ORANGE COUNTY

P. P. Pillans, M. D., Agent

During the year 1911 we had cases of diphtheria, smallpox and typhoid fever. Two or three deaths occurred from diphtheria. Infected children and those exposed were given the antitoxin.

Vaccination has about stamped out smallpox. We had only a few cases of the disease.

No common source of the infection in typhoid fever could be found for the few cases occurring.

The county's health in general has been good.

OSCEOLA COUNTY

'M. J. Hicks, M. D., Agent

As we have just passed the milestone of 1911, it now becomes my duty to render to you an account of the varied health conditions prevailing in our county during the past year.

Hookworm Disease.-The first I shall notice is the one most neglected and at the same time the most glaring of all the maladies with which we are afflicted in Florida. I think the cause of neglect is due in great measure to the fact that parents have not been educated to the danger to their children from this parasite, especially in the rural districts. They are pregnant with the old idea that the child is a dirt eater and will grow out of it without treatment. I should estimate from the best information obtainable that there have been about fifty cases treated in this county during the year, and I should say ninety per cent. successfully.

Tuberculosis.—I venture on this subject with uncertainty because of the migrating population with which we have to contend. It has been my observation that comparatively few of the native Floridians are afflicted with tuberculosis and the foreign elements come and go so often that it is difficult to keep track of them. I could not say how many cases have been treated, but believe that one-half dozen will cover the death list from the disease. It has been my experience that people coming to this county afflicted with tuberculosis, and who live in the open air and have plenty of good, substantial, nourishing diet, and who remain here through the summer months, are materially benefited, at least in fifty per cent. of the instances.

Smallpox. The number of cases of smallpox last year were few, owing to the general use of vaccine. From every opportunity presented, especially in the turpentine camps and other places where people have been crowded together, I have come to believe that quarantine plays but a small part compared to vaccination in the management of the disease. If the people were universally vaccinated, there would be no necessity for quarantine. There were about fifteen cases of the disease during the year, with no deaths. Malarial fever is never prevalent in this county to any extent; therefore, I can report but a very few cases, and as the years go by we have fewer, owing to the fact that the municipal government of Kissimmee and the people generally are making war upon the mosquito-breeding places.

We have had probably thirty-five cases of typhoid fever, with a mortality of five per cent. I have no knowledge of any antityphoid vaccine having been used.

Kissimmee has an up-to-date water plant and sewerage system. Our milk is furnished from a dairy that is sanitary in all of its departments and surroundings.

We have had one case of diphtheria, very malignant, but treated successfully with antitoxin. There have been no cases of measles, scarlet fever, whooping cough, dengue, hydrophobia or other communicable diseases, except those mentioned.

I have heard of but one case of pellagra and no deaths as yet. Anterior poliomyelitis, one case with one death.

I have inspected different localities in the county and find the county generally in a healthy and sanitary condition. The greatest nuisance that we have is the housefly, but, as we improve in modern methods, I think the fly problem will be finally solved by more rigid sanitary measures, especially if we continue to urge upon the people the necessity of more stringent sanitary usages in every department of the home.

I find that Florida Health Notes is doing good work in the county along sanitary lines. Am sorry to say that we have not as yet any medical inspection of schools, though it is a proper thing to institute.

The newspapers of the county could be an agent through which a vast deal of sanitary work could be done, and I find our papers are waking to its importance. We have no health organizations except our ladies' "Village Improvement Society," and I cannot

say too much in their praise, for they have certainly not failed to point out public nuisances to the town authorities and urge upon them the necessity for abatement. Florida Health Notes is the only public health literature we receive.

PALM BEACH COUNTY

C. M. Merrill, M. D., Agent

The most important matter of sanitation concerning Palm Beach County occurring within the past year is the authorizing of the issue of additional bonds by the city of West Palm Beach for civic improvements; of the funds available at an early date, sixteen thousand dollars have been appropriated for additional

sewers.

Of the contagious and infectious diseases the county has had more than its share. Typhoid fever, ten cases. Smallpox, two cases, which, occurring in succession, were treated under the tent method, which proved satisfactory to the public and the patients. Diphtheria has prevailed in the southern part of the county, eight cases having been recognized and two deaths having resulted therefrom.

