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Cbe Libtarp of tfce Dtotfion of ©ealtb affairs Clntoet0ftp of jRottij Carolina Cf)t0 book toa* prw eD North Carolina State Board of Health ***rn 5*rt ~* ^? *«^- Thirty-Seventh Biennial Report OF THE NORTH CAROLINA STATE BOARD OF HEALTH July 1, 1956-June 30, 1958 MEMBERS OF THE STATE BOARD OF HEALTH Appointed by the Governor H. C. Lutz, Ph.G. Appointed 1951 Term expires 1959 Mrs. J. E. Latta Appointed 1953 Term expires 1961 John P. Henderson, Jr., M.D. Appointed 1954 Term expires 1959 Lenox D. Baker, M.D. Appointed 1956 Term expires 1961 Z. L. Edwards, D.D.S. Appointed 1957 Term expires 1961 Elected by the Medical Society of the State of North Carolina John R. Bender, M.D., Vice-President Elected 1949 Term expires 1961 Charles R. Bugg, M. D., President Elected 1957 Term expires 1961 "Roger W. Morrison, M.D. Elected 1957 Term expires 1959 —Earl W. Brian, M.D. Elected 1958 Term expires 1959 EXECUTIVE COMMITTEE Charles R. Bugg, M.D., President John R. Bender, M.D., Vice-President Z. L. Edwards, D.D.S. J. W. R. Norton, M.D., Secretary EXECUTIVE STAFF AS OF JUNE 30, 1958 J. W. R. Norton, M.D., M.P.H., Secretary and State Health Director John H. Hamilton, M.D., Assistant State Health Director and Director of Laboratory Division Ernest A. Branch, D.D.S., Director Oral Hygiene Division J. M. Jarrett, B.S., Director Sanitary Engineering Division A. H. Elliot, M.D., Director Personal Health Division Fred T. Foard, M.D., Director Epidemiology Division Robert D. Higgins, M.D., Director Local Health Division E. C. Hubbard, B.S., M.P.H., Director Water Pollution Control Division Ben Eaton, Jr., Director Administrative Services Dr. Morrison elected to fill unexpired term of Dr. Crump. Dr. Brian elected to fill unexpired term of Dr. Dixon, deceased May 7, 1958. 22948 co H -J < UJ X u. OQ <o CO UJ < H o ^ O O >> 41 CJ= fcS ° .SS D >; m"S 35 H O^m P O Q™ S ^ 35 ZO 55 >p— i P O z I— < es w wz I— I oz w <! E-rSratH :Q - 35 ^ - So 2|go -k\P ~ Z*H < 35 £ 5 .22 H CC ft Q- - =3 H - 2 2 as 3 oH O SJ PQ -a H Q M ^ 2 O M ~££&^3 . a Q W - * o o £ u_; >2 S H a <! LOCAL HEALTH DIRECTORS IN NORTH CAROLINA N. C. State Board of Health, Local Health Division Raleigh, N. C. Department Alamance Alleghany-Ashe- Watauga Anson Avery-Yancey-Mitchell Beaufort Bertie Bladen Brunswick Buncombe Burke Cabarrus Caldwell Carteret Catawba-Lincoln- Alexander Cherokee-Clay-Graham Cleveland Columbus Craven Cumberland Currituck-Dare Davidson Davie-Yadkin Duplin Durham Edgecombe Forsyth Franklin Gaston Granville Greene Guilford Halifax Harnett Haywood Henderson-Transyl-vania Hertford-Gates Hoke Hyde Iredell Jackson-Macon-Swain Johnston Jones Lenoir McDowell Madison Martin AUGUST 1, 1958 Health Director Dr. W. L. Norville Dr. M. B. H. Michal Dr. Warren D. Carter, Act. P.T. Dr. L. E. Kling Dr. W. S. Cann Dr. David Tingle Dr. C. B. Davis Dr. H. W. Stevens Dr. G. F. Reeves Dr. J. Roy Hege Dr. William Happer Dr. Luther Fulcher, Act, Dr. William H. Bandv Address Burlington Boone Wadesboro Burnsville Washington Windsor Elizabethtown Shallotte Asheville Box 7525 Morganton Concord Lenoir P.T.Beaufort Hickory Dr. Z. P. Mitchell Dr. Floyd Johnson Dr. E. D. Hardin Dr. M. T. Foster Dr. W. W. Johnston Dr. J. W. Varner Dr. John L. Chesnut Dr. John F. Powers Dr. O. L. Ader Dr. W. A. Browne Dr. Fred G. Pegg Dr. A. J. Holton Dr. B. M. Drake Dr. W. N. Thomas Dr. J. L. Campbell Dr. E. H. Ellinwood Dr. Robert F. Young Dr. W. B. Hunter Dr. Raymond K. Butler Dr. J. D. Lutz, Act. P.T. Dr. John R. Folger. Act. P.T Dr. James A. Fields Dr. A. L. O'Briant Dr. W. W. Johnston Dr. Ernest Ward Dr. H. F. Barnes Dr. E. S. Grady Dr. R. J. Jones Dr. R. J. Jones Dr. W. F. E. Loftin Dr. Margery J. Lord, Act. P.T. Dr. W. A. Browne Murphy Shelby Whiteville New Bern Fayetteville Currituck Lexington Mocksville Kenansville Durham Tarboro Winston-Salem Louisburg Gastonia Oxford Snow Hill Greensboro Halifax Lillington Waynesville Hendersonville Brevard Winton Raeford Swan Quarter Statesville Sylva Smithfield Trenton Kinston Marion Marshall Williamston Mecklenburg NORTH CAROLINA STATE BOARD OF HEALTH RALEIGH September 11, 1958 . GRADV DIXON MD. PRtS TABLE OF CONTENTS Report of the Secretary-Treasurer, July 1, 1956-June 30, 1958 9 Conjoint Report, 1957 46 A Decade of Public Health Adjustment in North Carolina 51 Biennial Report, July 1, 1956-June 30, 1958—Central Administration 62 Local Health Division 67 Personal Health Division 76 Division of Epidemiology 81 Sanitary Engineering Division Ill Laboratory of Hygiene 116 Report of Committee on Postmortem Medicolegal Examinations 123 Oral Hygiene Division 125 Division of Water Pollution Control 129 Public Health Chronology (1952-1958) 140 REPORT OF THE SECRETARY-TREASURER AND STATE HEALTH DIRECTOR July 1, 1956-June 30, 1958 Abridged report of the activities of the State Board of Health as recorded in the Minutes: July 8, 1956. There was a special meeting of the North Carolina State Board of Health held Sunday, July 8, 1956, 10:00 a.m.