USA > Massachusetts > Bristol County > Attleboro > Reports of town officers of the town of Attleborough 1933 > Part 4
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During the year we have seen the eradication of tuberculosis from all the herds supplying the city with milk, and the enforcement of a regulation requiring all milk sold in this city to come from tuberculin tested cows. The cooperation of the local Milk Producers' Association with the department has brought about this important measure which should prove to be of great benefit to the producer as well as to the consumer of milk.
An effective educational campaign has been carried on through most of the year to stress the importance of pasteurization as a necessary added safeguard to our milk supply.
Furthermore, the city has been unusually free in the past twelve months of all of the common communicable and epidemic diseases, and few homes were quarantined during the latter half of the year.
Diphtheria apparently under nearly complete control, and with a new low incidence record almost established, visited us again toward the last of the year when two additional cases were reported and the first death was recorded in four years.
54
ANNUAL REPORT
VITAL STATISTICS
There were 250 deaths in Attleboro during 1933. The crude death rate based on the estimated population of 22,389 was 11.1 per 1,000. The infant mortality rate based on 290 live births during the year was 44.8. The largest number of deaths in one month occurred in January when there were 39. In- cluding non-residents, there were 18 deaths from pulmonary tuberculosis, 22 from cancer, 21 from chronic heart disease, and 16 from different forms of penu- monia.
There were 15 deaths from chronic nephritis, 29 from cerebral haemorrhage, and 10 deaths resulted from automobile accidents.
COMMUNICABLE DISEASES
There has been no widespread outbreak of any of the epidemic diseases this year. An unusually small number of contagious diseases was reported. The total number of all communicable diseases reported during 1933 was 306. In 1929 there were 770 cases reported, 247 in 1930, 455 in 1931, and 552 in 1932.
Diphtheria cases number 7 for the year, all in families where immunization had been neglected. Scarlet fever was also much less prevalent than in any recent year. Pulmonary tuberculosis showed a decrease of 10 over the very low record of 1932.
HEALTH EDUCATION AND PUBLICITY
Today, popular education in health, and the dissemination of information concerning the medical preventive means of disease control has largely supplanted quarantine, and a few other time honored methods formerly considered of such great importance in public health administration.
It is now evident that the cooperation of the citizens must be secured, and also maintained in every instance if reasonable measures directed toward their protection are to be successfully applied. It is not only necessary to tell the truths about disease prevention. Our problem is also to get these facts into the minds of citizens and to combat at times certain rather poorly organized attempts of individuals, and of small groups who occasionally display an extreme ignorance of the common functions, and services of health organizations.
Such individuals and groups may be counted on to persistently oppose many of the reasonable and essential activities carried on in the interests of their own, and of their children's health.
The department has made use of several new, and effective measures in its health educational work during the year.
The necessity of immunization to protect babies, and children of the pre- school group from diphtheria was stressed by nurses who visited the homes and talked convincingly with the parents.
The department nurse made frequent visits to families where persons were ill with communicable diseases, taught the essentials of disease prevention, and explained the reasons for, and the significance of quarantine.
An intensive and we believe a most successful campaign was conducted throughout the year to improve the quality of our milk supply, and to plainly emphasize the importance of pasteurization as a necessary safeguard to prevent disease transmission through milk. Weekly articles on this subject, and illus- trated advertisments appeared in the local newspaper.
Several addresses were given before local organizations by the health officer, and by the inspector of milk on the importance of milk control.
Form letters were mailed at intervals to every milk producer and dealer. Through this medium the inspector kept in closer touch with dairymen, and offered suggestions and assistance to them in their work.
