (437) February 27, 1920. 438 As predicted in the Public Health-Reports of February 20, the peak of mortality from inftuenza and pneumonia (all forms) in the group of 46 large cities included in the Weekly Health Index of the Bureau of the Census was reached in the week ended February 14. Considering these cities as a single group, the excess mortality rate (over that of a normal year in the corresponding season) was 853 for the week enided February 21, as compared with 1,322 for the preceding week, 1,241 for the week ended Februarv 7, and 746 for the week ended January 31. TABLE A.-Compar'ison of the excess 1 annual mortality rate per 100,000froin influenza and pneumonia (allforms) by weeks during the 1920 epidemictwith thatfor corresponding wveeks in the 1918 epidemic in cities included in the Weekly Health Index ofthe Bureau of the Census, considered as a wvhole.

Excess over, Excess over correspond- correspond- Week ended- ing weekr Week ended- ing week ofmedian ofmedian year. year.

1918 1920 Sept. 14. -6 Jau.3 ...... -56 Sept.21. 76 Jan. 10. -55 Sept. 28...... 3261 Jan. 17-27 Oct. 5...... 1..08 Jan. 24 ... Oct. 12...... 2,557 Jan.31 746 Oct. 19...... 4,592 Feb. 7 . 1,241 Oct. 26 ...... 4,695 Feb. 14 .... 1,322 Nov. 2.. 3.332 Feb. 2 ...... ------...... 8gm Nov. 9 1; 832 Nov.16 989 Nov. 28 ..... 620 Nov.30 526 Dec.7...... 617 Dec. 14...... 792 Dec. 21...... 801 Dec. 28...... 6f29

1 Exes eer the mortality rate from the same causes in the corresponding week ortho median year in thepeeiod ll1-1914. The weekl rates for the median year have been approxcimated by plotting the rate for themedia year breach mouth (thus affording a rouX.h"'normal" seasonal curve) foreach city and then by readingfrom the curve thc indicated median rate at the midpomt for each week. The excess has been found by subtrmeting this median rate from the actual rate for the corresponding weeks in 1918 and 1920. If the curves of tlio two epidemic waves be plotted on arithlog paper and fitted togetlher, it will be nioted that they are strikingly similar so far, especially if the excess over what apparently is the "norm" for 1920 is taken into consideration. Plating the peaks together and computing the ratios of the weekly excess rates for the 1920 -wave to- that of corresponding weeks -in the -1918 wave, it is seen that for the five highest weeks (ended Jan. 24-Feb. 21) the mortality in these large cities chargeable to the present epidemic is so far under 30 per cent of what it was in 1918. For the cities in which the peak of excess mortality from influenza and pneumonia (all forms) definitely appears to have been reached, the following table has been prepared. It should be noted that the data for cities appearing in the Public Health Reports for the two weeks preceding this issue have been considerably revised. 439 February 27,1920. TABLE B.-Erces of mortality 1 from influenza and peumonia (all forms) in peak week of 1920 epidemic compared with that of 1918 epidemic in certain citia.

Week in which Excess annual rate per Per cent peak occurred. 100,000-peak week. which 192

. ______peak week City. excess rate is of 1918 1918 1920 1918 1920 peak week excess rate.2

Cuicago,III...... Oct. 26 Jan. 31 4,620 1,886 41 AVashington, D. C ...... Oct. 19 ...do 7,989 2,072 26 Dayton, Ohio ...... Oct. 26 Feb. 7 5,352 1,611 .:30 KansasCity Mo .Nov. 2 ... do 3,173 3,362 106 Milwaukee, Oct. 26 ...do 1,915 1,927 101 Mieapols Minn .do...... do ... 1,963 2,065 105 NewYork N Y ...... do... do 5,091 1,705 34 Oakland, Ealif ...... Nov. 2 ... do 5,679 1,196 21 St. Louis Mo ...... do.... 1,581 2,399 152 St. Paul, Min3).Nov. 16 ...do 2,664 1, 465 5W. Syracuse N. Y.... Oct. 19 ...do 8,085 2,651 33 TVoledo, O hio ...... Oct. 26 ...do 2,642 865 33

Albany, N. Y...... do.. Feb. 14 8,535 980 11 Baltimore Md .Oct. 19 ... do.. 10,419 1,745 17 Boston, M'ass .... Oct. 5 ...do.. 7,925 1,399 18 Cambridge, Mass ...... do... do. 6,461 1,058 16 Cleveland, Ohio ...... Nov. 2 ...do 4,282 1,483 35 Columbus, Ohio...... i ...... Oct. 26 ... do 2,623 2,519 96 Grand Rapids Mich ...... (3 ...do (3)_ 1,285 (3) ndianapolis ind ...... Oct. 19 .. .do 2,210 2,004 1 .LoulsviIle,Iy ..Oct. 26...do3...... do3,770874 ; 23 Memphis Tenn ...... Oct. 19 ...do 6,042 1,836 30 Newark, i...... Oct. 26 ...do ... 5,123 1,50 29

New Haven, Counn...... do...do 66,033 1,630 27 New Orleans, a ...... ::do: ... do.;... 9,156 492, Omaha, Nebr. Oct. 19 ...do 4,547 1,802 40 Pittsburgh, Pa .... Nov. 9 ... do. -6,726 3,297 49 Providence, R. I .....Oct.d...do.4,94819 1,421 29 Richmond, Va. ... do ... do 6,275 857 14 Rochester, N. Y .Oct. 26 ...do., 4,077 824: 20 San Francisco, Calif .... Nov. 2 ...do. 7,927 1,341. 17

I Excess over the mortality rate from same causes in the corresponding week of the median year in the period 1910-1916. The weelly rates for the median year have be!n approxim'ated by plotting the rate for the median year for each month (thus affording a rough "normal" seasonal curve) for each city and then byreading from the curve the indicated median rate at the mid-point foreach week. The ezcess has been found by subtracting this median rate from the actual rate for the corresponding week in 1918 and 1920. The percentages appeng in a similar table in the Public Health Reports for Feb. 20 have been considerablyrevised and a number ofcorrectionshave been made in the table above. 3 Data not available. It will be noted that the peak of mortality in this epidemic wave apparently has definitely occurred in 31 out of 40 cities for which data are available. In 8 cities-Atlanta, Birmingham, Buffalo, Fall River, Lowell, Nashville, Philadelphia, and Worcester-further increases were reported for the week ended February 21. Incom- plete reports were received from Los Angeles, Oakland, and Jersey City, which cities apparently were at or near their peaks. The very wide variations in the ratios of the excess peak rates for 1920 to those for 1918 for the different cities (ranging from 5 to 152) are especially interesting and suggest correlations of possible signi- ficance from more than one point of view. In a later publication, where more complete data will be available, some analyses of these differences will be presented. February 27, 1920. 440 Note already has been ti4ade in a preliminary way of the quite definite geographical movement of the epidemic at successive time intervals. (Public Health Reports, Feb. 20, p. 386.) The later reports afford further evidence of this movement along the lines already mentioned. In Table II is given the number of deaths from influenza and pneumonia (all forms) by weeks in January and February to date, as reported in the Weekly Health Index of the Bureau of the Census. TABLE II.-Deaths from inftuenza and pneumonia (all forms) in certain laige cities, by ceeks, in January and February, 1920.

'WVeek elded-

Jan. 3. Jan. 19. Jan. 17. Jan. 24. Jan. 31. Feb. 7. Feb. 14. Feb. 21.

lbany,N. Y .6 3 2 3 14 19 29 23 Aanta, ...... 6 117 '10 110 15 32 '68 to Balt more, Md 31 20 35 24 59 122 268 231 Bhrmingham, A1a 1n 111 ' 8 16 14 22 is 5s Iloston,M.a . 24...... 28 2.8 45 85 158 255 . 6 BnfaloN.Y 13 10 7 9 17 67 141 145 (bd4 8 7 8 14 22 28 23 G ,.98. 1O7 153 472 1.10 1005 494 2&1 cinentl, s8 14 12 17 25 38 62 81 (3eveland, Ohio .28 21 25 26 41 158 258 177 Co1umbUs,Ohio 5 15 9 S 22 59 118 66 Dayton, Ohio 7 4 7 13 46 47 32 24 Denver, .Co l. 15 21 18 24 49 150 100 67 FaIIRiver, Mass 3 7 10 5 3 5 16 25 Grand Rapids Mich 3 1 4 2 6 31 37 32 ndianapolis Ind 13 18 116 21 36 92 124 72 Jersey 1ity,i.J 12 14 14 24 4 () (7) 7 Kanss City,Mo 12 13 29 9s 120 220 167 74 Los Angeles,Cslif 18 IS 18 19 22 42 88 (I) Liouisvile, Ky 9 10 10 9 1s 40 52 48 LoweIl,Ml ass 3 5 4 2 7 12 10Q 36 Msmpe TIS..e.. 15 12 12 11 1O 22 64 61 MllwaUkee,WIS 15 25 '13 45 141 184 121 41 MInneapo1is.1I n 20 12. 10 9 63 168 125 338 NoshviU, ? 4 8 11 6 12 8 23 47 ewark,N.;I. 15 17 14 38 55 116 142 9e New ven, n... 11 6 8 10 19 20 60 334 NewOriensLa. 18 27 21 27 32 36 62 331 NewYor.-4Y .. 195 218 261 511 1,3R 1,988 1,796 987 Oakland, Calif 7 4 8 * 20 24 55 54 (2) Omnba,Nebr ...... 5 4 7 13 45 62 73 32 Phlladelpbia, Pa..;.. 64 55 75 1081 153 289 564 020 Plttsbnr.h,P...... 55 47 53 55 76 168 417 290 Portlandr.... 4 113 '8 1 9 115 21 57 (2) Provkide,ne, R.I- .-. . 6 12 13 8 14 3) 88 82 Ricbmond,V. . 6 2 9 6 21 35 38 28 Rochesta N.Y 8 13 7 12 23 50 52 27 5t.I.ouis,Mo 47 57 41 73 236 401 282 129 St.'Psul, Minn 7 4 (2) 26 72 8o ff3 (2) Sn Francisco,Calif.. 20 14 26 48 59 115 137 113 9 12 4 7 12 39 9B 78 5ettle, Washq 4 3 12 64 Symrae,Spokane,Wash.N.-Y...... 60 9 83 inl 31 8932 78 32429 Toledo, 328 9 278 81s 54 50 WVsbsington.Wnshnktne,Ws.l...Ohio.D). C. 39 22 Z17 81 18182641S 164 f91555St Worcester, ass 5 10 9 7 14 15 44 52 'Deaths from pneumonia (all forms) only. No report. ' Dwths from inolena ony. In Table III is presented the annual mortality rate per 100,000 from influenza and pneumonia (all forms) by weeks in January and February to date for those cities in the Weekld Health Index for whichl population estimates are available. For convenience in comparison the " normal " annual rate from these causes in the 441 'February 27,1920. corresponding week§ is also shown in Table III. The method by which this "normal" rate was found is explained in the footnotes to the table. TABLE III-Annual death rate per 100,000 from influenza and pneumonia (all forms) by wveeks ended Jan. 3 to Feb. 21, 1920, andfor corresponding weeks of the median year in the period 1910-1916. 1

In medan year ofthe period 191-1916. 1920.

City. Week ended- Week ended- Jan. Jan. Feb. Feb. Feb. Jan. Jan. Jan. Feb. Feb. Feb. 17. 24. _1.Ja3. 7. 14. 21. 17. 24. 31. 7. 14. 21.

Albany, N. Y...... 407 406 399 387 370 346 93 139 649 880 1,350 1 065 Atlanta, Ga...... 225 228 239 253 276 302 2258 2258 388 827 21,758 22,300 Baltimore, Md...... 368 367 358 345 341 340 272 187 459 949 .2,086 1,797 Birminghm, Ala...... 294 307 325 337 344 346 2211 422 369 580 475 1 556 Hoston ...... 300 300 298 296 294 297 186 299 564 11,049 1,693 1,431 Buffaln, N.Y...... 211 212 214 216 220 226 77 209 187 738 1,55. 1,598 Cambridge, Mass...... 266 267 264 258 252 252 328 374 655 1,029 1,310 1,076 Chtcaga, III ...... 344 344 341 337 333 330 307 948 2,227 2,018 993 488 Cincinnati, Obio...... 258 266 271 275 276 276 150 212 312 474 773 1,010 C-leveland, Ohio ...... 174 173 173 174 177 185 161 167 264 1,016 1,660 1,139 Ohio. 214 212 210 210 212 219 208 185 509 1,366 28731 1,52 (Columbus,Dayton, Ohio ...... 268 270 269 26M 260 254 279 519 1,836 1,876 1,277 958 Fall River, Mass ...... 307- 344 394 435 450 452 406 203 122 203 650 1,015 Grand Rapids Mich...... 152 156 1.54 146- 139 137 154 77 231 1,193 1,42 1,2 Indlana)o~is,ind ...... 276 276 259 233 223 222 2 287 377 646 1,652 2,227 1,203 JerseyCrity, .J . 296 295 292 289 287 2897 229 393 1,047 '3) (3) 1,276 KansasCity, Mo. 261 275 286 294 300 300 482 1,595 1,994 3, - 2,775 1 230 Los Angeles, Calif...... 188 187 183 174 161 145 165 174 202 385 807 %3) LTouisville, Ky.228 234 236 239 243 253 215 198 387 859 1,117 1,3' Lowell, Mass .. 313 316 308 291 271 264 191 96 335 574 478 1 721 Memphis, Tenn...... 330 330 327 322 320 322 404 371 337 741 2,156 2,055 Milwauke,.Wis.181 185 187 189 190 ... 2149 517 1,621 2116 1,391 471 .Minneapolis, Minu ...... 220 228 228 220 206 183 136 122 857 2,285 1,700 4 517 Nashville, Tenn...... 312 317 332 367 393 418 481 262 525 360 1,006 2,056 Newark,N...... 276 274 261 243 224 220 170 3665 669 1,411 1727 1,131 New Haven, Conn...... 438 440 432 402 390 388 269 337 640 673 2 020 41,14S New Orleans, La...... 318 333 344 350 354 354 .8 368 436 491 '846 4423 NewYork N Y...... 265 270 276 282 290 298 261 511 1 308 1,987 1,795 987 Oakland, alif...... 174 165 153 143 130 120 195 487 584 1,339 1 315 (3)T Omaha, Nebr...... 272 281 295 305 310 310 202 376 1,302 1 798 2,112 Q26 Philadelphia, Pa.286 291 290 289 28 284 222 320 453 856 670 1,0I5 Pittsburgh, Pa...... 391 394 388 377 368 367 466 483 668 1,476 3,665 2,549 Providence, R. I...... 290 301 309 314 320 322 257 158 277 771 1,741 1 621 Richmond, Va...... 362 369 373 375 376 377 292 19' 681 1,136 1,233 908 Rochestcr, N. Y...... 225 225 218 206 200 198 138 236 453 984 1,024 532 Sr. Louis. Mo ...... 313 311 300 282 257 244 271 488 1, 78 2,681 1,885 862 St. Palll, Minn ...... ,.163 162 159 154 150 150 (3) 526 1,457 1,619 1,275 (3) Sen Francisc3, Calif...... 216 204 181 162 152 150 28 523 643 1,253 1,493 1,231 Syracuse, N. Y...... 199 203 217 224 229 230 258 323 1,001 2,875 2,520 937 Toledo, Ohio ...... 176 192 202 209 214 218 159 180 358 1,074 994 1,014 Washington, D. C...... 262 270 278 284 293 305 351 1, 052 2,350 2,129 1,194 714 Worcester, Mass...... 320 333 341 346 348 346 270 210 420 450 1,321 1,561

1The weekly rate for the median year in the period 1910-1916 is presented as a "normal" rate. It is, of course, only approximated, and was found by plotting the rate for the median year for each month (thus affordiing a rough "normal" seasonal curve) for each city, and then by reading fromn the curve the Indicated median rate at the midpoint of each week. IFor pneumonia only. 3Noreport. 'Influenza only. Table IV is based on Table III and shows the excess of the annual death rate from influenza and pneumonia (all forms), by weeks, ill January and February to date, over the seasonal "normal" in thte same cities. February 27,1920. 44 TABLE IV.- of .annua dea rae per 100,00 fromn inflwnza and pnumonia (all forms), by weeks, Jan. $ to Feb. 21, 1920, over that in corresponding week of median year (1910-1916) in certain large cit.'

Excess over corresponding week of median year-Annual rate per 100,000. City. Jan. 3 Jan. 10. Jan. 17. Jan. 24. Jan. 3L Feb. 7. Feb. 21.

Alny,N. Y...... -261 -314 -267 250 493 960 719 Atlanta',aa...... '- 85 s 209 S33 ' 30 149 574 21,482 '1,99 Baltimore, Md...... -106 -204 - 96 -180 101 004 1,745 1,457 Birmingham,...Ala....A1a - 5 '- 1 2-83 115 44 243 131 1,210 Boston, Mass ...... -131 -113 -114 - 1 266 753 1,399 1,137 Buffalo. N. Y ...... -69... -102 -134 - 3 -27 522 1,334 1,372 Cambridge 3Mass ...... 111 ....-68 62 107 391 7 1058 824 iMcagol...... -102 -118 -37 604 1,88 1,-681 660 158 Ccmati,Ohio....Ohi..... - 8 - 71 -10B - 54 41 199 497 734 (Aieveland, Ohio ...... -130-41 - 6 91 843 1,483 954 Columbus'Ohio ...... 130 -103.....- 6 - 27 29 1156 2,-519 1,309 Dayto,, dhI . ...51....-101 . 11 249 1,56 1, 017 704 al Rivr, mass..... -128 5 99 -141 -22 -232 200 5 Grand Rap Mich.. - 15 -105 2 - 79 77 1,285 1,016 IndIandpoiis1.ind.... '-168 62 211 101 587 1,0471,419 2,001 1,071 7#rsoy d it90i -J..-64 - 67 98 755 (') () go KasCity, o. - 31 - 31 221- 1,320 1,708 3,362 2,475 960 LosAAtles Calif -16 - 89 - 23 - 13 19 211 646 (3) Louisvilleiy . -12 -3 -13 -41 151 60 874 778 Lowell, '~ISS ...... -145- 66 -122 -220 27 283, 2. 1 457 Memp Tenn ...... 19 81 74 41 10 419 1836 1,733 Milwaukee Wis ...... 3111 2- 32 332 1,434 1,927 1,201 276 Minnea~noll=.- ...... 41 .....8 - 84 -106 629 2,065 1,'4 433 -130 -47 189 - 55 196 -17 613 1,i8 Iiewak,kN.J ...... -77-64 ..-106 91 408 1,168 1 508 9Un New Maven, Conn.. 0 -222 -160 108 208 271' 1,'6 4 7 NewOrlean La - 36 67 s0 36 92 141 492 469 York N Y -61 -42 - 4 241 1,082 1,706 1,506 689 Oaklabn ...... f -1 - 84 21 316 431 1,196 1,185 (3) - 616 OinahaWe,r...... ebr. -117 -151 70 95 1,00? 1,488 1,802 :Philadelphia Pa . ...76 ...--1k6 -64 29 163 567 1,384 1,551 Pittsburgh, ia ...... 75 ...12031 89 280 1,99 3 297 2,N Providence, R. I ...... - 34 ..-1- 33 -143 - 32 457 1 ,421 1,309 Rlehm4md, Va ...... -130-280 -70 -74 308 761 857 631 Y.;.: 4 38 -87_ 11 235 778 824 334 ...... 7 15-2 - 39 177 1,278 2,3991 1,628 618 StPaulX ...... -.79 (8 41,28 1,465 1,125 3 Sin Fr Calif.. _ 4 -608 67 319 462 1,091 1,341 1,061 Slracuse N' 10 100 59 115 784 2,651 2,291 707 bi1edo,6hl 19 24 - 17 -12 156 865 780 796 Wa&shgtn ..C 175 34 89 782 2,072 1,845 901 409 Worcester, Mass -117 1 - 50 -13 79 104 973 1,215

t'The kleek rates for the median ar in th period (1910-916) have been approated by plotting te' rate for teimedianyar for each mouth (thus fording a roug "normal soal curve) or eac city, and then by reading from the curve the indiated media rate at the midpohit for Each wee. Th3 excess has been found by subtracting this median rate from the actual rate for each week i 1920. When the difference is "minus" it is so indicated. 2 pneumoia wily. 3 Noreport. 4 For lluenza only. In order to facilitate the comparison of the present epidemic in the cities included in the Weeldy Health Index with the epidemic of 1918 for the same cities, the excess mortality rate from influenza and pineumonia (all forms) by weeks, from September 8 to November 30, 1918, is shown. These excess rates may be compared with those given in Table IV. It should be noted that the excess rates as com- puted in Tables IV and V are only approximated, but they are. believed to be sufficiently accurate to afford a fair basis for deter- mining the mortality from influenza and pneumonia (all forms) which properly may be attributed to epidemic conditions. 443 February '27,1920. TABLE V.-Bxeess -of annual death rate per 100,000fJrom influenza and pneumonia (all forms), by weeks, Sept. 8 to Novz. 30, 1918, over that in corresponding wveek of median year (1910-1916) in 4S large cittes.'

SePt. SePt.j SePt. Oct. Oct. Oct. Oct. Nov. Nov. Nov. Nov. Nov. City. j~14. 21.1 28. 5. 12. 19.126. 2. 9. 16. 23. 30.

Aby,N.Y ...... 37 .... 31 29 2,018 5,025 8,535 7,087 2,300 800 41 488 AtlataGa...... 110 .... 15 82 666 1,972 2,471 849 633 499 402 64 Baltimore,Md ...... 37 -5 43 794 4,25310,419 8,194 2,915 953 189 53 65 B Aralngham.....-23 -26 -33 322 1,493 2,770 3,369 2,095 1,061 1,-056 -990 1,694 Boston, Ms...... 188 1,634 5,015 7,925 6,68 3,765 17,350 .753 343 143 172 156 Buffalo, N.Y ...... 17 56 96 444 1,9 5,752 7880 4,89.4 1,723 743 217 216 Cambridge Mawss..... 253 109 4,82 6,461 5,285 7,845 867 759 189 262 248 140. Chicao . -53 -50...79 728 1,988 4,105 4,620 2,801 1,316 600 .305 223 Cniati, Oh'io...... -1 -21 - 4 137 749 2,291 3,386 2,957 1,882 1,046 1,137 997 Cleveland, Ohio.....:.-26 - 9- 2 44 177 928 2,818 4,'282 3,256 2,132 1,408 1,113 Columibus, Ohdo...:...-28 40 83 17 57 1,613 2,623 2,084 1,067 721 860 1,315 Da'ton, Ohio ...... 33 --- 9 23 13 1,155 5,248 5,352 4,'463 2,535 688 45 359 FailRiver, Mass ...... 264 715 3,863 8,'095 7,730 3863 1,53 '869 447 267 128 GrandRapIds Mich...... i 1,09 628 Indanaos,I~d.... -.6' '44 111 356 745 2,210 1,968 .1,402 96 735 967 1,653 ereyty .J...... -65 - 2 242 973 3,1666.... 6,823 ...... KansasCity, Mo...... 28 .... 108 47 1,521 2,713 3,117 3,173 2,177 1,198 921 1,461 LosAnteelsClf36 -14 -42 70 576 1,144 2,625 3,435 2,759 2,'664 1,688 1,405 Loulsvili y20 143 26 228 1,889 3,764~3,770 1,348 1,098 678 ,584 1,159 Loweil,Mass~...... -15 311 1,451 4,358 6,644 5,441 3,902 1,311 252 242 375 -73 Memphis, Tenn...... 2,624 6,04 5,479 2,254 - 392 402 -20 Miwue,Wis ...... -,4~ 91 108 711 1,215 1,915 1,328 91 675, 427 873 Mlnneapolis,Mlnn.j...... 97 120 59 1,,28D 1,963 1,541 1,191 1,151 575 490 Nashville Tenn~..... 21 45 124 5,5388,327 5,420 2,206 2,135 446 464 -747 Newark, ...... 9 27 565 2,205 4,799 5,123 4,444 2,014 1,200 687 :501 New Haven, Conn. ..-32 401 1i,102. 2,479 4,906 6,033 5,519 2,615 1,459 50.3 621 New Orleans La.-... 231....-54 294 1,852 8,385 9,156 4,368 1,957 822 ~281 356 NewYork 9 Y . -20D 11 93 629 2,010 4,107 5,.091 4,259 2,122 885 473 -223 Oakland (ai..19...-32 -9 354 936 3,271 5,679 3,728 1,603 811 .164 Omh,N-ebr...... -26.1211,887 4,547 4,164 2,618.- 1,1245 929 790 Philadelphia, Pa...... - 31 31 157 2,014 7,71613,515 8 841l 3,448 986; 350 154 106 Providence, R.i ...... - 3 115 348 1,868 3,587 4,948 4,21012,558 1,162 575 502 290 Rchmond, Va...... 66 -31 57 1,2Z46 4.,14 6,275 4,0251 2,1l66 760 586 243 5.77 Rochester, N.Y...... -4 -49 6k 32. 612 1,902 4,077I3,989 1,914 886 648 585 St. Louls,-Mo ...... iSn-1 17 St 82 478 1,135 1,436I1,581 1,37 1,358 1,0691,374 St. Paul,&...nn...... 21 ... 12 -32 1,177 14,458 1,091 22000 2,141 2,664 _1,706 1,306 San~Francisco, Calif...... -28 53 56 N0 921,0 5,899 7,927 4372,4141 857 400 Syracuse,.N.Y...... 1,150 4,410 6,991 8085 4 425~2,088 784 610 83 76 Worcester,Mass...... 141 438 2,L965 5,891 6,813 4,702 2,465 1,662 ....272 744 467 Th weekly rates for the median year in the pericd 1910-1916 have. beeni approximated by plotting the rate for the median year for egach month (thus affordmn a og nra"seasonalcreo eah city, and then by readn frmtecurve the indicated miedian rate at the mid-point for each week. .Thc excess has been found b ut~tn hsmda rate from the actual rate for each week in~1918. When the difference is "minus ti oidctd

IVY AND SUMAC POISONING By E. A. SW3EET, Surgeon, United States Public Health Service, and Dr. C. V. GRANT, Office of Drug, Poisonou, and Oil Plant Investigations, Bureau of Plant Industry, UTnited States Department of Agriculture. INTRODUMTON. The fact that certain species of plants beloniging to the Rhus, or Sumac fa ily exert a poisonous. action upon the skin of perso'is susceptible to their influence, has long beeni a matter of general recognition. Inasmuch as the poisonous growths possessing this characteristic thrive in A erica, and are especially prolific hin certain sections of the country, it seems desirableefrom a health stand- point to bring together the general iniformation on this subject in' rFebruary 27, 1920. .JAA order that the public may become better acquainted with the nature of these plants, methods by which they may be recognized, and the various means of preventing their toxic effects. The sum total of the incapacity and economic loss arising from this cause can scarcely be estimated, to say nothing of the bodily discomfort which commonly ensues, but certainly they are sufficienit to justify a more wider. spread knowledge of the practical aspects of the Rhus problem. DESCRIPTION OF THE PLANTS. The niative forms of Rhus2 which produce skinl eruptioins belong to several species distinct botanically, including the vines fand shrubs known as poison ivy and poison oak, an(d also the poison sumac shrub or tree. Despite their variety of form these planits are closely related and po-,ssess certain prominent peculiarities by whiclh they can usually be distinguished without difficulty, so that by acquiring some slight knowledge of the characteristic appearance of their leaves, fruit, Minter buds, and of their habit of growtlh, oie may readily avoid them at all seasons of the year.- Poison Ivy and Poison Oak. Poisoll ivy and poison oak occur as woody lperelmial vines or as low erect plants, or trailing shrubs, andl are most rea(il-y distinguished by their leaves, which are always divided into three leaflets, and by their smootl, whitish, waxy fruits. which resemble mistle- toe berries in appearance but vary ini size from * to 1 of an inch in diameter and contain a sinigle stony seed. Of- the -various names applied to these plants- in different localities the conunonest are poison ivy, poison oak, mercury, piery, climbing or trailing sumac, and poisoIn vinte. For purposes of recognition and consideration with respect to their poisonous properties, the several botanical species may be included under one general descriptioni, althouglh great variations in clharacter of growth anid in the, forms of the leaflets are founid, in many instances even oIn inldividual planlts. While the names poison oak and poison ivy are used interchange- ably, the term poison oak is often restricted to plants with an erect or bushlike habit of growth and with leaflets resembling certain types of oak foliage. Thus the plant generally known as poison oak 3 throughout the Pacific coast region from Lower California and Arizona to Canada, occurs as a bush, sometimes attaining a height of I Tlhrough the workl of a number of investigators, knowledge of the toxic grouip of Rhus plants has been greatly increased In recent years with respect not only to the nature of the poisonous principle but also to the dermatitis produced by It. In the present buletin the results of these investigations have beenfreely consulted in preparing a genera summary of the available information on the subject. -To those desirous of obtaining more detailed information, the references found on page 458, which, however, do not consti- tuto a complete bibliography of the Utorature, may be of assistance. 2 The species of poison ivy and poison sumac are-grouped by some botsnical authors under the generic name Toxicodendrmn. 3 Rhus dirersiloba Torr. and Gray. Public Health Reports, Vol. 35, No. 9, February 27, 1920. .I _ 1 ._

FIG. 1.-Poison oak, Rhus diversiloba Torr FIG. 2.-Poison ivy, Rhus radcans L. Branches and Gr., of California and the Pacific of poison ivy vine showing leaves, aerifl root. Coast. lets, and flowers.

|~- FIG. 3.-Poison oak, Rhus qtercifolia (Michx.) FIG. 4.-Poison oak, Rhus rydbergii Small. A Steud., of eastern United States. western form known as Rydberg's poison oak. Public Health Reports, Vol. 35, No. 9, February 27, 1920. _n .1

FIG. 5.-Leavesof poison ivy, Rhueradicans L. FIG. 6.-Leaves of Virginia Creeper Parthenocissus quinquefolia L. PtancA.

