Following are excerpts from “The Typhoid Toll,” a paper by George A. Johnson, consulting engineer, New York, read before the American Water Works Association at its annual convention at the Hotel Astor, New York, June, 1916, by lohn C. Trautwine, Jr., C. E., Philadelphia, Pa.:
What Typhoid Is.—Typhoid fever is a loathsome and often fatal disease, contracted only by taking into the mouth the dejecta of typhoid patients, whether still suffering or supposedly cured (pp. 259, 292).
What Typhoid Does.—It is as dangerous as smallpox (p. 291). It numbers 100 victims to every passenger killed in railroad accidents (p. 252).
In the last thirty years the typhoid money loss in the United States was more than three times the net property fire loss (p. 269).
In the United States, each year, there are 300,000 typhoid cases and 20,000 typhoid deaths (pp. 253, 313). In ten years one person in every 33 suffers from the disease (p. 253). Of those who survive many suffer from depleted vitality. They are rendered less useful and less supporting, and succumb more readily to other diseases (p. 253).
The vital capital needlessly dissipated by typhoid fever amounts to $2,500,000,000; equivalent, at 6 per cent, to an annual expenditure of $150,000,000 (pp. 250, 253).
Successful Sanitation and Its Cost.—For 33 large world cities (total population 40,000,000) including New York, Boston, Chicago and Philadelphia, we find
*Reduction 37 per cent. (p. 262).
In these 33 cities, in 1912, the total deaths were 628,000. Under the conditions of 1881-1885, 1,036,000 would have died in 1912. In other words, of each 100,000 persons in those cities 1,000 fewer now die annually than in 1881-1885 (p. 263).
Filtration of Public Water Supplies.—In certain American cities, now aggregating 34,000,000 inhabitants, we have:
Filtration costs on an average about 40 cents per capita per year (p. 252).
In cities having filters the water-borne typhoid has been practically stamped out (p. 260). Filtration, properly done, is 100 per cent, efficient (p. 307).
Remaining Obstacles.—The progress made is the result of the application of knowledge acquired by scientists, and applied chiefly by the community as a body politic. The remaining evils (indicated above under “What Typhoid Does”) are due (p. 249) to popular ignorance, resulting from popular indifference, and
- Insufficient power, and insufficient means, for health officials (pp. 253, 254).
- Human life is sacrificed to trifling reduction of tax rates (p. 255) and
- Carelessness respecting protection of foods and drinks, especially against flies (pp. 277, 292, 296-298).
- In Jacksonville, Fla., in 1910 there was 329 typhoid cases. The privies were then made fly proof, and, in 1912, there were only 90 typhoid cases. Reduction 72 per cent. (p. 300).
- Protection of water supplies (pp. 300302). Pollution of public water supplies is wholesale homicide (p. 313). An examination of many farm wells in the United States disclosed the fact that at least 60 per cent, of them were polluted (p. 301).
- Handling of clothing, excreta, etc., of typhoid patients (pp. 289-291).
Remaining Work.—Give wider powers, and ample appropriations, to health officials (p. 250).
Thus enable them to enforce existing laws (p. 313), and then make it a jail offense for municipal officials to permit unsanitary conditions (p. 313).
Insist upon greatly increased care in the personal matters above noted.
Results to be Expected.—Typhoid fever is entirely preventable (p. 249). Public health is purchasable, and cheap. Each community can determine its own death rate (p. 255).
The substitution of pure for impure water, in the cities of the United States, would reduce the urban typhoid death rate from 20 to 14 (p. 310), saving 3,000 lives annually, and reducing by 45,000 the number of typhoid cases each vear (p. 311).
This represents a vital capital of $375,000,000 (about the cost of the Panama Canal) w’hich, at 6 per cent, interest, means an annual saving of $22,500,000. To build such water purification works for 30,000,000 oeople would cost $100,000,000; and the annual cost of their operation, plus interest and depreciation, would be not more than $12,000,000, leaving $10,500,000 as a substantial nucleus for a public health fund to be spent in general disease prevention work (p. 305).
National prosperity depends upon national productive power, and this, in turn, upon national health (p. 257). No community is so poor that it can afford to put up with an inferior water supply. Better do with ill-paved streets (p. 269).
Efficient filtration will cost 40 cents per capita per year (p. 252), and will reduce the typhoid fever death rate by two-thirds to three-quarters (p. 305).
Every dollar, now efficiently spent in sanitation, will return several dollars to the community. The balance is always on the right side of the ledger (p. 252).
Tables showing typhoid fever death rates in American cities since 1880; typhoid rates for cities, states and areas by months, years and seasons are included in the paper.
The following letter has been issued by the American Water Works Association :
At the recent convention of the American Water Works Association a noteworthy paper, entitled “The Typhoid Toll” was presented by George A. Johnson, consulting engineer and sanitary expert of New York, it was discussed by thirty-five representative American physicians, engineers and public sanitarians. The paper, with full discussion of about fifty printed pages, is now in press, and will form a pamphlet of about 125 to 150 pages. In this fashion it should prove a valuable educational document for water works men, health officers, public officials and individuals of all classes, it will serve a very useful purpose in the school room. This paper lias been most favorably commented on by the technical and public press, and is the best plea for filtration of public water supplies ever written. It is a nonscientific treatise covering the general subject of typhoid fever, its causes and means of prevention; its toll of lives and its economic significance. It will be greatly to your advantage to give it wide publicity in your city, and to see that your local health board and library have copies. Your local newspapers should be furnished with a copy, and you should see to it that they give it publicity. It will help you in your efforts to secure a letter water supply and better all around sanitary conditions in your city. The copy containing the discussion is strongly recommended. The opinion of thirty-five of our best public men are therein set forth. This is a splendid opportunity to obtain a veritable mine of good advice and sound information at a trifling cost. The paper is printed in Volume 3, No. 2, June, 1916, Journal of the American Water Works Association, and the discussion will be published in the September Journal; but you should have separate copies of the paper to insure wider circulation than it will have in the Journal; a circulation among other than members of the Association. Order copies for the local newspapers, for the local board of health, for the State Board of Health, for prominent physicians in vour city. To give this information the publicity’ it deserves the American Water Works Association decided to place it within the reach of everyone. The paper will be received from the publishers about September 15th next, and thereafter will be available for distribution as long as the edition lasts, under the following schedule of prices, which are scaled so as merely to cover the cost of printing and postage:
*Reduction 55.5 per cent. (p. 307).
(Continued on Page XVII.)
(Continued from Page 242.)
Without With Number. Discussion. Discussion.
Single copies, up to a total of 100……_$0.20 per copy $0.25 per copy One hundred copies.15.00 per 100 18.75 per 100 One hundred to five
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Orders, accompanied by check or money order, should be sent at once to the undersigned. The number ot copies printed will be limited to the number of advance orders received. Pass this circular along to others who you think may be interested. Blank form for order is enclosed.
JOHN M. DIVEN, Secretary, American Water Works Association.
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