55
ANNUAL REPORT
A SAFE MILK SUPPLY
The function of a health department in relation to its supervision of the city's milk supply as we see it includes the maintenance of a service for the control of milk at its source of production and in its subsequent handling until delivered. Proper control then begins at the farm where the milk is produced, and adequate inspection service should be able to assure the consumer that the milk is obtained under clean conditions. The producer must live up to certain minimum regula- tions implying cleanliness of production. If he can't do this his producer's permit is revoked. The inspector of course cannot be present all the time, and mistakes occur in the best regulated dairies. The possibilities of infection getting into milk may be almost remote in a very few dairies. Yet there is always a chance that this may occur at any time in any one of the average dairies. There is an abundance of proof that this statement is true. It is therefore the depart- ment's duty to see that any infection which may get into the milk-and this does occur at times despite precautions-will be prevented from reaching the consumer. This result in accomplished by proper pasteurization, a necessary added safe- guard to be applied to all market milk. Most of the people understand these facts, and that is why a majority of consumers in this city and all over the state drink pasteurized milk from choice.
We need inspection then to insure cleanliness, and pasteurization to insure safety. Neither one of these requirements alone is sufficient. Pasteruization alone can't make dirty milk clean nor make of it an ideal food. Inspection alone, no matter how thorough, will never prevent disease germs from occasionally getting into milk and causing unnecessary illness.
Outbreaks of disease carried by milk may occur in any city so long as its milk supply remains unprotected by pasteurization. Forty-five to fifty milk borne epidemics occur in the United States each year. In Massachusetts during the last five years there have been sixteen epidemics of milk borne infection, all on comparatively small milk routes.
The local regulation requiring pasteurization or certification of milk becomes operative as this year closes. A small group of producer dealers oppose it and legal action is threatened.
The department's efforts will not be spared to secure, and to maintain for this city,-A SAFE MILK SUPPLY.
TUBERCULOSIS
This disease has shown a slightly increased incidence over the low record of last year. More cases of the pulmonary, and also of other forms were reported. There were 59 cases of pulmonary tuberculosis noted, and of this number 12 were in Attleboro residents. The prevention of this disease constitutes a real problem for every health department. Every case reported here is immediately in- vestigated, and measures are adopted which seem best for the patient, and for children, and others who have been in close contact. Nearly all local cases are hospitalized as such provision has proven most suitable in the interests of the patients' welfare, and also for the protection of members of the immediate family, and of the community. All contact and discharged cases are visited regularly by the department nurse, and are also examined at the tuberculosis clinic held weekly for that purpose. Dr. Garnet P. Smith, Superintendent of the Bristol County Hospital has given freely of his time as consultant in the clinic, and we feel that his efforts, and advice together with the X-Ray service furnished by the County Hospital has been of great value in discovery, and early diagnosis of this disease.
A further reduction in tuberculosis incidence especially in the childhood type of this affection seems probable in the near future with improved methods of diagnosis available and with the recent elimination of tuberculosis from the herds supplying us with milk.
56
ANNUAL REPORT
Pasteurization in the near future of the remaining small amount of raw milk sold here will we hope end our dangers of tuberculosis transmission through our milk supply.
DIPHTHERIA CONTROL
Seven cases of this prever table disease were reported in 1933. In the pre- vious year there were nir e cases. Immunization had been neglected in every case. Ore death occurred in December, the first death since 1929. Five deaths from diphtheria have been reported here in the last twelve years.
The annual diphtheria prevention campaign was conducted during the last quarter of the year. A systematic house-to-house canvas of the city was made including the outlying districts. Two extra nurses were employed for this work. Lists of homes for visitation were made from recent birth records to secure in- farts, and children in the younger age groups. A large percentage of the children immur ized were in this younger age period which is the one of greatest suscepti- bility to the disease. The nurses employed in this work carried on a successful educational campaign and the necessity of immunization of babies, and young children was made the basis of their appeal to the parents.
The usual weekly clinics in the centre were well attended, and a larger number of children than usual were immunized in the clinics held in Hebronville, and South Attleboro. After eleven consecutive years of immunization service we are able to demonstrate in the accompanying chart how the diphtheria case rate is being steadily reduced, and held in control by our annual prevention work.