FIG. 7.-Poison sumac, Rhus vernix L. 44-5 5ebruary 27, 1920, 4 or. 5 feet, and has leaflets (Fig .1) resembling leaves of the western oaks; but it is also found growing as a vine, and is sometimes called poison ivy.. In the East, from New Jersey, Delaware, and Virginia, south and southwestward, the name of poison oak' is often used to distinguish from the poison ivy vine2 (Fig. 2), a form growing as a bush (Fig. 3), with lobed leaflets somewhat suggestive of leaves of scrub oak-; while westward from Minnesota, Nebraska, and Arkansas, to Washington, Montana, Colorado, and New Mexico, this name is applied to- a low bush3 or trailing shrub form (Fig. 4) whieh does not climb. Familiarity with any one of the forms (Figs. 1 to 5) will enable even the careless observer to recognize poison ivy or poison oak wherever encountered, whether as a vine, trailing shrub or bush, or' at least to avoid readily all plants bearing a suspicious resemblance to it. The vines attach themselves to trees, walls, fences, rocks, or any adjacent support by means of aerial rootlets, and are without the twining tendrils found on many climbers. They sometimes climb to t.he tops of the highest trees, and are occasionally found witlh stems 3 or 4 inches in diameter. The forms growing as erect bushes, or shrubs with trailing underground roots, usually attain a height of a few inches to about 3 feet, but in favorable situatiolns are often found as bushes of- luxuriant growth 4 or 5 feet high. The leaves of all forms have stout, rather long stems, bearing 3 leaflets, 2 of which are opposite and short-stalked, while the third or terminal leaflet is long-stalked. The lea.flets are from 1 to 4 inches long; dark green on the upper surface, lighter, sometimes with a velrety covering of fine hairs underneath, withi smootlh or more or less indented margins, and of the variable forms herein illustrated (Figs. 1 to 5) The tendency of the leaflets to form irregular, notched, and indented margins is ani aid to t.he identification of the plants; and in forms with generally smooth margins, a deep notch or several indentations on one side of the leaflets (Fig. 5) are characteristics wvhich often serve to confirm the identification. Small, inconspicuous, yellowish- greeni flowers, borne in loose branching clusters about 1 to 3 inches long, growing out of the angles between leaf stalks and plant stem or above scars along the sides of the branches, appear in early summer and are followed by the small, globular, smootih, greeni fruits which become white or ivory color as they ripen. These waxy fruits, which remain on the plants until late in the winter, are about one-fourth of an inch in diameter in the commoner forms. They are globular in shape, sometimes flattened or lopsided, and with the advance of the season have a tendency to dry and wrinkle, often losing their thin I Rhus quercifolia (Michx.) Steud. The name B. tgcxnrmon has befn applied to this plant by some authors, but is generally considered to refer to the poison ivy vine (R. radicans). Rhui rdkane L. aRhus rpdbergii Small. By some authors this is considered only a low form o1 R. radicans. February 27, 1920. 446 outer coating and revealing the single deeply grooved stone which they contain. Poison ivy or poison oak in one or various forms infests practically all parts of the country except mountain elevations above about 6,000 feet and arid lands. It is found in fields, pastures, woodlands, and thickets, along roadways and streams, often also in city parks, cemeteries, and suburbs, sometimes mixed with other shrubbery in such a manner as to escape observation until attention is attracted to it by the occurrence of cases of poisoning. It adapts itself to the greatest variety of conditions, spreading through deep hollows and ravines, flourishing in dry soil and on hillsides, often spreading by underground roots from which small, erect shrubs arise, and showing the tendency to ascend trees or any support encountered in its growth. Its highly attractive foliage, which is red when the young leaves first unfold, becoming green with the advance'of mild weather, and turning in autumn to beautiful shades of scarlet and orange, has led to its being preserved to some extent as an ornamental vine or shrub, and at times to the collection of its foliage by personis igniorant of its identity and injurious properties. Many cass of poisoning result in this way. In the F)astern States, anid westward as far as Wyoming anld Texas, the Virginia creeper 1 (Fig. 6) is found generally in the ~sanie localities as the poison ivy vine, which it resembles somewhat in its habit of growth and in the shape of its leaflets. Probably becauise of this resemblance it has occasionally been reported as a source of ivy poisoning, but it is harmless to the touch and is readily dis- tiniguished from poison ivy by the fact that its leaves are dividedl into 3 to 5 leaflets to a stalk. Moreover, though it is sometimes supported by aerial rootlets like poison ivy, it has also numerous tendrils like those of vines of the grape family, of which it is a member, and its fruits, which are inedible, are blue in color, have red stems, and contain 2 or 3 seeds. Trhe fragrant, or sweet-scented, sumac, and the ill-scented sumac are Rhus shrubs with trifoliate leaves, resembling forms of poisonI ivy so closely that they may not be readily distinguished ill some instances. Both differ from the poisonous Rhus species in their flowers, which appear in dense spikes before the leaves, and in their red fruit; they also differ in the aromatic properties indicated by their names. The fragrant sumac is found in rocky woods from Canada to Florida, and westward as far as Minnesota, Kansas, anid Louisiana, wvhile the "skunk bush" occurs from Illinois and Texas westward to Washington and California, growing in dry soil. X Parthenwissus quinquefolia (L.) Planch. Z&7 Vebruary 27,1920. *NIn Sumac., Poison sumac grows in moist ground, usually in swamps or along low, miry banks of streams and ponds. It occurs from the New England States south 'as far as Florida, and westward to Minnesota, Aikansas, and Louisiana, and is known under various local names such as poison dogwood, poison elder, poison ash, thunderwood, and polsonwood. It frequently grows as a tree 10 to 20 feet high, and may attain a height as great as 30 feet, with trunk 5 to 10 inches iAi diameter; but it is more abundant as a shrub, with several slender, clustered stems. The trunk has smooth, light-gray bark, while the young twigs are reddish brown when they first appear, turning to orange brown by the end of their first year, and the older branches have the gray color of the trunk. The leaves are about 7 to 14 inches long, and consist of a slender stalk bearing 7 to 13 leaflets, arranged opposite one another in pairs, with a single usually long- stemmed leaflet at the end, those at the side being attached to the, stalk by short stems (Fig. 7). The leaflets, which are of an elon- gated oval shape, with entire margins, attain a size of 3 to 4 inlches long and 1' to 2 inches wide. When they first unfold in the spring they are of a bright orange color and ha'Ve a velvety covering of minute hairs, 'especially along the margins and underneath. This covering soon disappears. At maturity the leaflets are dark green and glossy on the upper surface, with prominent scarlet midribs, and lighter green underneath. Early in summer minute yellowish- green flowers appear in narrow clusters, about 3 to 8 inches long, growing out of the angles of the leaf stems niear the end of the,' branches, and are followed by shining ivory white or yellowish`fruits, globular in shape but somewhat longer than thick, about l inch in' diameter, rese.mbling those of poison oak and poison ivy alreadv described, and containling a single yellow grooved stone'.: The foliage turns early in autumn to brilliant red, orange, and russet shades. The leaves fall early; but the drooping, long, slender clusters of pearly fruit remain, often until the following spring, and, with the light gray bark and pointed purplish winter buds, are means of identifying poison sumac in its winter state. Those persons having little familiarity with the identity of trees and shrubs occasionally confuse poison sumac with the harmless sumacs, certain species of ash, elder, and various other shrubs and trees bearing somewhat similar foliage. They also confuse it with dogwood to which it beai's no resemblance. The poison sumac leaves are, however, readily distinguishable from all of those plants, while the difference in character, appearance, and color of the fruits is such as to enable one to exclude them without difficulty. It is well to re- I Rhus vernix L. lFebruary 27, 1920. 8_' member also that the poison sumac occurs on moist or swampy land, and in drier locations it is found only along the borders of swamps and bogs or where the ground is wet during part of the year. .Its loose, drooping clusters of -flowers, and later of ivory-white fruits, are entirely different in appearance from those of the harmless sumacs of the region in which it grows. These latter produce flowers and fruits on densely covered upright terminial spikes which are of a conspicuous red shade in the fruiting stage. Aside from conspicuous differences in form, the number of leaflets into which the leaves of the harmless sumacs are divided, which ranges from 9 to 21 and 31. in the commoner species, as compared with 7 to 13 in the poison sumac, is a further aid in distinguishing them. The statement that native forms of sumac with red fruit. are harmless should, perhaps, be qualified with respect to a rare form occasionally found from North Carolina to Georgia, and which has. been reported as poisonous by various writers and declared harmless by others. This is a low shrub 1 to 3 feet high, spreading by under-. ground roots. Its leaves are 12 to 14 inches long, and consist of about 11 broadly oval leaflets about 21inches long and lj inches wide, stemless or very short stalked with the exception of the terminal. leaflet which has a stalk three-fourths of an inch long with winged margins. Its flowers are produced in dense clusters at -the ends of branches, and its fruit is bright scarlet when ripe, and covered with fine silky hairs. A near relative of.the above-describedforms is the poisonwood or hog gum-tree of the West Indies, also known as coral sumac, which occui.s in the hummock lands of southern Florida. Its sap is said to he danigerously poisonlous to touch, and inflammation of the skini is reported to have been caused by mere proximity to tlhe plants. The plant is usually seen as a small tree, but sometimes attains a height of over 35 feet, with short trunk 2 feet thick. The bark is of a reddish brown color, separating into plate-like scales, between which the bright orange color of the inner bark is seen, and marked by dark spots caused by exudations of a resinous gum. The gum of this tree; collected by incising the bark, is employed medicinally to some extent as an emetic, diuretic, and purgative. The leaves are 9 to 10 inches long and consist of a stout stalk, thickened at the base, bearing 5.to 7 (or-sometimes 3) oval or almost heart-shaped leaflets 1 to 4 inches long. The leaflets have short stalks, are glossy green oni the upper surface and dull underneath, and have smooth.margins. The tree produces small yellowish-green flowers in clusters about 10 inches long, followed by bright orange-colored, oblong, one-stoned fruits about three-fourths of an inch long. =47 February 27, 1920. NATURE OF THE POISON. The various toxic species of Rhus apparently cause skin irritation through the same toxic principle. The nature of this poison has long been a matter of study, but it now seems to be established that it is an-oily principle, called toxicodendrol, which can be extracted from the leaves, roots, flowers, green fruits, and in fact all parts of the plant with the possible exception of the polleni and ripe fruit. Experi- ments have shown that the minutest quantities of this oil can produce poisoning. -Consequently, contact of the body with the growth, however slight, may result in the transference to the skin of enough of the poisonous principle to exert its poisonous effects. It is not necessary that this contact should be direct, as ani intermediate object can transfer the poison to the skin; for example, articles of clothing or farm implements which have brushedl against the plants may be later handled, thus giving rise. to potsoning, and the possibility of contracting it from horses, dogs, or other- animals which have been in contact with the plants should not be overlooked. While there is reXason -for believing that the nonvolatile toxicodendrol is the sole toxic, principle concerned, it was formerly sup; posed that Rhus poisoning was caused by- volatile emanations.from- the plants, and there is still much diversity of opinion concerning the matter. Apparently authentic cases of Rhus poisoning whiclh appear to have originated without direct or indirect contact with the plants have been reported. Many persons who know the plants and ares careful to avoid -them are convinced that they have been poisoned by pawing -by them or observing them from a short distance. Cases of this kind are. sometimes attributed to transference of the poison, by minute particles or other dust from the plants, possibly pollen or leaf hairs, which might be borne through- the air for considerable distance. Although it seenms to have been shown conelusively that the poison is not formed or normally contained in either pollen or leaf hairs, this does not exclude the possibility that they might take it up by coming in contact with other parts of the plant.- It is probable however, that many cases supposed to have originated in this way have actually been due to direct or indirect contact. The exact manner in which the poisoning lhas occurred may readily be overlooked, since in many instances the appearance of the eruption is delayed for several days and traces of the poison sufficient to produce injury may be conveyed by clothing or other articles long after contact with the plants. Numerous attempts to produce poisoning experimentally by emanations from Rhus plants, and from the oil itself, have been unsuccessful.: On the other hand, there is excellent foundation for the popular belief that smoke from the burning plants will give rise to irritation, and some of the worst cases of Rhus poisoning undoubtedly originate in this manner. February 27 1920. 450 Taken internally in toxic doses, the plant is reputed to have the properties of a violent irritant and narcotic poison. Cases of poisoning of children from eating the fruit have been reported. Horses and cattle eat poison-ivy foliage freely, apparently without any ill effects, at least from the relatively small amounts consumed under usual conditions. SUSCEPBITY. it has long been a matter of observation that certain individuals possess a marked degree of resistance to the action of Rhus toxin. It is not strange that they should thus come to regard themselves as immune, although there is good reason for believing that absolute immunity does not exist. Experiments with persons of this type have shown that when they are subjected to prolonged exposure, or.to.the application of the toxic principle of the plant itself, they react to some degree and are therefore not immune. That varying degrees of susceptibility to the. poison exist, there cani be no doubt; but here again we are on treacherous ground, as a person may be repeatedly exposed -without noticeable symptoms only to have his pride humbled upon a subsequent exposure. Some individuals are not ordinarily susceptible to ivy but do react to sumar.. Since the poison in the two plants is apparently the same, the difference is explained by the fact that the sumac generates and distributes the toxin in larger quantities than does the ivy. Likewise, certain individuals claim to be insuseeptible to the leaves but admit that the smoke,- which contains a finely divided but heavy dosage of the toxin, causes symptoms. The rule can be offered that whenever a large amount- of toxin is deposited upon the skin, and the person is markedly susceptible, the reaction *ill be severe, whereas if the dosage is small and the susceptibility slight, the reaction will be mild, in fact so light in some cases as to be unnoticeable. The actual contact with -the plant may occur in such a way as to cause. little or no transference of the toxin, and consequently no noticeable effects in an individual who on another occasion may be severely poisoned through acquiring a heavier dosage, particularly from freshly bruised stems or leaves. For the same reason the plants are most poisonous in the sprinig and summer when their acrid juice is abundant, although they retain their poisonous property even long after drying, and injury from old herbarium specimens is-not uncommon. Certain local conditions, such, for example, as the thiclmess of the integument, and- the state of the skin as regards perspiration at the time of exposure or subsequent thereto, may serve, however, to modify the irritation. A-fkl February 27, 1920. SYMPrOMS. The time elapsing between exposure and the earliest manifestation of symptoms varies from a few hours to 5 days or even longer, depend- ing upon the susceptibility of the individual, the degree of exposure, and the amount of resistance of the parts involved. The hands, forearms, and fce are most often attacked, as they are especially subject to exposure. The feet and legs of barefoot children, for manifest reasons, also afford a favorite site for t.he eruption. Other reions of the body, such as the trunk, the genital organs of males, or the breasts of females, often become involved either as a result of direct exposure or the conveyance of the irritant to these parts by the hands, clothing, or t.hrough bathing. A tub bath is frequently the means of disseminating the irritant to sections of the body other than those primarily affected, and the disease in excep- tional instances may even originate from contact with the clothing or skin of some other person, so that in a sense it is "catching." The symptoms of an ordinary attack of Rhus poisoning vary con- sidetably. The earliest evidence of trouble is a slight itchilg or burning sensation. As the inflammation develops, the itching and burning become more intense, at times causing marked annoyance and even disturbance- of sleep. Scratching affords partial relief, but inasmuch as the inflammation is aggravated in this way and the poison may be d'istributed to unaffected -sections, it should be re- sisted. Occasionally, patients of some phlegmatic type will be met with who make little complaint of eit.her itching or burning, but usually these are the most distressing symptoms. In severe eases, or when infection by pus germs has occurred, actual throbbing pahi may be present, especially in dependent parts. The skin eruption shows wide diversity. It may conisist merely of reddening of the involved surfaces, accompanied by swellin-g, the redness being in proportion to the degree of inflanumation. More often small vesicles, containing-serum, develop, usually in streaks or patches. The coalescence of several of these spots results in the formation of blebs, or blisters, which may cover a square inch or more of surface. When these serum-containng lesions rupture, their con- tents are discharged, producing a moist or weeping effect, such as is often seen in acute eczema. In moderately severe cases, pustules form, the pus pockets resulting from the entrance of germs which are normally present upon the skin or which have been introduced by scratching. Scab formation in the latter stages is common. Any or all of these lesions may accompany the inflammation so that the skin frequent.ly presents a decidedly angry appearance. After the subsideaee of the inflammation, peeling of the integument occurs, the layers of the skin often coming away in large patches, leaving a r,ebrua.Y-27, 1920. . Ar, denuded surface of the new skin beneath. The desquamation takes place within from a few days to a week or more after recovery, and may, in mild cases, be so slight as to escape observation. Swelling and oedema of the parts involved nearly always occur. If the tissues making up the inflamed area are lax, as for example. about the eye or scrotum, the swelling is apt to be pronounced. Quite commonly, one, or even both eyes may be entirely closed, the. ear may become twice its customary size, the lips distorted, and. other parts have their normal lines obscured. The swelling usually terminates as rapidly as it develops, and should not, under ordinary conditions, occasion undue alarm. Tn certain complicated cases, where the invasion by pus germs is particularly severe, small abscesses may form. Such cases are accompanied by enlargement and tenderness of near-by glands, by pain, fever, anid other evidences of constitutional disturbance. In rarer instances ulcers develop; complications of this character are apt to be followed by scars. Ordinarily, however, the disfigurement from Rhus poisoning is but temporary, the skin soon regaining its normal color and appearance. Occasionally when a person is exposed to the irritant at frequent intervals, a more or less chronic inflam-- mation of the skin resembling eczema develops, and the sufferer is qr!'te at a loss to know the source of his trouble. On the whole, the skin eruption resulting from Rhus poisoning does not differ materially from that caused by a number of other irritant poisons, as, for example, such chemicals as bichloride of mercury, arsenic, and certain anilin compounds con-tained in dyes. It is well to know that identical effects are also sometimes produced by urine, pus, anid other irritating bodily discharges. The seasonal- prevalence of the iniflAmmation, the history of exposure, and the fact that Rhus poisoning is much more commoin than that brought about by other agents, vill give a clue to the chara.eter of the disturbance. PTREVENTION. Much can be accomplished toward the protection of persons who come in contact withl Rhus vines, and also in preventing or lessening the disastrous effects following exposure. Toxic plants can usually be handled with impunity if rubber gloves are worn, provided none of the dust or irritating material come3 in contact with the body. Care should be exercised in removing the gloves from the hands, as they necessarily will harbor the toxic material and any contact with the skin is apt to cause trouble. After the gloves have been removed they should be thorouglhly washed with soap and water, rinsed several times, and laid away. The water in which the infected gloves are washed will naturally contain the poisonous principle, hence it may not be entirely innocuous. Ordinary thick gloves of firm texture, 453- February 27, 1920. with gauntlets to protect the wrists, may be used in place of rubber gloves, but the protection afforded is not always absolute. Inasmuch as clothing which has come in contact with the leaves may serve for an indefinite period to convey the infection, a change of garments following exposure is to be recommended, this change to include shoes, which perhaps more often than any other article are a source of indirect contagion. The anointing of the parts to be exposed with cot- tonseed or olive oil, or vaseline, is said to serve as a protective means of considerable value. The oil must later be completely removed by repeated washing. In some localities the belief is prevalent that eating poison ivy leaves in the spring will confer immunity during the year, but this seems at best a dangerous experiment and severe cases of poisoning contracted in this mannerhave been reported. In the present state of knowledge of the subject, therefore, it is believed that attempts to confer immunity by the ingestion of leaves or extracts of the plant should be undertaken only under the guidance of a physician. One of the surest and best methods of individual prophylaxis is the use of soap and hot water. It has been found that the Rhus poison after being deposited upon the skin requires a certain time for penetration, and if this penetration can be prevented, irritation and the resulting eruption will not occur. Hot water and soap act mechani- cally, and if judiciously used constitute by far not only the most serviceable preventive but also one of the best curative agents which we at present possess. The washing should be done as soon after exposure as possible. If considerabletimehas elapsed-thatis, from 12 to24 hours-thismethod should be adopted -in the hope that at least a portion of the material which has not had time to penetrate will be removed. A soft brush, or better, pieces of gauze, should be used, although there is no objec- tion to a wash rag, provided several are available. Much harm can be done with a stiff brush vigorously wielded, as in this way the minute particles of toxic material may be driven further into the superficial layers of the skin, resulting in more acute and pronounced inflammation than otherwise would have occurred. A heavy lather should be produced and the washing continued for 4 or 5 minutes. Several pledgets of gauze should beused, each being discarded in turn, in order that the poison may not be distributed by the cloth. For the same reason the water should be changed frequently, or running water used. To obviate the danger of disseminating the poison to unaffected parts, only the exposed or diseased area should be immersed, if this is feasible. After drying the area, it is well to repeat the process in 4 or 5 hours. Alcohol exerts a solvent action upon the toxin and can be siimilarly used, care being taken to flush the parts with an 1610900-20 2 ]P*bI uar:t1.920. 45.4 excess of the liquiid. The alcohol shoulId first be diluted with aa eq1 quantity of water. Ordinarily if either of these procedue is qsro. fully folk',wed, much if not al of the toxic material will be reowwd and the inflammatory reaction prevented or greatly lesened. Where the exposure has been more general, a bath for the eire body, with the exercise of the precautions mentioned, followed by- a change of clothing, is a good preventive measure. The hair shouM not be neglected. A shower is to be preferred for the reasons indi cated, but if this is not piaeticable, the water in the t-ub should be changed at least twice. Bathing, if improperly performed, may result in the appearsace of the rash on parts of the body not at first involved, althotgh this secondary eruption is usually less intense than that at the original focus. Handling of the body should be discouraged. lEven in those cases where the hands are not involved they are liable to harbor the toxin, hence it is easy to understand why their movements should be restricted. This will be difficult wnth children, and most adults wil meet with considerable inconvenience in the observance of this prohibition. Freedom of movement is without danger if the hands are properly scrubbed. TREATMENT. If the treatment previously outlined fails to prevent the develop, ment of the skin poisoning reaction, it is still possible by intelligent effort to alleviate in large measure the distressing symptoms. Before undertaking measures for relief, one should remember, howeverl that any treatment for disease is more intelligently administered by, a skilled physician than by a person unskilled i medical knowledge. It is also well to recall that what is indicated int one ease may be contraindicated in another, and that a particular stage of a disease may, and often does, require treatment which would be disastrous were it instituted at a later period. For these reasons, therefore, it is desirable in serious cases to secure competent medical advice, if such is obtainable, and to follow strictly the directions given. Where for any reason this is not feasible, the following treatment is recms mended: If the skin is highly inflamed or the eruption extensive, it i advi. able to keep the atient in bed, as rest of an inflamed part invariably hastens cure. lxure to the sun during hot weather inereases perspiration and aggravates the inflammaation, hence is to be avoided. The comfort of the patient will be increased if the clothing is thin the bedding light, and the room kept cool. Care shouild be exercised to see that no part of the clothing irritates the inflamed area.'- It i well to maintain the bowels moderately free; for this purpose a Seidlitz powder before breakfast, as necessar-r, is ben-eficial. &mmer weather diet-that is, plenty of fruit, coof drinks, and frozen des- serts-is indicated, particularly if moderate fever accompanies the 455 February 27, 1920. inflammation. Should this or other constitutional symptoms such as pain, headache, or loss of sleep, be present, suitable remedies are to e prescribed by the hysician. For the eruption itself, scores of remedies and numerous favorite prescriptions-many of which are claimed by their advocates to possess distinctive virtues, if not specific qualities-have been recommended. In spite of these claims it is necessary to state that no specific treatment for Rhus poisoning is. yet available. The very multiplicity of preparations. recommended, ranging in character from brine to brimstone, and also including the j'uice of at least 20 different plants, in itself constitutes reasonable proof of the correct- ness of the above statement. The irritation is in its nature self- limited, usually requring only a week or 10 days for its entire sub- sidence, hence it is easy to understand how numerous so-called cures have arisen. For the relief of itching nothing is better than the immersion of the inflamed surface in hot water for several minutes, gradually increasing the temperature until the water is as hot as can be borne. If the eruption ison the face, the hot water can be applied by means of a thick towel. As previously mentioned, the soap-and-water treatment is distinctlv curative in those)cases where all of the poison has not penetrated. It is better that the inflamed area should be left exposed to the air rather than tightly bandaged. If the bandages are kept moist with a solution of cooking soda or borax (a teaspoonful dissolved in a cup of water), or with other solutions to be mentioned, there is no objec- tion to their use. In any event they should be frequently changed, more especially when pus has formed, or when the secretion is excessive. Ointments, in the acute stage, should not be used; compounds with a fatty base serve to scatter the toxic oil and thus tend to aggra- vate rather thani relieve the inflammation. In the latter stages of the disease, after the toxic material has exhausted itself and a certain amount of inflammatory reaction still persists, soothing or astringent ointments are of value. Hot solutions of permanganate of potash (of 2 per cent strength if the skin is intact, but only half as strong if the skin is broken) have been much in vogue. The drug is thought to exert a direct action uponthe poisonm much the same manner as vinegar counteracts the efect of an alkali. One disadvantage of permanganate is that it stains theskin a mahogany brown ofgeater or less intensity; but this stain in timewill wearoif, or it canbe immediately removed by the application of lemon juice. A 10 per centsolution ofhyposulphite of soda, photographer's fixing liquid,applied as a wet dressing, gives in many istances bene- ficial results. A similar solution ofsulphate of magnesium, Epsom salts, is entirely harmless and allaysthe inflammation as satisfac- torilyas most other remedies. A lotion made of 1 part of the fluid extract of Grindelia to 10 parts of water, introduced as a specific, has likewise been extensively used withvarying results. Since applications of solution of sugar of lead, a favorite treatment in earlier days, generally rove disappoint after the inflammation has developed, and involve the of le poisonig if used over extensive areas, they are not recommended. If used in the early stages it Ftbiuary 27, 1920. 456 should be remembered that lead salts precipitate the toxin and thX treatment should therefore be followed by washng remove any traces of the poison thus deposited. The blebs or bliste if fully developed, should be opened with a sterile needle and the ar serum expressed with a pledget of ablorb. enft cotton. This serum is hamles and does not spread the ibfo- tion to uninvolved areas. The integument, however, should not be removed until the new skin beneath is well formed and its sensltte. ness diminished. In the late stages the application of a mild boric acid or zinc oxide ointment hasts the eure, IMPORTANCE OF YOY POISON IT. The more general destruction of all noxious vegetation is to be encouraged by every possible means. Every landowner should feel that he is in a measure responsible for illness resulting from exposure to irritating plants growing upon his premises, even if such illne or incapacity does not happen to occur among members of his own household, and he should adopt such meants as are necessary for the elimination of this dangerous material. Communities should see that poison ivy flourishing by public waysides and in parks is destroyed. It is, of course, realized that this destruction can not always be brought about in a single season, as these plants are particularly persistent in their growth, frequently springing up in diminished amount year after year even when they are supposed to be totally destroyed; but if continued effort in this direction is made, ultimate success is sure. In dealing with this problem of eradication in rural districts, it may be possible to secure the cooperation of a group of neighbors whose combined efforts will greatly enhance the effectiveness and thoroughness of the work. It is not unusual to findthat a single vine growing close to a frequented walk, or perhaps in the farmer's door. yard, is the cause during the season for many cases of suffering, and the country boy who has undergone seasonal torment from ivy poisoning can frequently vividly recall the identical vine which gave rise to his attacks. There is little reason for permitting dangerous conditions of this character to persist. The fact that clinbing vines of the Rhus family enhance the beauty of the surroundings should not stand in the way of destructive measures, as their very beauty, enticing as it is to the uninitiated, makes them the more dangerous. Since relatively few people are able to recognize the various toxic plants-and even when this recognition is possible, exposure can not always be avoided-destruction of those plants is the only sure mean of prevention. Knowledge concerning harmful plants and their identification may well be disseminated as a part of the courses of instruction in public schools. The differences between poison ivy and the har.iless Virginia creeper, and the characters by which the several forms of 457 February 27, 192& sumac may be contrasted, afford a most interesting addition to natural-science courses and can easily be made the topic of a lesson of practical value even for children in the lower grades. Considerable success has been achieved in this way in teaching children in malarious regions to distinguish between disease-carrying and nondisease- carrying mosquitoes. Lessons of this character constitute a profitable form of nature study and can be made particularly attractive even to the dullest pupil. Methods of Emdicatiol. For the removal of poison ivy it is sometimes possible to employ persons who are not readily susceptible to Rhus poisoning, but the exercise of the protective measures already suggested should enable anyone to undertake the work without injury. Those who are highly susceptible to the slightest exposures, and who on that account have special cause to fear the plants, may incur less risk by undertaking the work of eradication in late fall after the sap is out of the plants, which are then less likely to produce injury. -The means to be employed may be -determined largely by convenience. The most rapid and effective method of dealing with isolated clumps of poison ivy is simply to grub them out, taking care to remove thoroughly the running rootstocks, which, if left in the ground would soon produce another crop of the plants. In infested fields the plants may be destroyed by plowing up the soil and planting cuitivated crops. The plants can be killed by mowing repeatedly so as to exhaust the root system by destroying the foliage as fast as it appears, but to be successful, the mowing should be carried out persistently. The use of kerosene has been recommended by the Forest Service of the United States Department of Agriculture, after thorough investigation and trial, as an effective means of destroying poison ivy in situations where injury to other plants is not to be feared. In many cases one thorough wetting with this agent, applied by sprinkler or spraying pump, will be sufficient. Where the growth is so thick that only a part of the foliage is reached by the first treatment, a second application is sometimes necessary. The effectiveness of the treatment will be inereased if the soil is disked or cut up slightly so as to expose the roots to the action of the kerosene. It must be remembered that kerosene will injure or destroy all vegetation and is therefore not available for use near valuable trees. On the other hand, t.he usefulness of the soil is not long impaired, locations where the ivy has been exterminated by this method in the spring or summer being found covered with new growth of other plants by fall. Crude petroleum, which has the advantage of being less expensive than kerosene, has been found equally effective, but it is less suitable in places where it is desired to avoid prolonged detrment to the soil. Pebruary 27, 1920. 4t58 In work imdertaken by the Massachusetts Experiment Station it was found that arsenite of soda, could be. used- very successfily. to, kill poison ivy on stone walls, buildings, and along fence, and oua large trees over 6 to 1Q inches in diameter WithoQt injury tQ the trees. In these experiments a solution prepared by dsoLving 1 X 2 pounds of sodium arsenite in 10 gallons of water wa fond etiva For destroying patches of poison ivy, 10 gallons of this olution Wi. be required per square rod. It has the disadvantage of being. equally injurious to small trees and other desirable ve'getation, and may render the land useless for cultivation during a prolonged period. As the preparation is poisonous, care should be exercised to keep horses and other live stock awry from the poisoned plants. Other methods employed. include spraying with hot, brine of a strength of 3 pounds of salt per gallon of water, repeated several times during the spring or summer at intervals of 10 days. to 2. weekls or the application of strong. chemicals, such. as concentrated sul. phuric acid. The use of corrosive che-micals, however, involve a risk of injury to.the user which is needless in view of the availability of safer means of eradication. EFERlENCES. Schamberg, 3. F., The Desensitization of Persons against Ivy Poisoning: Journal of the American Medical Association, vol. 73, No. 16, p. 1213, 1919. McNair, 3. B., Poisonous Principle of Poison Oak: Joumal of the American Chemical Society, vol. 38, pp. 1417-1421, 1916. Bessey, Charles E., The Volatile Nature of the Toxic Constituent of Poison I-vy: American Journal of Pharmacy, vol. 86, pp. 112-114, 1914. Adelung, Edward von, An Experimental Study of Poison Oak: Archives of Internal Medicine, Vol. II, pp. 148-184, 1913. Warren, L. E., Some Observationfs on the Pollen of Posen Sumac: Journal of Pharmacy, vol. 85, pp. 546-549, 1913. S Rost and Gilg, Der Giftaumach, RBhs toxicodedron L., und seine Giftwirkungen: Berichte der Deutochen Pharmazeutische Ges chaft, Jahrg. 22, pp. 296-358, 1912. Stone, G. E., Effects of Chemicals and Proprietary Preparatios on Weeds: Moms. chusetts Expmt. Sta. Report, pp. 63-72, 1908. Poison Ivy: Mass. State Board of Agriculture, Nature Leaflet No. 9, 1915. Stevens and Wawren, Poison Suma: American Joumal of Pharmacy, vol. 79, pp. 499-522, 1907. Syme, W. A., Some Contituents of the Poison Ivy Plant: Johns loplin Uni- versity, Thesis, 1906. Stevens, A. B., Japanese Lac: American Journal of Pharmacy, vol. 78, pp. 53-68, 1908. Schwalbe, K., Die giftigen Arten der Familie Rhus: Mfinchener mediziche Wochenschrift, vol. 49, p. 1616, 1902. Pfaff, Fr., On the Active Principle of Rhi t eodoindon *ad R?hs venenata: Journl of Experimental Medicine, vol. 2, p. 181, 1897. Ivy Poionuing and its Treatment: Rhodora, vol. 4, pp. 43-45, 1902. Chesnut, V. K., Principal Poisonous Plants of the United States: U. S. Depart- ment of Agriculture, Division of Botany, Buletin 20, 1898. WN'hite, James C., Dermatitis Venenata, Bston, 1887. 459 February 27, 1920. A SIMPLE APPARATUS FOR OBTAINING BLOOD SPECIMENS. By JOHN W. HART, Regional Consultant, Division of Ven3reaI Diseaso3, United States Public Health Service. Several methods of securing specimens of blood for laboratory examination have been used with more or less success since the uni- versal adoption of the Wasserman and other serological reactions in the diagnosis of disease. Most of these methods have been evolved to meet special requirements, and they vary from the simple insertion of a needle into the vein and the draining of blood into a test tube, to several complicated methods devised to meet special conditions. One of the most widely known of the methods is that of Kiedel, in which a vacuum tube is used. The following method is based on the vacuum principle, but is simpler and more economical than the Kiedel tube. The apparatus is composed of the following parts: An all-glass(or, preferably, metal) stopcock about I inch in length; an all-metal syringe, 15 cc. capacity, such as those used for irrigations in ear, nose, and throat work; 3 short pieces of rubber tubing, about 1 inch in length, A-inch bore; a 16-gauge luer needle; and several test tubes of the desired capacity, drawn out at the open end to a diameter of about i of an inch (Fig. 1A). For use it is assembled as follows: The stopcock is connected with the drawn-out end of the test tube by means of one of the short sections of rubber tubing. The second section of tubing is connected with the outlet of the metal syringe, and the third section of tubing I is connected with the butt end of the _ luer needle. The apparatus is now ready for use. The outlet of the stopcock is connected with the outlet of the syringe, 0 and a vacuum is secured by pulling out U on the plunger and then closing the stopcock (Fig. 1B). The needle is then alA attached to the stopcock outlet and the XJ apparatus is ready for drawing the speci- il men (Fig. 1C). After the insertion of the needle the stopcock is opened -and the blood is drawn into the tube by the vacuum. The tube can then be sealed in the flame as is done with the Kiedel tube. The advantages claimed for this method are important and are as follows: 1. The cost is less than that of the Kiedel tube. While the initial cost may be more, the subsequent cost is only that of the containers for the specimen. A I. February 27, 1920. 460 2. If after inserting the needle in the arm and oping thopk it is found that the vein has not been tapped, the-neede can be left in place and the stopcock and tube removed while a new vacuum is swcred. Under the same circumstances with the Kiaela the tube is worthless, and failure to reach the wein, which is:g^enlly discovered ifter the tube is broken, means an extra expense together with an added discomfort to the patient caused 'by the withdaail and reinsertion of the needle. 3. Any amount of blood can be taken at one time; the amount is limited only by the size of the container. 4. There is a certainty of securmg a specimen at the first puneture, no matter how small the vein-a feature to be considered when dealing with the hypersensitive patient and those persons in whom the vein can not be punctured by ordinary methods. 5. Last, butmno least, the needle can be held firmly in place while the stopcock is opened, overcoming the great ohjection to the Kiedel tubethat the needle may be moved through the wall of the veinwhil breaking the glass, and the danger of withdrawing the needle from the vein when pulling on the plunger while using -the luer syringe method. The method here described is in use in several of the clinics of -the South, and from all reports it is proving not only entirely satisfactory, but is found to be cheaper than the Kiedel tube. The apparatus is easily cleaned and practically no attention is required to keep it in perfect condition; arnd in the larger clinics it is only necessary to have a number of stopcocks and needles.

