PUBLIC HEALTH DIVISION of the MUNICIPAL REFERENCE LIBRARY 3rd Floor, 505 Pearl Street Open to the general public for reference use. Material will be loaned to persons on the payroll of the City. ACCIDENT PREVENTION.-Lipman, W. H. Accident prevention from a medical viewpoint. (Nation's Health, Jan., 1922. PP. 35-36.) AIR ANALYSIS.-Automatic filter for the measurement of suspended impurity in the air. (Royal Sanitary Institute Jour., Jan., 1922. pp. 265-268, illus.) BOTULISM. Thom, Charles. Botulism from the regulatory viewpoint. (Am. J. Pub. Health, Jan., 1922. pp. 49-53.) CHILD HYGIENE-Clark, Tallaferro. Some child hygiene activities of the United States Public Health Service. (U. S. Public Health Reports, Jan. 13, 1922. 35-44.) pp. CHILD PLACING.-[California State Board fection and disinfestation. (Jour. State Med., Jan., 1922. pp. 28-37, illus.) HEALTH EDUCATION.-Turner, C. E. Motion pictures as used in health educa tion. (Nation's Health, January, 1922 pp. 17-19, illus.) HEART DISEASES.-Harris, L. I. Cardiac diseases in adolescents and adults. (Na tion's Health, Jan., 1922. PP. 10-13. tables.) HEART DISEASES.-Sobel, Jacob. Control IODINE.-Rector, F. L. Iodine as a wound VITAL STATISTICS-CITY OF NEW YORK Deaths, and Annual Death Rate Per 1,000; Deaths According to Certain Causes and Ages; Deaths and Death Rate Under One Year Per 1,000 Births For Thirteen Weeks 19 Total deaths 26 3 Annual Death Rate 11.15 10.74 10.46 10.89 11.30 12.08 12.37 13.28 13.23 14.13 13.61 16 41 *Acute Infectious Nov. Nov. Dec. Dec. Dec. Dec. Dec. Jan. Jan Jan. Jan. Feb. Feb. 7 14 21 28 4 11 1837 2067 18.47 "Acute Infectious Diseases" include Typhoid Fever, Scarlet Fever, Measles, Diphtheria. Whooping Cough, Smallpox and Cerebro-spinal Meningitis. Does not include suicides. Mortality Summary for the Week Ending Saturday Noon, February 11, 1922. *Corrected by redistributing deaths according to borough of residence. During the first six weeks of this year there were 9,975 deaths, a rate of 14.85 per 1,000 popation. During the corresponding weeks of last year there were 8,625 deaths, a rate of 13.04 per 1,000 population. During the first six weeks of this year, 1,373 infants died, a rate of 89. per 1,000 births. During the corresponding weeks of last year 1,219 died, a rate of 80. per 1,000 births. Infectious Diseases in the Department of Health Hospitals tIf the deaths under one month, numbering 116 from all causes, be deducted from the total deaths under one year, the resulting rate will be 72 per 1,000 births (weekly average). *Includes deaths from Erysipelas 4, Syphilis 4, Diabetes 32, Alcoholism 1, Locomotor Ataxia 2, Paresis 4, Arterio-sclerosis 83, all other congenital causes 19. 827 29.82 Mean temperature, Minimum temperature, Maximum temperature, Published weekly by the Department of Health, City of New York, 505 Pearl St., New York, N. Y. Entered as Second-Class matter October 16, 1917, at the Postoffice at New York, N. Y. Under Act of March 3, 1879. Subscription, 10 cents per annum. ROYAL S. COPELAND, M. D., Commissioner of Health. NEW SERIES, Vol. XI. FEBRUARY 25, 1922. No. 8. EPIDEMIC JAUNDICE. In New York City. The attention of the Department's Bureau of Preventable Diseases was recently directed to the occurrence of several cases of epidemic jaundice in the City of New York. Several of the cases were under the care of private physicians, and the majority of the patients were children. As a consequence, inquiry was made of 18 of the principal hospitals in the City to ascertain whether any cases of epidemic jaundice had come under the notice of these institutions. A total of 6 cases were discovered, as the result of this. Two cases were in Bellevue Hospital, 1 patient having been sent in from the Borough of The Bronx, and the other was a resident of New Jersey, and 3 additional cases were reported among children in a Brooklyn institution, and 1 case from an institution in Harlem. The last mentioned case was a resident of New Jersey. This patient died, so far being the only fatal case. A doubtful case was found in another Brooklyn institution. One Brooklyn hospital had six cases, and another one case, which had been diagnosed as catarrhal jaundice. Within the last three weeks, however, there have been no new cases brought to the notice of the Bureau of Preventable Diseases. In view of the fairly large number of cases reported from various parts of the state, outside of the City of New York, these facts in relation to the prevalence of epidemic jaundice are of interest. Physicians attached to hospital service, as well as those who have treated cases in private practice, are urged to co-operate with the Department of Health in ascertaining more fully the facts with reference to this disease, by reporting any cases that may have come under their notice during the last two or three months, and submitting such important facts in the