DIPHTHERIA IN ATTLEBORO, MASSACHUSETTS
CITY of ATTLEBORO
50€
100
DIPHTHERIA CASE RATES
400
300
200
200
100
1
40
40
IMMUNIZATION
20
RATES
0
1915
16 17 18 19 20 21 '22 '23 '24 '25 26 27 '28 20 30 -1
32
33
34 :35
The upper part of this chart illustrates the decline in the number of cases of diphtheria per 100,000 population from 1915 to the end of 1933. The lower portion of the chart shows the number of cases iminunized per 1,000 population each year since 1923.
The two comparative maps of the city illustrate in a striking way the marked reduction in diphtheria cases and deaths.
The first map shows the cases and deaths in a four year period just before immunization started, and the second map depicts the incidence, and mortality of the last four years.
20|
57
ANNUAL REPORT
DISTRIBUTION OF DIPHTHERIA CASES AND DEATHS IN ATTLEBORO In two comparative four year periods
ATTLEBORO
DIPHTHERIA CA'FG AL DEATHS 1918-22
-
-
The four year period immediately prior to the beginning of immunization work in 1923. The dots indicate cases, the stars represent deaths. 150 cases and 6 deaths.
. . 58
ANNUAL REPORT
MAP SHOWING LAST FOUR YEAR PERIOD
ATTLEBORO
DIPHTHERIA CASES AND DEATHS 1930-34
Eleven years of active immunization work has been completed with marked reduction in incidence and mortality. 30 cases and one death.
59
ANNUAL REPORT
DIPHTHERIA PREVENTION CLINIC RECORD 1933
Total number of treatments
1459
Total number immunized
with toxoid.
49
with toxin-antitoxin
527
Total number tests
20
Reshick tests .
258
Positive reschick tests.
6
Negative reschick tests
220
Not read.
32
New cases under 6 years immunized.
365
New cases under 2 years immunized.
131
New cases 2-4 years immunized.
104
New cases 4-5 years immunized.
31
New cases 5-6 years immunized.
99
DIPHTHERIA IN ATTLEBORO Rates per 100,000 population
Year
Cases
Case Rate
Deaths
1921
37
185
2
1922
11
.54
0)
1923
13
63
0
1924
6
29
1
1925.
8
38
0
1926
9
42
0
1927
23
109
1928.
20
93
0
1929
20
92
1
1930
6
28
0
1931.
8
36
0
1932.
9
40
0)
1933.
7
32
1
CASES OF DIPHTHERIA IN ATTLEBORO By Age Groups
Year
0-4
5-9
10-14
15-19
20-20
30-39
40 plus Unk'n
Total
1922
4
2
2
1
1
0
0
1
11
1923
5
3
2
1
1
1
0
0
13
1924
2
1
1
0
1
0)
1
0)
6
1925
3
2
0
1
0)
0
1
1
8
1926
4
4
0
0
1
0
0
0
9
1927
5
8
1
4
1
3
1
0
23
1928
4
6
4
2
2
1
0
1
0
20
1930
1
3
1
0
0
1
0
0
6
1931
3
0
3
0)
0
0
2
0
8
1932
3
4
2
()
0
0
0
0
9
1933
0
5
2
0
0
0
0
0
7
1
0
20
4
1
1929
4
10
New Schick tests.
60
ANNUAL REPORT
ATTLEBORO HEALTH CAMP Established 1923
The camp has finished its eleventh season of usefulness in caring for under- nourished boys. Mabel M. Brown, R. N., Supervisor from 1925 to 1932 inclusive, was unable to take charge of the camp this year.
Her eight years of faithful and constructive service as supervisor will be remembered by all who are interested in the camp's activities.
Mrs. Lois Wilmarth, R. N., was selected to fill Miss Brown's place, and her supervision was commendable.
Her report as supervisor follows:
ATTLEBORO HEALTH CAMP
A representative group of 40 underweight boys spent six weeks this year of 1933 at the Attleboro Health Camp.
The camp routine remained practically the same as in previous years. The various phases of health education such as posture, mental and physical hygiene were taught daily. Self expression was encouraged through the teaching of dramatics and outlet for creative energy was provided through the classes in handcraft of a number of kinds.