CHILD HEALTH SUPERVISION. Owing to the growth of interest manifested in child-welfare wtivi- ties by State and local departments of health, as evidenced by the establishment of divisions of child hygiene in an increasmng-numbe&r Of those departments, it is not inappropriate at-this time to invite attention to maternity and infant welfere schemes that ar being considered or adopted in other countries. The following extracts are taken from The Medical Officer of January 10, 1920. Nursing Sdheme. In an attempt to coordinate the activities of the volunteer mrsing associations with those of the legally constituted health authorities, the following maternity and infant welfare nursing scheme has been adopted for the county of Pembrokeshire, South Wales: 1. A central committee to be formed of 12 members, 6 of whom shall be appointed by the county council and 6 by the South Wales Nursing AssociatiQon. *461 February 27, i9R* 2. Th duties of the central comihittee to be- (a) aging and dismissig nurses workng under the sche;i (b) 1eponsibility for starting new associations in di>- t*its where there am none at present; (e)l ' fr the groouping of paishe and the con- sideratio the number of nurses required for each district. 3. The county council to pay £90 per annum to each local association for each nur employed, as sanctioned by the central corn- mittec, and, in addition, a sum not exeedin £25 to each new a4so- ciation for initial expenses. The local ations to undertake to carry out the work required by the public-health committee and the education committee of the county council as scheduled. 4. The county council grants to be paid quarterly to the secretary of each loeal assoiation. Each local association to pay its own nurse or nuifsea 5. Each local asswiation to have a coimittee of not less than six members, of whom the county councillor representing the district shall be one, and alsw any alderman of the county council living in the district. 6. Each local association to 'resent a balance sheet annually to the central committee, and to send in reports of the work of the nurse as may be required by the county medical officer of health. 7. A superintendent nurse to be engaged by the central committee when the scheme is in full working order, if necessary. 9. The county council to give a grant to the nursing association for the training of nurses for work in the county. 10. For the purpose of obtaining grants from the various govern- ment departments concerned the £90 should be divided equally among the following five branches of work-namely, midwifery, public health, tuberculois, school nursing, and school visiting, and the initial grant of £25 for instruments, etc., should be charged as a maternity and child-welfare expense. Assstance in Providing Milk. In view of the large number of applications received from expectant and nursing mothers for assistance in providing milk and of preparing a scheme for supplying milk at cost price, and in view of the increase in the maximum price of same, the maternity and child-welfare sub- committee of the Swindon town council recommended the followitg schedule: (4) That not more than 1 pints of milk be provided daily, free of cost, for children under 1j years of age, where the total weekly income of the family, after deducting the amount paid for the rent of the house, does not exceed 7s. 6d. per head. (b) That not more than 11 pints of milk be provided daily at half cost for children under 1 years of age, where the total weekly income of the family, after deducting the amount paid for the rent of the house, is between 7s. 6d. and lOs. per head. (c) That the consideration of the questiQn of providing a supply of milk for children between 11 and 5 years of age be deferred for the present. (d) That not more than 1 pint of milk be provided February 27, 1920. 462 daily free of cost to expectant anti nursing mothers where- the total weekly income of the family, after deducting the amount.paid for the rent of the house, does not exceed 7s. 6d. per head. (e) That not more than 1 pint of milk be provided daily at half cost to expectant and nursing mothers, where the total weekly income of the family, after deducting the anount paid for the rent of the house, is between 7s. 6d. and 10s. per head. On approval of the recommended scheme by the ministry of health wide publicity and notice to expectant and nursing mothers is to be given by handbills and otherwise. Insrcdion. The following is a suggested list of suitable subjects for talks im- parting useful information collectively to mothers at welfare stations, taken from a report by P. Caldwell Smith, which may be found useful: Baby clothes. Indigestion in infants. Best food for Britons. Infection and disinfection. Breast feeding. Influenza. Care of the body. Infantile diarrhea. Care of the feet. Labor-aving devices. Care of the teeth, eyes, nose, and throat. Measles. Childhood insurance. Open-air schools. Chicken pox and mumps. Ophthalmia neonatorum. Clothing of infants and young children. Rashes a baby can have. Common ailments. Rickets: How caused. Convulions. Skin, The. Cleanliness of person, clothes, sur- Sunshine and fresh air. roundings. Superstitions of lying-in period; need for Day nursenes. proper nourishment. Early symptoms of infectious diseases. Tonsils and adenoids. Feeding of children from 9 months to 3 Tuberculosis. years of age. Vaccination. First aid at home. Vermin of all sorts; how to get rid of Flies. them. Food substitutes. Whooping cough. Food values. General hygiene. Habits and need for early training. National kitchens. Hay-box cooking [fireless cooker]. Organizations in this borough to help Hand-feeding. mothers and children. Housing. Work of welfare centers and how they How infectious diseases are spread. help mothers. How to wash woolen garments. What did each mother do to practice Hygiene of pregnancy. economy in war time? 463 February 27,1920. For purpose of comparison, the estimated cost of providing milk as outlined is presented. The cost of providing 1j pints of milk daily for 12 montis,, free of coot, fQr S0 children under 13 years of age (as w-ti0di par. a) would bs £568, is., and that the cost of providing 1j pints of milk daily for 12 months for 50 children under 13 years of age, at half cost (as mentioned in par. b), would b £284, 7s., 6d. T-he medical officer of health also estimates that the cost of providing 1 pint of milk daily for 12 months for 100 expectant and nursing mothers (as mentioned in clause d) would be £760, and the cost of providing 1 pint of milk daily for 12 months for 100 expectant and Bursig mothers (as mentioned in clause e) at half cost would be £380. PREVALENCE OF DISEASE.

No health department, State or local, can effectively prevent or control diease uoithot knowledge ofwhen, where, and under what tions cases are occumnrg.

UNITED STATES.

CURRENT STATE SUMMARIES. Telegraphic Reports for Week Ended Feb. 7, 1920. These reports are preliminary, and the figures are subject to change when later returns are received by the State health officers. ALABAMA. cAUwouNA-continned. Cases. Cerebrospinal meningits ...... 2 Smallpox-CntInued. Cases. Chicken pox ...... 11 Los Angeles County . . 5 Diphtheria ...... 18 Martinez ...... 8 . Influenza ...... 2,366 Marysville ...... 4 . . M laria ...... 1 Riverside County 9 Measles ...... 20 Sin Francisco...... 23 Mumps. 2 Typhoid fever...... 4 Pneumonia (all forms). 42 CONNECTICUT. Scarlet fever...... 10 Smallpox...... 29 Cerebrospinal meningitis: Tuberculosis (pulmon y)...... 14 New Haven...... 1 Typhoid fever...... 4 Chicken pox...... 41 'Vhoopin.g cough...... 17 Conjunctivitis...... I Diphtheria: ARANUS. Fairfield County-Bridgeport. . . 12 Chicken pox...... 21 Hartford County-Hartford ...... 19 Diphtheria...... 3 New Haven County- Hookworm...... 1 New Haven...... 5 Malaria...... 16 Waterbury...... 6 Measles ...... 25 Scattering ...... 24 Ophthalmia neonatorum ...... 1 Influenza: Pneumonia ...... 12 Fairfield County...... 676 Scarlet fever...... 1 Hartford County ...... 411 Smallpox...... 10 Litchfield County . . 98 Tubercuosis...... 5 Middlesex County .. 94 Typhoid fever...... 7 New Haven County...... 824 Whooping cough...... 7 New London County ...... 362 Tolland ...... 9 CA rORNA. County Windham County ....i...... 297 Cerebrospinal meniWitis: Lethargic encepalitis .. 2 Oakland...... 1 Measles: San Francisco...... 2 Fairfield County- Influenza ...... 7,420 Bridgeport...... 10 Leprosy: Danbury...... 9 Santa Clara County .. 1 Norwalk...... 4 Pellagra...... 1 Stamford...... 19 Smallpox: Hartford County- Chico ...... 8 East Hartford .. 4 Kings County...... 5 Enfeld ...... 27 Long Beach...... 9 Hartford...... 10 (464) 465 February 27, 1920.

CON N -ontlawd. OlRDA. Cases. YMeas Continued. Diphtheria 3 1 Eatford County-ontinued. Dyentery ...... Influenza .... ,420 New.Brtain. 5 Plainville...... 21 Malaria ...... 6 Pneumonia ...... 67 gton..... 15 LAtciftel County- Smallpox ...... 7 Typhoid fever ...... 4 North Canrat ...... 4 Winhester ...... 19 GEORGI. 26 New Haven County- Chicken pox ......

A nson ...... 28 Conjunctivitis (acute infectious) ...... 3

Hamn...... 13 Diphtheria ...... 7 New HEavenn...... 48 Dysentery (amebic) ...... 1...... New London County- Dysentery (bacillary) ...... East Lyme...... 4 Favus ...... 1 New London...... 13 Garman measles ...... 2 Norwich...... 15 Hookworm 74 Influenza Scattering...... 28 ... 7,809 Mumps...... 29 Malaria .. 9 Pneumonia: Measles ...... 2...... 29 Fairfield County- Mumps ...... 6

Shelton .. . 15 Pneumonia 167 2 Stamford ...... 6 Poliomyelitis ...... Iartford County- Searlet fever ...... 14

Bristol ...... 4 Septic sore throat...... 10

canton ...... 6 Smallpox ...... 12

Hartford ...... 11 Tuberculosis (ptulmonary) ...... Manchester...... 6 Typhoid fever ...... 14 New Britain...... 12 ,Whooping cough ...... 16 New Haven County- niNOIS. Hamden 4 Meriden 9 Cerebrospinal meningitis: Chicago ...... 4 Waterbury...... Naugatuck. 17 Diphtheria: New London County- Chicago ...... 128 Groton...... 7 Evanston ...... 6 Scattering ...... 60 Now London ...... - 22 Influenza: Norwich ...... 17 Chica ...... 597 Windbam Conty-Putnam... 19 Scattering ...... ,640 scattering ...... 29 Lethargic encephalitis: Paiomyelitis-Woodstok...... 1 Chicago ...... 4 Scalet fever: Hartford County- Compton ...... Decatur ...... 1 Hartford 7 Pneumonia: New Britain ..... 8 Chicago ...... 257 Windsor...... 9 Scattering ...... 313 New Haven County- Scarlet fever: New Haven ...... 4 Chicago ...... 235 W tbury...... 28 Quincy ...... 7 Scatteing...... 24 Riverside ...... 4 sore throt...... 1 &ptic Woodstock ...... 8 Tuberculois ...... 38 Scattering ...... 65 Wbhoping cough - ....-.. - - - . -- i - 51 Smallpox:

Chicago ...... 5 DELAWARE. Hancock County-Pilot Knob Town- 2 Chicken poV ...... ship ...... 1 Diphtheria...... Jacksonville School for Deaf ...... 7 Influenza...... 43 Kendall County-Fox Township ...... 5

fses...... 70 Scttering .... 44 2 9 pB..ps...... Typhoid fever ...... 12 Pneumonia...... INDIANA. Scarlet fever: Laurel...... 5 Cerebrospina! meningitis: Wilmington...... 1 Elkhart County ...... 2 Smallpox...... 1 Diphtheria: Tuberculosis ...... 2 Lalke County ...... 13 Whooping cough...... 4 Scattering ...... 19 February 27, 1020. 466

INDIANA-conlinued. iowA-continued.IOWA--CQU&MU9Q. Influenza: Cases. l'ollomyclitis:P'oliomyclitis: Cases.CAM. I Clay Counly ...... :.,£o0 Van Buren County ...... I

Grant County ...... 313 ScarketSmiliet feocr:fercr:

Hendriclks County ...... 2.-5 CouncilCo-ancil Bluffs...... 5

Jennings County ...... 158 Des Moines ...... 5 4 MZsr-in County ...... Hamilton County ...... 4 Owen County ...... Scattering ...... 35 Putnam County ...... Smallpox:

Wabash ...... 23 County 129 Davenport ...... 23 Wells 12 County ...... 672 MaonMam Citycity ...... 12

White ...... 8 County 147 Story County ...... 8

...... 28 Scattering ...... 1,624 Scattering ...... 282 Measles: 'W'hoopingW'hooping cough ...... 2 Bartholomew County...... 18 Delaware County...... 58 KANSAS. 177 Grant County...... 16 Diphtheria ...... 177 InfluemaInfluenza ..... Greene County...... 26 ...... 10,02685 ScarletfeverSmletfever...... Jay County...... 23 10.285 Lake County...... 14 Smallpox...... 102 Marion County...... 109 LOUIANA.LOUMANA. Switzerland County...... 20 meningitis I Vigo County...... 29 Cerebrospinal meningtis...... 9 Wabash County...... a8 Diphtheria ...... 3 1539 Wayne County...... 26 Influenza...... 315344 Rabies in anima'-s: Pneumonia ...... 448 Greene County...... 1 Searletfever ...... 458 Scarlet fever: Smallpox ...... 45 fever 7 Allen County...... 4 Typhoid fever ...... 7 Bartholomew County...... MAINE.MMNE. Carroll County...... 8 25 pox Clay 4 Chicken pox ...... 25 County...... 6 Elkhart County...... 17 Diphtheria...... 6 Floyd County...... 5 Influenza: 171 Grant Coumty...... 4 Bath ...... 171 103 Kosciusko County...... 6 Fa-.mingtonFa&.mington ...... 103 12o Lake County...... 12 Freeport ...... 1W Jo5 Marion County...... 24 HalloweUHallowell ...... 105 105 Monroe County...... 4 Lake-viewLakeview...... 105 120 Shelby County...... 4 Mount Desert ...... 120 100 St. Joseph County...... 9 Oldtown...... 100 Tippecanoe County...... 6 Paris ...... 176 100 Wabash County...... 10 Presque Isle ...... 100 148 Warrick County...... 4 Sanford ...... 148 40,3 Scattering...... 45 South Portland...... 403 150 Smallpox: Van Buren ...... 150 ...... 1,901 Delaware County...... 6 Scattering ...... 1,901 Grant County...... 4 Measles: 14 Lake County...... 4 Lebanon...... 14 41 Marion County...... 8 NoTthNorth Berwick ...... 41 9 Putnam County...... 5 Oxford ...... 9 7 Spencer County ...... 7 MumpsScattering ...... 377 St. Joseph County...... 7 Mumps...... "I , 37 Pneumonia 139 Vanderburg County...... 6 ...... 139 Wabash County...... 26 Scarlet fever: 10 White County...... 11 Norway ...... 10 4 Scattering...... 26 Presque Isle ...... 4 12 Scattering ...... 12 IOWA. smalapoxSmallpox...... 44 Chicken pox ...... Tuberculosis...... 44 Diphtheria...... 18 Typhoid fever...... 6 IMuenza ...... 869 TyphoidWhoopingfevercough ...... 176 Measles: Whoopingcough...... 17 Ackley ... .. 4 ...... MARYLAND.1 Council Bluffs...... 6 Chicken pox ...... 62

Scattering ...... 8 Diphtheria ...... 51 Mumps...... 4 Germanmeasles ...... 5

Pneumonia...... 6 Influenza ...... 4,758 I Week endedDiphtheriaGermaLanFriday.measift...... 515 InfluenzaChickenpox...... 4,75862 467 February 27, 1920.L

etnue Caj. NEW YoRK-continued. Cases. L iWar...... -.~ . Diphtheria ...... 169 5 Influenza ...... 11,304 ...... ,,...... ,. ;34a1 Measles:

1 Westchester County ...... 225

Opthenwa ...... ;...... PellagraI..... L Scattering ...... 653 (l I Pneumonia eum ..m...... I3S ...... 1,689 15 Poliomyelitis:

. Rochester .sor...... 5ri ...... I Scarlet fever ...... 194

Trachoma...... I Smallpox-Buffalo ...... 4 T belosis...... 47 Typhoid fever ...... 9 Typhoid fever...... Whooping cough ...... 186 Whooping cough...... , ...... NORTH CAROLINA. MJNNESOTA. Cerebrospinal meningtis ...... 3 Cerebrospil meningitis ...... Smallpox...... Chickenpox...... 51 Diphtheria ...... 23

MONTANA. Measles ...... 104

Pneumonia (all forms) ...... 455 Cerebrospinal meningitis ...... 1 Scarlet fever Diphtheria ...... 2 ...... 23 Septic sore throat ...... 2 Influenza ...... 1,400 Smallpox ...... Pneumonia ...... 18 0oo Typhoid Scarlet fever ...... 36 faver ...... 3

Smallpox ...... 28 Whooping cough ...... 95

Typhoid fever ...... 1 VERMONT. NEBRASKA. Chicken pox...... 10 Chicken pox ...... 18 Diphtheria ...... 4 Cerebrospinal meningitis ...... Influenz3 Diphtheria.: ...... 1,314 Measles ...... 95

Omaha ...... Mumps...... 56 Scattering ...... 8 Pneumonia ...... 5 Influenza ..... 3, 27 Scarlet fever ...... Measles: . 7 Typhoid fever ...... 3 Benkelman...... 7 Whooping couigh ...... 31 Lexington ...... 7 Lincoln ...... 39 VI'RfGrNM Omaha Smallpox: ...... 12 Scattering ...... 4 Bland County, several...... 4 Giles County, several. Mumps...... 13 Pneumonia ...... 6 Southampton County ...... 1 Scarlet fever: Stafford County, several.

Dalton ...... 14 Washington County......

Elgin ...... 4 Wise County, several. Lincoln ...... 5 WASIITON. Omaha ...... 32 Chicken pox...... 76 Scattering ...... 22 Smallpox: ~pwhtlwria...... 17 Influenza...... 4,596 Brownville ...... 16 Measles ...... 26 Chappell ...... 5 Mumps. , .... 72 Lincoln ...... 30 Pneumonia ...... 256 Omaha...... 10 Scarlet eover ...... 80 Sidney ...... 5 Smallpox...... 166 Scattering ...... 4 Tbereis4 ...... 4 Whooping cough ...... Typhoid fevor..... 3 NYEW ;BROW. Whooping cough .31

ufluena..... 2, 79 WEST VIRGIA. Measles: Unusally prevalent through the Diphtheria ...... 15 State. Measles: Pneumonia ...... 850 Wheeling. 36

NEW YORK. Scattering. 3 Scarlet fever: (Exclusive of New York City.) Grafton... 4 Cerebrospinal meningitis: Scattering. 8 Aurora ...... 1 Smallpox: Larchmont ...... Beckley. 8 Mamaroneck...... 1 Huntington. 4 February 27, 1920. 468

WEST VIRGIA-ontinued. wwCoNS--continued.

Smallpox-Continued. CCses. Milwaukee-Continued. Ceae.

Salem ...... 14 Tuberculosis ...... 22

...... 3 Scattering Whooping cough ...... 42 Typhoid fever ...... 3 Scattering:-

Chicken pox .8...... s

Diphtheria ...... 16 WISCONSIN. Influenza ...... 6,247

Milwaukee: Measles ...... 387

Cerebrospinal meningitis ...... 1 Ophthalmia neonatorum 1...... Chicken pox ...... 39 Scarlet fever ...... 139

...... 17 Diphtheria Smallpox ...... 93

Influenza ...... 27 Trachoma ...... 1

Measles ...... 28 Tuberculosis ...... 13

Scarlet fever ...... 38 Typhoid fever ...... 5

Smallpox ...... 12 Whooping cough ...... 67 Kentucky Report for Week End'd Feb. 14, 1920.

Cerebrospinal meningitis: Cases. Measles -Continued. c mes. Clark County ...... Fleminin Ccunty...... 15 Jefferson County ...... 1 Harriscn County...... 25 Kenton County ...... Jackson County...... 14 McLean County ...... 2 Kenton County...... 40 Owsley County...... McCracken County ...... 15 Chancrold ...... 2 Owsley County...... 76 Chicken pox ...... 55 Simpscn County...... 19 Diphtheria: Todd County...... 10 Jefferson County...... 12 Scattering...... 92 Scattering ...... 17 Mumps...... 19 Dysentery ...... 2 Ophthalmia neonatorum: Erysipelas ...... 1 Jefferson County...... 1 Gonorrhea ...... 65 Pneumonia:

nluenza: Boyd County ...... 12

BellCounty ...... 108 Hardin County...... 10

Boyd County ...... 338 Jefferson County...... 57 Caldwell County ...... 120 Sattering...... 173

Campbell County ...... 125 Scarlet fever:

Carlisle County ...... 166 Campbell County...... 4

DaviessCounty ...... 106 Graves County...... 7

Frankllin County ...... 347 Scattering ...... 25 Grailt County ...... 123 Septic sore throat ...... 7 Graves County...... 128 Smallpox:

Harrison County ...... 194 Bell County ...... 7 Jefferson County .53...... 3 Hopkins County...... 8

Kenton County.156...... 1 Knox County ...... 12

Larue County ...... 143 Lincoln County ...... 4

Lawrence County...... 191 McCracken County...... 29 Lincoln County ...... 112 McLean County : 29

Mason County ...... 194 Pike County ...... 5

Meade County ...... 199 Whitley County...... 10

Pendleton County ...... 120 Samttering...... 12

Woodford County ...... 127 syph ...... 31 Scattering ...... 2,537 Tonsillitis ...... 15 Ma ia ...... 2 Trachoma...... 11 Measles: Tuberculos...... 37

Barren County ...... 14 Typhoid fever...... 17

CampbellCounty ...... 44 Whooping cough...... 42 469 F'ebruary 27, 1920. SUMMARY OF CASE REPORTED MONTHMY BY STATES. Tables showing, by coun the repartel cases of cerebrospinal meningitis, ria, pellaira, polio myets, smallpox and typoid fever ire publsel under the name of these diseases. (se names of these and other diseases In the table of cntets.) The folowing mothly State reprt incude only those which were receivel darin- the current week. Thse reports appear eaeh week as reeived.

