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All communications relating to the publications of the Department of Health should be

addressed to the Commissioner of Health, 149 Centre Street, New York

Entered as second-class matter May 7, 1913, at the post office at New York, N. Y.,

under the Act of August 24, 1912.

New Series, Vol. II.

OCTOBER 11, 1913.

No. 41

SCHOOL INSTRUCTION OF CHILDREN AT OTISVILLE SANATORIUM.

Up to the present time, children suffering from tuberculosis and removed to the sanatorium of the Department of Health at Otisville, N. Y., have experienced an interruption of their school education during the period of their sojourn within the institution. A realization of this fact caused Commissioner Lederle on August 16, 1913, to address the following communication to the President of the Board of Education:

"In the Tuberculosis Sanatorium at Otisville, Orange County, New York, there are sixty-seven patients, male and female, between the ages of 18 and 20 years and

one hundred and thirty-four patients, male and female, between the ages of 4 and 17 years. The Department has no facilities for giving school instruction to children over fourteen years of age. We do give instruction to the illiterate who are especially anxious to learn, but we are not able to offer instruction to all patients between the ages of fourteen and seventeen years, as the institution is administered mostly by 'patient labor.' It has occurred to me that among the large number of school teachers under your jurisdiction there are some afflicted with tuberculosis, and that it might be possible, if the plan meets with your approval, to detail the necessary number of teachers to the sanatorium, where they would receive proper treatment and at the same time earn their salaries, in instructing the patients.”

This communication was referred to the Committee on Elementary Schools and by them the matter was brought to the attention of the Board of Superintendents. On October 2_the Board of Superintendents adopted a resolution recommending to the Board of Education that three classes for tubercular children should be organized in the tuberculosis sanatorium of the Department of Health and that the same should be known as Public School 300, Manhattan. The committee, however, while approv. ing of the plan for the instruction of children in the sanatorium did not approve of the recommendation of the Board of Superintendents that these classes should be designated as Public School 300, Borough of Manhattan, for the reason that classes composed of children suffering from tuberculosis conducted in Bellevue Hospital and on the ferryboat "Southfield,” under teachers appointed by the Board of Education, form annexes to Public School 14, Manhattan, and they deemed it advisable that the classes to be organized in the tuberculosis sanatorium should be made an annex of Public School 14. On October 8, in accordance with the recommendations of the Committee on Elementary Schools, the Board of Education adopted the following resolution:

"Resolved, That, in accordance with the request of Hon. Ernst J. Lederle, Commissioner of Health, and in accordance with the recommendation of the Board of Superintendents, three classes of children who are patients in the Tuberculosis Sanatorium, of the Department of Health, Otisville, N. Y., be organized subject to financial ability, and that the same be made an annex to Public School 14, Manhattan.

"Resolved. That the Committee on Supplies be, and it is hereby, requested to furnish books and supplies for said classes."

PROSECUTIONS FOR EXPOSURE OF FOOD TO CONTAMINATION.

In the last edition of the Weekly Bulletin, brief reference was made to section 46 of the Sanitary Code, which provides as follows:

“No food, except fruits and vegetables that are peeled, pared or cooked before consumption, shall be kept, sold or offered for sale or be displayed or transported unless protected from dust, dirt, flies or other contamination. The term 'food' as herein used shall include every article of food and every beverage used by man, and all confectionery.”