The camp was fortunate in having four counsellors, each trained for their par- ticular duties and all cooperating faithfully to fulfill the camp objectives.
The Lion's Club contributed in many ways toward the success achieved. The boys looked forward with enthusiasm to the many evening entertainments arranged for by the Club and in which many members participated.
The following are a few averages on entrance of the 1933 and 1932 groups for comparison :
1933
1932
Average age
10 1-2 yrs.
11 yrs.
Average height
53 1-2 in.
55 in.
Average weight
61 1-2 lbs.
68 1-2 lbs.
Average percent underweight.
12.6
13
The average gain this year was 8 pounds. 21 attained the average or over and 19 attained their normal weight. The total gain was 327 3-4 pounds.
The boys ranged from 8% to 22% underweight on admission.
The weekly distribution of gains was as follows:
Total Gain Total Loss Net Gain
1st week
110
1-4 109 3-4
Av. Gain 2.74
2nd week.
69 1-4
0
69 1-4
1.73
3rd week
33 3-4
3-4
33
.84
4th week
39
2 1 3-4
37
.97
5th week
40
38 1-4 1.00
6th week
35 3-4
3
32 3-4 .89
Total
327 3-4
7 3-4
320
8.19
The boys' mental well being is such an important factor to physical well being that one of the most important duties at camp was to understand each boy as well as possible that we might help him acquire or maintain right attitudes. To cooperate with us in this the parents were encouraged to keep in touch with us.
May it here be recorded that at the closing of camp season many parents expressed their sincere appreciation to Attleboro Health Camp.
Respectfully submitted, (signed) Lois E. Wilmarth, R. N., Supervisor.
61
ANNUAL REPORT
CONCLUSION
The blessing of less sickness, and a lower death rate is now an established fact throughout the country. The question is often asked as to why in the face of such economic distress and unemployment we have enjoyed comparatively favorable, and improved health conditions. Doubtless a large part of such im- provement may be due to a better and more general understanding of hygienic principles, and their practical use in our every day life. Even the diseases which are difficult or impossible to control have been less prevalent. People have been forced to live without many of the luxuries that are after all non-essential. They have necessarily avoided the excesses and extremes in which they formerly in- dulged. More sensible living has been conducive to better health. A wider knowledge of disease prevention has contributed to a large extent in the lessening of illness.
During the past ten years public health work has extended its service in al- most every community. It has taught individuals and families to think more of their own health. The preventable diseases have received more widespread attention. Diphtheria, typhoid fever, and smallpox are no longer common. Tuberculosis, shows a rapid decline in incidence over the past few years since better facilities are available for early diagnosis, and improved treatment in sanatoria has been provided. Many years of work have been necessary to bring about these changes. It is fair to assume that such results will have some per- manence and that the health consciousness of our citizens will neither immediately disappear nor be destroyed.
Respectfully submitted, WILLIAM O. HEWITT, Health Officer.
ESTIMATED APPROPRIATIONS FOR 1934
SALARY AND WAGES
Health Officer
948.20
Inspector of Milk.
1,500.00
Inspector of Slaughtering .
475.00
Inspector of Animals.
300.00
Tuberculosis Nurse
1,443.88
Care of Dump-Labor
694.58
Garbage Disposal
1,400.00
Clerical
496.15
STATE SANATORIA
State Sanatoria.
3,000.00
OTHER EXPENSES
Quarantine and Contagious Disease Hospitals:
500.00
Nursing and Care at Home.
180.00
Rent.
150.00
Light
15.00
Phone
40.00
Laboratory Maintenance .
100.00
Care of Dump-Material
25.00
Auto Maintenance.
500.00
Tuberculosis and Diphtheria Prevention Clinics
300.00
Physicians' Fees
450.00
Fees to Cities and Towns
100.00
Inspection of Plumbing
140.00
Office Supplies
100.00
Incidentals
50.00
Total
$12,907.81 William O. Hewitt.