State. .0. 10 .&2 I. 0 c .4A I- 042 20 10 Ariona (January, 1920) ...... 2 8 160 1...... 4...... 1 111 .i17 1 *Cabfmrnla (Doember, 1919) ...... 7 425 1,743 2 341 38 343 Colorado 55 1...... 44 ...... 82 7 (December, 1,..... Delaware (January, 1920) ..... 41 - '300 ...... 28 16 4 Fnury, 1920) ...... 7 81 2,057 116 53 4 17 ...... 47238 11 629 (ecember, 1919) ...... 9 1,27 668 68 1,827 ...... 1,8851 165 LouIsiana (January, 1920) 91 968 58 57 4 1 '35 1 ...... 44 23 ..... 399 14 Maryland (January, 1920. 2 339 4,057 1 992 ...... 3 39 3 977 Michigan (Jamuary 1920) ...... 882 ...... IW ...... 3,640 ...... 478 48 208; Minnesota (Decemi 1919)...... : JS 363 ...... 441 ...... 2 397 45 192) .3 61 2,988 41 ...... ,358 538 7

New Mexico (January, 1 51 335 ...... 135 ...... 1* 60' 102 15

...... 4 72 ...... 11 115 .... 1 Rhode Island (January, 1920) 147 1,170 ...... 72 Vemont (January, 1920) ...... - 41 '1181 487 ...... 1. 12 ...... 1 135 Wrest VIrinia (January, 1920) ...... 10 287 3,536 184 ...... 283 431 RECIPROCAL NOTIFICATION. Minesota-December, 1919. Cases ofcaminunicable di8eases referred during December, 1919, to other State health departments by department ofhealth of the State q/f Minnesota. Disease and locality of notification. Referred to health authority of- Wlihy referred. Tt'beretulils: Mayo Clinic, Rochester, Lemoore, Kings County, Calif...... 5 advanced. Olmsted County. Decatur, Macon County, Ill...... 11 moderately advanced. Sheldon, Iroquois County, Ill...... Wheaton, Dupage Co., Ill...------I apprnl cured. Story City Story County, Iowa..... 1 apparently arrested; left Mayo Decorah, *inneshekCounty Iowa. cLifor homes. Hanltwn, Worth County, iowra. Brooks, Adams County, Iowa...... Charles City, Floyd County, Iowa... Mfissoulassoula County Montt... Billing, 'Yellowstone Co ifont..... Wase WayneCount Rebr...... 11u7,Iorton Coun~ty, k. Dak ...... Arthur Cass County, N. Dak...... 9prngeld, Clarkc County, Ohio.. Hayti, Hamin County, 1. Dak. Platteville, Grant County,Wis.. Lysite Fremont County, Wyo...... City andCounty Hospital, Siouxc bity, Woodbury County,Iowa. Left hospital for his home in Sioux Ramsey County. City, Iowa. Jamestown, Stutsman County, N,, Left hospital for his home in James- Dak. tow, N. Dak. Thomas Hospital, Minne- Cogswell, Sargent County, N. Dak... Letfthos ital for his home at Cogs- apolis,HennepinCotnty. well S.Dak. Philadelphia, Philadelphia County, LFeft hospital for her home in Phila- Pa. Sandusky, Sauk County, Wis..... Left hospital for his home at San- dusky, Wis. Typhoid fever: Redwood Falls, Redwood Chautauqua, Chautaulua County, Was living at home in Chautauqua, County. N. Y. N. Y., 3 weeks previous to first symptoms. St. Paul Hospital, St. Buffalo, Cass County, N. Dak...... Taught school at Buffalo, N. Dak., Paul, Ramsey County. 3 weeks previouis to first symptoms. Diphtheria: Blooming Prairie, Steele Chicago, Cook Couinty, Ill...... Came to BJloominy Irairie from Chiecago to spendThristmas vaca- County. tion. BSmlpox: Tra Estherville, EmmetCounty, Iowa... Came to Redpath Township, from Redpatbh Township, 1919. verse County. -1 Estherville, Iowa, Dec. 27, 1610900-20 3 Februar 2T,129. 470 -ACTJOMYCOS& Illinob Rewt for D _eber, 1919. During the month of December, 1919, one case of actinomycosis was reported in Illinois. ANTHRAL

Philadelphia, Pa.-Week Ended February 7, 1920. 4 During the week ended February 7, 1920, one case of anthrax was reported at Philadelphia, Pa. CEREBROSPINAL MENINGIS. State Reports fw December, 1919, and January, 1920.

New cases 1Nwms IPlace. reported. || Place repote&.

______.i , Arizona (January, 1920): Louisiana-Continued. Coconino Coumnty...... 1 Evangeline Parish...... 1 Gila County ...... 1, Frarnklin Parish...... 1 LaL., eIte Parish...... 1 Total...... 2 Natchitocees Parish...... 3 Orleans Parish...... 3 California (December, 1919): Rapides Parish...... 3 Fresno County- Fresno...... 1 Total...... 1s Glenn Cotmty...... 1 Los Angeles County- Maryland (January, 1920): Los Angeles...... 1 Baltimore ...... 2 San Francisoo...... 4 Minuesota (December, 1919): Total ...... 4 Hennepin County- Minneapolis...... 2 Colorado (December, 1919): Robbinsdale...... 1 Weld County...... Lake County- Two Harbors...... 1 Florida (January, 1920): Murray County- DuvWal County- Ioa Lake.-.. 1 Jacksonvile...... Eseaznbia County...... Total...... 5 Hillsboro Coumty ...... 1 Tampa...... 1 Nebraska (January, 1920): Lafayette County ...... I Saline County...... 3 Pasco Coumty ...... I Pinellas County.------1 New Mexico (January, 1920): Hidalgo County ...... 1 Total...... 7 Rhode islAnd (January, 1920): Illinois (December, 1919): Cumberland (town)...... 1 Cook Coumty- West Warwick (town)...... 3 Chicago ...... 2 Harve ...... Total...... 4 Franklini ('ollnty- West Frankfort . . Vermont (January, 120): Montgomery County- Washington County- Litchfield...... I Northfield...... 1 Peoria Cotnty- Hollis Township ...... West Virginia (January, 1920): Peoria...... 1 Favette County...... 1 St. Clair County- GrnbrierC-ity ...... 1 East St. Louis...... 1 Jackson County ...... 2 Mascoutah...... Kanawha Comnty ...... 1 Marion Coumty...... 1 Total...... 9 Mercer County ...... 1 Pleasants County ...... 1 Louisian3 (January, 1920): Ritchie County ...... 1 AUnParish...... I Wetzel County 1 Bossier Parish ...... Calasieu lParish ...... 1 Total...... is 471 February 27, 1920. CEREBROSPINAL MENINGMS-Continued. City Repo for Week Ended Feb. 7, 1920.

Pbce. Cassm. Deaths. Plaoce. Cases. Deaths.

Appl, Ws. 1 I...... Minnepolis, Minn...... 1 Attleboro, Mss... 1 New York, N. Y...... 7 3 BaltInore Md...... 1 N...... 1 Bufalo, . N4. y...... Chleao,I ...... 1 Portland, Oreg...... 2 ...... Dallas, Texc.:...... 1 Race, Ws...... 1 ...%...... Detroit, MIch...... 1 Sacramento, Calif...... 1 ...... lint, Mch...... 1 Salt Lake City, Utah. 1 ...... Galveston, Tex...... i San Francisco, Calif...... 3 Gary, Ind...... Wausau, Wis...... 1 Kansas City, Mo...... Worcester, Mass ...... 1...... LO Aneles, Calif ...... 1 ...... Wilkes-Barre, Pa...... 3tlwaukiee, Wis...... 1

DIPHTHERIA.

See Telegraphic weekly reports from States, page 464; Monthly summaries by States, page 469; and Weekly reports from cities, page 494. INFLUENZA. State Reports for December, 1919, and January, 1920.

1'lce. New ses New cases reported. Place. reported

Il - '.I California (December, 1919): Illinois-Continued. Alameda County- Aklexandria County- Oakland ...... 2 Thebes...... Butte County- Delta...... 2 Chico ...... 1 Bond County- Fresno County- La (irange Toqwnship...... 2 Firebaugh...... 1 Boone County- Selma...... 1 Belvidere...... 1 Clenn County- Bureau County- Orland ...... I Buda...... 3 Humboldt Cctnty- ('arroll County- Eureka...... S1 (Chadwick ...... 6 Imperial County- Mount Carroll...... 2 El Centro...... 9 Champaign County- Kern County ...... 2 Champaign...... 4 Taft...... 5 Homer...... Kings County...... 9 Christian Conmty- Los Angeles County...... 6 Assumptioh...... Long Beach...... 2 Clay County- Los Angeles...... 20 Louisville...... 10 San Fernando ...... I Clinton County- Monterey County- Breese...... ing City ...... 4 Germantown...... Orange County...... 2 Cook County- San Bernardino County- Chicago ...... Ontario ...... 1 Evanston . .... San Bernardino...... 1 LaGrange . San D,ieo County- Moss Point .I 3 8an-iep ...... Lyons ...... Santa Barbara County- Oak Park...... 7 Santa Barbara...... 4 Dewitt County- Santa Clara County...... 1 Clinton...... Siskiyou Couty- Dupage County- ?ort Jon ...... Wheaton...... 4.; 37 Sonoma County...... Effingham County- Tulare County- gham...... 2;;6 Lindsay...... 1 Montrose...... 5 Yolo County-...... 2 St. Francis Township...... Davis...... 1 Fayette County- Winters ...... 1 Brownstoun ...... San Francisco...... 17 Ford,Countv- Township ...... 2 Total...... ill FrankliRogersCounty- Illinois (December, 1919): Cave Township...... Adams County- Hancock County- Quincy...... Augusta...... February 27, 1920. 472 INFLUENZA-Coutinued. State Reports for December, 1919, and January, 1929-Continued.

r 7-B New caseS New cases Pisafe. reported. l'lace. .eaw * ---~~~~~~~~~~~~~~~~~~~~~I;- linois-Continued. Illinois-Continued. Henry Coutntv 4 Sangamon Count-y- Cambridge...... 4 Springfield ...... '. 4 Orion. 2 S&ott County- Iroquois Cotunty- Bluffs...... I Milford...... 1 Naples ...... 2 Jackson Cotunty-- Shelby Couinty- Grand Tower. 1 Cowden...... 1 Jasper County- Shelbyville...... 10 Rose liilL. I St. Clair County- Jefferson C'ounty-- Caseyville Township. i McClellan Township... 4 East St. Lotus ...... 26 Waltonville.------3 Stites Township...... 6 Johnson Cotyty WStark Cotmty- Cyp,)ress.s------1 La Fayette...... 15 Vienna.------2 Wl omin g.....o.....-.-.t' 2 Jo lDaviess County- Stephenson County- Apple River ...... 2 ~ 2 Kane Couinty-- Ridott Township...... 8 Batavia 6 Tazowel ...... 1 Cuty Mtaple P1ark.------Pekin ...... 4 Sutgar (Grove Towniship..... 1 South Pekin1920): ...... 2 aikakiee (County - ITllion County...... -... 28 Mtanteno ...... Reynolds Precinet...... 4 Saline Towntship ...... 2 V i isonC nty ...... 1 St. Amnc Precinct...... Sidell.Mee. ... 6 Kendall Cotunty- I Whiteside C oumty- Fox Township ...... SterlingEureka.------...... 2 Knox County-- WilloCounty- Oneida.------11 Peotone ...... 5 Lake Coumty- MSoke,a...... 1It Zion City...... 4 Lawrence County- WiCimson County- Russellville...... 6 Car terville ...... 2 Lee County- GranvisRe...... t.. 3 Ashton Townshil ...... 2 Winnebago County- Livingston Count.y- wixnebago...... 2 Chatsworth...... 8 eoodford County- Chatsworth Township...... 5 I IE:llrekQa ...... 1 Forest Township ...... 2 urlalesticTowns .p. 3 Logan County- See ...... 1 Lincoln ...... 1 Total...... 668 M1cLean Coumty- BIelleflower Towslhiip...... Malrylanid (Janmiary, 1920): Empire Township ------. 2 lialt;imove ...... - 2,288 Macon County- .Calegans County- Argenta...... 2 Cumnberland...... 94 6 Rural districts ...... 42 Decatur.------Maeoupsm County - Camp Heade Po....i....Grou 113 1 Doine Arindel County- Palmyra ------Virden ...... AnDapoll ------5 Aadison County--- Ruraldistriets ...... 32 Bethalto...... 4 IlrltimoreCounty- New Dotiglas ..-- .-- ...... 1 Ruiraldistricts ...... 263 ISason County- CarrolleCounty- Friends Creek Township .... Westminster ...... 41 Mason City...... Iuramdistricts ...... 83 'Marshall County-- Calvert Cowamty- Steuben Township...... 911 Rturaldistricts ...... 13 Sparland...... Caroline County- Menard Comty- - 91, Rural distric.s...... 8 Tallula...... 2 CecilCounty- Mercer County- Rural districts ...... 5 Windsor...... t ..... Charles County-- Ogle County- Ruralditricts ...... 119 Mount Morris Touwnship .... 1! Indian Head 1l'roving Ground.. 4 Peoria County- Dorchestercounty- Brimfield ...------.. i1 Cambrde...... 1 Peoria...... -...... Rural districts ...... 9 Pike County -- rFrederickc County-- Alton Townr.lii)p...... 11 Frederc ...... 13 Hull...... Ruml districts ...... 75 Plensant Vale Township...... G;arrett om - Putnam County- R ml ...... 25 Greenville Township...... HarfordCounty- Rock Island County- Bel Air...... 2 Rock Island...... Ruraldistricts...... 36 Saline County- Howd coutmr Carriers Mills...... RuraldistUits...... 6? 473 February 27, 1920. INnUENZA-Continued. State Reports for December, 1919, and January, 1920-Continued.

NewCaSeS Neweases Plae. reported. P'lace. reported.

1 _ - Maryland-Continued. Minnesota-Continued. Kent ony Crow Winlg County- 1 Riral districts ...... Crosby...... Montgomiery County- ('oodhue County- Rural districts...... 380 Cannon Falls...... 1 George County- I Hennepin County- Prince Ruraldistricts ...... 198 Minneapolis...... 7 Queen Annes County- Isanti County- Rural districts...... Isanti Township...... 1 Somerset County- Kittson Connty- Crisfield...... 1 Kennedy.. 3 Rural districts ...... 6 Lyon County- St. Marys County- Cottonwood...... 1 Rural districts...... 8 Morrison Countv- Washington County- Little Falls...... i1 Hagerstown...... 93 Swanville...... Rral districts ...... 8 Platte Township...... Wicomico County- rtamsey County- Salisbuiry..------2 St. Paul...... Rural districts ...... 5 Stearns County- St. Cloud . 1 Total 4,057 Holding Township...... 2 _~ Stevens County- Minnesota (December, 1919): Chokio...... 1 Aitkin County- Todd County- Clark Township...... 1 Ward Township ...... 4 Cass County- Remer...... I Total...... 36 ______I - I' City Reports for Weeks Ended Jan. 31, and Feb. 7, 14, and 21, 1920.

Cases wreek ended- jDeaths *eek ended-

I'lace. Jan. Feb. Feb. Feb. Jan. Feb. Feb. Feb. i31- 7. 14. 21. 31. 7. 14. 21.

Adams Mass. ...,--.-!-...... 72 50 Ohio 120 134 251 7 9 Allameda Calf 17-0 260 201 2 65 26 ...... Alemandis Na. 9.I lliac e, 166

...... AlpApea bch...... 1- 10 9 ---39 ------..6 ------116 amsu-,t l ...... 'Uton ~~~~~~272 428 6is 97 Anacondi, Mon.t ...... 45 2 5 :...... 2...... ?...... Anderson,Ind 25 ....;...... Ann Arbor, Mch. 267 152 2 30 69 67 ...... 73...... Anniston, Ala ...... ,~i3 !...... 97 363 215 Ansonia, Conn...... i60~~~6 5 74 -- ...... f Appleton, Wis ...... 90 81 ...... 1 1 ...... 11 Arington, Mass 52 68 ...... i66...... -----...... oo**-39 ~~~~~...... 19-@ii AsburyPark, N. J 20 23 1 1o@ivv*** Ashlsad Ky 28 131 253 258 ...... 33 2 6 AshtabuN, Ohio 117 121 21 1 4 Atlanta, Ga 242 1,868 2,258 1)427 11 16 50 74 50 t ...... i. l Atlantic City, N. J ...... 50 39 '22 Attleboro mass 46 117 29 15 ...... - Auburn, Me 6 24 33 ------..- ...... Auburn, N. Y 5 90 ...... 18----1------0- - ...... Austin, Tex.. Baltinore id...... 1 1.. 1 ;3,412 4,530 1,614 14 44 -3 l '5 Bangor iie ------. '49 '193 ,,,,,,,,.,,, ...... Barberfon, Ohio - 7 2 1...... BarreVt-- ...... BatoWn Roe L .... 111 .1 Battle c...... 168 31 ...... Bayonne, N. J .--- 108 77 Bearice, Nebr 15 171 16 ...... -...... ----- Beaumont, Texc...... ! ~~74 ...... --. 4i 6 ...... N.J .. 42 29 ...... t,is... 989 .... .I ...... February 27, 1920. 474 INFLUENZA-Continued. City Reports for Weeks Ended Ja. 31, and Feb. 7, 14, and 21, 1920-Continuied.

Cases week ended- Deaths week; ended- P'lace. -I Jan. Feb. Feb. Feb. Jan. Feb. [Feb. Feb. 31. .. 14. 21. 31. 1 7. 14. 21. _- -1

Beiiton Harbor, Mlich. O ...... 1500 2 ...... Berkeley, Calif...... 26 385 347 6 ...... [4 55 66 ...... I Beverly, Mass...... 15 .. Biddeford. Me..------...... Billings, Mfont ...... 31Dl 53 8...... Birminigham, Ala...... 2417 ...... 444. I 27 Bloomfleld, N. J...... 1 11 12 3 ...... 2F1 Bloomington, 111...... 3 201 80 ...... is1 Bloomingtoi, Iid..(. 2 ...... 38 52 21......

W. Va...... 5 100..... 137 81 ...... Bluefield, .6...... *139 j 19 Boise, Idho...... 15a 45 53 ...... 1. Boston, Mass...... 1,606 2,,59W . 2.113 760 w 191 Brazil, Iiid...... 1 2 157 116...... 11 *1 Bridgeport, Conin...... 406 649 437 287 ...... _.1 .24...... Bristol, Coun...... 45 95 158 46 II 1 Brocktoii, Mass ...... fiO 45 8...... 4 Brookline, Mass...... i4 4i6 72 33...... 4 ...... -...... Brunswick, Ga...... 8 iS 4 92...... 1 Bufalo, N. Y...... 470 1.260 1,333 ...... q, 81 I Burlington, Iowa...... 95 5 28 5...... 2 Burlington, Vt...... 2 1 12 24. 3 Butler, Pa...... 28 77 58 52. Butte Mont...... 68 112 66 10. 24 .2 Cdilac, ch...... 12 75 200...... 3' Cairo, II'...... 4 125 10j 112. .1...... 2 CnrdeMlass...... 591 GM 183...... 9 Cant;n m...... 2 12 9 6 53 25 20 t ...... Canton, Ohio...... iii39 ...... 53.. 20 19 19 3 Cape imrrdeau Mo...... 18 Ce Rapids a...... 1512 97 14 ..... Centralia, I ...... 2 107 19 11 Chaiiute, K s...... G 150 421.

Charleston, S C...... 211 826 1.208 759 ...... 2. .1633 Clarleston W. Aa ...... Va 14 921 210 35 C'harlotte, W C...... 2 237 393 123 .im4 Chattanooga, Tenn...... 51 170 181 106 ,...... 1 3 14 Chelsea, Mass...... 10; 148 116 31 .... 2 147 ,. Wnne yo...... 1 1 20 ...... 1 Chicago, Ill...... 9.955 4,641 1,741 597 240 127' Chicopee Mass...... 4 5 17 16 1 ChillicotAe, Ohio...... ------... --.... -- 57 22 Cincinnati Oh...... 10t 388 456 334 3 Cleland hio...... 1,084 2,243 1,064 483 79 151 Clinton iass ...... '7 '25 29 Cofeylle, K n...... 33 118 103 .i4*1 S.... Cohoes N. Y...... 3 245 107 60 .8.... Colorado SEr1ngs, Colo...... 37-8 6.. Couba 9".S. C oo...... 101 3133 387 168 Columbus, Ga...... 10 152 351 192 10 Columbus, Ohio...... 512 1 2,013 7-02 160 68 49 Concord N. H...... -1...----.--...... I 1 I33 Corpus hristi Tex...... 41 114 28 5. Cortland, N. i ...... 102 ...... 32 . 27 Coshocton Ohio ...... 10,% ..... 132...... Council Bfuffs, Iowa...... 152 .47i 2...... 18 .... 2 Covington, K...... 1 101 93 103 *4113 I2 Cranston, R. I...... 15 22 16 8 ------Cumberland, Md...... 112 423 403 252 19 4 Dallas, Tex 1, 569 1,114 818 207 9 } 171 Danbury, Conn.------|...... 152313 25.4 17 Danvers, Mass...... 1 24 35 17 Danville, Il...... 1,000 800 286

Danville, Va...... 61 ...... Davenport Iowa...... 310 132 182i. 4 Dayton, Aoho...... 25 19 5 3 Decatur, Jl...... 460 210 82 15

Dedham, Mass...... 1 ...... Denver, Colo ...... 62 141 Des Moines, Iowa...... 18 ...... I...... Detroit Ih...... 6,922 1,529 282 35 Dover, W. H...... 5 13 59 31. Du Bois, Pa...... 150 140.. DubulqueJsrnIa ...... , 317 251 *24*8 425 East Chicago, 2231 36 Ind ...... i...... a I Including pneumonh 475 February 27, 1920. WNUENZA-Continued. City Repors for Weeks Ended -Jan.-31, and Feb. 7, 14, and 21, 1920-Contintied.

Cases week ended- Deaths week ended- Plae. Jan. Feb. Feb. Feb. Jan. Feb. Feb. Feb. 31. 7. 14. 21. 31. 7. 14. 21.

A -. East Cleveland Ohio 38 1...... 1.. EatPI p on iii;...... 1 14 22 :.. EastOran4o, i...... 293 169 117 22 ...... i.....I...... 2 R. I. 11 2 ...... East St. Louis, i...... 476 338 111 0 EIln,IIIl...... 101 6 3 61 ..... 2 Elkhrt,Ind...... 82 32 6 ...... i Elmira,N.Y...... 9 12 3-1...... ------W El Paso, Tex...... 1 14 . . 34 ...... Englewood, N. J. 236 29 Erie, Pa.. 401 2,587 .986~ .2 Eureka, Calif ...... 10 8 81- 1 Evanston, Ill ...... 187 67 10 ...... Evansville Ind...... 26 I 1- Everett, Miss..:. 117 594 1 ------Fairmont,W. Va. 39 178 6 Fall River, Mass . . 34 185 197 11 sOhio...... 24 ...... 1- - h ...... 569 26 1 6 Foddu Lac Wis...... 89 183 3 Fort Dodge owa .12 ...... Fort Scott, ans 2 2 ...... Fort Smith, Ark . 521 ...... 3 7 Fort Worth, Tex...... Fostoria Ohio ...... 12 47 12 . . 15 51 ...... 5 Framlngiiam- Mass 15 Freeport, ll ...... '19 '12 1 13 1- .i Fremont, Ohio 12 '4 2 ...... 2 , Ill. 101 61 1...... Csalesburg 342 72 (Galveston, Tex 7.. 7 274 I 1 1238 .3 Gardener Mass . 2 15 12 ...... Gary,InU . -- 7 2 . Grand Mich .. 301 414 4 Ra;pids, 35 14 Granite City, 11l . 116 1 - 2 G.reat Falls, Mont.. 48 113 193 ...... 1- Gorcen Bay. Wis 36 79 ...... Greenfeld,Masse:...... -....? 30 108 ...... 1 Greenwich, Conn ...... 131 127 44 47 1 1 25 ...... Hackensack, N. J 175 118 29 1 124 Hammond, Ind ...... 2 ...... Harrison, N. J...... 7 ...... 602 116 27 22 38 HIartford, Conn .---501--- 543 208 1, 8 Haverhili, Mags...... 1291 380 35 2 . libbing, Minn ...... 701 316 245 412 I''''''''' HIighland Park, Mich...... 3161 147 58 ...... HIobo'kcn,N. J ...... 49 34 4 3 Holland. Mich . 24 16 10 ...... Holyoke, Mas- ...... - - 29 37 31 ...... Hot Springs, Ark .... 30 135 211 ...... Huntingto IndT .d 30 1 1 12 Huntington,W. Va...... 10 584 ...... 2 .40.. 39 ...... Hutchinson, Kans.. 50 40 6 Independence MWo ...... 100 200 0 Indianapolis, mnd ...... 481 211 76 ...... Ironton, Ohio...... 4..... Tronwood, Mich ...... 5 58 199~ ...... 34 ...... Ishpemingch ...... {....I 291 68 .-----...... 51 248 Itac N.t...... 251 it '''''''i' ...... 130 Jatown'.Y...... i...5731 962 104 1 Iane s ..ll ...is.l 136 12 3 ...... 3effersonCtMO ...... Jersey Ciy I....-.-. --..... I24i4 ...... 40 14 ...... 185 | 4 iamzooMih ...... 283 298 87 22 ...... Caty lrane, ti ...... 5 34 56 290 ...... Kosa Ci'Kan ...... l745S 722 N. 191 55 32 Kem MO ...... ,,,,,,,,13-.....151 720 39 ...... 1 147 69 ...... llmeleNH ...... 10 45 241 ...... tsWis...... l...... 308 15 laclcatN. Y 108. - -.20194 1 Kalamarosso,9...... M2c0 309 so ...... La Ciy.,Kans ... 13 56 55 I 1 lSovDl,Ten...... l...... 4311 IIncluding pneumonia. February 27,1920. 476 INFLUENZA-Continued. City Repots for Weeks Ended Jan. 31, and Feb. 79,14,. and 211,1920--Coatizued.

Cases week ended- f Deaths week ended-

Jan. Feb. Feb. Feb. Jn Feb. Feb. Feb. 31. 7. 14. 21. 3. 7. 14. 21.

Lancaster, Ohio...... 9 60 ...... Lancaster, Pa ...... 20 123 45 ......

La Salle, 141 87 Lawrence,1lI...... Kans ...... 39 205 143 85j...... 1... Leon3inster, Mas15 32 106 ----1..... LxntnKy...... 3 44 97 801 2 Lima,Ohio ...... 127 1971 141..... 1 4 6 Lincon Nebr ...... 76 40 4...... s.... 8 a

Little Rock, Ark...... 150 744 6101...... Lokport,N. Y...... 22 136 1751 711...... 4.j Logeah Calif...... 53 128 95 ...... 1.... LoanOhio...,...... 103 200 80 39 2 2...1 Lonee,Calif ...... 675 2,215 2,1563 ..... 8 4 12..... L------220 492 73 2 1i27 5 . Lowell,....as.. 70t 214 407 340 11...... Lu nMicli ...... 100 74...... LnbrgVa...... 33 207 .306 127f i 1 5 LynMs...... 133 333 280 137111 8 26 1 Mao,(a...... I..... 24 ...... '...... 1...... Mds,Wis ...... 336 221...... 4 14...... I.... MadnMass ...... 151 439 315 ...... 5 10..... Maceter, Conn ...... 148 194 59 6 2 2.... i.....

... .. 64 87 10...4 ....61 1 .. . Marintte Wis M anc..h...ester,..N I72f... . . 2 ..11 .. . Maie ...... 113 192...... Marion,In...... 19 60O 56 44.21 . ..3' Marion, Ohio...... 61 14...... 4......

*Marlboro, Massq...... 7 ...... 'Marquette, Mich...... 67 ...... Martins Oho1 12 MasoCi7,iIowa.8..24.5:.1...Ferry, 402..... Medford,Mnss .~~~...... 65 82 ...... -2.2 39, 1 Melrsemaws...... 31 22 40...... 4..... Memphis Tenna.7...... 53 1,333 1,085 327 1 7 22.13 Meriden,Conn...... 158 '150 270 103...... 2...... Methuen,Mass...... 22 46 32 27 ...... Mfiddletown, N.Y ...... 89 Milwaukee, Wis ...... 796 27 ...... 10. Minneapolis, Minn...... 2,074 1,225 ...... 4...*....149...... 131 44 Mishawaka, Ind .1...... 1...... 5 2 1 Msol,Mn...... 1 70 125 41 32...... 1 2..... Mobile,Ala ...... ' ~~8 3021 6751 4821 4 1 i()9 Monmouth,111 1~...... 201 361..... 1...... I Mno,L...... 6...... MotoeyAla ...... 49 .. 99 . 16 Mraown, W Van...... 50 281 123 ..... N.J ...... 5 6 31 7.1...... 11 .... W. L...... 284 2 1 ...... Moxdville, VaY.. I Mount Vernon, N...... 183 51...... 2..... Muncie, .. .. 9...... 2 .... MuscatineWladIowa ...... 20f14 821431 .I....1.....a..... Nashvi29 182e, .....::j1 2412 10 34 New Ten.n.'. ...N...... 2, 103 29---- 18298 ..... 31 621 52 .... NewBedford,Mass ...1 8 170 289 2601....i ...... New Br ...... 3-57 6691 17843 131 14 NewBrunswick,.N.I. 160 165 462!185 10 N w rg,N.Y ...... 9.....1...... 1...... NeMryotmas!...... 12.j43 48 12...... 4...... Nwae,'onn. .242) 2;785!89 41 I 7 3 New London, Conn... 1181 98 19: 7 ....!...... NewOrleans, j,~~~~~~. 2461 32 782 47814 7 34i..... Nwport,R.l...... 641 W8 905 313 9 5 Ne ton, Msa s83 1524 58 ...... 7.. ... NeYork-N...... 30,4561 21,388 8,091 3,030 . W 945 394 73 N~~~araFalls,N.Y ~~~~~1.1 173 358.1 0 N: oIk,VA ...... 241 1...... ;2.

...... 2. .... 2 ... North Adams. Mass;...... Ii... 3 376 n. NorthamnptNorth Mas-s.i 2 ..... 19.I...... 2 . ...I North Alttebaro.1.ittle R..ck,Mass..:..i.Ark...... 36 Nodrh Tnawnda N.Y....1 30 12710...... 91...... 477 Febiruary 27, I2SM

FLUNZA-.Oontiued. ..IN -6 Ci(ty Reports for Weeks Eaded Jan. 31m, sand Feb. 7g,14,v and 21, 12M-GContd.

Cases week ended- Deaths week ended- Plaee. ~~~~Jan. 1Feb. Feb. Feb. 1Jan. -Feb. Feb. Feb.. 31. J 7. 14. 21. 31. 7. 14. 21.

Norwalk~,Conn ...... 2 20 91..... 2..... 3 1 orlhConn ...... 176 59 50.301 3...... 10 1 Nowo,Ohio...... 1 16 3...... Oakland....lif. 438 78...... 2 38 ...... Oak P,Il.129...... i 41 Ifj 2...... j...... OklahomaCity,Okla~~..724 264 44 4 838 12 Oan N.Y...... 2 431...... OmhaNb...... 400 144 301 6 1 01 OrangeN 3 ... 120 131 58 25f... 43~ 2

PauaC.1. 24 45 123 ....4 ...... P IkrbgWVa. 40 146 391 19...... 2! 61-i......