-5:00 p.m., in the Board Room of the Cooper Memorial Health Building, with President Dixon presiding. Dr. Norton asked for clearance on the minutes of the last meeting so that certain actions taken at that meeting might be considered final and acted upon. Dr. Lawrence suggested that since this is a special meeting for a special purpose, the approval of these minutes be postponed until the next regular meeting, and this was done. Before going into the public health laws, Dr. Dixon explained that at Pinehurst certain members of the Board got together and studied the first Chapter to acquaint themselves with it and to get something started toward making recommendations. At that particular meeting, the attorney for the State Medical Society was present. At a meeting in Winston-Salem about a year ago, the subject came up of changing the name of the executive officer from State Health Officer to Commissioner of Health, and a resolu-tion was passed to that effect, and setting up a State Department of Health. The medical members of the Board talked it over with the attorney for the State Medical Society, and he advised that so long as things go along as they are, with the men we have in control, it would be perfectly alright, but if sometime a different type of man got in as the head of the depart-ment of health that it would be very easy for that particular man to request appropriations and laws that would make him a czar in the department of health, if he so saw fit, and the Board would have no say-so in the policies. It would become just a figurehead. The attorney saw that as a possibility. Dr. Lawrence commended Dr. Crump and Mr. Ligon for carrying out almost to the letter of the law the suggestions as they understood them. The following changes were made in the proposed revision of the public health laws: ARTICLE 1—General Provisions Section 1, (d) was rearranged to read: "Any action or proceeding com-menced before this Chapter takes effect, and any right accrued, is not af-fected by this Chapter, but all procedures thereafter taken shall, insofar as possible, conform with the provisions of this Chapter." Item (e) in the same Section was rearranged to read: "Whenever a power is granted to the State Board of Health, or a duty is imposed upon a public officer, the power may be assigned or the duty may be performed, unless this Chapter expressly provides otherwise, by a deputy of the officer or by a person duly authorized by the State Board of Health." 10 Thirty-Seventh Biennial Report Under Section 2, "last known" was inserted before residence and before principal place of business. ARTICLE 2—Administration of Public Health Law Section 3, State Health Officer was changed to State Health "Director". In reference to Section 1, members of the Board appointed by the Gov-ernor, Dr. Lawrence moved that in view of the custom for more than twenty-five years, or for the life of this Board it has been customary and in practice that the Governor did appoint one or more licensed physicians, that this particular specification be left as it has been presented at this time. Dr. Crump seconded, and motion carried. Section 3—From page 2—In a discussion as to whether or not training and expei'ience in public health should be inserted as one of the require-ments for the State Health Director, Dr. Current made this statement : The taxpayers of our State have seen fit to set up a school of public health maintained by citizens' money of the State, and men are trained there and trained in public health in a fashion similar to the way that medical men are trained in medicine, dentists in dentistry, and so on down, in the specialized field of public health. Public health has grown like other parts of our country has grown until now. It is a specialized type of health service to the citizens at large. I would not for a minute agree to a State Health Director who did not have an M.D. degree, but I would in a like manner not give my consent to one who did not have a degree in public health training, and that degree by a school that is authorized and re-cognized as a standard public health school. I see no point in the local health groups over our State wanting specifically trained physicinas that are also trained in public health and then this Board feeling that the top level man should not have equal or better training. So my opinion is that the top flight man in public health service of our State should be an M.D. and should also have a master's degree in public health. Dr. Dixon remarked that Dr. Norton is the first formally trained State Health Officer we have had. He agreed with Dr. Current that since county health officers have to have public health training, we should have the same thing in the top State position. If we lose a health officer, we should set a precedent that we look about among our county health officers and find the best man in the State in public health work to promote. Dr. Current further explained that the reason he said trained by re-putable schools of public health is that training in the constituted schools of public health can be done quickly, but it is not the only way that a person can become trained in public health. Dr. Crump moved that we add to the fourth sentence of Section 3—"and shall be trained in, and shall have had experience in, Public