62
ANNUAL REPORT
HEALTH DEPARTMENT RECEIPTS, 1933
State subsidy on patients at Pristol County Tuberculosis Hospital on cases settled in Attleboro . . State reimbursements on State cases, cases not settled in Attleboro nor any city or town in Massachusetts, and cared for at the Bristol County Tuberculosis Hospital.
.$ 1,186.43
37.87
Licer se fees collected, 1933 270.50
$ 1,494.80
RECOMMENDATION
The adoption of a definite dental health program is recommended.
The care of the teeth, and the prevention of dental disease from early child- hood on is now universally recognized as an essential part of the public health plan of every city. Disease of the teeth, and adjoining structures have an im- portart bearing on the general health of both children and adults. It is again suggested that as soon as practicable some provision should be made to meet this deficiency in our local health program.
William O. Hewitt.
DEATHS BY MONTHS, 1933
Deaths
Stillborn
January
39
2
February
19
1
March.
22
1
April
14
0
May
23
1
June
24
4
July
21
3
August
9
1
September
13
0.
October
21
3
November
24
1
December
21
0
Total
250
17
CORRECTED DEATH RATE
Population
No. of Deaths 209
10.3
1923
20,346
263
12.9
1924.
20,551
254
12.3
1925.
20,756
261
12.5
1926
20,961
257
12.2
1927
21,166
267
12.6
1928.
21,371
269
12.5
1929.
21,576
300
13.9
1930
21,777
224
10.2
1931
21,982
269
12.2
1932.
22,187
284
12.8
1933.
22,389
250
11.1
Death Rate
1922.
20,141
The city's death rate for 1933 based on the census population of 22,389 was 11.1 per one thousand inhabitants.
63
ANNUAL REPORT
INFANT MORTALITY
Totals.
Male.
Female.
1-2 days. Under 1 day .
2-3 days.
3 days-1 wk.
1-2 wks.
2-3 wks.
3-4 wks.
3 wks .- 1 mo.
1-2 mos.
2-3 mos.
3-6 mos.
6-9 mos.
9-12 mos ..
January
32100
00000011100
February
1 1 0 0 0 0 1 000000000
March
0
0 0 0 0 0 0 000000000
April
1
1 0 0 0 0 0 100000000
May
1
1 0 0 1 00000000000
June.
1
1 0 1 000 000000000
July .
2 11011000
0000000
August 0
0 0 0 000 000000000
September
2
1 1 1 0 0 0 0 0 0 0 0 0 1 0 0
October 1 1 0 1 000 000000000 November 1 1 0 1 000 000000000 December 0 0 0 0 0 0 0 0 0 0 000000
Totals 13 10 342 11 1 00 0 1 1 2 0 0
Broncho pneumonia 1
1 0 0 0 0 0 000000100
Cerebral Haemorrhage 2 1 1 1010000000000
Gastro Enteritis 1 1 0 0 0 0 0000001000
Myocarditis 1 0 1 000 0000000100
Premature Birth 7 Spina Bifida
70 2 2 0 1 1 00010000 1 0 1 1 0 0 0 0 0 0 000000
13 10 3 4 2 1 1 1 0 0 0 1 1 2 0 0
64
DEATHS BY AGES, 1933
Deaths .
Number of
Female
Male
Under 1 year
1-2 years
2-3 years
3-4 years
4-5 years
5-10 years
10-15 years
15-20 years
20-30 years.
30-40 years
40-50 years
50-60 years.
60-70 years
70-80 years
Over 80 years. .
January
39
21
18
3
0
0
0
0
1
1
0
2
1
4
6
6
5
10
February
19
5
14
1
14
0
0
0
0
0
0
0
0
0
1
3
2
9
5
2
March
14
10
9
1
0
C
0
0
0
0
1
2
0
0
1
3
5
3
3
2
7
3
June.
21
9
12
2
0
C
0
0
1
1
1
2
0
1
1
5
4
3
July .
9
5
4
0
0
1
0
0
0
2
1
1
0
0
0
2
2
0
August.