Parsans,Kans . .. 32 113 114 .... Pasadena,..Cal.f. 107 223 1651 811 216Pasi,NJ...... 2967 139' ....1 21----762---- .....r...... 270 296 173 2i 921...... j...... PeoriaIi...... 320 333 45 10...... 3 PerthAmboy, N.J...... 90 67 16 1...... Petesur,Va...... 80 182 210 160 1...... Phaepha,P...... 1,321 2,62.7 2,212 1,069 16 W7 ~218 0 Pittsfield Mass. 120 181 145 8------6

Piantield, N. 3.141 0 I2..... 4 ..... PortChe.ter,...Y .51 35 4 4 ..1::::: ....:..1 Pontiac,.M...... 209 ....8. 562 16 I.....1---- ...... ,M...... 294 .545 380 1331 1 71i 12 Portland, Oreg..... 215 553 742...... 2 4 29..... Portsm uth,NH...... 17 49 15 ...... Portsmouth, Ohio...... 197 645 ...... I 8...... Portsmouth Vsa9...... o...... I......

Providence, R.I ...... 574 1,9488 1,201 72 13 30 282 Provo,Utah.~~~~~~~~1,700560 ...... Quincy Ill...... 33 930 659 121 ..... 2 Quincy, Mass...... 86 84 ...... 3..... Rlacine Wis ...... 2102 35. 361 Rae,.C...... 526 6891 758 122 12.S Readlng,Pa ...... 37 N5...... 48f 2 18. - 9 Redlan , Ca ...... f 8 ...... i...... Red Wn, Mn...... 28 43 ...... 1...... Reno,Nev...... 6 59 621.------Richmond, m[d ...... 24 49 .1 1 .----- 1...... Richmond, Va...... 1,866 2,516 S42 359' 101 23 20.1 Riverside, Calif .3J 65 97 106 -----1------Rocheste',N.Y . i.217 6833 601 1751 9 25 12. 21 RockfIslad, IIl . 165 ...172 . 1.1...... A RockIord fil1 7 1 ------J..2,..... RockyMontN.C ...... 100 250 250 2509..--- 2 Rome, Ga ...... 17 148 5-16 646.------.....5..... Rome, N.Y.58...... I' Rutland, Vt...... 124 ...... 1..... Sawremento, Calif ...... 2292 271 173 153 510 2 8 St..Cloud Miunn...... 57 1522 78 25-----. ------1- 4 St. Josel iMO..:...... 219 884 654A 2 16411 St. Paul Minn...... 1,071 413 44 ...... 55 61 4 ..... Salem, kass...... 13 13 .....4 7 .---- 11.... Salem, Oreg...... 11 3o 6 Salt Lake City, Utah...... 1,233 1,2884 476,----4----- 6-j '41 52 . 21 San Bernardino, Calif ...... 45 70 ...... ;...... SanDiego Calif...... Ii' :192 25 .....7.... Sand.sk...O.io.. 62 101 841 31 ...... I...... 2 Sanfcrd,Me . ~~~~~52~~~~141 2413 148 ....~.. rnic,Calif...... Sa 789 1,474 271...71...... Santa Anas Caif...... Santa Barlaa Calif .i....10...I.

Santa-Cmnz, Calif...... 10...... Saratoga Springs, N.Y ~~49 1534 267 14 .-.. Sa Be.Marie,Michb...... 19 5. 9 7...... Ssvannh,Go ...... 24j 59 1,588 972 -f 6 16.44 Seattle., WaA2781 1,25.3 90 ...... 52 101 Flebruary 27, 1920. 478 INFLUENZ-Continued. City Reports for Weeks Ende-d Jan. 31, and Feb. 7, 14, and 219,1920-Continued.

Cases week ended- ]Deaths week ended-. 1la~~~~c.~Jan. Feb. Feb. Feb. Jan. Feb. Feb. Feb. 31. 7. 1-4. 21. 31. 7. 14. 21.

Siouix Falls,% S. Dak ...... 253 286 60 128 5 4 9 1 Somerville, Mass...... 161 396 319 72.....1 12 3 S9outh Bend, Ind...... 25 5 1 1-l...... Southbridgc, Mass...... 6...... Sprtanbrg, S.C...... 153 480 305.4.....5 3 ..... Spokane, Wh...... -4...... --- Sringfied, III...... 56 . 76 4 .------..... Springfeld, Mass...... 36 18 201 1 7812 17 Springfield, Mo ...... 1 5 ..... Springfeld, Ohio...... 139 252 122 10 ..... 4 . 1 3

Staunton:Va..:...... 67 762 16...... Steelton 1Pa ...... 4 45 4 3..1...1 Steubenville. Ohio...... 5 4 2 1...... Stllwater,Vi~nn...... 6...... Stockton, Calif...... 115 I212 142 ..... 3 ..... 1..... Syracuse,...N.Y. 4741 62 15 10 8 32 5 25

Taunton Mass .. 11 3-4 44...... 4 1 2 TreHue Ind...... 4 34 10 1s5...... 2

TifnOhio...... 33 56 71 ...... 1...... Toledo, Ohio...... 235 299 274 62 7 19 19.20 Tope aKans..:---,194 418 591 229 1 5 5 12 TaesCitVP mich...... 17 72 73 39 ...... "Trnoy, N.Trinidadh...... 8. Cob 286,~~~. 380 223 160 2 5 5 14 Tucson,. Ariz...... 10 2...... Tuscaloosa., Ala ...... 60 ...... Tyler,Tex 71 ...... Union,N.J . 3 3...... Valljg,CaifMn...... 100 50 ...... WacoIT'ex 9...... 6 5 196 1 ------3 2

Ivalla' Walls; Wash ...... 6...... WValtbam, Mass ...... 290 212 92 .....2 1 1 Washinzton, D.C ...... 16161 557 298 104 77 62 17 34 Waterbury, Conn...... 1,157 448 146.-. 1 .....

WVatertowna, Mass ...... 32 35 34.8...... WatertowumNY. 9 154- 211 125...... 3 NWausau WI...... 115 346 115 ...... 1I WVebster, Mass...... 7...... W%estfield,l Mass ...... 6 57 44...... 1 WestHobok-en N.J...... 91 19 4...... 2...... I West New Yorl-, N.J...... 19 5...... 15 1...... W"est Orange, N.J ...... 114 93 ..... 11 2 2...... Wheeling, W.Va...... 27 82 . 134 63 ....19 . 14 White Plains., N. Y...... 231 ...... 1i...... Wichita Ksans...... 214 230 165 142 1 3 2 9 WJlkcs-ilarre, P ...... 2 10 11 21 Wilkinsbtirg, Pa...... 9 90 42 18...... 6 Wllininton, N.C ...... 54 41..... 581 ...... 2 Winebestcr, Mass ...... 26 Wmindham Conn.8...... 2...... Wi1nona,Mih3nn . 1'5" 55 12 1 ...... 11 2 1 WinsthopWinsthon-aem-MassN.c...... C.1,810...55....5 7730 5,151 532424..... 27...19.. 14.... Woburn,ila...... s.....a... . . 1. 2..... IN 41 7 Wor'cestrYonkcss~~7Y.148Mas ..206...55...204 463 418 214269 75 41 23 . 18 Zanesvile Oh ...... o...... 308 ......

I Including pneumonia. LEPROSY. LA Junta, Colo., and Omaha, Nebr. During December, 1919, a case of leprosy was reported at La Junta, Colo., in t-he person of Mrs. T., a Mexican. During January, 1920, a case of leprosy was reported at Omaha, Nebr.' in the person of C. Y., a veteran of the Spanish-American War. 479 February 27, l920.. LETrARIC ENCEPHALITIS. UaUforna and Illinois. During the week ended February 7,- 1920, one case and one deat.h from lethargic encephalitis were reported at Oakland, Calif. Dur- ing:the month of December, 1919, 18 cases were reported in Illinois, 16 of wvHich occurred in Chicago and two in Aurora, Kane County. MALARIA. State Reports for December, 1919, and January, 1920.

New eacss i New * ases Place. reported. I Place. repopted. California (December, 1919): S Illinoi-ontinued. -Los Angeles County- Clinton County- Los Angeles...... 1 Germantown. 1.1 San Francisco.---- 3 Cook County- I Presidio...... 3 River Forest. 1 Santa Cruz County- Franklin County- Santa Cruz...... 1 Broming Township. 7 Shasta County...... 9 Zeigler.j 2 Jasper County- Total...... 17 Rose Hill. 2 Johnson County- Florida (January, 1920): Cypress... 4 Alachua County...... 4 Montgomery County- By County...... 5 Witt...... 2 Bradford County...... 2 McLean County- Broward County...... 2 Colfa... Citrus County ...... -- .- 1 Perry Conty- Columbia County...... 1 Soth West Precinct. Dade County...... 1 Randolph CountY- De Soto County ...... 2 Red Bud...... Duval County...... 4 Saline County- Jacksonvl...... -9 Carrier Mills...... Escambia County...... 1 St. Clair County- Pensacola...... 7 Stite3 Township ...... 2 Gadsden County.------2 Union County- Hamllton County...... 1 Alto Pass ...... 10 Hilsboro County...... 2 Reynolds Precinct. Tampa...... 10 Wabash County- 68 Holmes County ...... - 2 Keensbturg...... 3 Jackson County ...... 5 White County- Jefferson County...... 5 Morris City...... Lafayette Cofunty...... 2 . Is Lake County...... 4 Total ... Leon County ...... 7 Levy County...... 3 Louisiana (January-. 190): 3 Madison County------2 .tcadia Parish . 11 Marion County.------! 3 Caleasieu Parish ...... 2 Monroe County- Caldwell 1'arisi. 1 it Key West... . De Soto Parish. . 13 Okaloosa County...... 1 Grant Parish . 3 Okeechobee C-ounty...... 8 Iberia Parish. 58 Orange County...... lIberille Parish Osceola County...... La Salle Parih.. 1. Paseo County...... 2 Orleans Parish. 9 Pinellas County...... 1 Ouachila Parish ...... 32 . Polk County...... Rapides Parish ------13 Putnam County...... 1 St. Martin Parish ...... - St. JohnsCo;mty..------1 St. Tammanv Parish..------1 1 133 St. Lucie County.- Tangipahoa Parish...... Seminole County...... 1 Sumter County...... 21 Total . 58 Taylor County...... 4 Volusia County...... 1 Maryland (January, 1W20): _ Wakulla County...... 1 Charles County- , . White Plains...... TOdal ...... 16 New Mexico (January, 1920): _ Santa Fe County...... Illinois (December, 1919): Valencia Conty...... 2 County- Bond 3 Panama------. 2 Total...... February 27, 1920. 480 MALARIA-Continued.

City Reports for Week Ended Feb. 7, 1920.

Place. Cases. Deaths. Plac. CP Deaths.

x . Alexandr,...... La 1 7 ...... Dallas ...... Tx 4 Anniston, Ala ...... 1...... M.m...... Te... 2.. Birminga-m Ala .4..... S an Clif...... 1 Charleston, i. C ...... Stockton, Calif......

MEASLES. See Telegraphic weekly report3 from States, page 464; Monthly summanes by StateF, page 469; and Weekly reports from cities, pag 494. PELLAGRA. State Reports for December, 1919, and January, 1920.

New cases Newcams I'lace. reported. Place. reported. California (December, 1919): Louisiana (January, 1920): Los Angeles County- Caddo Parish...... ,;...... I Los Angeles ...... East Feliciana Parish .1 Florida (January, 19290): Parish ...... I Dad:County-- _ ~~~~~~JXacrksonnpPaishVerno~n .1...... M iami.1 Total.4 DadsdenDwadsenCounty-..2.Vernon..Parish.1County . Osceola County .1 Total. 4 City Reports for Week Ended Feb. 7, 1920.

Place. Cases. Deaths. Plac Cases. Deaths.

1 Atlanta, Gaa. I 2 Fort Worth, Tex ...... 1 Birmingham, Ala ...... 1. Mobile, Ala ...... l

Chattanooga, Tenn ...... !. . I Montgomery Ala ...... l N. 1 Columbs, Ga ...... 2. Raleigh, ......

Corpus Christi, Tex ...... 1...... 1

PLAGUE (RODENT). New Orleans, La The table below gives a record of rodent cases of plague at New Orleans, La., from February 14 to 19, and is a continuation of the table printed on page 414 of the Public Health Reports dated Feb. ruary 20, 1920. No case of human plague in New Orleans has been confirmed since, December 30, 1919. Mus Alex- Total andrinus Mus mus- Mus rodents Dateconfirmed.confirmed.Date mus culus. vegicus.gNor- pau ~~andrattus.ifetd

1920. Feb. 14 ... 1 1...... 2

Feb. 15 ...... 22 Feb. 16 ...0...... I 2 ...... 2 Feb. 17 ...... 2...... 0 . Feb. 18.2 ..4 .. 6 Feb. 19 ....1 ...... 1 AIN febmuary 27e 1m, PNEUMONU (AL FORMS).

Cit . orts for Wek Eded Feb. 7, 1920. Place. .Cases. Deaths. Place. Cases. Deaths. _ _ t .- |--,_ Akron, Ohio...... 82. I. East St.Touis, lll...... 10 Alameda, Ci aif...... Elgin, III...... 4 7 Alexcandri0,! Va...... 8 6 Elizabeth, N. J...... 19 14 Alac Ohio ...... 1 ...... Elkhart, Ind ...... ; 8 7 AlM ina.W ...... IclI 8 Elmira. N. Y. 22 4 Algin ill ...... -.--...... ElrPas, Tex ...... -- ...... 7 Ames6ury, Mam...... 2 Englewood, N. J ....- 4 &naconds 'Mont...... Evanston. Ill ...... 4 Aknm Arbor, Mich ...... 16 Everett. Mass ...... 2 4I Anniston, Ala...... 3 Fall River. Mass...... 9 Ansonia, Conn...... 2 4 Findlay. Ohio...... 11 Arlington, Mass...... 2 2 Flint, Mich ...... 84 81 Asbury Park, N. J...... 3 1 Fort iVorth. Tex ...... 28 I shland K ...... 17 ...... Frainingham. Mass ...... 3 Ohio . - 1 A--htabula, Fremont, Nebr...... 2613 Atlanta, Ga...... 7 6 Fremont, Ohio ...... Atlantic Citv, N. J...... 12 6 Galesburg, Ill...... 7 Attleboro stass...... 2 I Galveston, Tex...... 1 Auburn, Me...... 1 I...... Giardner, Mass...... Aburn, N. Y...... 4 Gary, id ...... II138 Baltimore Md...... 3 Genera. N. Y...... Bangor, fie...... 2 Glens Falls, N. Y...... Barberton, Ohio...... 6 ...... (Gloucester, N. J...... 6i ...... Battle Creek. Mich...... 14 3 Grand Rapids, Mich...... 633 13 Bayonne, N. J...... 16 Ill ...... Beatrice, Nebr...... 2 Granite City. Beaumont, Tex...... 3 CGreat Falls, Mont.. 2 6 Bedford, Iid. Greleey, Colo...... Greenfield. Mass...... Belleville, -N. J ...... Greensboro. N. C Benton Ilarbor, Afich...... Berkeley, C(alif...... Greenwich, Conn.... 101 Mass hiack-ensack. N. J...... 15 3 Beverly, ...... Hammond, mnd...... 2 164 Bid;leforl, Me...... 16 Harrison, N. J...... 7 16 Billings, Mont...... Hartford, fiUnn...... 8 Birminaham, la...... Haverhill, Mass...... 10 Bloomfield, N. J...... 2 Hibbing, Minn.... i8 Bloomington, Ill...... ih. Boston, Mass...... I highland lPark-, 38 1-...... Bridgeport, Conn...... Hoboken, N. J...... 42 28 Bristol, Con...... Holland. Mich...... 9 II1 Brockton, Mass...... 2 Holyoke, Mass...... - . Brookline Mass...... blot Springs, Ark...... 4I Blffalo t. Y...... 113 17 hluntington, Ind...... 1L Burlington, Iowa ...... Independence, Mo...... 30 '20 Burlington, Vt...... ---- 6 Tronton, Obhio...... Butte, Mont...... 8 Ironwood, Mich...... Cadillac, Mifh.------4 Irv-inggtoi. N. J...... 11 ,...... 1615 '4 Ishpening Miei ...... 71 Cairo, Ill....4 N 11 Cambridge, Mass2 .1 5 ...... 44 i Ithaca, Y...... 17 Canton, Ill...... 1982 Jacvksonville,III...... 2 Ohio...... 16. 3 Jamestown. N. Y...... 9 Canten, ...... 8 Centralia. Il...... 33 Jefferson City. Mo...... Chanute, Kans..------Jersey City. N. J ...... 19 Mo...... --.*.| 5 Charleqtcn, S. C '-.------25 Joplin. Charleston, W. Va ...... 10 Kalamazoo. Mi.h. l Chattanooga. Teu-...... 32 '92 i Kanlkakee. Ill.- 1 Chelsea. Mass.------. Kansas City. Kans ...... 453 Chicago, Ill...... 13 Kansas City. Mo..i 1961 Ohio.------...... Kearny. N. J. 13 Cificinnati, H 1 125I Cleveland, Ohio..------..... iKenne, N...... *--.---.. I 0j Cohoes, N. Y ...... Kewanee. Ill ...... 8. C 11 Kokomo. Ind...... Columbia, ...... 1...... N. Y. .I Columbus, Ga...... Lackawxanna...... Columbus, Ohio...... Lo Fayaette, lnd.------21 Concord, N. H...... Lantaster. Ohio.------26 Corpus Christi, Tex...... 31 Law-renve. Kans....------! 2 Council Bluffs, Iowa-.- 358 Leavenworth, Kans..... ! 3 12 Covington. K ...... Leominster. Mass . 1------25 ...... 3 23 Cranston, R. I...... Lexington,Ky 331 Cumberland, Md---.------Lima, Ohio ...... 7 6 Dallas, Texx...... i Lincoln. Nebr.------l 7 4 Dauvas, Mass...... 25 Lock-port., N. Y ...... 8 Danville, Va..------Logansport, Ind ...... 263 Calif...... Dayton, Ohie...... LongBeach, 4 18 Ohio ...... 3 Decatur, Ill ...... Lorain, Denver, Cabo...... Lo Angeles Califf ...... 134 Detroit. Mih...... ikY---...... ! 34 Duluth. Min...... LJowell,,,,Mass 112 Durham, N. C...... udinton,MYich ...... EastChicago, Ind...... 2 Lynchbulrg, Va...... 4 East Orane, N. J...... Lynn, Mass...... 9 February 27, 1920. 482 PNEUMONIA (ALL FOIM)-Continlued. Ci'ty Reports for Week Ended Feb. 7, 1920-Continued.

Place. Cases. f_Deaths. place. Co.I Deaths. 11 , Ga...... 1 1 Pueblo, Colo. 12 ade, ...... 7 9 Quincy, Ill S Manchester, Conn...... 8 2 ...... 2 ,8 Manchester N H...... 4 4 RahwaY N. J. 2 Marion,Nainin-d.n ...... 1 a, Calif. . 10 Marion Ohio...... Reno, Nev. 8 2 Martinsburg W. Va...... 3 Richmond, Ind...... 8 Mason Citv Iowa...... Richmond, Va. .4 25 Mattoon, Pi ...... Riverside, Calif...... 6 2 Medford Mass ...... 1.2 5 Rochester, N. Y...... 80 25 Melrose 'Mass...... 1 Rockford, nl...... 37 26 Memphis, Tenn...... 14 Rock Island, Ill...... 26 6 Meriden, Conn...... 2 3 Rocky Mount, N. C. 2 Methuen, Mass...... 3 3 Rome, Ga Middletown, N. Y...... 4 5 Rutland, Vt. 2 3 Middletown, Ohio...... 5 Sacramento Calif...... 14 6 Milwaukee, Wis...... 154 St. Cloud Mimi. 8 3 Minneapolis, Minn...... 37 St. Jo3epA .o 39 .12613 Mishawaka, Ind...... 3 St. Pau ...... 2 23 3issoula Mont...... 2 Salem, Mas . 4 2 Mobile, Xla...... 4 Salem, Greg ...... 1 1 Montgomery, Ala...... 3 Salt Lake City, Utah. 21 Morgantown W Va...... San Bernardino. Calif 1 Morristown, V. J...... 8 San Diego, Calif. 14 Moundsville, W. Va...... 4 10 &ndusskOhio...... 2 2 Mount Vernon, N. Y...... 39 21 8nford, Me ...... i11 ...... Muscatine Iowa...... 7 San Francisco, Calif. 20 14 Nashua. i. H...... 2 Santa Barbara, Calif...... 14 Nashville Tenn...... 2 6 Santa Cruz, Calif...... ''''''''i Newark, 6i. J...... 222 46 Saratoga Srings, N. Y....::: 1 New Bedford, Mass...... 8 15 Sault Ste. Marie, Mich...... 7 2 New Britain, Conn...... 25 3 Savannah, Ga...... ,'15 6 New Brunswick. N. J...... 14 ...... Schenectady, N. Y...... 3 Newburyport, Masvs...... 3 3 Sioux Falls S. Dak...... 4 2 New Castle, Ind ...... 50 8 Somerville 'Ma...... 4 6 New Haven, Conn...... 9 South Bend, nd. 2h New London, Conn...... 19 2 Spartanburg SB C ...... 4 New Orle La. 20 32 Springfield, [ss...... 3 New Philadeiphia, Ohio. 2 Springfield, Mo...... 8 Newport, R; I...... 4 4 Spingfield Ohio...... 18 Newton, Mass...... 7 4 Stamford, on...... 5 New York, N. Y. 4,535 1,023 ...... Niagara Falls, N. Y...... 17 6 Steubenville Ohio 3 6 . Norfolk, Va...... 35 20 Stockton, Cahif...... :.... North Adams, Mass..... 1 ...... Superior, Wis...... ;i20 15 North Little Rock, Ark. 2 Syracuse, N. Y...... 57 North Tonawanda, N. Y..... 20 Taunton, Mass...... 2 Norwalk, Conn...... 2 8 Terre Haute, hId...... 19 4 Norwich Conn...... 5 3 Tiffln Ohio...... 1 Norwood, Ohio...... 7 2 Toledo, Ohio...... 36 Oakland Calif...... 10 17 Topekla, Kans...... 19 6 Oak Par, I...... 9 10 TraverseCity Mich...... 1918 1 Oklaoma City, Okla..... 8 4 Trenton, N. J...... 4 22 Olean N Y...... 3 1 Troy, N. Y...... 8 Om , Nebr...... 32 Tucson, Ariz...... 1 Orange, Conn...... 1 Vallejo Calif...... 6 Orange N J ...... 6 Wco, Tex...... 10 PaducaQ, Ky:...... Wakefield, Mass...... 22 Parsons, Kans...... 3 Waltham Mass...... Pasadena, Calif...... 9 2 Washington. D. C ...... 102 Passaic, N. J...... 45 6 Waterbury, 41 2 Paterson, N. J...... 109 Waterton, Conn...... Mass...... 1 Pawtucket, R. I...... 2Watertown N. Y...... 18 1 Peekskill N Y ...... 3 Wausau, Wjis...... 22 3 Peoria, Ill...... 18 West Hoboken N. J...... 15 Perth Amboy, N.J. 9 7 West New York, N. J:...... Petersburg Va...... 5 2 West Ornge N. J. 49 Philadelphia, Pa...... 373 182 WhEeling, W. Va. 4..... P bllipburg N.J...... 2 White Plins N. Y...... 4 Piqua Ohio...... 4 Wichita, Kans...... 25 Pittsfleld, Mass...... 9 4 Wilmington, Del...... 11 Plainfie'. d,N.J .... 2 Wimingtn N C...... 4 1 Plymouth Mass...... 2 Winchester, Mas...... Pontiac, )fich...... 26 Winona, MInn...... 7 Port Chester. N. Y...... 3 Witon-salem, N. C...... 49 Portland, Me...... 21 8 Winthrop s...... 4 1 . Portland, Or ...... 17 Wob ...... 4 Portsm,outh N. H...... W er s...... 8 Portsmouth Va...... 18 Yonkers 6.Y. 20 Poughkeepse N Y...... 17 16 Zanevlie, Ohio...... 2 Providene, i.I ...... 26 _ Li 483 February 27, 1020. POLIOMYELITS (INFANTILE PARALYSIS). State Reports for De r, 1919, and January, 1920.

New eases cases reported. Plc.NowPlae.por.

hL2- (Deember, 19Marvland (January, 1920): I.osmy: 1altimor( ...... 8 ., Michigan (January, 1920o: Florida (Jauary, 1920): Jackson County...... 1 Putnam County ...... 1 Menominee County.1 - Wayne County .I Illinois (December, 1919): Cook Cotmty- Total...... 3 Chigo... 2 Greene County- Minnesota (December, t919): WhiteHallTownship 1 Stearns County- Carrolton .1 St. ('louid ...... 1 Kankakee County- Yellow Medicne County- Kankakee Township ...... 1 Hazel R Toshlp ...... Lake County- H o ElaTownship. 2 Total ...... mlHe ry County- 1 New M no...... 1 New xico (January, 1920): Rock Island County- Dona Ana County ...... 1 East Moline ...... 1 St. Clair County- Rhode Island (January, 1920): Macoutah . I Providence County- McDonough County- Provide ...... Mound Township ...... 1 est Virginia Total.11 (January, 1920): Total ------o 11 tnamounty...... 1 Louisiana (January, 19120): Winn Parish ...... _

Baltimore, Md., Bloonington, IL, and Los Angeles, Cal. During tihe week ended February 7, 1920, two cases and one death from.1)oliom elit.is were report-ed at Baltimore, Mrd.; one case was reported at Bloomington, 7111.: and one at Ios Angeles, Calif. RABIES IN MAN.. Colorado Report for December, 1919. During December, 1919, One.ease of rabies in man was reported in Colorado. SCARLET FEVER. See Telegraphic weekly reports from States, page 464; [onthly summaries by States, )age 469; and WVeekly reports from cities, page 494. February 27, 1920. 484 SMALIPX State Reports for December, 1919, and January, 1920-Va na;on. Htories.

Vaccination history ofcases.

Caiffornia (December, 1919): Alanieda County- Alameda City...... 4 ...... , 9 Oakland...... V ...... 1 Butte County...... 1 ...... Chico...... F 2 Contra Costa County- ...... Concord...... I 9 Martinez...... 1 11 ...... Pittsburg...... 17 ...... Walnut Creek...... 2 I . Del .Norte County...... Fresno County...... i7 9 Coainga...... Ijumboldt County...... IIi.I 8 ...... Arcata...... Blue Lake...... I ...... 1 .. 1.. Eureka...... 2 ...... Imperial County- ...... Holtville...... 1 ...... I...... 3 Kern County...... -- .-- 1...... 1 ...... I.. Bakersfield ...... "I 1 KiingsK County- ...... ianford...... 1 1 ...... Los Ange!es County...... it ...... 11 ...... El Segunda...... 1 ...... 1 ...... 18 ...... Long Beach...... 18 ...... Los Angeles...... 24 '22 ...... P'asadena ...... ; 3 ...... 3 ...... Pomona...... ------1 ...... 1

South Pasadena...... 1 Venice...... 1 ...... 1 Whittier...... 4 5 Madera County...... 91 ...... ' ...... I.. Mendocino County...... I Wilits...... 1 ...... Merced County- Merced...... 1 1 ...... Monterey County- Monterey .-..-..- . 1 ...... Napa County...... 16 12 4 Napa...... - 63 42 16 Orange County...... 1 Brea...... 1 ...... i1 Orange...... 1 ...... Riverside County...... 13 6 7 Blythe...... 1 1 ...... IRiverside...... 15 101 3 Sacramento County- I Saeramento...... 6 11 San Bernardino County...... 1. Chino...... 1 Rialto ...... -.- ...... San Bemardino...... 2 ...... San Diego County- .1 Oceanside...... 1...... 1 ...... Ran Diego-...... ----.- 2...... San Francisco...... 13. I San Joaquin County...... 11.I...... 5 6 Manteca...... 7...... 3 4 Stockton... 4. 1 3 San Luis Obispo County...... 1...... Santa Clara County...... 1.I...... San Jose...... 4. 2..... 2 ......

Shasta County...... 1...... 1 ...... Sonoma County-

Healdsburg...... 3 i2 ......

Stanislaus County...... 2 ...... 2 ...... Turlock ...... 4 ...... 1 Tulare County...... 2 ...... 1 Ventura County...... 1 ...... Fillmore...... 5 ...... -...... Ventura...... 1 ...... L Total...... 341 3 7 250 68 I= I' -- 480 February 27, 1920. SMALLPOX-Continued. State Reports for December,-1919, and Januaty, 1920-Vaccination Histories-Con.

I I I Vaccination ihistory ofcases.

Vaccinated Phee. oweses|Deaths. within estinate-Iiastedwthan Never suc- History not 7years morct7 an Icessftilly jobtainfedor pr cg |pe adingaccinated. tincertdio attack. ac .. u_ I -I Colorado (Deeember, 1919):

Arapahoe Cotinty...... 3 ...... 2 1 Bent County...... 9 9...... Delta County...... 5 ...... 4...... Denver...... 180 20 ...... 1.;8 2 El P*9 County...... 8 ...... 1 fi Huerano CoDunty...... 111 ...... 9 2 Jeffersof Cotmty...... 6 ...... 6 ...... 6 La Plata County...... 176 14 1 Larimer County...... 33 2...... 26 Las Asiimas County...... 1 ...... i Lincoln County...... 7 ...... 3 2 Morgan County...... 1 ...... I'...... I.. Otero County...... 1 ...... Prowers County ...... - 1 ......

Pueblo County...... 7 ...... 2....j

Rio Blanco County...... 4 ...... C San Mguel County...... 6 ...... 4 Washington County...... 4 WVeld County...... 39 4 ...... 34 1 Total...... Florida (January, 1920): Duval County- Jacksonville...... *'scambia County...... 22 8 . 8 I 20 Pensacola...... 2 ...... ___ .85 2 Hillsborough Cotmty- Tampa...... 2 ...... 2 ...... Holmes Co ty...... Lake County.-.. -. ------...... Santa Rosa County...... 1 3 1. Wwhington County......