Health work." Motion seconded by Dr. Current, and unanimously carried. In the same Section, "traveling and hotel expenses" was changed to read "traveling and subsistence expenses." In Section 5, the next to the last sentence was changed to read "or by a majority of the members of the State Board of Health", instead of "the executive committee." Section 8 was changed to read: "The administrative staff of the State North Carolina Board of Health 11 Board of Health shall have and exercise such administrative duties and authority as may be assigned by the State Board of Health." Dr. Baker moved, seconded by Dr. Current, that Items 7 and 11 under Section 8, Duties of the Administrative Staff of the State Board of Health, be moved to Section 6, Powers and Duties of the State Board of Health. Motion carried. Dr. Baker moved that Item 12 of Section 8 be moved to Section 9, Duties of the State Health Director, and be made Item 5 under that Section. Seconded by Dr. Crump. Carried. The word "shall" was changed to "may" at the top of page 12, under Item 13. Under Section 9, Item 4 "an employee" was changed to "a responsible employee". ARTICLE 3—Local Health Departments Section 4, Compensation of Board members, was changed to read "except that they may receive eight dollars per diem". ARTICLE 7—Vital Statistics Section 9, Burial-Transit Permit Authorizing Burial or Other Disposi-tion of Body, Dr. Crump moved that the following be added to the first sentence: "except for those moves necessary for the body to be prepared for and removed to the funeral home". Dr. Baker seconded and the motion carried. The same insertion was made in Section 10, Fetal Deaths to be Registered. Dr. Baker moved, seconded by Dr. Crump, that Mr. Ligon study the wording of this insertion carefully to make sure that it covers our needs. Carried. Adjournment for lunch at 12:30 p.m. In Section 15, "Coffins" was added to the title, to read "Sales of Cof-fins and Caskets Regulated". Section 32, Church and Other Records Filed and indexed: Fees for Transcript, was changed to read "and it shall be the duty of the State Registrar to preserve such parts of record or transcript and to make a record and index thereof in such form as to facilitate the finding of any vital information contained therein". ARTICLE 9—Immunization In Section 1, "tetanus" was inserted after the word "diphtheria". ARTICLE 10—Venereal Disease Section 2 was changed to read "Any physician or other person respon-sible for diagnoses' and treats to "treatment of". ARTICLE 12—Sanitary Districts Section 6, Item 17e, insertion was made to read "and such person, firm or corporation shall have at least a reasonable time, to be determined by the Local Health Director". ARTICLE 13—Water and Sewer Sanitation Section 4 was left as is, with the request that Dr. Norton and Mr. Jarrett 12 Thirty-Seventh Biennial Report rewrite it in more detail, with the Attorney General's approval, and mail it to the Board members. ARTICLE 15—Private Hospitals and Educational Institutions Section 1, Regulation of sanitation by State Board of Health, was changed to read "To safeguard the health of patients, residents and students of private hospitals, sanitariums, sanitoriums, nursing or convalescent homes, educational or other institutions or abodes in North Carolina". At the end of the last sentence, "which are covered in ARTICLE 2, Section 8, sub-section 13" was added. ARTICLE 17—Cancer Control Program It was suggested that in the note on the changes made in Section 2, the words "and is not limited necessarily to low income citizens" be deleted. In Section 5, Reporting of cancer, in the first sentence, the word "require" was changed to "request". ARTICLE 19—Loan Fund for Dental Students Dr. Dixon suggested that a note should be added to Section 1, explaining that "The Little Jack Loan Fund" be so called at the request of Dr. Branch. The act was supposed to have been named that when it was set up by the fund and was left out of the original law through oversight. ARTICLE 22—Remedies In Section 1, "Except where otherwise provided" was inserted at the beginning of the paragraph. Section 15, Effective date, should read "This act shall be in full force and effect from and after December 1 following adjournment of the Legislature." Mr. Ligon was asked to explain the background and purpose of the re-organization commission appointed by the Governor to study organiza-tion of state government. The commission asked the Institute of Govern-ment to make a study of the inspectional activities of the State Board of Health and the State Department of Agriculture in the areas of meat, milk, poultry, rendering plants, pure food and drugs, soft drinks, to present to them what the statutes of the State Board of Health are and what the statutes of the State Deparment of Agriculture are. If they feel that some functions in one department should be in the other, they will ask the heads of the departments to meet with them to discuss those possi-bilities. A factual report, stating where the functions are, is to be pre-sented to the reorganization commission next week. Dr. Norton and Mr. Ballentine have been asked to