13
8
5
2
0
0
0
0
C
C
1
1
0
1
1
3
3
1
September
21
12
9
1
0
0
0
0
1
0
1
2
1
0
1
5
7
2
October .
24
9
01
1
0
0
0
0
0
0
0
1
0
3
4
7
5
3
November
21
9
12
C
0
0
C
0
0
1
0
1
0
1
6
1
4
4
December
TOTALS
250
111
139
14
0
3
-
1
00
6
7
15
10
21
35
52
50
33
.
0
0)
0
0
2
0
0
1
0
1
3
3
6
3
April.
23
7
16
2
0
2
0
1
2
1
1
0
2
2
0
3
24
13
=
1
0
0
0
0
May.
22
8
1
4
3
0
1
2
1
ANNUAL REPORT
-
1
65
ANNUAL REPORT
CAUSES OF DEATHS, 1933
January .
February
March
April
May
June.
July
August
September.
October
November .
December.
Totals.
Abortion.
1
1
Accident-Automobile
21212
1
1 10
Accident-Diving
1
1
Accident-Drowning
2
2
Acidosis
1
1
Alcoholism
1
1
Angina pectoris
1
1
Appendicitis
1
2
1
Arterio sclerosis
6 4 2 4 2
3 5 1
Arthritis-chronic
1
1
1 3
Bronchial asthma
1
1
Bronchitis-acute.
1
1
2
Cancer
1
1
2
4
2
2 1 3
22
Carbuncle.
1
1
Cardio renal disease
1
1
Cerebral embolism
1
1
1
3
Cerebral haemorrhage
3
1 3 13
2 1
2 5 5
29
Cholecystitis-acute.
1
1
Cholecystitis-chronic
1
1
2
Coronary embolism
1
1
1
3
Coronary thrombosis
1
1
2
Diabetes mellitus
3 1 1
5
Endocarditis-chronic
2
2
Epilepsy
1
1
Gastric ulcer
1
1
Gastro enteritis
1
1
Goitre, toxic.
1
1
Haemorrhage from stomach
1
1
Heart disease, orga nic
4312 3 2 1
1
1
1
21
Intestinal obstruction
1
1
Leukaemia
1
1
Myocarditis, acute
2
1
3
Myocarditis, chronic
3
1
1 3
1
1 3
16
Nephritis, acute
2
2
Nephritis, chronic
1 3
1
1
1
1 4
15
Ovarian Cyst.
1
1
Pernicious Anaemia
1
1
4 27
1 2
66
ANNUAL REPORT
CAUSES OF DEATHS, 1933-Continued
January .
February
March
April.
May.
June.
July
August
September
October
November
December
Totals.
Peritonitis, general.
1
1
1 3
Pneumonia, bronchial
1
1
2
4
Pneumonia, lobar
2
1
1
1
1
2
1
3
12
Premature birth
1
1
1
1
1
1
1
7
Pulmonary embolism
1
1
1
3
Prostatic obstruction
1
1
Pyelo-nephritis.
1
1
Septicaemia
1
1
Scarlet fever
1
1
Spina bifida
1
1
Stillborn .
2 1
1
1431
3
1
17
Suicide, stabbing
1
1
Suicide, hanging.
1
1
2
Suicide, pistol wound
1
1
Tetanus.
1
1
2
Tuberculosis-pulmonary .
3
1
1
313
1
3
1
18
Tuberculous ulcer
1
1
Totals
41 20 23 14 24 28 24 10 13 24 25 21 267
ANNUAL REPORT
CASES OF CONTAGIOUS DISEASES, 1933 DEATHS FROM CONTAGIOUS DISEASES, 1933
Neonatorium
Ophthalmia
Pneumonia
Lobar
Influenza
Mumps
Measles
Cough
Whooping
Chicken
Fever
Typhoid
Fever
Scarlet Diphtheria
Pulmonary Tuberculosis
Other Forms Tuberculosis
Tuberculosis
Hilum
German Measles
Tetanus
Dog Bite
Encephalitis Lethargica
Malaria
Cases
Deaths
Cases
Deaths
Cases
Deaths
Cases
Deaths
Cases.