41.I...... 4 ...... Total...... 3 238 ...... 3 ...211 27 Maryland (Jamnary, 1920): 4~_., Baltimore ...... Allegany County-,

Cumberland ...... MeCool...... 3...... Dorchester County- Cambridge...... 2 Prince Georges County- ...... Fort Washington..... 1.1 Washington County- Ilagerstown ...... 1 14 j...... Total ...... 14 Michigan (January, 1920): I1 1 A urCounty...... 2 I...... Baraga County...... 1 1------...... 1 Barry County...... 11 1------. 3 1 Bay County...... 5 1------.5 Berrien County...... 1 1------. II...... Branch Count. 8 1------. 3I 5 Calhoun Coun?r. 7, 1------.. 5 2 2 2 Charlevoix County...... 1------.. ., Cheboygan County...... 2 ...... Clare Cu ty...... 1 Clinton County...... 3 2 1 C(rawford County...... 3 2 1 Delta County...... 4 3 2...... Eaton County...... 2 I...... I1 1 Emmet County...... 2 ...... Conesee County...... 27 ,...... Gogebic County...... 47 112 18 20 Grand Traverse County...... 6 1 4 HoughtonCounty...... 22 3 ...... i. 6 ...... 3 Huron County ...... 3 161090° 20 1 February 27, 1920. 466 SMALLPO-Uontinued.

State Reports fr Deember, 1919, 1ammy, 192S-Vaccimati.n Ht.rIes;-Oa.

Vaccination history ofcases.

Last vac- I'laee. Newease Deaths. Vascinated cinated reported. Iwithin more than Never ae- Historynot 7ye 7 years cessfully obtained or preceding preceding vaccinated. uncertain. attack. attack. I I Michigan-Continued. Tngham Coulnty...... 1001 . 5 16 78 lonia 15 ...... County...... J 11 Iron Cotnty ...... ,...... Isabella County...... 2 2 ...... Jack-son County...... 6 ...... 2 4 Kalamazoo County...... 7 2 Kalkaska County ...... ,!...... - ...... 4 ...... Lake Coounty ...... , . 1 Macomb Couinty ...... I ...... Manistee County...... 10 9 ..t...... Menonminee County...... 2 1...... Montealm 4 ...... County...... 4 ...... Muskegon ...... County...... Newaygo ...... 8 County...... 4 {...... Oakland County ...... 2 ...... 19 Oceana County...... 2 ...... 3 8 .I. Ontonagon County...... 8 ...... Osceola County...... :s 1------...... 1 1 Otsego I1 ...... 1- ...... CountW...... 4 Presquie Isle County...... Schoolerait County...... 2 ...... 2 ...... St. Joseph County...... 1 ...... Tuscola County...... Van Buren County...... 2 ...... 1 ------. 2 ...... i WVashtenaw County...... 2 ...... |...... 2 Wayne County...... 79 ...... 1------. 5

Total ...... 47 I. 15 130 316 Minnesota (December, 1919): Becker County- Detroit ...... 9 ...... Audubon Township. 2 ...... Lake View Township. 1I . ..i ...... Lake Eunice Township... 1 ...... Bigsone County- 1 Ortonville ...... 1,...... Beardsley ...... -.- 4 ...... Gra-eville ...... Graceville Township.... ::...... ------...... Blute Earth Couinty-

Mankato ...... Clay County- 1....1 -----1------1.. UTe _,n...... Eglon Township ...... Highland Grove Township ...... ------1 1...... Parke Township ...... *...... Clearwater Countmty-- I Dudley T'ownship...... -- -| - ----1- Douglas County- 11 Alexandria...... 44 I Solem Township...... I Urness Towanslup.... I -1 ------1 ------.- - - . {...... La Grand Township...... 1 11 Faribault County- I5 t...... Blue Earth...... 2 ...... I...... 1- ' -'''.. 1------. Frost ...... 3 ...... 1- - --... 1 1 -..... Winnebago...... 4 ...... 1 Emerald Township.. I ...... Fillmore Cotmty- 31 York Township ..... ------Hennepin County- Browndale ...... 1, ...... *1 1 1 Minneapolis...... 4 51 12 Medina Township...... I Hubbard County- Park Rapids...... * - ' ' ' '. I Nevis T-ownship ...... , Isauiti Conmty- '- -...... 1 Bram...... %*. Cambridge...... 2...... il [...... 487 F'ebruary 2'7, 1920. SMALLOX-Continued.

State Repors for December, 1919, and Januaay, 1920-Vaceination Histories--Con.

_-. V.accination history of cases.

Newcasea i.ccnaed Last vac- reported. moren thn Never sue- History not 7 years moyeatsn I cssfully obtained or preceding pI ng vaecinmated.1 uncertain. attak, _attack.

Minnesota-Continued. 1 Isanti County Continued. I ... Cambridge Township .... 1 ''''' Stanford To ..i...... I--';''|'''''' Wyanett Townshp...... 10 ...... Itasca County-

...... Deer River...... 31 . . Keewatin...... 11 .. I... Kanabec County- mora...... I ...... -...'----...3 Arthur Township...... I1 ...... - 3 '1 Comfort Townsip...... 1 ...... South Fork Township..... !-.---...... Koochiching County- Rat Root Township. .--...... 2 1 Martin County- 1...... Truman...... I Silver Lake Township...... Mille Lacs County- ...... Isle Harbor Township...- 11 ...... Olmsted County------..1. Rochester...... 6 ...... Pleasant Grove Township. 1 ...... -- -7 SalemTownship...... 7 ...... '. Ottertail County- Fergus Falls...... Fiberg Township...... Maplewood Township...... ------t......

Ramsey County- 29 St. Paul...... 29 .....!.9. Rice County- Faribault...... Rock County- 1 ...... '...... Luverne...... Clinton Township..------3 St. Louis County- .... 2 ...... Duluth...... 1 Hibbing...... Scott County- .. .. ------1''.'--.'-'-- Shakopee...... 3 Steam County- 1 1 7 ...... Kimball...... 8 ,.,,-,,,-.--...... 1 St. Cloud...... 28 Waite Park...... 1 Fair Haven Township.... 1 J I @ 27 I1. Steele County- Owatonna...... 5 I ... 1 Havana Township...... ~~~~~~~~~322 ...... Todd County- Staples...... 25 Traverse County- Wheaton...... 1 ...... Redpat...... Tara Township...... 4 Wabsha Coumty- LakeCity...... 1 Mmm...... 1 Zumbro Falls...... 2 ChesterTownsip...... 3 .I2...... 1 ...... -.,--.-''''1 ...... 1 Elgin Township...... Wadena County- .. Wadena...... 1 Wing River Township.... 1 Washtn CountY-_ .. j 26 ...... St. Pau Park. 26 ...... I ...... '''''''''' Cottage Grove Township.. 1 ......

397 ...... ~61 12i 3641 13 Total ...... February 27, 1920.48 SMAILP0X-COwtiniked. State Reports for December, 1919, a* January, 19ft-Vawhe*ioh 'Is!rIM-dhla.

Vaccination history ofcame.

IPlace. New Deaths. Vaeealed liaStedS reported. witin CmnaedthnNever sue- fistorynot 7years cesafuly obtalnbd or procattak attack vaccinated uncertain.

New Mexico (January, 1920): BernalilloCounty .6...... ,2 Chaves Couinty ...... 4 ...... 2 DonaAnaCotinty...... 8 ..6' 2 Eddy County...... 2 ...... 2...... Grant County ...... 9...... 1I 3 LincolnCounty...... 3...... 1I 2 ..... OteroCotmty ...... 32 SanlutanCounty. 5...... 13...... 2 ...... Santa Fe Counity...... I...... I...... SierraCounty.------1 19 ...... 2 17...... Socorro County ...... 2...... II TorraneeCouinty ...... 1...... 1..... Union Cotulty .------. 1...... I...... Valenh4a County ...... I...... Total...... 10 ...... --43

State Reports for December, 1919, and January, 1920. 1 Place. ('ases.C Deaths. ~~~~~~~~~~~~ItPlace. Cues. Deaths.

Arizona i(January, 1920): Illinois-Continued. Maricopa County..... 7...C. allatin County ...... 2...... Ynvapai Couinty ...... 3.....Equality. 17...... -- ~~~~~(.reeneCounity...... *37. Total...... 10 ...... le...... 12 . -- c~~~~~renfield ...... 3...... Delaware (Janutarvy 1920) W4hite11aII...... 4...... Milford ...... 3ioaiousw .'. Hil i . Dagsboro ...... 2 Roins"i 1...... 4WrightsI...... d...owshp. township.... 2 . Georgetown ...... 8...... Carrollton ...... 2...... IValkervfie...... 3:..... Toal...... -Total. 16 1~~~~~~~~~~IifmiltonCounty..... 1it...... Crook Township.... 2...... Illinois (December, 1919): Broughton...... 3..... Adams Counity- MNcLcansboro.1.... Clayt-onl...... HendersoniCounty .... 4..... (Quincy Soldiers' Home.. 2----- Jack-son County...... 8. Calhoun County ..... Coran...... 2.... Belleview Precinct.. 2...... R..... Carbondale...... I...... Hardin...... 2 !....J.s.rCo..t.I...... Cass County ...... 10 ...... frson.Count. 7. Christian County--- Jersey Couny- May townLship 34....a...... JerseyvIle ...... Taylorville ...... : Johnson County ...... 4...... Cook County- Kane Couinty- Chicago...... 8.....Airora...... Cumberlaind C-ounty- U Victoria ...... 2...... Grnu.....I... I...... Kenda1lCotnty ...... 2...... Derkwod . 3Knox County- Dek....b.Coun..y-.... Galesburg...... 5.~...... EaganCumnty ...... 31 ...... Victoria Township.... 1 . Edgar County- Lp onv Stratton ...... 3 ..... Logncounty-......

Chrisman ...... MHenry County- Paris .1...... Spring Grove 1....I .... Edwards County..... 8...... McLean County- Browns .1...... I...... Normal ...... 2...... Fnki County ..... is ...... I Mac"n Cowity.- 1I.... Franklin ...... i ...... Eastern township.., eI'6 Ialnbielle Township. 1...... 489 February 27, 1920. SMALLPOX-Continued. State Reports for Deember, 1919, and January, 1920E-Continued.

Place. GCa. Deaths. Plc. Cases. Deaths.

1imnols-Continued. Loulsiana-Continued. Madison County- Orleans Parish...... 83!...... AMtbn ...... 2 ...... OuachitaParish...... 4 ...... 1 ...... St. James Parish...... 1 ...... Eet Alton...... 2 ...... Vermilion Parish.... 1 ...... Le1Fonol...... 1 ...... Washington Parish..... l ...... Marion ty...... 1 ...... Mason County...... 4 Total ..... 123. Mercer County...... 1 ...... Pewytown Township. 1 ...... Nebraska (January, 1920): MorranCounty...... 2 ...... Adams County...... 11 ...... Jackionvffle...... 2 ...... Antelope County...... Murmyville...... 6 ...... Banner County...... Peoria County- Boone County...... 'Peoriae... 5 ...... Box Butte County...... 21 !...... Bartonville...... 2 ...... Boyd County ...... Perry County...... 7 ...... Buffalo County...... 3 9...... PiattCounty- Cheyenne County...... 4 ...... 1 ...... Clay De Lana...... County...... 1 ....'...... Pike County ...... 4 ...... Colfaxc County...... Newburg Township .. 2 ...... Custer County...... Pearl...... 3 ...... Dawes County...... Pulaski County...... 10 ...... Dawson County...... 43 Richland County- Denel County...... Olney... 1 ...... Dodge County...... madiscn Toship... 2 ...... Douglas County...... !...... Rock Island County..... 4 ...... Gage County...... Rock Island...... 10 ...... Garfield County...... @ ...... Moline...... 4 ...... Gosper County ...... 2 ...... Saline County ...... 29 ...... Hall County...... 3...... Sangamon County...... 2 ...... Hamilton C:ounty..... 1 ...'...... Sprinefleld...... 4 ...... Hitchco County...... 3 ...... New Berlin Township 1 ...... Ilolt County...... 14...... 6 ...... SchuylerCounty ...... 2 ...... Howard County...... fI91.....t...... 8 ...... Jefferson Scott County ...... County...... 21 ...... Glasgow ...... 3 ...... Kearney County...... 10 ...... 5 ...... Keith County...... Manchavter...... 40 ...... St. ClairCounty ---. 2 ...... Kimball County...... I t...... Freeburg...... 2 ...... Lancaster County.

. Loup O'Fallon. . . .. County. 14 i...... - lnion County...... Madison County......

...... County...... Vermilion County...... 1 Merrick 50 ...... 2 . . . . Danville. . . . Morrill County...... 5.I ...... Wabash County...... 2 ...... Nemaba County...... - .Varren County...... 14 ...... Nuckolls County...... 2. Monmouth...... 131 ...... Otoe County...... 10I i...... Kirkwood...... 15 ...... Pawnee County...... 13 t...... Lenox Township.... 5 ...... Perkins County...... 1 ...... Swan Creek...... 1 . . . . Phelps County .... 10...... 3 Swan Township ... 3 ...... Platte County...... I I...... Little York...... I . . . . Richardson County... 542 ......

...... Saline County...... 2 ...... Kelley Town3hip.... 2 2 ...... Ha!e Township.... 1' . . . . Saunders County...... 10 ...... White County...... 10 ...... Scotts Bluff County..... Iiilian Creek Town- Seward County...... 1...... ship ...... 13 . . . . . Sheridan County..... WhitesideCounty- Sioux County ...... 1...... 4...... -- Morrison. 2 ...... Thomas County...... New-rton Township.... 2 ...... Wayne County...... 1921...... WillCounty- Webster County...... 2., Joliet. 2 ...... Wheeler County.... 20 Wheatland Township 2 . . . . York County...... WilliamsonCounty- 2, ...... Marion...... 1 ...... Total......

1 ...... Winnebago County...... '...... Rockford...... 2' ...... West Virginia_(January, 1920): Berkeley County...... 42.__f...... Total ...... 629 Boone County...... Braxton County...... 1, ...... Louisiana (January, 1920): Brooke County.. 2...... umPtion Paris...... 2 Cabell County.. 12...... Avoyou Parish...... 2 ClasCouns...... Beauregard Parish...... 1 rdy C unty...... Caddo Parish...... 12 Fayette County..... 42...... EastCarroll Parlsh...... 1 Hancock County.... fi...... IbervilePars...... 7 Hardy County...... 1...... Jefferson Parish...... 4 Harrison County...... 4...... Jefferson Davis Parish.... 1 Kanaha County...... 10...... LafayetteParish.... 1 Lewis County...... 1...... Narte)itocbes Parish. 2 Lincoln County...... February 27, 1920. 49 SMALLPX-eozi-atiaued. State Reports for Deember, 191, and January, 192-Cantinued.

Place. Cases. Deeaths. Plae. Cam. Deaths.

West Virginia-Continued. West Logan County...... 1 RitehileVirginia-Continued.County. MIcDowell County ...... 37 -raylor (ounty.& - I - Marion County...... 12 | Tpshur County. 9 Marshall County...... 2 Wayne County. 10 Mercer County ...... 129 WVebster County. 18 Mineral County...... 5 Woed County. 2 Mingo County...... 311 Wyoming County. 1 Monroe County...... :s1 Preon County...... 5 Total.. 431 Raeigh County...... 20

City Reprs for Week Ended Feb. 7. 1929.

Coase. Deaths. IPlace. Cases. I Deaths.

Akron, Ohio...... 3 ...... gnsport, IId: . 2 ...... Alameda, Calf...... 3 ...... Long Beach, Cali ...... 2 ...... AplX Bis...... 2 ...... LosAngeles Calif...... 8 ...... Aur,e...... 2 ...... Louisiille, Ky ...... I ...... Baltimore Md...... Ludingts,t Mich...... 5 ...... Birmngham. Ala...... 10 ...... VyFb\a...... 1 ...... Bluefield, W. Va ...... 8 ...... I 8i0,WS...... 3 ...... Boise, Idaho...... 9 ...... IManitowoc, W~is...... I ...... Buffalo, N. Y...... 3 ...... Mankato ...... 3 ...... Canton Ohio ...... 4 ...... Marion, d ...... 1 ...... Cedar iapids, Iowa...... 4 ...... |Ma n ...... o 3 ...... Chicago, IIl...... 2 ...... IMa ...... ;X,. 9I ...... Cleveland, Ohio..... 4 ...... 5 ...... CoHffyvile, Kans...... I ...... IMasonCity Iowa...... Coltumbus Ohio...... 2 ...... Ohiol ...... ('ouncil Biulls, Iowa...... 3 ...... 1Milwaukee1 Xis.! 1218 ...... Dallas Tex . 1 51 ...... Mineapoli, Misn...... 261 Danvile, Va..:::...... I ...... Nensl}New Orleans,e C L.a.ali...... -l. '''''''''i ...... Oaklanid.alf Davenport lo-wa...... 1I ...... ;..... IOgden. I Dron1, oAio ...... tah..-.-.--;--...-...... 37 ...... Denver, ...... l Oklahoma City, OIa. C01l ...... Mich. Nebr...1 Detroit, ...... Omaha, ...... Dubque, Iowa ...... Padneah, KY...... 17 Dulut, M ii ...... Peoria, Ill ...... 4 ...... Durham, N. ( ...... P'ine Blutff Ark_.. 42 ...... ElPaso Tex ...... i ...... Ilonita ci..,f 1' ...... Flint,ii ...... Portland, Oreg ...... Fond'du Lac, W .is 2 ...... Por(smouth,Va...... I1 Fort Smith, Ark. 5 ...... , P'ueblo. Col...... ------. Fort Worth Te'.x------.-- 13 ...... - Raciiue', 'i ...... 1 ...... Galesburg, ili Riverside, ('alit ...... 233 ...... Galveston, Texi.. . 1 ...... I Rock Islajnd, Ill ...-.,.| ...... G;ary, Ind...... St C-lotud Minii.. 1 is ...... ("Frandl N1ich...... Mo 23 ...... Rapids St. Josepi,Mo.l . Si. Loulis, .. yIl ...... G;raniteCity Min . Great Falls, Mont ...... St. Paul, l 15 ...... Green Bay, Wis...... Salem, Oreg ...... HlammnonaInd ...... 3 San Francisco, Calif...... 8 ...... Hot Ark ...... 2 7 S~prings. 1 1...... Santa Barbara. Calif...... Huntmgtan,In d ...... ,i1.12 Siotx Falls, S. l)ak ...... 2 1 ...... Hutchiuson, In(l ...... Kans ...... Suoth Bend, 6 ...... S. ('...... 1 ...... Ironood, i ...... M.. 131...... Sp)artanbuirg. 1 Janesville, Wis...... Springfiehl. Ohio ...... 1 ...... Steubenville, Ohio Kalamazoo, Mich..... 2. ..i 3 ...... Kansas City, Kans. 17. Suirior. WiS . 8 Kansas City, Mo:....:..... 1 1 Trinidad, Colo...... 1 ...... Kenosha, Wis ...... 21. Wshing_t4U 1).('- ...... 4 ;...... Ill 'is Kewanee, ...... I71. WaOuiu, ...... 4 ...... Knoxvill Teni2. Wichita, Kanis ...... 9g ...... Kokcomo, ind...... Del...... 1, La Fayette, WIlmt.ington, N ...... md...... ! IWilmington .C...... 1...... Leavenwvorth, Kais...... 2...... Lincoln, Nebr...... Zanesville, Ohi...... 1.

- 491 February 27,1920. SMALLPOX-Continued. Vaccinations on Canadian Border, 1920. Reports from Public Health Service officers on the Canadian border show that vaccinations were performed at points of entry to the United States from February 12 to February 18, 1920, inclusive, as follows: *Taccibations. Buffalo...... 347 Detroit ...... 929 Niagara Falls ...... 207 Ogdensburg 1 .. 59 Port Huron ...... 342

Sault Ste. Marif e ...... 53 TETANUS. City Reports for Week Ended Feb. 7, 1920.

Pllace. Cases. Deaths. [ Place. Cases. Deaths.

Chicago, Ill...... 1 Richmond,....2Va...... 1. ....1 New Yorkc,N.Y\.11...... Wilmington, N. C....2 ...... ~~~~~~~~~~~~~~~~~~~ TUBERCULOSIS. Sec Telegraphic weckly reports froml Stta-tes, p. 164 ad(l WVeekly reports from cities, p. 494. TYPHOID FEVER. Staie Reports for December, 1919, and January, 1920.

a New cases Newcases reported. Jlace. reported. Il. Arizona (January. 1920): Colorado (December, 1919): Mohave County ...... I Denver County...... Kiowa County...... I California (DeremLer, 1919): Prowers County...... 1 Alameda County- Pueblo County...... 1 Oakland ...... Weld County ...... 1 Fresno County ...... Total Clovis...... 1 ...... 7. Imperial County- El Centro...... 1 Delaware (January, 1920): Kerrn County- Wilmington...... 1 Taft...... 1 lMilford...... 1 Los Angeles County...... 2 Middletown...... 1 1 1 Arcadia ...... Dover...... Los Angeles ...... 12 Madera County- Total...... 4 Madera. 1 Mereed County. 1 Florida (January, 1920): Monterey County. 3 Baker County...... King City. 2 Bay County...... Riverside County. Bradford County...... 1 Banning. 1 Columbia County...... 2 Dade County- Sacramento County- 3 Sacrament3. 2 Mami...... 2 San Francisco. 2 De Soto County...... San JoaQuin County- Duval County...... 2 1 2 w'wanin eca-- ...... Jacksonville...... 2 Eseambia County...... 1 gonomaContSoo y...... y.u 1 Stanislaus County. 1 Pensacola...... 1 Hillsboro County...... 2 El Dorado County. 9 Tamp...... 1 Total.. 38 Holmes County...... Jefferso County...... I I No report for Feb. 18 February 27, 192t. 42 TYPHOID I9VE-4Icainued. State Reports for December, 1919, and uary, -Continued. NeW caseslm Plave.I reported. Place.c.amnr"mud I Florida-Continued. Il inois-Continued. Madison County...... --.-.-.-.--- Saline County. 1 13 Manatee ('ounty ...... 3 Saz¶imon County- Orange County...... 2 Pinellas County ...... 3 ifi11i!ingfie. 1 Polk County ...... I 2 St. Cisair County. I Volusia Couinty. ------6 East St. Louis...... I I. Belleville ...... Total...... 47 St L'berty------1 Tau well County- Illinois (December, 1919): 2 arington...... 2I Adams County--- JVermtio XCounty- .' 1 Quincy...... Danville ...... Alexander County- Potomac. Elco ...... 1 Wabash County 1 J3rown County--- Will County- Mount Sterling...... 1 Jolieto. Christian County...... 2 Joliet Township. 12 Taylorville...... Williams County- Clark- County- Cambriam. Marshall...... 3 Winebago Coumty- West IJnion...... Coles County...... 1 Mattoon...... Total...... Cook County_- i Chicago...... 1I Louisiama (Januar, 1920): Crawford County- Aen Parish...... 2 Oblong...... Avoyalles Parish...... Cumberland Coumty...... Bcaureaard Parish...... 1 De-witt County..------Caddo brish...... 1 Douglas Count ...... 2I Caidwell Parish...... 1I Fayette Couinty- De Soto Parish...... 2 St. Peter...... Grat Paris ...... 5 Vilbertoni...... 1 Iberville Parish...... St. Elmo...... 2 Lafayette IParish...... I Franklin County- Lafouvche Parislh...... 12 West Frankfort...... 3 NAachitoebes Parish ...... 1 Ziegler...... 1 Orleans Parish. Gallatin County...... 11 Ouneha Pais... 2 Fagle Creek Township...... 2 Pointe Cotpee Parish...... Hamilton Cottnty- Rapides Parish.. 1 MeLeansboro...... 1 Sabine Parish. Henry County. St. John lParish...... 1 Jackson County...... St. Martin Parish...... 1 Jefferson County-- 41 Webster Plarish...... Webber Township ...... 1 Kankakee Counity ...... 5 Total...... Lake County-- WVaukeg:ani ...... 32 Maryland (Januiary, 1920): North 1 (hicago...... 4 Baltimore...... 1 Lawrence County...... ----- 2 Baltimore County- Logan County- Catonsville...... 1 Lincoln...... Oela ...... l MfcDonough County - 11 Cecil County- I Hue Township...... Elkton ..... 12 Mfacon County ...... l Charles County- Decatur...... Waldorf ..... 1 Madison County ...... 21 Riverside ...... -.*l Alton ...... Bryantown, R. Wood River...... Dorchester CountY- 15

Marion County ...... Hurlock, R...... Odin ...... - Frederick County- 1 Montgomery County ...... l 11 LiUbrtytown...... 1 Litchfieild ...... : BUnswick ...... 1 Farmers%ille ...... Middletown Morgan County - 1; (G arrett County- 1 W\oodsoi) ...... Kitzmiler...... 1 Jacksonville...... Kent County- 1 Ogle County ...... Galena, R. D .. . Pine Rock Township...... lrince G(eorges County- I Peoria County ..... 3! Aquaso...... 1 Pike C(oonty ...... Queen Annes County- New Canto(n...... I1 Sudlrsville, R. D. Randolph County...... 11 Somersa C y- KaskasU-ili Township...... Dames Rlichiand C'ounty I Qamte .~...... D . Olney ...... 1 B. | Rock Island County ...... St. MWryWestoverCounty- I. East Moline...... -I Moline...... TalblaCountJtTrappe., if. D ...... 4Y3 February 27, 1920. TYPHOID FEV-4ontinued.

State Reports for Del eber, 1919, and January, 1920.

rew cases New cases Plaoe. Place. reported. reporte.

Mabnd-Continued Mineets-Continued. I Watewan County- I 2 8t.. Jaes ...... 8prXg...b...... 1 Vilkin County- 1 Williaesport, R. D...... 2 Campbell Township...... I 39 WEina County- lowiston ...... 1 Michigan (January, 1920): Wrighit C.ounty-- Alleg County ...... IYaple Lake...... 1 Calhou CountyC u ...... ty...... 3 Chippewra County ...... 1 Total...... Genesee County...... 2 Grand Traverse County...... 1 Ncbraska (January, 1920): 1 Oratiot County...... 2 Cuming County...... 3 County...... Douglas County...... Ingeis County .--- Halt County..... I Iron CoUnty...... 1 Knox Couty. Isaeer County...... 2 Lacater C'ounty...... I Kent County...... LapeerCounty...... 1 Total...... 1 LMenae County...... Manistee County...... 61 New Mexico (Jantuary, 1920): Monroe County...... 1 Baemlillo County...... 3 Oaldand County...... 2 Chaves Coumty...... 21 Saginaw County...... 6 Collax Coumty...... 1 St. Clair County...... 2 De Baca County...... 1 St. Joseph County...... 1 Grant County...... 2 Wayne Coumty. 13 Otero County...... Qay Couty...... 1 Total ...... 48 Rio Arriba County...... _~7 Socorro County...... 1 Minnesota (December, 1919): Beltrami County- Total...... 15 Rhode Island ChippewaCounty- (January, 1920): Montevido...... NewDort County- Clay County- 1rewport...... Moorhead ...... XVermont (January, 1920): Oakport Township...... Addison County ...... 6 Crow Wmg County- Bennington County ...... 1, Chitteien County...... Dakota County- Orleas County ...... Hastings...... WashingtonCounty...... 3 Sth St. Paul.... 1 Ilennepin County- Total ...... 12 nneois...... Murray County- West Virginia January, 1920): Iona ...... Barbour ('ounty 4 Norman County-- Boone County ......

Felten Township ...... Fayette County* Olmsted County-- 1 (ilmer County ...... Rochester...... Hancock County..3------3 Ottertail County- Kaiaawha (Countiy ...... LS DeerCreek ...... 1;i LewV 'Cou-nty...... 1 Fergus Falls...... Lincoln Coiunty ------..I Aurdal Townsip...... 4:, Logran Colmnty ------... 4 Deer Creek Township ...... Maion Clounty ......

Mason ...... 2 PennlnWut~asnt.y-- 1! County Merewr County ...... I Polk Couny- Mineral County ...... I East Grand Forks...... Mingo Counlty...... ! RamseyCouty- Mononralih > l t ...... Coun i1 1 St. Nul...... MonraeCounfy ...... 2 RenvilleCounty- NicholmCounty I

Fnu i i .. Ohio Cout.r -3 St. LouisCounty-- PUSants ('ountn y ...... I Duluth PocatonL COul,n -..-,,,- i Embrrass Putmnm Colin'y ...... 2 Township...... I, Scott County--- TW ITiI 0,11t'I'.i...... New Market ...... 41: RanIlolp Comnty.. 3 ReIane County ...... I Stears County--I 1 i St. Mrtin ..... 21 St. .nty... Martin Township ....-.--.| Tvkrum.rsCunty ...... 3 WSte Coun ayn County ...... erti t.ip ...... Wirt out ...... , Woel C nty.------3 ...... St tr ...... Trotal...... 135 Pebruary 27, 1920. .494 TYPHOID FEVER-Continued. City Reports for Week Ended Feb. 7, 1920.

Place. Cases. Deaths. Place. Cases. Deaths.

Allentown, Pa...... 1...... Milwaukee, Wis ...... 2 1 Atlanta, Ga ...... M 1 ...... Minneapols, Minn...... 1...... Auburn, N. Y ...... 1...... Montgomery, Ala...... 1...... Baltimore, Md ...... 1...... Nashv ille, Tenn ...... 2...... Birmingham, Ala ...... 2 1 Newark N.J ...... 1...... Boston,Mass ...... New Orfeans La.. Buffalo, N. Y 3...... New Philadeiphia,Ohio'...... Charleston, S. C . . 2 .. New York, N. Y ...... 3...... Coffeyville, Kans . . 1...... Northamrton Mas3 1 .1 Dallas, Tex...... 2 ...... Oakland, CalifI.. Denver, Colo . . 2...... Philadelphia, Pa...... 5 Detroit,Mich...... 2 ...... Portland, Oreg ...... 1...... Erie,Pa . .1...... I ------Richmond,Va...... 1 Everett, Mlass . . 1 1 Sacramento,Calif ...... 1...... Galveston, Tex ...... 1...... St. Louis, Mo...... 2 Grand Rarids, Mich 1...... San Francisco,Calif ...... 1 1 lHammond,1nd...... 4 3 Savannah Ga 2 1 Hutchinson,Kans ..1...... Sprinrfiel ass 1 ...... Independence, Mo ...... Was...... wa-hington D. C ...... Joplin, Mo ...... 1 ...... Waterbury, Conn...... 1...... Kokomo,Ind...... 2 ...... Wilmington, Del...... MWattoon,Ill ...... 1......