PASCO COUNTY

W. E. Seay, M. D., Agent

(No Report.)

POLK COUNTY

C. W. Love, M. D., Agent

(No Report.)

PUTNAM COUNTY

E. W. Warren, M. D., Agent

Health conditions have not differed the past year from former years greatly, except in minor detail. About fifty cases of smallpox have occurred. A few deaths (two that I know of) have occurred from tuberculosis. One small outbreak of typhoid fever, on the eastern side of the St. Johns River, in which there were six deaths, was the most noticeable change from last year. Two cases of scarlatina in Palatka were reported. Some measles and mumps appeared, the former in the spring, while the latter is prevalent at the present time.

Little general attention has been given to the treatment of hookworm disease. Only one physician in the county has taken any interest in the subject, although the disease exists here to a very large extent.

So far as I know, only two cases of pellagra exist in the county, and no deaths occurred from it during the year. One case of anterior poliomyelitis has come to my attention, and it is gradually improving.

Nothing is being done to prevent mosquito breeding or to prevent the spread of typhoid fever. Our county has no health authority, nor has the city. Attention has repeatedly been called to this matter by the local agent of the State Board of Health, but no effort has been made to correct it. No public lectures have been made upon health subjects, although the Ladies' Fortnightly Club have asked for a lecture by Dr. Byrd of the State Board of Health at the time of their next or annual meeting which occurs in a few days, on any subject he may select. They suggest medical inspection of schools, which has been begun in the Palatka schools in a small way, or inspection of milk supply, or hookworm disease.

The vital statistics of this county are not accurate by any means. Only a few of the physicians of the county and a small per cent. of the midwives furnish reports to the State Board of Health, so far as I can find out. The importance of this work does not seem to be appreciated by them.

Florida Health Notes is of immense importance to the people of this county. A vast amount of information is imparted to the ones who read it. I would like to see it mailed to the head of every family in the state. Other literature on health and allied subjects gotten out by the Board has created a lot of interest, especially the "Typhoid Primer" recently out by Dr. Byrd. I should like to see every family in our county have a copy of it.

ST. LUCIE COUNTY

W. E. VanLandingham, M. D., Agent

(No Report.)

ST. JOHNS COUNTY

E. S. Estes, M. D., Agent

1911 has been a very healthy year, with very few cases of communicable diseases. Absolutely correct statistics are difficult to

get, as the physicians do not report these diseases excepting smallpox, scarlet fever and diphtheria. The following will show all cases reported to me.

Smallpox, in St. Augustine, 3 cases, one death, malignant type.

Scarlet fever, 8 cases, no deaths.

Typhoid fever, about 10 cases, none contracted here.

Tuberculosis, several deaths, no cases reported.

Hookworm disease, not very prevalent.

Pellagra, none.

Diphtheria, two cases.

Not very much is being done in regard to the care of children in school, at present, but a movement is on foot to have examinations made twice a year by local physicians who are willing to do this work.

The general health conditions in St. Augustine are splendid.

SANTA ROSA COUNTY

H. Mason Smith, M. D., Agent

The year 1911 was marked with improvement in the sanitary conditions of this community (Milton). Several sanitary ordinances were enacted, which were rigidly enforced, and which have had a far-reaching effect on the public health. Among them was an ordinance providing for screened and sanitary privies and for a Sanitary Inspector. Confectioneries and fruit are also required to be screened. Drainage has been improved and several sanitary nuisances have been removed.

We have had smallpox from the first of the year until June. As the people are seing more the necessity of being vaccinated, and as they submit to vaccination, it was only in communities where the disease was not reported that there was any noticeable spread.

Measles has existed in the county in epidemic proportions almost the entire year, one community after another being invaded, until the almost isolated communities have been reached and the entire county covered.

Ten or twelve cases of typhoid fever, four cases of sporadic meningitis, have been reported at various times during the year. There were no cases of scarlet fever, diphtheria, or anterior poliomyelitis reported.