meet with them. Dr. Norton reported that there had been another meeting of the Polio Vaccine Advisory Committee on June 21. The main thing brought out was the fact that 1,904,412 ccs. of polio vaccine has been allocated to North Carolina, which includes the thirty per cent that the State Board of Health is permitted to buy and also the amount that is made available to phy-sicians in private practice. We have an eligible population of about 1,800,000 which includes those under 20 plus pregnant women. Also the State has had quite a large amount of vaccine which has not been purchased by com-mercial channels and has not been available for State Board of Health North Carolina Board of Health 13 purchase, and other states are asking for it. The Committee authorized Dr. Norton as Chairman of the Committee to use his discretion and re-lease vaccine for use in other states, where there is a demand for it and where our demand hasn't caught up. We can call it back when the demand is greater. Under that provision we have released approximately four hundred thousand ccs. The President of the Medical Society, who is a mem-ber of the Committee, Dr. Donald Koonce, was asked to form a committee which would sponsor a publicity campaign to build up the demand for the polio vaccine so that the children would get their protection as promptly as possible. Dr. Koonce is moving along with the formation of that com-mittee with Dr. Sam Ravenel of Greensboro, as Chairman, and plans for informing the people about the fact that the vaccine is safe and that it is, as far as we can tell, now apparently relatively effective. The de-mand now is to be stimulated to become equal to the supply of Salk Vaccine. Dr. Norton, in explaining the material that had been distributed to the Board members, suggested that every Board member use every possible opportunity to inform whatever groups are available of the program of the State and local health departments, so that the people will be better in-formed with regard to the work and responsibilities and the importance of the public health work and when we have our next meeting of the Legisla-ture it will help us to have more friends there. Dr. Norton has asked Mr. Richardson to prepare additional material, correlating services, bud-gets, budget needs, etc. When that information is gotten up it will be sent to the Board members. This should serve as a basis for private and group discussions by Board members to help people to be better informed, such groups as medical society, dental society, service clubs, PTA, women's clubs, etc. Dr. Norton asked the Board's approval that he discuss the matter of raising the salary range of Division Directors with Mr. Coltrane and Mr. Dinty Moore, who in turn would help sell it to the Advisory Budget Com-mission. He requested that the President of the Board go with him. Dr. Baker moved that the Board request of Dr. Norton to take up the salaries of division heads with the assistant director of the budget and with the Advisory Budget Committee with a request that they be at least equal to the range for superintendents of State Mental Hospitals. Dr. Current seconded and the motion carried. Dr. Dixon asked Dr. Norton to make an appointment for them with the assistant director of the budget, to discuss salary increases of the Division Directors. August 19, 1956. A regular quarterly meeting of the North Carolina State Board of Health was held on Sunday, August 19, 1956, at 10:00 a.m., in the Board Room of the Cooper Memorial Health Building with Presi-dent Dixon presiding. Dr. John Bender moved that the minutes of the Executive Committee meeting held on April 19, 1956 be approved as circulated to Board members. Motion seconded by Dr. Crump, and carried. Dr. Dixon read a supplemental paragraph from a letter from Dr. Baker, dated July 6, 1956 which he suggested should be added to the June 1, 1956 minutes of the Board. This insert, or paragraph, also had been circulated 14 Thirty-Seventh Biennial Report among Board members. Dr. Crump moved, seconded by Mrs. Latta, that Dr. Baker's statement be added to the June minutes, after which the min-utes would stand approved as circulated. Motion passed. On motion of Dr. Crump, duly seconded, the minutes of the July 8, 1956 meeting of the Board, were unanimously approved as circulated. A further discussion was held regarding Dr. Ann DeHuff Peters' re-quest to be permitted to use sterile normal salt solution in the eyes of new-born babies instead of silver nitrate. It was pointed out by Dr. Elliot that the Board has not approved the proposed procedure. It was the consensus of the members that presently approved procedures should not be changed at this time by the State Board of Health. Dr. Bender moved that the Board notify Dr. Peters of this fact, in a letter. Motion seconded by Mr. Lutz, and unanimously carried. At this point, proposed budget requests and justifications for the bien-nium 1957-1959 were taken up. Each Director was asked to present the proposed budget for his Division and explain the various proposed changes and justifications for same. Secretary Norton presented the tentative budget request for Central