Deaths
Cases.
Deaths
Cases.
Deaths
Cases
Deaths
Cases.
Deaths
Cases
Deaths
Cases
Deaths
Cases
Deaths
Cases
Deaths
Cases
Deaths
Cases .
Deaths
Cases
Deaths
Cases.
Deaths
Cases
Deaths
Cases
Deaths
January . .
0
0 0
0
2
2
0)
0
0
1
0)
2
1 ()
1
0
0
+
0
0
0
0
0
0
0
0
0
C
4 2
0 1
0 0 6 1
0 0)
0 0 0
0
0
0
3
0
0
0
0
Jur e. July . August.
0
0
0
C
0
0
0
0
0
0)
0
0 13
0 ()
()
0
0
0
0
4
0) 0
0 -
0 -
0 0
1
0
4
0
C
0
00 1
0 0 0 0
October .
0
0
0
0
2
2
0
0 1 1
C
0
-
0
0 010802 1
00
0 2
0 0 0
0 -
0) 0
0 0
0
3
3
0
1
0 1 100 0
0
0 0
0 0 0
0 0 0
0
0 0 0
0
0 2
00
00 0
November . . December. . .
0 0
0 0
0 0
0 0
3 5 3 0
13
0 0
C 0 18 0 5 0
0 0
2
0
0 0)
0 ()
0 0)
0 0
0
0
C
September .
0
0
0
0
0
0 0
0 0
0 1
0 1
0 0 0
02
0 1 1
C
0
0
0 00
0 11 0
3
0 0 28 00
0 () 0
0) 1
0 0
C 1
1 0 0
6 4
0 0
0 0
0 0
0 0 0
May. .
0 0
0
0
0
1
1
0)
0
0
0
0
0
1
0
0
0
0
0
227
0
C 0
0 0
0 4 0 0 0 0 104 0
1
0
0
0
0
0)
0
0
2 0
0
0
March .
0
0
0
0
3
0
0 6
0
0)
0
0
0
0
0)
2
1
0
0
0
1
0
0
0 1
0
0
4 0
0
0
0 0
February .
0 0 1
1 0
0
0
C
1
0
0
0
0
1
C
1 0)
0)
9
1
1
0
8 3 5
1
0
0
0
0
0
0
0 3
0
0 0 0 0 0)
0
1 0 2
0)
1
0
0
0
0)
0
0
0
0
0 0
0
1
1
0
April.
0
0
0
0
0
0
1
3
0
0 0
0
0
1 0
200 0
Totals. . . 0
Pulmonary tuberculosis cases non-resident. Pulmonary tuberculosis deaths non-resident
47 18
0 0010 1
4 1 0
2 020
0
0) 0) 0
0 0
3 1 000 6 1
0) ()
0
0
0
0
1
0 0 -
C
0
0
C
0 0)
0)
0)
0
0
0
2 0
0 0 0
67
C
-
C 0 0 0 1 0 24 12 0 0 5 0 4 0 40 0 31 0 1 0 22 1 7 0 59 18 7 1 28 0 1 0 4 236 0 1 0 1 0
0
Pox
68
ANNUAL REPORT
REPORT OF MILK INSPECTOR AND AUTHORIZED AGENT
December 27, 1933
Dear Dr. Hewitt:
I am very pleased to submit my first annual report as Milk Inspector and Authorized Agent of the Attleboro Health Department.
I have held this position only since July 1, 1933, so that my report will cover only six months.
My work with the Attleboro Health Department has been particularly pleasant, You, Dr. Hewitt, as health officer, have been most helpful and friendly to me, giving me your time and attention whenever I felt it necessary to ask for advice or help. I feel that I am very fortunate to be in your employ. Coming to Attleboro as a stranger, I have found the people of this city very friendly, the milk producers and milk dealers with whom most of my work has been have been very cooperative and have readily taken my suggestions showing that they have a keen interest in making their milk a high quality product.
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