TYPHUS FEVER. Maryland Report for January, 1920. During Janumary, 1920, two cases of tvphus fever were repoitedl it MarylMand. DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS. City Reports for Week Ended Feb. 7, 1920.

,~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Popula- Diphtheriaj wMeafle. Scarlet Tuber- ion as of Total I ~~~~fever. cubosis. JuJtly 1, 1917 deaths Civy. stimated from 9; )y U.S. ; all .0 Census cauises. & tIreat). v) 0 r.) , .S ,

Aberdeeni S Dak ...... 15,926 ...... 2 ...... ,...... Adams, VIass...... 14,406 2 ...... - ----1 --- - 1----- Akron Ohio...... 93,604 44 ...... Alameda, Calif...... 28,433 11 1 1----. Alexandria, LA...... 16,232 4 3 Alexandria, Va...... 17,93) 14 ...... Allentown Pa...... 65,109 ...... Alliance, dhio...... 19,51 I...... ,. i -- -1 211...... Alpena Ilieh...... 13,365 ...... 16 ...... vv..'''1.. I...... Alton, ill 23,7183 1 . 1.....184...... Altoona,Pa..l 59,712 I25 3 .8 1 Amesbury, Mass ...... l 10,200 ,...... ;...... Anaconda, Mont...... 10,631 Ann Arbor Michl...... 15,011 ...... 31 1...... I.....i Anniston, kla...... 14,326 4 28..1 ...... Ansonia, Conn...... 16,954 908I ...... Wis...... 18,005 ...... Appleton, -- - 2-2 Ar ington;, Mass ...,.... ,,,. 13,0731 ...... 6 I.. 2 ,...... Asbur Park, N.J ...... I 14,629 4I ...... 1 1:::1 4 ...... Ashtaul O.hio...... 12,008 Atlanta, (a...... l 193, 144 901 Atlantic City, N. J...... 59,515 17 42 144. .1 57 Attleboro mass...... 19,776 8 1- ...... 1, Auburn, ie...... 37,607 1 3. Auburn, N. Y...... 37,823 24 [...... Austin, Tex...... 35,612 8. 11 ...... 1 1----.- Baltimore Md ...... 594,637 351 40 Bangor, iie...... 26,958 495 Pebruary 27,1920. DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS- Continued.

City Reports for Week Ended Feb. 7, 1920-Continued.

Popula-Dih era Measles. Scarlet Tuber- tion2as of Total Diphtheria. fever. culosis. July 1, 1917 deaths (itv. (estimated from -v b SU.8. all U; 4t Census cauteuses. w,W I Buireau). a ss i CX Qz A | - i~~~ ---l a- Barberton, Ohio...... 14,187 13 1 . ,...... 1 ...... 544 Baton Rouge, La...... 17. 9...... ''i Battle Creek, Mich...... 'Q,i1 6 3 . 13 ...... 5 ...... 3 Bayonne, N. J...... 2,20 ...... 4 . 1 ...... ,...... i.. Beatrice, Nebr...... 10,437 4...... l...... 851 Beaumont Tex...... 28, 14 ...... Beaver Fa Pa...... 13,749 ...I.1...... Bedford d...... 10,613 1...... 13 ...... Belle e N. J...... 12,797 ...... Beloit, VIs...... 18,547 ...... 1''' Benti Harbor, Mich...... 11,099 ...... 4 ...... 6 Berkeley Calif...... 60,427 20 1 . 78 5 ..... Berlin l9. H...... 13,892 5...... B e^ Pa .---'---- 14,353 ...... 3 ...... Beverly, Mass...... 22,128 6...... 1 ...... 6 ...... Bil s font...... 15,123 6fi...... 2 ...... Birmingham, Ala...... 189,716 7-2 3 . 16 ...... 8 ...... Bloomfield, . J...... 19,013 2...... X 3 ...... Bloomington, 111...... 27,462 16 1 . ...i...... 3 ...... 2... Bloominton, Ind...... 11,661 0...... Bluefield a ...... a.. 16.123 1 ...... - 1. Boise, Idho...... 35,951 7 ...... Bosto, Mass...... ,67.813 408 47 4 278 fi I-4 4 .5..- Braddock, Pa...... 22,060 ..... 8 .... 2 ...... Bard, Pa...... '14,544...... I ..... 3 ...... Brazil, Id...... 10.472 1...... 1...... 60 12 . .... Bridgeport, Conn...... 124.724 17 ...... : ...... Bristol, Conn...... 16.318 8 2 ...... Brocn, Mass...... 09,152 17 6 1 ...... - ...... 1 Brookline 33,526 13 ...... Brunswicf-, Gaass...... - 10,984 4 ...... Buffalo, N. Y...... 475,7,81 200 49 5 ...... 20 ...... Buringto, Iowa...... 25,144 16 ...... S...... 1 ...... Vt...... 21.802 11 ...... Burlington, ...... Butler, Pa...... 28,677 .. 1...... Butte, Mont...... 44,'O7 22 2...... 1 ...... 2 ...... 36 Cadllac, Mich...... 10,15 1 .1. 1- ...... 7 Cairo, Il. 15,995 ...... 7 ...... Cambridge, Mass...... 114.293 46 2...... 8 2 6 ...... 1 Canton, Ill...... *13,674 14 ...... Canton, Ohio...... 62.566 59 3 1 .... Carbondale, Pa-.------19. W7...... 1 :::::: 4 Carlisle, Pa...... 10.795...... 3 ...... Carnegiw, Pa...... 11,963 .. 1 ..... 2 ...... Cedar Rapids, Iowaa...... 38.033 7 2 . -...... Centralia, Ill...... 11,838 6...... : Chambersburg, Pa...... 12,475- .. 3 . 15 ...... 4...... Chaaaute, Kans ...... 12,968 ...... 2..... S. 61.041 25 3 ...... Charleston, ('...... 3 W. 31.060 ... 2 . Charleston, Va...... Charlotte, N. ('...... 40.759 13 ...... Chattanooga, Tenn...... G1.575 25 . .. 3 7 ...... Chelsea, 48.405 22 ...... 2 Mass..------...... ~ ~ I...... ~ ~ ~ Chester, Pa...... 41.857 .... :3 ...... 1 I...... i Chi, Ill...... 2.547,201 1.945 117 11 197 326 I...... , ss...... 29,950 5 11 1 7 .s ...... Cincinnati, Ohio...... 414.248 156 8 ...... Ohio. 692,259 366 31 2 16 :1 ...... Cleveland...... Clinton. Miass.------..-...-.. 13, Js7 3... I~2 ...... Coatesville, Pa. 14,tX...... Cofleyville, Katai...... 18,331 ...... 2 ...... i Cohoes, N. Y...... 25,292 7 1 . 2 ...... Columbia,8...... 35,15. Columbus, Ga...... 25,306 12...... Columbus. Ohio ...... 220, 135 136 1 ..... 28 20...... Concord, N. H...... 22,858 11 ...... 1819 ...... I...... Connbllvie, Pa...... 15,876 ...... I...... 1. ... CorpusChrlsti .ex...... 10,8367 . Council Bluffs, loa...... 31 838 23 ...... 3 'Population Apr. 16, 1910. Feleruary 27, 1920. 496 DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS- Continued. City Reports for Week Ended Feb. 7, 1920-Continued.

a- | -- Popula- Diphtberia.I Measles. Scarlet Tuber- tion as of Total fever. culosis. fuly 1, 1911r w;AA0+h. l- I City. (estimated from. - by U. S. all Census causes. Bureau). I V 1- , I I I 3- I~ Covington Ky...... 53,623 15 ...... 42 .... 1 .2 Cranston, hi. I.. 26,773 6 ...... 3 ..... 1 Cumberland, Md...... 26,686 13 ...... 2 ..... 3 Dallas, Teax...... 129',738 109 15 1 ...... 1 2 Danbury, Conn...... 22,931 8 ...... 9 ...... -1 Danvers, Mass...... 10,037 ...... -2 Davenport, Iowa...... 49,618 2 ...... -.... Dayton, Ohio...... 128,939 ...... 10 ...... 5 Decatur,Ill...... 41_483 38 ...... 119...... 1 '38 Denver, Colo...... 268 439 261 16 23 ...... 27 Des Moines, Iowa...... 104,052 4 ...... 5 1... Detroit Mich ...... 619,648 1, 147 97 108 4 66 Dovcr, i. El...... 13,276 4 ...... Dubois, Pa -...... 14, 994 ...... 1 1... 1...... 8 Dubuqiie, Iowa...... 40,096 ...... 2 ...4 Duluth, Mlinn...... 97,077 .32 1...... 5 Dunmore. Pa...... 21,286 ...... 1 ...1 1 Durham, N. C...... 26, itO ...... -1 ...... EastChicago, Ind 30,286 1...... 43 I...... 8 East Cleveland, Ohio ...... 13, 864 2 5326 ...... Easton, Pa. 30,854 ...... ,2 East Orange, ...... 43,761 4 243 1 East Providene R.I...... 18, 45 2 ...... 38 East St. Louis, ...... 77,312 ...... 18 1 1 Elgin, Ill ...... ,.,,.. 28, 5l2 1 1...... 1 EUzabeth N I . 88,830 20 3 64 6 Elkhart I'd...... ,. , 22,273 ...... 2 4 18 Elmira,N. Y . 382,27 18 28 3 El Paso, Tex . . 69,149 ...... 1 I...... Englewood, N. J...... 12,603; I5 ...... Erie, Pa..: ...... 76,592 20 69 Eureka, Calif...... 15,142 61 Evanston, Ill...... 29,304 2n ...... 1 ...... I5G Everett, Mass...... 40,160 3 8 ...2 Fairmount, W. Va...... 16, 111 .62 3 ...... Fall River, Mass...... 29, 828 3 ''7' 9 Farrell, Pa...... 110,190. 17 1 2 ...... I. . 1... Findlay, Ohio...... 114,858 45 1-- 1... Flint, biich...... 57,386 3 is 1...... l- --. 14 Fond du Lac, Wis...... 21, 486 1633 1 .. 1 Fort Smith, Ark...... 29,390 2 ...2 Fort Worth, Tex...... 109,597 13 ..*. *...* -...... I- ...... Fostoria Ohio 10,959 ...... I s.. 1v.. Framinpiiam, Mass. 14, 149 ...... Freeport,IL...... 19 844 18 ...... 2 ...... 3895 1...... Fremont,Nebr 10,080 ...... 1--- Fremont,Ohio...... 11,034 9 ...... 1...... Galesburg, Ill...... 24,629 16 ...... Galveston, Tex...... 42,650 1727 ...... l...... 1 Gardner, Mass...... 17,534 ...... Gary, Ind...... 55,000 ...... }...... 1 Genev N Y. 13,915 624 ...... 1...... I 1 GlenslalNY; , ...... I~ 17,160 15 ...... Grand Rapids Mich ...... 132,861 68 2 '23 4 GraniteCity i. 15,890 ...... 20 ''''.i' ...... Great Falls kont. 113 948 16~ 5 3 3 Greeley,C-oio...... 11,942 ......

Mo s ...... 217 ...... 1...... Greenfield, 12,251 l-- ...i. Greensboro N. C...... 20,171 ...... I 1 ...... Greensburgh Pa. 15,881 27 ...... Greenwich donn... 19,594 ...... 2 IHackensaci N J...... 17,412 ...... 1 Hammond,fnd...... 27,016 4 9 ...... 7 Harrrisburg, Pa...... 73,276 1 ...... 1 Earrison, N. I...... 17,345 ...... I 1 ...... 1

Hartford Con...... 112,831 7 ...... 14 Haverhili,mass...... 49,180 1- -1 1.-1...... Hazlton, Pa...... : . 28,s81 2 ...... 1 Ribbing, Minn...... 17,550 3 1 1 ...... 41 Highland Park, lOch. 33,859 3 ...... Population Apr. 15,1910. A07 February 27, tiN.

DIHTERIIWA,IL MEASE,SCRE FEVER, AND TUBERCULOSIS-.

(sty Reports for Week Ended Feb. 7, 192(1-Continued. Scai

Measles. rlet ITuber- rer. culosis. tio of Total aly nasw1, 1917 4Aths, Ife______City..

Hoboken N J..... 78,324 47. 3 1 2 2 3 j.i

1.1. ... Holland, i(lCh.. .. 12,.459 Holyoke, Mass...... 06,503 21 ..... 19 1 Ht Springs,Ar 17,4190 7...... N. Y...... 12,87S 7...... Hudson, .1 1 HAntiuton, lad...... f'82 8...... Hnnton, W.VVa...... 47,686 7...... Hutchno,ae 2 21,401 ...... ----- I.roawood,Mieh. i:::::: 16,7-10 ...... 2...... 4 ------'12,448 4...... 2 Nis...... 1 0,017 7 .I--- ...i. anevingto, 15,500 21 ...... 2 3 Jeffksonvill'el..... 37,431 22 1 .... 14,411 14 .---- 53 1 13,712 10.------...ii. Jersey City N.J.... 3.2,5Wo.... 21.... 57 ... a Johnitown,pP...... Joplin,Mo.- ...... 33,400 5 1.... 1...... Kalamazoo Mich. 50,408 29 1 .14,270 6...... 02,0 6 46 KansasCity, Kans-...... M1 .. -- KansasCity Mo 305,816 ...370O 8 1 85 4 16 9 10 2 13 2 3 earny N 24,325 9 ...... Kene kH 10,725 7...... 329,833.....1I....2.... 1- 13,607 22 ...... ------59,112...... 4 1 74j 1 3 1 Kokomo, lad 7 I ...... 21, 12 -- Lackawanna, N~~~~~.Y. __ '. '. J*6,219 6----- 1--..... Larosse Wi...... -- LaFayette Ind...... 21,481 .- Laneasterl,45ho...... 16,086s 5.1 .. ... ------Lraneaster, Pa...... 51,437..... 9 13 .... Laurel, Ms...... 12,313..... 1 .------Larece an...... 13,477 4.------.4 La rece Ma ------. 102, f.23 37 4 1 4 ---- 4 '19,363 1 Levnoth, Ks...... 9.-- -- - 21,365 5 -- .....- 4 41,997 22 2.... 13 I Lma, Oio...... 37,145 15 .. 2 60 I Licl,Nebr ...... 46,0957 39 ---- . .- 3 17 20,028 6...... I ---- Loasot, Ind ...... 21,338 9 4 LogBah,Calif ...... 29,183 16 .. 7 20 Lorain,Olf...... 535,485 210' 51 1 34 .... 19 4 8 Liouisville ~...... 216,808 118 16 .... 6 4 LUdigo,Mich...... Lyc auga...... 148,299 .-... ---f

-- 46,099 17-- ... .. 4- , Mtadis .. . . aanyCity,Wis.------Pa ...... 15,,85 4...... I Madon,Mas...... 17, 709 2... 2 .i Manchester,Con...... 52,243 32 .. Manchester, N. If...... 76,4907 16 I'

1333an...6.. 4--- I Myete. Wis...... i Matrion, Lnd...... 1 ..... 2.5 Marlon,Ohl ...... kg9,412324,6129 15 1. 14 1IasonCit~ Iowa...... 14 ,"8 .--- Mattoon, tti ...... 12,364 ...... 30... I 'iPopisiation Apr. 15, Febraary 124920.7, 498 DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS- Continued: City Reports for Week Ended Feb. 7, 1920(JContinued.

Popula- Diphtheria. Measles. Scaret Tuber- tioni as Of Total fever. culosis. July 1, 1917 deaths City. (estimated from I, byU.S. all . . Census causes.j Bureaui). r ~I

...... Meadville, Pa ...... 13,968 ...... 2 ...... Medford, Mass...... 26,681 16 ...... 1 ...... I Melrose Mass...... 17,724 6 ...... 5 ...... Memphis, Tenn...... 151,877 .6 7 7 8 ...... 7 4 Meriden, Conn-.------21,431 6 4 ...... 4 6 ...... 3 ,i Methuen, Mass...------14,320 6 1 ...... I 1 ...... ,....-.. Middletown, N. Y...... 15 810 ...... I 9 ...... Middletown, Ohio...... 16,3834 8 1 .. . .. 2 ...... Milwaulkee, Wis...... 45,008 300 25 31 1 Minneapolis Min...... 373,448 294 15 1 17 10 3 13 9 Mlshawaka,/nd...... 17,083 7 ...... Missoula M1ont...... 19,075 7 ...... Mobile, .la...... 59 201 35 ...... Monessen, Pa.. 23,070 .....i.. 4 ...... Montgomery, Ala...... 44 039 . 2- MorgaitowII W. Va...... 14,444 4 ..... Morristown, N. J...... 13,410 14 Moundsville, W. Vsa...... 11,513 10 ....i.. 9 ..... MointCarmel, Pa...... 20,709 ...... I...... l-- - - Mounit Vernon, I...... 10,043 27 ....1 ...... 1 - -- Muncie, Ind...... 25,653 ...... 23 ..... 1--.- Muscatinle Iowa...... 17,713 ...... }...... 26 ...... ,...... Nashua, N?. H...... 27,641 1 NashviUe. Tenn-...------118,136 113 ...... I s Newark.New3r. N.J...... N.. 418,789 2401 %; 5 201 ...... I x New Ped.ford, Mass...... 121,622 46 37 ...... l 3 New Britain, Conn...... 55,38Q5 ...... 1------New Brunswick,%. J...... 25, 855 4 ..... 1-- -- 8 ...... 14 ..... Newburyport, Mass...... 15,291 ...... 52 1 -- New C-astle, bld...... 14,144 ...... 1-'- New Castle, Pa...... 41,915 ...... 1, II'''''' New Haven, Comnn...... 152,275 ...... 3 ..... Con...... 6.1 71I 7 ...... I...... New London, 21',199 2 ...... 1... New O0-leans La...... 377,010 147 7 ...... 257 1 { 15

...... 10 ...... 1...... New Philadeiphia, Ohio. 10,133 ...... 4 ..... 10 2 ...... Newport, R. I...... 30,585 1-- --- Newtoon, Mass...... 44,345 11 1 ...... - 4 .i...... New York, N. Y...... 5,737,492 3,502 339 2,035 0 4 178 20 3 93 1... Niagara F;alls, N. Y...... 38,466 ...... 1 ..... 4 Norfolk, V'a...... 91,148 5 ...... 1...... 1- -- 4...... Norristown, Pa...... 31,969 3 ...... 1 ..... 2 North Adams, Mas...... 22019 2 ...... 2...... Northampton, Mass...... 20,006 ...... -..... 5 ...... 2 North Attleboro, Mass...... 11,248 ...... North Braddock, Pa...... 15,684 ...... North Little Rock, Ark...... 15,515 ...... 12 ...... North Tonowanda, N. Y. 14 060 ...... Norwalk. Conn...... 27',332 15...... I--''-i Norwich Conn...... 21,923 4 3 2 ...... 1 Norwood, Ohio...... 23,269o 8 1 5 ...... 1...... Oakland, Calf...... 06,405 110 1 96 '2 ...... 7 Oak Parlk, Ill...... 27,816 15 2 2 ...... 2 Ogdensburg, N. Y 16,845 17...... Ogden, Urtah...... ,32,343 17 1 ...... Oil City, Pa...... 20,162 ...... Oklahoma City, Okla...... 97,588 221...... 3 Olean, N. Y...... 16,927 10 1 31 3 ...... 1......

. 17 Omalha. Nebr ... 177,777 86 2 2 31 Orange, Coann ... . 14,393 4 ...... Orange, N. J...... 33,636 18. 3 ...... 2 Wis...... 36,549 ...... 28 ...... - - - Oshkosb, 3 Paduicah, Ky...... 25,178 ...... ,..-- Parkersburg, W. Va...... 21,059 ...... 1.11 ...... 1''-'' Parsons, Kans...... 13,952 ...... ,...... PasaTdena Cslif...... 49,6,70 1011111 ...... 1'-'-''.... Passaic, R. J .. 74,478 311 21 1 ...... ,...... Paterson, N. J ...I 10,512 26 10 18 ...... Pawtucket R I 60,666 15l...... s...... Pe offA y,N.J. 19,034 5 ...... ,...... Peoria, N ...... 72,184 444 ...... 1...... ' 'I ' Perth Amboy, N. J...... 42,648 14 1 ...... :l I Population Apr. 15, 1910. A499 Feldruary 27, 192. DIPHTHERIA, MEASLEIS, SCARLET FEVER, AND TUBERCULOSIS- Continued. City Repor1t for Week Ended Feb. 7, 1920-Continued.

Popula- Diphtheril a. Measles. Scarlet Tuber- tion as of Total fever. July 1 1917 deaths 87 j_. City. (estimated from byU.B8. all 8lureau).Census causes. . d) 11111_ _e { - - a l - T Petersburg Vaa. 25,817 ...... 1 I Phiadelphia, Pa. 1,735; 14 747 76 PhialsbuWrg,N.J. 15,879 5 17 [494~ ...... Pine B1uff Ark. 17.7'7 7 ;...... Piqua. Ohio. 14; 275 R 12 ..... Pittsburgh, Pa.. .19 Pittsfield, lass.. t 39'678 2R, ...... 1243 1 Pittston, P&a..... 18,975 ...... 3 J 24 15 Plainfield, N. . 330 ...... Plattsburg, N. Y...... 5 Plymouth. Mass ...... 1 14,0011h~xiii 3 :::::: Pa...... 19,439 9 Pontiac, Mich...... 18,00 42 6 ...... Port Chester, 10 ...... N. Y...... 16 ,727 6, ...... Porand ...... 64,720 35 .. 4...... 13 Portand, Ore!.. .308,399 100 5 ...... 5 ...... 1 4 Portsmouth, N. 11 ...... 11,730 . 7 ...... Portsmouth, Va...... 40'693 ...... Pottstown, Pa ...... 16,987...... 10 Pottsville, Pa. 22,717 ...... 4 Potghkeepsie, N. Y...... 30,786 2 ..... 2 ...... Providence, R. I...... 259',895 100 ...... 22 ...... 8 Pueblo, Co ...... 56,084 15 1 ...... Quincy, Ill...... 36,832 16 ...... , . .. -7 ,1 Qudncy,lass 39,022 14 5 ...... 4 .... -.-,.-..-...... 4...... R I, Wis...... 47,485. *..... 9 Rahway, N. J...... 10,361 4 ,...... C ...... 11 . .. Ralei.i,IN. 20,274 16 4 111,607 ...... 3 ...... Rading, Pa...... 1 2.. Redland, Caifa...... 14,573 3 1 ...... Reese, Nev ...... 15,514 4 4 ...... Richmond, Ind ...... 25 080 18 ...... 42 ...... -1 11.- - Richnoud, Va...... 158' 702 108 ...... 91 ...... 2...... 14 Riverside, 0al11...... 2,496 9 ...... I1 ...... Rochester, N. Y...... 24714 121 175 4 RFockerd, Ill...... 58,39 49 3 1 ...... Rock Island, Ill...... 29,452 14 66...... 2 ...... Rocky Mount, N. C...... 12,6 -3 6 ...... Rutland, Vt 15,038 8 3 ..;... Sacramento. i8,984 32 1 Calif...... ------St. Joseph, Mo._ 86,498 54 ...... 1 ...... 1 St. Louis, Mo.. 768,3' 665 ...... 6 9 1. St. Paul, Minn...... 252,465 15 9 1 20 . . . Salem, Mass...... 49,346 25 ...... Salem, Oreg. 21, 274 4 ...... Salt Lake City, Utah...... 121,623 121 1 ...... 1 ..... San Bernardino, Calif...... 17,616 6 .. ...1 San Diego, fif...... 56,412 38 3 ------I 7 2 San dusky, Ohio...... 20,226 14-27 Sanford, -Ie... 11,217 0 ...... 2 ::::::1 1- i''. San Francisco, Calif...... 471,023 231 31I ...... 325 1 .3 Santa Barbara, Calif...... 15,360 3 ...... 2 -- - - - Santa Cruz, Calif...... 15,150 1 4 1 ...... -- ---1 Saratoga Springs. N. Y...... 13,839 3 4 - -- - Saulit Ste. Marie, Mich ...... 14,130 5 ------I ...... 3 Savannah, Ga...... 69,250 45 .....21...... - - -- -I N. 103,774 .34 ...... 14 ...... Schenectady, Y...... - --1 2 Scranton, Pa...:...... 149,541 ...... 1...... 31 - - - - -I . I 6 4 Shamokini, Pa...... 21,274 ...... Sharon, Pa...... 19,156 .... - - -1 ,,,,. ,1 ...... lShenandoah, Pa...... 29,753 ...... - - -- -1 7 Sioux City, Iowa...... e e s *el 3 58,568 ...... ; Sioux Falls. Dak...... 16, &IR7 12 - - - --I ...... Somerville, Mass...... 88,618 46 1 - ---- 1 South Bend, Ind...... 70,967 43 ------I Spartanburg, S. C...... 21,985 - - - - - l Sprngeld, MIas...... 108,668 43 18 - - --I Springfield o ...... 41,169 20 - - - - -I Sprinield Ohio...... 52,296 49 Stamord, ...... 31,810 ...... 9 Stalnton, Va...... 11,823 13 l Februaiy 27. 1)92i6. 5-00 DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS- Continued. City Reports for Week Ended Feb. 7, 1920-Continued.

Popula- Diphtheria. Measles. Scarlet Tuber- tion as of Tot July 1, 1917 deat City. I(estimated from by UT.S. allI . 8 I .e!!_ fee. Census causas.l -1lw.. Bureaui). I.I

-Beeltos', Pa ...... 15,759 ..... *iubenville, Ohio ...... 28,259 stilranter. Min...... '10,198 Stockton, (Calif...... 36,209 14 2...... 6 ...... 1 utevror, Wis ...... 47,167 yraeuse, N. Y...... 158,559 . .3 5 1 ..... 'Tiunton, Mass ...... 36,610 Terre Haute, Ind ...... 67,361 Tiffin, Ohio...... 12,',o2 6 16...... ::. . Toledo, Ohio...... 202,010 32 7 1 247 2 19 1 4 7

Topeka, Kans ...... 49,538 22 3 ...... 3...... 1 Traverse Citv, Mich...... 14,090 6 ....2...... 'renten, N. I ...... 113,974 58 5 5 . .... Troy, N.Y...... 78 094 33 1 ...... 2 2 Tucson, Aris ...... 17,324 Uniontown Ila ...... 21,600 ...... 22 Vallejo, Cajif...... 13,803 8.... 1 1'. Virginia, Minn ...... I 15, 954 ..... Waco, Tex...... i 34,015 I x ...... 5 . 2 .. .. I.i Wakefield, Mass..., 12,947 Waltham, Mass ...... 31 011 2 ...... 12118 11 I-- 1-.-!211 Washington, D. (------369,282 IIN .. .5....32 . 1 Washington, l'a ...... 22,076 ...... Waterur Con...... 89,201 ...... 2 .. 2 j. 1... Waterton, Mass...... 15,188 19 Watertown, N. Y ...... 30 404 . Wausan, 72 ...... 2 Wis.s 19,666 .... West Chester. Pa...... 13,403 ...... 4 I...... : ~...... Westfield, Mass ...... 18 769 41 1: 9 1 West Hoboken. .... 44,386 19 6 ' .'3 West New York, N. J 19,613

West Orange, N. J. 13 964 I 2 i . 'Wheeling, W. Va.. 43,657 1 .iI. "Wichita, Kans. 73,597 4 1...- - ...... Pa Wilkes-Barre 78,334 .1 ...... 1.... ------,------} Wilkinshmrg,'Pa.... 23,899 i0 ...... ~~~~I1 48 ...... I------Williamsport, Pa. 34,123 . 181 ...... I...... 4.a ...... I .. ilmington, I)c ...... 95 369 .l ..:::.. .:::...... '. W-lmington, N. C...... 30' 400

Winchester, Mass...... 10,812 8 I ...| ,. 2 1.1 Winona, Min...... 118583 861 : | 8|1 ; 5.---- Winston-Salem N. C...... 33,136 21 Winthrop, H ss... 13,105 Woburn, Mass...... 16, 076 Worcester. Mass...... 166,106 7!2 3.... 32...... 13! 11 62 . Yonkers, N. Y...... 103,066 4.6 1 1 York, Pa ...... 52 0770 ...... 6| I Zanesville, Ohio...... 31,320 5111.27'...... '

I Population Apr. 15, 1910. FOREIGN AND INSULAR.