Administration Division and explained the reason for the transfer of some of the Federal funds to State was in order that several key positions paid for by Federal funds may be transferred to the State payroll,—that we would be on safer ground if Federal funds should be further curtailed. Secretary Norton discussed two new positions for the Board of Health, namely, an Administrative Assistant and a full-time Deputy State Health Officer. The office of Administrative Assistant to the Secretary and State Health Officer was provided when the Board was reorganized on its present basis, in 1950, but no appropriation has been requested up to this time. Discussing the possible request for a Deputy State Health Officer, the Secretary explained that this position was now in force in many of the up-to-date health departments and its importance was being stressed at national meetings. At this point, Dr. Norton paid tribute to and expressed appreciation of Dr. Hamilton's work as Assistant State Health Officer, in addition to his many other duties. In considering this new item of the budget, Mr. Lutz moved that the Board go on record as approving this new position and that the official title be Deputy State Health Officer. Motion seconded by Dr. Current, and carried. In discussing the increase of salaries for Division Directors, it was thought that the salary for the Deputy State Health Officer should rank about the same. The Board also approved the inclusion of a flat 10 percent increase, across the board, for all employees. Dr. Fred T. Foard, Director of the Division of Epidemiology, went into detail, explaining the proposed requests in his Division and various Sec-tions for increase in salaries, personnel, equipment, etc., and giving justi-fications for each item. He told why a considerable increase in the alloca-tion for Occupational Health program is necessary and displayed charts and graphs comparing employees engaged in manufacturing industries 1950-1955, and other information pertaining to increase in industry in North Carolina. North Carolina Board of Health 15 Dr. C. C. Applewhite, Director of the Local Health Division, reported on the proposed budget and justifications for local health services. He said that he would appreciate guidance by the Board in preparing a formula to be used for the distribution or allocation of funds to local health de-partments. This was discussed. Dr. Bender moved that the Local Health Division staff be authorized to propose the same, or to work out a new-formula which will provide for a most equitable distribution of State funds to the county health departments, subject to the approval of the State Health Officer. Motion seconded by Dr. Crump, and unanimously carried. The meeting recessed at 11 :45 a.m. for lunch and reconvened at 1:00 p.m. The first item presented was by Dr. Foard, Epidemiologist, who reported to the Board regarding a case of lepromatous type of leprosy which was diagnosed last year in Surry County and is now receiving treatment in the Public Health Service Hospital in Carville, Louisiana. He said Dr. R. B. C Franklin, the Health Officer, does not want to assume the responsibility for permitting the patient to return to Surry County and is seeking advice from the State Board of Health as to whether the patient should be per-mitted to return as long as he is in the infectious stage. The subject was discussed at length, and it was the consensus that no leprosy case, in an infectious stage, should be admitted to North Carolina. Dr. Crump, there-fore, moved that the North Carolina State Board of Health disapprove of individuals who are under treatment in the Carville Leprosarium infected with leprosy returning to the State until they are certified by the proper authorities of the USPHS as being non-infectious. Motion seconded by Dr. Bender, and carried unanimously. Dr. A. H. Elliot, Director of the Personal Health Division, reported on the proposed budget for the Personal Health Division giving justifications for all recommended increases. Dr. John H. Hamilton, Director of the Laboratory of Hygiene, was next on the agenda for reporting on his requests and justifications for the Laboratory. He discussed the continued growth and activities, especially in cancer cytology, virology, chemistry and bacteriology. He also stated that he was happy to report that on June 30, 1957, the twenty year bonded indebtedness would be paid off for the Shore Laboratory of Hygiene Building. Discussing the proposed budget and justifications for the Oral Hygiene Division, Dr. Branch reported an imperative need for more school dentists, to provide for expansion of work among the children of North Carolina — for corrective and educational work. Mr. J. M. Jarrett, Director of Sanitary Engineering Division, followed, explaining the needed increase in personnel for his Department and the justifications for same. At the close of the hearings, President Dixon recognized Miss Reynolds, the Budget Officer, and gave her an opportunity to make comments with reference to the proposed budgets. There was a general feeling expressed by Board members that the proposals were minimum and