The Health bulletin [serial] - University of North Carolina at Chapel Hill

26 The Health Bulletin June, 1951Minimal, moderate, and far advancedtuberculosis 34.2Suspected tuberculosis 25.0Diagnosis reserved 16.0Cardiovascular 63.3VENEREAL DISEASE CONTROL SEC-TION—Maurice Kamp, M.D., ChiefSatisfactory progress in venereal diseasecontrol, especially syphilis, has beenmade during 1950. There has been agratifying drop in the early or infectiouscases of syphilis reported. The decreasein reported cases of congenital syphilisis not as marked. Morbidity data andother pertinent figures reveal the following:I. Cases reported for the first time:Syphilis Gonorrhea1949 6,699 16,1771950 5,168 14,934II. A comparative study over a threeyearperiod of primary, secondary, andcongenital cases showing the percentagethey comprise of the total cases reported:Number Cases Percent Number Per CentYear Primary and Primary and Con- Con-Secondary Secondary genital genital1949 2,093 31.2% 416 6.6%1950 1,196 23.1 346 6.6III. Total admissions to the two VenerealDisease Centers at Durham andCharlotte1949 6,7911950 5,232Total admissions in both Centers sinceopening in 1943, through December 31,1950: 53,413.During the report period the Sectioncontinued a special case-finding projectin cooperation with the United StatesPublic Health Service whereby trainedvenereal disease investigators were employedby the State Board of Health andassigned to local health departments inareas of high incidence. At the end of1950 there were 20 of these individualsserving 41 counties. In 18 other countiesthere were locally employed investigators.In those counties not having investigatorspublic health nurses providedsimilar service. The functions ofthis group included careful interviewingof all new patients by using special interviewingtechniques and the investigationof the contacts named by the patients.The following table illustrates the effectivenessof this program and at thesame time emphasizes the need for continuationof the control program inorder not only to make possible a furtherreduction in the incidence ofsyphilis but also to prevent an actualincrease in incidence from the reservoirof undetected cases. The extent of thisreservoir is probably considerable, inview of the increase in infected contactsfound by means of increased effort.A comparative three-months study ofepidemiological activity is shown below:Infectious Syphilis Contacts Number NumberYear Number of Named per of InpatientsPatient Contacts fected1949 1,080 .79 853 2971950 777 3.01 2,339 748This clearly shows that it is possibleto secure a great number of infectedpeople, even though the number of patientsin a comparative period decreases.Contacts interviewing and investigationof contacts has been emphasized duringthe calendar year. Although it ismore difficult to find infected people,this study shows that they do exist.Increased effort was made in cooperationwith the prison system. Because ofexcellent cooperation on the part of thechief prison physician, our local investigatorswere permitted to interview infectedinmates in the 92 state- operatedprison installations. In addition, the prison-wideadoption of penicillin therapyfor the treatment of syphilis effectedbetter over-all control, including thatof short-term prisoners.Due to the decline in the number ofcases of syphilis and the consequent risein cost per patient day, the RapidTreatment Center at Charlotte wasclosed December 31, 1950. The encouragementof the local health departmentsand private physicians to treat cases ofvenereal disease locally also contributedto the decreased number of Rapid TreatmentCenter admissions. Gonorrhea istreated almost exclusively on a localbasis by private physicians and localhealth departments with the one injectiontreatment of penicillin.