From July 1 to October 1 of the current year, 450 prosecutions have been instituted by the Division of Food Inspection for violation of section 46 of the Sanitary Code. In fully 50 per cent of these cases the exposure of foodstuffs has taken place within doors. Although in many instances sentence was suspended, $328 in fines were assessed, and in consequence a marked change for the better is noticeable in the case and protection of foodstuffs. The policy of the Department of Health has been to prosecute typical cases in practically every section of the City, so as to circulate widely among store keepers the information that a new regulation is in force. It is a well established fact that the neighborhood associations of the different trades are the best disseminators of matters which are of personal interest to those trades. An active opposition to the enforcement of this section of the code has been encountered on the part of the larger "quick lunch" establishments, which maintain that a strict interpretation of the section will drive them out of business. The practices carried on, and until recently permitted, in establishments of this character, are decidedly insanitary. To cite a case in point: While an inspector of the department was conversing with the proprietor, the latter called his attention to an individual who was at the moment selecting from the centre of a pile of sandwiches the one which seemed to suit his fancy best. This man's hands were covered with a rashi punctuated with open sores, a state of affairs which could hardly have been conducive to either the health or appetite of other customers. On the counters of this establishment was also (lisplayed confectionery of various kinds, subiect to the contamination of Aies, dust and promiscuous handling. These faulty conditions can readily be remedied by placing all the food exposed to view in glass cases which open only to the rear and are in charge of a cleanly attired waiter or salesman. The customer would probably be quite willing to indicate through the glass which article of food he preferred, and this could then be delivered to him on a ladle or fork in the hands of the attendant Of course, an innovation of this kind would involve a little more original outlay and nossibly slightly increased expense for maintenance, but in order to conduct their business in accordance with the present official standards of sanitation, the proprietors of these establishments must adopt some such method.

PROSECUTIONS FOLLOWING DETECTION OF IMPURE FOODSTUFFS.

In our last issue were published the results of prosecutions following the detection of impure foodstuffs by the Inspectors of the Department. This action of the Department is not sporadic. It continues day in and day out during the entire year. It would be monotonous and unnecessary to publish the results obtained each week and they will only be noticed from time to time in the weekly editions of the Bulletin. On October 6, cases were prosecuted in the Court of Special Sessions as follows:

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PROGRESS OF THE LOCALIZED EPIDEMIC OF TYPHOID FEVER.

Early in the history of the outbreak of typhoid fever in the lower eastern district of the Borough of Manhattan, the Department suspected a certain creamery milk supply as being responsible for a majority of the cases. The milk supplied from this creamery was excluded from the city on or about, the 6th of September. It was predicted at that time that, if this action of the Department was well grounded, the number of persons becoming infected after about September 20 would sensibly diminish. This prediction is being verified for, at about that time there was a rather sharp decline in the number of onsets among the reported cases, followed by the inevitable rise due, in all likelihood, to secondary or contact cases. In the beginning of the outbreak, the suspected company supplied about seventy per cent. of the cases infected. At the present time, this company is supplying less than thirty per cent. of the cases reported and the total number of cases reported is also steadily decreasing.

DEATH RATE FOR THE WEEK. There were 1,301 deaths and a rate of 12.63 per 1,000 of the population as compared with 1,393 deaths and a rate of 14.05 during the corresponding week of 1912, a decrease of 92 deaths (relatively a decrease of 146 deaths, if the increase in population be taken into consideration) and of 1.42 points.

Diphtheria deaths decreased from 19 to 9 and diarrhoeal diseases from 120 to 95, pneumonias from 118 to 107, pulmonary tuberculosis from 165 to 139, Bright's disease and nephritis from 136 to 94. The mortality from whooping cough and scarlet fever was approximately the same. The most noteworthy increase was that of typhoid fever, the number of deaths reported in the week of October 12, 1912, being 15, as against 27 in the week just past, an increase of 80 per cent. The only other cause showing a considerable increase was organic heart disease, the mortality from which rose from 173 to 190.

The number of deaths under one year of age decreased from 289 to 230, under five years of age from 394 to 334. The mortality of the ages of 5 to 65 years remained about the same, while that over sixty-five years of age showed a large decrease from 262 deaths to 227.

The death rate for the first forty-one weeks of this year was 14.06 per 1,000 as against 14.33 during the corresponding period of 1912. a decrease of .27 points.

VITAL STATISTICS
Summary for Week Ending Saturday, 12 M., October 11, 1913.

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Cases of Infectious and Contagious Diseases Reported.

Week Ending.

July Aug. Aug. Aug. Aug. Aug. Sept. Sept. Sept. Sept. Oct
26. 2. 9. 16. 23 30. 6. 13 20 27

Oct. 11.

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