that the Board of Health could not carry out its duties with less. Mr. Jarrett presented a proposal for a new sewage treatment plant and 16 Thirty-Seventh Biennial Report sewer extensions at Littleton, North Carolina, stating that the town re-quested it be ordered to make this improvement, so the money could be raised. Mr. Jarrett stated that an investigation had been made of the situation in Littleton which resulted from improperly maintained privies and residential septic tanks, along with four highly overloaded municipal septic tanks which discharge partially treated sewage into small streams creating a health hazard. He also pointed out that all documents relating to this matter had been carefully examined, and were in order according to legal requirements, and recommended that the request be granted. Dr. Crump moved that the RESOLUTION ADOPTED BY THE NORTH CAROLINA STATE BOARD OF HEALTH ORDERING THE TOWN OF LITTLETON, NORTH CAROLINA TO MAKE NECESSARY SEW-ERAGE AND SEWAGE DISPOSAL IMPROVEMENTS, be approved. Motion seconded by Mrs. Latta, and unanimously carried. (Resolution filed in Minute Book) Mr. Jarrett also presented a request from the City of Oxford, North Carolina, for the State Board of Health to permit controlled fishing in Lake Devin, the municipal water supply lake. He explained the regulations applicable with the granting of this request and said that, in his opinion, no adverse effects would be experienced in the quality of the water and that fishing from boats would be feasible and safe from a public health standpoint. On motion of Dr. Current, seconded by Dr. Bender, the RESOLUTION OF THE NORTH CAROLINA STATE BOARD OF HEALTH AUTHORIZING THE CITY OF OXFORD, NORTH CARO-LINA TO PERMIT CONTROLLED FISHING IN LAKE DEVIN, MUNI-CIPAL WATER SUPPLY LAKE, was unanimously passed. (Copy filed in Minute Book) At this point, a further discussion of the revision of the Public Health Laws was considered, and the following changes made, with instructions that Secretary Norton transmit them to Mr. Roddey M. Ligon of the Institute of Government to be included in the revised edition: — It was moved by Dr. Bender, seconded by Mr. Lutz, that the Board reconsider the action taken at the July 8 meeting relative to changes in the Public Health Laws and omit the wording "a licensed physician" in Article 2, Section 4, page 5. The motion was unanimous. It was moved by Mrs. Latta, seconded by Dr. Bender, that in view of the fact that the General Assembly has seen fit to have a dairyman listed as a must ap-pointment by the Governor, that the wording "reputable dairyman" be added to the revision as a member of the Board. Motion unanimously carried. The revised change reads as follows: — ARTICLE 2, Section 4, page 5—Change last sentence of paragraph to read "One of the members ap-pointed by the Governor shall be a licensed pharmacist, one a reputable dairyman, and one a licensed dentist." ARTICLE 13, Section 4, page 138:—Sanitary sewage disposal; rules,— should read as follows:—"Any person owning or controlling any residence, place of business, place of public assembly, or other improved real pro-perty shall provide a sanitary system of sewage disposal consisting of an approved privy, an approved septic tank or a connection to a sewer system under rules and regulations promulgated by the State Board of Health." North Carolina Board of Health 17 The following items of interest were reported on and discussed by Secretary Norton:—(1) Dr. Leroy E. Burney's appointment as Surgeon General of the USPHS to succeed Dr. Leonard A. Scheele at Washington, D. C, (2) attendance by the Secretary at the Work Conference on Nuclear Energy held in St. Petersburg, Florida; (3) met with and addressed for the third time the State Association of County Commissioners. The Secre-tary also reminded the Board that the NCPHA will meet in Asheville, May 28, 1957, for only one day because North Carolina will be host to the Southern Branch, APHA, in Asheville, May 29-31, 1957, which consists of sixteen Southern States and the District of Columbia. Dr. Norton urged that as many of the Board members as possible attend meetings of the health officers at State Medical Society meetings and NCPHA—that it gave the health officers inspiration and stimulus to know that their State Board is back of them with understanding and support. Dr. Norton also announced the meeting of the State and Territorial Health Officers and the Conference of the Surgeon General of the USPHS and the Chief of the Children's Bureau in Washington, November 2-10; also the meeting of the American Public Health Association, Atlantic City, November 11-16, 1956. The Secretary also reminded the Board members that when they call in to the Central Office here on official business it is appropriate for that call to be made "collect". Dr. Norton invited the Board's attention to an article in the "News and Observer", in which it was stated that he is opposed to making vaccination against poliomyelitis compulsory at this time; that, in his opinion, it should be continued on a voluntary basis until that has been given a fair trial and the necessity for compulsion should arise. The