clinical history as it may be practicable for them to give. All such communications should be addressed to the Director of the Bureau of Preventable Diseases, Department of Health, 505 Pearl St., Manhattan. In New York State. (From an article in "Health News," January, 1922, by Edward S. Godfrey, Jr., M. D., Director, Division of Communicable Diseases, State Department of Health.) "Several outbreaks of epidemic jaundice have been investigated by sanitary supervisors and epidemiologists of the Department during the past two years, most of them during the past two months. The first to be reported occurred in March and April of 1920 in the little village of Berkshire, Tioga county, some 16 miles north of Owego, on the Lehigh Valley Railroad. The next outbreak to come to our attention occurred during January, 1921, in Chenango county. "More recently we have had reports of a family outbreak in the town of Brookhaven, L. I., and more extensive outbreaks in Oswego city and Hannibal in Oswego county; Macomb, Fowler and Morristown, St. Lawrence county; Georgetown, Madison county; Bowerstown, Otsego county; Fair Haven, Cayuga county, and Red Creek, Wayne county. We have also learned through the Laboratory of the occurrence of a number of cases in the city of Rochester. "The Berkshire outbreak was apparently confined to one family with the possible, though improbable exception of one case; this latter case was under medical attendance from January 25 until March 10, when she died, death being attributed to malignant disease of the liver and gall bladder. The other cases consisted of 7 out of 8 children in one family, ages from 3 to 16; the father and mother and a three months' old infant not contracting the disease. The cases were characterized by headache, anorexia, abdominal pains, jaundice, constipation, dark and bile stained stools which later became clay colored, biluria, and prostration seemingly out of proportion to the severity of the illness. Some of the cases showed distressing vomiting, epistaxis, and pains in the muscles of the legs and arms. One child had convulsions with the onset. The fatal case, above referred to, is stated to have had a sudden onset, although the patient had not been entirely well for some weeks. There was intense jaundice with loss of weight, a temperature of from 100 to 101.5 and nose bleed which upon one occasion was so copious that the physician found it necessary to pack the nose. This woman was 64 years of age and was a neighbor of the 7 cases which occurred later. "The outbreaks which occurred in Chenango county were investigated by an epidemiologist of the Department about three weeks after the last case had occurred. In this county the outbreaks were located in the city and town of Norwich and in the town of Guilford. These cases varied greatly in type and in the intensity of the symptoms. All of them, however, were characterized with sudden onset, sometimes with chills and fever, headache, nausea, vomiting and either obstinate constipation or marked diarrhoea. Jaundice was present in only 50 per cent of the cases. When present it developed on the fourth to seventh day, sometimes accompanied by an enlarged and tender liver and spleen. Fever was not constantly noted but when observed it fell by lysis. The nervous manifestations were marked, consisting of headache, dizziness and anxiety. There was a long period of convalescence with considerable emaciation and loss of strength, the entire course from onset to complete recovery lasting about three weeks. These Chenango county outbreaks covered 121 cases. In about 30 per cent of the cases hiccough lasting from 48 to 72 hours was a prominent symptom. Epistaxis was present in from 20 to 50 per cent of the cases. In at least two instances epistaxis was so severe as to require packing of the nasal cavities, and in four cases purpuric spots along the anterior tibial surfaces of the legs were observed. There was apparently no tendency to relapse nor were there any fatalities. Two cases who were pregnant aborted, one at three months and the other at seven months, both running a temperature of 103 to 105 for three or four days thereafter. Diffuse urticaria was noted in several instances. "It is perhaps questionable as to whether or not all these cases were suffering from the same affection, but the cases with and without jaundice and with and without hiccough were otherwise similar and some had both hiccough and jaundice. The two types appeared and disappeared at the same time. It is possible, of course, that there were two different infections prevailing synchronously and that some individuals were suffering from two different infections at the same time. It should be noted in this connection that Stokes and his collaborators found icterus absent in approximately 25 per cent of their cases. These were confirmed by blood or urine examinations. |