INFLUENZA ON VESSELS. Steamship "Carrfilo"-Kingston, Jamaica. The steamship Carrillo from New York arrived February 2, 1920, at Kingstoni, Jamaica, with a history of 15 cases of inifluenza of mild form developing en route. Steamship "Melita"-Plymouth, England. Accordinig to information dated January 24, 1920, the troopslhip 3Melita arrived at Plymouth, England, from Bombay, with a history of about 200 cases of inifluenza occurring on board during the voyage. Steamship "Roger de Luria"-Santa Cruz de Teneriffe. Influeniza was reported January 17, 1920, on the steamship Roger de Luriia, att Santa Cruz de Teneriffe, Canary Islands, witlh 70 cases occurring among passenigers and crew. The vessel received a bill of healtlh Janiuary 12, 1920, but returned to Santa Cruz. The type of the disease was stated to be for the most pl'rt mild. The Roger de Luria left Barcelona, Spain, December 16, 1919. AZORES. Quarantine Against Inuenza-Ponta Delgada. According to information dated February 7, 1920, passenger-s fromi the U-nited States arriving at Ponta Delgada, Azores, will not be permitted to lanid in the event of influenza haviing developed on the vessel en route. Vessels arriving from any port in the United States at which influenza is reported present are made subject to three days' quarantine without regard to the occurrenice or nionoccurrence of influenza oni board during the voyage. BULGARIA. Typhus Fever-Varna. Under date of February 18, 1920, 110 cases of typlius fcvcr were reported at Varna, Bulgaria. CANARY ISLANDS. Further Relative to Influenza-Las Palmas.' A severe epidemic of influenza was reported January 17, 1920. at Las Palmas, Canary Islands, with from 10 to 20 fatalities occurring daily. (Population, about 65,000.) I Public Health Reports, Feb. 6, 1920, p. 312. 1610900-25 (501) February 27, 1920. 502 CUBA. Communicable Diseases-Habana. Coommnuniicable diseases have been Aotified at Habana, as follows:

Broncho-pneumonia ...... 42 Chicken pox...... it Diphtheria ...... ''''''''i' 3 Influenza ...... 212 23 133 Leprosy'...... ---...... 19 !Earia...... 14 ...... 1 5F)9 Meales...... 4 ...... 12 Paratyphoid fever ...... 2

Pleuropneumonia ...... 1 I ......

Pneumnonia...... 7 5 ...... Scarlet fever...... 2 ...... '2 smauxpo...... 5i 8 Typhoid fever ...... 4 ''''''''i' 228 From tlhe interior, 18. 2 From the interior, 13. FEDERATED MALAY STATES. Influenza-1918&

The first wave of influenza in 1918 in the Federated Malay States was observed in June and July. The type of the (lisease was state(l to be mil(l. About the middle of September influeniza became epidemic, reaching its maximum in October and terminating about the middle of November. A total of 5,643 influenza deaths was reported. The total number of reported deaths (luring tlhe year 1918 was 67,639, giving a. death rate of 52.85. the populationi being estimated at 1,279,8,59. The hiighest death rate reported for the l)eriod 1911- 1917 was for 1911 (viz. 39.11), and the lowest was for 1915 (viz, 28.9). INFLUENZA. 'The following informationi was takeni from-i reports receivcd (dutriing the week ended February 27, 1920:

Place. Date. Cases. Deaths. Remarks.

Brazil: Porto Alegre...... Nov. 1-30...... a Canada: Nova Scotia- Halifax Feb. 1-7...... 2 Yarmouth ...... Feb. 11...... 42 Ontario- Fort William and Port Feb. 1-7...... 2 Arthur. Hamilton ...... Feb. 8-14...... Present. Sarnia...... do. 222 Saskatchewan- ..... Moosejaw...... Jan. 25-31...... 1 Regina...... Feb. 1-7...... 9 Large number of respiratory dSease es report. 503 F'ibrtuary 27, 1924). INPLUENZA-Continued.

Place. Date. Cas. Deaths. Remarks. -i 1.. Cuba: Cienfuegos...... Feb. 1-7...... 85 3 France: Marselle...... Dec. 1-31...... 116 Jan. 26, 190: Present. Pai...... Jan. 1-10...... 60 Guatemala: Livingston...... Feb. 5-11 ...... | Present in mild form. Japan: NaMmmai ...... Jan. 12-18 ...... Present. Yokoha...... Jan. 19-25 ...... Epidemic. Mexico: Pledras Negras...... Feb. 8-140...... 1 ...... Estimated. Spain: Valencia...... 7 Jan. 1824 ...... Sweden: .. .. Goteborg...... 27 Dec. 28-Jan. 3 ...... Malmo ...... Jan. 4-10...... 11. Stoc;kholm ...... Dec. 28-Jan. 3 ..... 2 ...... UTnion of South Africa: Durban...... Nov. 1-30 ....

CHOLERA, PLAGUE, SIALLPOX, TYPHUS FEVER, AND YELLOW FEVER. Reports Received During Week Ended February 27, 1920.' CHOLERA.

Place. | Date. Cases. Deaths. Remarks.

Java: ...... West Java .Dec. 1919: C'ases, 3. 3 19-25, Batavia ...... Dec. 19-25 ...... I rhilippine Islands: ManIla ...... D£...... Dc.21r1 ...... Provinces ...... Dec. 21-2., 1919: CaseS, 43;

.. Dec. 21-27 deaths, 25. Antique...... 11

......

Occidentae...... Ng do 3 torsogan.. . do... 8 ayabas -do 1 2 Sorsogo ...... do..... J'rovincis...... Dec. 28, 1919-Jan. 3, 1920: Cases,

Albay ..... Dec. 28-Jan. 3 17 9 127; deaths, 97.

Ambos Camarnes...... do. 7 8

Antique ...... do 59 Batangas ...... do. 1 1 .9 2 flail- ...... -do

Laguna ...... do. 2 2

Mountain ...... do. 3 3

Pangasinan ...... do ...... SorsogoIl ...... 1 l ...... do 14 11 Tayabas ...... do...... 2 2 Russia:

Novorossisk ...... Nov. 8-11. 3

Odessa ...... Oct. 25-Nov. 7 93 Siam: Bangkok ...... Dec. 7-20 .115 37

PLAGUE.

Brazil: 3 Porto Alegre...... Nov. 1-30......

...... 1920: 8; deaths, 5. Egynt...... Jan. 1-15, Cases, Provice- Assiout...... Jan. 13...... 1 1 Indo-China: Saigon...... Nov. 24-Dec. 7.... 3 Java: East Jara- Surabaya...... Dec. 10-16...... 239 | Residency. Peru: Trujillb...... Dec. 29-Jan. 11.... 6 2 And in vicinity. Siam: Bangkoklc...... Dec. 14-20...... 4 2 straits Settlements: 1 Singapore...... do

I From medical officers of the Public Health Service, American consuls, and other souirces. February 27, 1920. O4u CHOLERA, PLAGUE, SMALLPOK, TYPHUS FEVER, AND YELLOW F'EVER-Continued. Repots Received During Week Ended Febrnr 27, 1920-Continued. SMALLPOX.

Plc. DaIe. Cases. Deaths. I Remarks.

Canada: British Columbia - Vancouiver.---:--- Jasi. 11-17...... ;-~~~~~~~~~~~~~4 Nova Scotia Sydney .------Feb. 1-7...... 5 Ontario- Fort William and Port .....do. 7 Arthur. llamiltoui ...... Feb. 8-14...... 4 Ottawa...... Feb. 1-7...... 2 Peterborotulgh ...... Jan. 9-31...... 6 Qtiebee-- Montr-eal...... Feb). 1-7...... 3 1. China: Amoy...... Dcc. 10-22...... 1 Do...... Dec. 30-Jan. 5...... Canton ...... Dec. 28-Jan. 10...... IPrevaleuit. Changsha ...... Jani. 4-10--...... t...... Chungkling .... Dec. 2S-Jnn. 3...... Preset. . Foochow...... Dcc. 14-27.. ... I ...... Do. 1)o...... Dee. 28-Jan. IO....I ...... Do.

Nanking...... Jani. 4-17 ...... Do. Colombia: 10 Barrallilla ...... Jan. 1S-24...... Sttated to be epidemic. France: Paris...... Jan. 1-10... .. 2 Germany: I11 Prussia...... Oct. 19-Nor. 2. .... 1,110 332 Nov.23-29, 1919: Cases, 32; datLhs, 12. Grcece: Saloniki...... Dee. 22-28...... 9 10 Italy: (leno ...... ;...... Dec. 1-31...... 32

Leghorn ...... Jan. 4-1 1 ...... 1 ...... M ssina...... Dec.29-Jan.4..... 3 2 San Fralello. ....do. -.----- 6 Japan: I Taiwan Island...... Dec. 14-31..... 28 Do ...... -.-.-.-.- Jan. 1-10 ..------9 7 Java: East Java

Surabaya .... iDe. 10-1- ...... 2 ...... esideny. West Java...... De...e....De. 19-25, 1919: Cases, 32; deatls. i 4. Mexico: Ciudad Juiarez...... 1 telm. 1-7..... 1 Newfoundland: St. Johns...... l)e(A. Ja1--jan. 6..... 2 At out ports, 7 ases. Present at other localities. Nov. 2-Dec. 5. I ease ea~h at 1rinceton and §1St. Anthony. Present also at 2 other localities. PoInthagbieseE.ast .fra: Inhambaue ...... r 21-27. P De. .. . Present in S districts. Mozambiquie ...... Quelimane...... c. ..Jdo...... ;2....'... j Spain: Valencia .. Jiai. 19-24 ..... 1-4 Tunis: Tunis ...... I TYPH-US FEVER.

Austria Ot...... Oct. 12-No\ov.?2...1 10 Bulgaria: Varna..Feb...... 110 Estionta ...... Feb. 16. 1920: Cases, 7,500 to Niva ....1Feb. 16 ..... 2,500 8,O). E:stimated mortalitv, 49 Reval .0 do .... 2,50W per cenit. Germany .....Oct. 26-Dee. 6..... 3 In repatriated soldiers. a reece: Cavalla ...... Dee. 22-28...... 3

Drama ...... do.. ;. Thassos Island ...... do.....1. I Zihna . . do...... I 505 February 24, 19.00. CHOLER.A PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FBVER-Coitinued. Repots Rewed Dug Week Endie Februay 27, 1920-Continued. TYPHUS FEVER-Continued.

Plaee. Date. Cases. Deaths. Remarks.

. ital`ce...... De. 8 ...... 2 Japan: 1 j sak,i...... Jan. 12-18......

San Luis Potosi .... Feb. 1-7...... Present.

YELLOW FEVER.

Mexico:II Merida ...... Dec. 21-27...... I Total, June-Dec. 27, 1919: Cases, Do .... Dec. 28-Jan. 3..... 1 ..... 47; deaths, 21.

Reports Received from Dee. 27, 1919, to Feb. 20, 1920. CHOLRA.

Place. Date. Cages. I Deaths. Remarks.

China: A o ...... Nov. 4-17...... 2 Chose(korea)...... OCt. 20-Nov. 16, 1919: Cases, Chemulpo...... Oct. 1-31...... 3 525; deaths, 3,144. Aug. 15- 15,192; Fuan...... 34 30 R1Ov. 16, 1919: Cases, lrovinces- ....do . deaths, 9,823. Ke{ik...... Aug. 16-Nov. 16... 224 135 Keli .....do. 64 38 ..... do . 4,01.. 2,770 ANorth Chuse...... _ ...... do. _ 1 j-- North Helan ...... do. 3,196 2.434 North Kankyo...... do. 497 275 35 North Keisho...... do. 63 North Zenran...... do. 1,326 692 South Chuse...... do. 9s30 590 South Heian..., ..... do. 3,031 1,858 ,South Kankyo...... do...... 970 Souith Keisho...... do. 318 156 Soulth Zenra...... do . 657 288 Greece: .....do...... Saloniki...... Oct. 10...... 1 ...... Oct. 19-Nov. 29, 1919: Deaths, Bombayr...... NOv. 2-8...... 15,698. Calcutta...... Calcuta OCt. 26-Dec. 27.... 181 166 Madrs...... Nov. 23-Dec. 27... 14 5 DO...... Dec. 28-Jan. 3..... 5 5 Rangoon...... Nov. 30-Dec. 13... 5 3 Saigon...... Oct. 27-Nov. 23... 5 4 Japan: Nov. Kobe...... 24-30. island: Oct. 22-Nov Taiwan ...... For entire Tokyo...... Nov. 10-20..... 1 30,1919: Cases, 651; deaths, 385. Java: Oct. 6-11, 1919: One case, 1 death. East Java...... At Pasoeroean. 14. West Java...... Nov. 5-Dec. 18, 1919: Cases, Nov. Batavia...... Nov. 5-Dec..6-Dec. 18.18..i..... ii..14...... 14 Philipiple Islands: anuita...... Nov. 2-Dec. 20.... 19 10 Provinces...... Nov. 2-Dec. 20,1919: Cases, 1,574; Albay .....do...... Nov. 2-Dec. 20.... deaths, 1,126. Ambos...... maie... 66 34 Antique...... do. 139 102 Batangas...... Nov. 2-Dec. 13.... 38 28 Boo ...... do. 34 27 Cay ...... Nov. 3-15...... 35 20 Cap...... Nov. 2-8...... 6 5 Nov. 2-Dc. 6..... 25 16 Cebu...... Nov. 2-Dc. 20.... 23 14 February 27, 1920. 506 CHOLERA, PLAGUE, SMALLPOX,FIV&-Continued.TYPHUS FEVEBR AND YELLOW Reports Received from Dee. 27, 1919, to Feb. 20, 1-bontinued. CHOLERA-Continued.

place. Date. Cases. Deaths. Remarks.

Islands-Contd. PhilippineI rovinces-Continued. N Davao ...... - Nov. 9-15 6 4 Norte ...... Nov. 2-29. 42 40 - Ilocos i----- Ilocos Sur ...... Nov. 2-22. 18 15 Iloilo ...... Nov. 2-Dec. 20.... 55 Isabela...... Nov. 2-Dec. 13...., 167 77 Laguna ...... Nov. 2-Dee. 0.... 23 17. Mindoro ...... Nov. 2-1)ec.f. 81 30 Mountaiin ...... Nov. 2-Dee. 13.... 6 4 Occidental Negros...... Nov. 2-Dee. 20.... 98 50 Pangasinan ...... Nov. 20-Dec. 20... fiO 46i Rizal ...... l.do 41 15 Sorsogon...... Nov. 2-Dec. 13.... 208 139 Tarlac...... , ., Nov. 2-22. 11 11 Tavabas ...... Nov. 2-Dee. 20.... 54 :13 I'nion...... NoV. 9-15. 5 5 Poland:

Garwolin ...... Present in Noveniber, 1919. Kowal ...... Do. Stryi ...... l ...... Do. Siam: Bangkok...... Oet. 5-De. 5...... 108 Straits Settlements: Singapore ...... Oct. 5-Nov. 2. .... 14 13 Sumatra: Deli ...... Oct. 1-31. I

PLAGUE.

British East A trica: Kisul . .ept. 28-Nov. 1... 6 6 Dee. 14-20, 1919: Present in Btrazil: vicinity. Bahia ...... Nov....'o. 915 . Ueylon: Colosnbo ...... ---.Oct. 26-Nov. 29... . 18 19 0 ~hule: Antofagasta ...... Dec. 8-14. . 1 . 1 ('l4na: Ilongklong ...... Dec. 7-13.-----.- Ecuador: Guanaqtuil ...... Nov. 1-31. Egypt -- . ...-- ...... Jan. 1-Dee. 25. 1919: Cases, 867; Cities- deaths, 469. Alexanidria.. . Dec. 3...... 1 From vessel Rachid Pacha. Province- Assiotut...... 3-. 21. 30 17 Creece: Saloniki ...... Oct. G-l)ec. 21. 19 India ...... Oct. 19-Dee. 20, 1919: Cases, Bomba - ...... -...... iOct. 19-Nov. 29.. 5 28,558; deaths,.21,,g. Karachi ...... Nov. 9-29.. 3 2 Madras Presidency ..: Nov. 9-Dec. 2. 1, 06& 704 Do ...... Dec. 28-Jan. :3. 106 74 Ralngool .. -...... I!Nov. 2'-De. 13... 18 17 Oct. 19-Nov. 1, 1919: Cases, 10; Indo-China: deaths, 7. Saigon . Oct. 27-Nov. 2 . 8 Java: East Java...... Sept. 2-Dee. 9,1919: Cases, 1,255; deaths, 1,254. Surabaya Resi- dency- Perui: Salaveury (Truijillo) ...... Nov. 1-D)ec. 21 ...I 9 1 Present in surrouinding country. . Senegal: Dakar ...... Nov. 1-30...... 146 Inclutding Dakar and vicinity. Straits Settlements: Singapore...... Oct. 21e1ee. 13. 5 4- Syria: Beirut ...... Dee. 22. 29 I...... Turkey: ...... Nov. 14-Dee. 20... 11 ...... Present Dee. 11, 1919. Nov. 14- Constantinople 20, 1919: Present In viCinity. On vessel: S. S. Kaisar-i-Hlind ...... Nov. 28. a At Port Sd, Egypt. From ...... Bombay, Nov. 15, for Londo :507 February 27, 1in CHOLEA, PLA(UE SMALLPOXf, US FEVER, AND YELLOW F MIalued. Reports Received from Doe. 27, i919, to Feb. 20,190-Continued. SMALWOX.

Pace. Date. Cases. Deaths. Remarks.

I 1 - Algeria: Departments- Algiers...... Nov. 11-Dec. 31... 65 Do...... Jan. 1-10...... 26 Constantine...... Nov. 11-Dec. 31... 15 Do ...... Jan. 1-10...... 2 Oran ...... Nov. 11-Dec. 31. 90 ...... Do. Jan. 1-10...... 25 South Territory ...... do. 5 Arabia: Aden...... Dec. 24-30...... 1 Bolivia- La Paz...... June 29-Dec. 27 ... 216 D)ec.29, 1918-Jtne 28, 1919: Cases, Do...... Dec. 28-Jan. 3..... 6 4. 86; deaths, 44. Dec. W-2 1919: Cases, 7: deaths,6. Brazil: Bahia...... Oct. 26-N'ov. 22.". . 1, 704 1,022 Pernambuco...... Nov. 10-16.. 29 Riode Janeiro. Sept. 28-Nov. 25. . 372 1054lO Canada: BrttishColumbia- Vancouver...... Nov. 30-Dec. 6.... I Do...... Jan. 4-17...... 8 Manitoba- Winnipeg.. Jan. 11-17...... 2 Nova Scotia- 21-27 Halifax...... Dec...... ; 2 Do.... Jan. 4-27...... 3 Sydney...... Dec. 7-13...... 1 Do...... Dec. 28Jan. 31.... 4 Counties- Cumnberland...... Dec. 14-20...... lres'ent. Invern ...... do Do. Pictou...... -do...... Do. Ontario...... Nov. 1-29, 1919: Cases, 1,67Z Nov. 30-Dee. 6, 1919' Cse 125, in 45 1Iocalties,excluoivei Dysart and Toronto. Dec. 1- 31, 1919: Cases, 1,414; deaths, 2. Dec. 28, l91Jan. 31, 1Q20: Cases, 1,161; deaths, 20. Fort WiLUiam an(d Plort 41 Arthur...... Jan.2-31...... GloucesterCounty...... Oct.-Nov., 1919: Cases, 3. Dec. 14-20...... Hamilton...... 4 Do...... Jan. 4-Feb. 7...... 3 Ki¶slon...... Dec. 21-27...... Do...... Dec. 28-Jan. 31 .... 17 ..... North Bay...... Jan. 11-17...... Ottawa...... Dec. 14-20...... 3 ...... Do...... Dec. 28-Jan. 17...... Peterborough...... Dec. 21-27...... 21 ...... Do...... Dec. 28Jan. 24. ... 21 ...... Pre3cott...... Jan. 4-10...... 1 ...... 1 SaultSte. Marie...... Dec. 7-27...... Do ...... Dec. 28Jan. 3...... 727 Toronto...... Dec.7-27...... Do...... Dec. 28-Jan. 31.... 650 5 2 Windsor...... Dec. 14-27...... Quebec- Bonaventureand Gaspe 7 Count .------Jan. 1-31...... Montreal...... Dec. 7-27...... 3 Do...... Jan. 18-24...... 2 Quebec...... Dec. 7-27...... 4 Do...... Jan. 4-31...... 9 Saskatchewan- Moojaw...... Dec. 28-Jan. 31.... Saskatoon...... Dec. 14-20..-o --- Ceylon: Colombo...... Nov. 16-Dec. 13... 10 China:

Amoy ...... Nov. 4-Dec. 8.... Pre.sent. Pec. 15: Three death3. Canton prepent...... Nov. 2-Dec.27...... Chnagh-ing...... do...... i )o. F_...... Nov. 16-Dee. 6...... Il)o. N king...... Dec.627...... Do. D...... Dec. 28-Jan. 3. Do. Sangbhai...... Dee.22-28.... I February 27, 1920. 50B CHOLERA, PLAGUE, SMALLPOX, TYPHUS -EVER, AND YELLOW FEVER-Continued. Reports Received from Dec. Z7, 1919, to Feb. 20), 192-Continued. SMALLPOX-Continued.

I a Place. Date. Cas. Deaths. Remaks.

-I I p Chosen (Korea): F usan...... Oct. 1-31...... 2 1 o u& el ...... do. 9 1 Colombia: Barranquilla...... Nov. 16-De. 20... 50 2 Do...... Jan. 11-17...... 1 Cuba: Habana...... Jan. 31...... 4 Children living in same hotse. EgyPt: Alexandria...... Nov. 12-Dec. 16... 23 12 Do...... Jan. 1-7...... 9 5 Cairo...... Oct. 1-Dee. 9...... 55 26 Port Said...... do. 6 6 Finland: Provinces- Nyland...... July 16-31...... Tavastehus...... do. 11 Viborg..------.....do. 23 Finland ...... Oct. 15-31,1919: Cases, 6. Provinces- Nyland...... Oct. 15-31...... 4 .lelsingfors. Tavastehus...... do. 1 Ruraldistrict. Viborg...... do 1 Do. Finland...... Nov. 1-30,1919: Cases, 45. Provinces- Abo Och Borneborg.... Nov. 1-1.5...... 1 Nyland ...... Nov. 16Dec. 15.... 24 St. Michael...... do . 7

Tavastehus...... do. 5 Vasa...... do . 11 V'iborg ..... NoV. 16-30...... 6 Germany...... Oct. 5-15, 1919: Cases, 32. In ad. dit`1on to previously reported cases; Sept. 28-Oct. 4, 1919: Cases, 2. Greece: Saloniki ...... Nov. 10-Dec. 21.... 17 16 India: Bombay...... Oct. 12-Dec. 20.... 38 9 Calcutta...... Oct. 26-Dec. 27.... 186 260 Karachi...... Nov. 23-Dee. 27... 6 2 Ma4ras...... Nov. 2-Dec. 27.... 31 13 Do...... Dec. 28-Jan.3..... 3 1 Rangoon...... Oct. 19-Dec. 14.... 41 15 IndoChina: Saigon ...... Oct. 27-Nov. 23.... 2 ...... S Italy: Lo* 'Genoa...... Province: Nov. 17-Dec. 28, 191t. Messina...... Nov. 10-Dec. 28.... 55~ Cases, 15; deaths, 3.

Milan...... Nov. 1-30...... 6 ..... Naples ...... Dec. 28-Jan. 10.... 6 10 Province of Messina. Dec. 14- San Fratello...... Dec. 1-28...... 49 28,1919: Cases, 68. Trieste...... Jan.3-10...... 9 ...... Tturin...... Dec. 28-Jan. 4....- 1. Japan:

Kobe...... Dec. 15-21...... 1...... Taiwan ...... Nov. 1-20...... 10 Entire island. Java: EastJava ...... - Sept. 28-Dec. 18, 1919: Cases, 34. Residency- Surabaya...... Oct. 25-Dec. 18.... 24 ...... WestJava...... O.. Oc7ct-Dec. -18, 1919: Cases, 627; Batavia...... Oct. 17-Dec. 12... 49 22| daeths, 147. MIexico: Acapulco...... Nov.9-15...... 2 ...... Chihuahua...... Dec. 21-27...... 2 Do...... Jan. 11-17...... Ciudad Juarez...... Jan. 11-17...... 1 Dcc. 1-31 ...... 1. Guadalaiars...... 1'''''i' ...... Mexsico P!ity...... Nov. 15-Dec. 20... 11 San Luis Potosi...... Dec. 14-20...... Do...... Jan. 18-24...... 1 Tehuantepec...... Dec. 25-31...... 6 Do...... Jan. 1-15...... 31 Newfoundland: St. Johns...... Dec. 20-26...... 3 Dec. 13-26, at outports, 6 eases. Present at 8 otherlocalities. Do...... Dec. 27-Jan. 30.... 8 Out , 3 eas. Present at otherltcaUties. 509 February 27, 1929.

eHfOLERA, PLAGUEi SMALLPOX, TYPHUS FEVER, AND YlELLOW FEVE-Continued.

Reo Received from Dec. 27, 1919, to Feb. 20. 19290-Continued. SMALLPOX-Continued.

Pla}e. Date. Cases. Deaths. Remarks.

:- __ -1 I------__- -- Panama: Colon ...... Doe. 15-21...... Portugal: Lisbon ...... Nov. 30-Dee. 27...... 55 Do...... Dec. 28-Jan. 17...... i. 44 Oporto...... Doe. 7-20...... 5 Portuguese East Africa: Lourenco Marques.... Nov. 23-Dee. 20... 9 ...... L Wresentin 5,dislricts Nov.-Dec. 20,1919. with 56 reported esses. Districts--- G.aza ..... DeC. 7-13...... Present. Inhambane...... do...... Do. Mozambique...... Do. Quelimane...... Do. Tete...... do...... Do. Towns- ..do.'...... ~..... Inhambane...... do.-do...... Mozambique...... do.do...... Quelimane .... . do... *2 Tete...... 1 ...... Spain: Barcelona...... Nov. 6-Dec. 27.... 26 Do...... Dec. 28-Jan. 14.. 16 Bilbao...... Nov. 1-Dec. 20...... 4 Cadiz.------Oct. 1-Nov. 30...... 6 Valen'ia...... Nov. 10-Dee. 27... :39 9 Do ...... Dee. 28-Jan. 17.... 24 ...... Vigo ...... Nov. 18-Dec. 27... 14 ...... Do ...... Dec. 28-Jan. 3..... 2 Jan. 11-17, 1920: Present in vicinity. Sumatra: Medan ...... Oct. 1-31...... 8 Ttmis: Tunis ...... ;...... Dee. 23-29...... 1 Turkey: Constantinople...... Nov. 9-Dec. 14.... 27 tTnion of South Africa: Johannesburg...... Oc.t. 1-31...... 10 On vessel: S. S. Roggeveen...... 1' VesSel fromn Java; at Nodiica New Caledonia. Case lOft at Noumea. Vessel ariVed at Svdney Jan 2, 1920. .. S. S. Sarcoxic ...... Dec.23...... 1 At Ponta beladanAzorbS. From Rotterdam for New York.

TYPHUS FEVER.

Algeria: Departments--I Algirs -Dec. 11-31 ...... 2 . Constantinc...... Nov. 11-Dec.31 2 . Do ...... Jan. 1-10. ' 1 . . . . Oran ...... Nov. 21-Dec.11... 5 ...... Austria: Vienia ...... Sept. 7-14 .. 5 ...3....1 Sept. 7-1, 1,919: Cases; 7. Bolivia: La Paz ...... Junle 29- )ec. 20... 30 31 Dce. 29 1918-June 28, 1919: Denths'. 52. Do ...... Jan. 4-10 2 Bulgaria:'!Luofr ...... DeC. 31-31 1 1 Do ...... Jail. 1-101 2 Canada: Ontario Province...... 1c. 1-31, 1919: One case. Chile: Antofagasta ...... Nov. 17-1Dec. 14.. 14 Santiago...... Jan. 12-Sept. 30, 1919: Cases, 5,153; deaths, 1,023. Outbreak in October. 1918. Nov. 9-DeC.27.. 9M 114 Dee.1-13,1919: Cases,700;deaths, A'a1paraiso...... 18. Do...... c..De.1 28-Jan. 11.... 90 23 February 27, 192e. 510 CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-Continued. Reports Received from Dee. 27,1919, to Feb. 2, 192v-Continued. TYPHUS FEVER-Continued.

Place. Date. Cases. Deaths. Remarks.

China: Antung...... Nov. 3-Dec. 14.... 2 Czeeho Slovakia: Prague...... Dec. 21-27...... 1 Egypt: Alexandria...... Nov. 12-Dec. 16... 6 1 Do...... Jan. 1-7. 5 Cairo...... Oct. 1-Dec. 9. 98 1... Port Said...... Oct. 1-Dec. 2...... 2 i Finland: Province- Viborg...... July 16-31..... 2...... G.crmany...... Oct. 5-25, 1919: Cases, 10-civil 3; 7. Great Britain: Ipopulation, military, Belfast...... Dec. 28Jan. 3.... 1 Glasgow...... Nov. 30-Dec. 6.... 2 ...... Greece: ...... Cavalla...... Nov. 17-23...... 1 Drama...... Nov. 24-30...... 1 ...... Saloniki...... Oct. 6-Dec. 21..... i "%ungary ...... ,...... Aug. 25-Sept. 14, 1919: Cases, 6. Italy: Tret...... Dee. 14-27...... 3 ...... Do ...... Dec. 28-Jan. 3.. . 1 ...... Venice ...... Nov. 17-23...... 4 Japan: Nagasaki ...... Dec. 1-28...... 4 2 Mexico: Chihuahua...... Dec. 21-27...... 2 ...... Do...... Ian. 11-17...... I Mexico City...... Nov. 16-Dec. 20...... Saltillo ...... Nov. 1-30...... 2 San Luis Potosi...... Dec...... 1.. 14-27...... Present. Do ...... Dec. 28-Jan. 31...... Do. Paraguay: ...... Asuncion...... Nov. 30-Dec. 6.... P'eru: 1 Cerro de Pasco ...... Dec. 7-13...... I'ortu,ga:

Lisbon...... Dec. 6-12...... 2 Spain: Barcelona ...... Nov. 20-26...... 7 ...... Corunna...... Nov. 24-Dec. 7.... 2 ...... Tunis: Tunis...... Dec. 14-20...... 1 ...... Do...... Doec. 29-Jan. 31.... 2 Turkey: Constantinople...... Nov. 14-Dee. 27... 49 ......

YE:LLOW FEVER.

Brazil: Bahia.Octt . Oc. 28-NTov. 8.... 1 2 Mexico:

Campehe...... Dec.20 ...1.. I Merida ..... Dec. 7-20 ... 3 2 The cases were sent from (Opi- chen, vicinity of Muna. One death in case from Mins. To- tal to Dec. 20: Cases, 46; deaths, 20.