article commented that two local health officers favor a compulsion enactment by the 1957 General Assembly. The Board appeared in agreement with postponement of any request for legal compulsion. The Secretary announced that the official budget hearing for the State Board of Health would be held Wednesday, September 5, 1956, 9:00 a.m. to 1:00 p.m., Room 513 Revenue Building, and urged that as many mem-bers as could possibly do so attend on an official trip for which they would be entitled to reimbursement. Dr. Dixon stated that he had reached the conclusion that it was not advisable to call Board meetings on Sunday and that there would be none, unless absolutely necessary. October 17, 1956. A meeting of the North Carolina State Board of Health was held on Wednesday, October 17, 1956, in the Board Room of the Cooper Memorial Health Building, 2:30—4:50 p.m., with President Dixon presiding. On motion of Dr. Lenox D. Baker, seconded by Dr. G. Curtis Crump, the minutes of the August 19, 1956 Board meeting were approved as circulated by the Secretary. Secretary Norton discussed a revision of a change in the recodification proposal to include the mayors of cities other than county seats, when the population is above 15,000, on county boards of health as regular ex-officio members of a county board of health. The Secretary was asked if he recom- 18 Thirty-Seventh Biennial Report mended the change, and he replied that this proposed change would have many supporters and few to object. Dr. Baker moved that ARTICLE 3, Section 1, page 15, line 7, be amended to read after the parenthesis: "the mayor of any other incorporated city within the jurisdiction of the county health department, and which has a population in excess of 15,000 according to the latest decennial census, and that other appropriate changes to con-form to this amendment be made." Motion seconded by Dr. Crump, and carried unanimously. Secretary Norton called the Board's attention to the fact that in the old public health laws there was no reference to the position of Vice- President of the Board, and since the Board has such an office it should be recognized by statute. It was moved by Dr. Baker, seconded by Dr. Current, that the word Vice-President be inserted after the word President on page 6, line 6, Article 2, Section 3. Motion carried unanimously. Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, pre-sented a request for the proposed new sewage treatment plant and sewer extensions at Ayden. He stated that the town of Ayden had requested an order from the State Board of Health to install said plant and sewer ex-tensions. He pointed out that his Division had investigated the sanitary conditions—that the Board of Commissioners had adopted a resolution re-questing an order making it mandatory that Ayden install an adequate sewage collecting system and sewage treatment plant in order that the town could issue sufficient bonds to cover the two installations. Mr. Jarrett recommended that the request be adopted. On motion of Dr. Lawrence, seconded by Mr. Lutz, the RESOLUTION ORDERING THE TOWN OF AYDEN, NORTH CAROLINA TO MAKE NECESSARY SEWERAGE AND SEWAGE DISPOSAL IMPROVEMENTS was unanimously car-ried. (Copy of resolution filed in Minute Book) Mr. Jarrett also presented a request from the town of Creedmoor for permission of the State Board of Health to permit controlled fishing in Creedmoor Lake, the municipal water supply lake. He pointed out that with the volume of water in the lake and the strict regulations controlling fishing activities no adverse effects would be experienced in the quality of the water and that fishing from boats would be feasible and safe from a public health standpoint. He recommended favorable action by the Board on this request. On motion of Dr. Current, seconded by Mrs. Latta, the RESOLUTION OF THE NORTH CAROLINA STATE BOARD OF HEALTH AUTHORIZING THE TOWN OF CREEDMOOR, NORTH CAROLINA TO PERMIT CONTROLLED FISHING IN CREEDMOOR LAKE, MUNICIPAL WATER SUPPLY LAKE, was unanimously carried. (Copy of Resolution filed in Minute Book) In the absence of Mr. Earle C. Hubbard, Executive Secretary of the State Stream Sanitation Committee, Mr. Jarrett gave a preliminary re-port on a study of closer coordination between the State Board of Health and the State Stream Sanitation Committee as it relates to overlapping duties and stated that it was the opinion of the Committee that it might be well to have Mr. Ligon of the Institute of Government review the Stream Sanitation laws in connection with revising the regulations re-lating to water and sewerage as contained in our public health laws, in North Carolina Board of Health 19 order that the Stream Sanitation Committee would be more closely allied with the State Board of Health. After this report and review from Mr. Ligon, Mr. Jarrett and Mr. Hubbard will go over the recommendations of Mr. Ligon with the Stream Sanitation Committee and then submit the revisions to their Boards for their consideration and advice. Secretary Norton reported briefly on the four personnel recommenda-tions from the Commission on the Reorganization of the State Government, as they affect the Board of Health. He read each recommendation and com-mented on them; also said he had had a visit with Mr. Donald Hayman and that the Merit System Council was in contact with the Reorganization Commission. The first two are probably unnecessary and there were part-icular objections to items three and four. No action taken other than a request to keep the Board informed. Dr. Martin P. Hines, Chief of the Public Health Veterinary Section, presented a request for two amendments to Regulation 40, relating to the quarantine and destruction of psittacine birds. In presenting these re-quests, Dr. Hines asked that in the regulation providing for the destruc-tion of infected psittacine birds, a paragraph be added to Item 1 of Section P entitled "Authority and Notice", which will provide that treatment recently made available may be given in lieu of the destruction of birds in infected aviaries. Dr. Hines also requested that Item 4 of Section P (Page 3 of existing regulation) entitled "Birds Not of the Psittacine Family" be entirely deleted from the regulation governing infected turkeys and other domestic fowls, and another paragraph substituted. The change in regulations was discussed. Dr. Lawrence moved that the following-revision of the communicable disease Regulation 40 relating to psittacosis be accepted. Motion seconded by Dr. Crump and carried unanimously. The revision follows: REVISION OF COMMUNICABLE DISEASE REGULATION 40 RELATING TO PSITTACOSIS WHEREAS, various methods of treating psittacine and non-psittacine birds known to be infected with psittacosis, have been found to be effective, and WHEREAS, no indemnity is provided the owner or other person in pos-session of infected birds which must be destroyed under present Regula-tion 40, NOW, THEREFORE, Regulation 40, governing the control of psittacosis is hereby revised as follows: Section P. Control of Birds. 1. Elimination or treatment of Infected Birds. Authority and Notice. By adding, at the end of existing paragraph, the following: "The owner of proved infected birds or those which have been ex-posed to or associated with birds proved to be infected with psittacosis may elect in lieu of destruction, to treat said birds under the supervision of and in a manner prescribed by the North Carolina State Board of Health. If, following treatment, the quarantine authority finds that a health hazard no longer exists, it may release the bird or birds from quarantine." Section P. Control of Birds. 4. Birds Not of the Psittacine Family. By striking out the entire para-graph beginning with the word "Birds" and ending with the word "Health" and substituting therefor the following paragraph: 20 Thirty-Seventh Biennial Report "Birds not of the psittacine family are to be regarded as dangerous to the public health when they have been proved to be infected with psit-tacosis or have been exposed to or have associated with birds proved to have psittacosis. Such birds shall be quaranted by the local health officer or by a representative of the North Carolina State Board of Health, and shall remain in quarantine until either destroyed or treated under super-vision of and in a manner prescribed by the North Carolina State Board of Health. If, following treatment, the quarantine authority finds that a health hazard no longer exists, it may release the bird or birds from quarantine." Secretary Norton, Dr. Branch and Dr. Current all discussed the fluorida-tion of municipal water supplies, expressing their hearty approval of this public health measure which had previously been approved by the Board. Dr. Current, in his discussion, described the program now being promoted in Gaston County. At the request of Dr. Grady Dixon, Miss Mary B. Deaver, Chief of the Nutrition Section, was present. He had asked her to present some ideas for combating the problem of malnutrition in infants and young children as this seems to be a primary need in his community. She discussed the possibility of using a community such as Pitt County for developing a pilot study in this area of nutrition. Dr. Baker moved that the Board go on record as approving such an educational study or program, and also that the one additional nutritionist be secured which has already been included in the proposed budget. Motion seconded by Dr. Current and unanimously adopted. At this point, Dr. Baker referred to the Board minutes of July 8, 1956, in regard to the motion of Dr. Crump, seconded by Dr. Current and passed relative to the State Health Director's holding a Master's Degree. Dr. Crump moved that the above motion be rescinded and deleted from the minutes with regard to this qualification and that the wording in lieu thereof be inserted as follows: "and shall be trained in, and shall have had experience in, Public Health work". Motion seconded by Dr. Current, and unanimously carried. Dr. Baker also stated that there was another sentence in the same para-graph which could be improved on. It now reads "The State Health Director shall be the Executive Officer of the Board and shall devote his entire time to Public Health work". That public health work as now used would not limit his work in that field in other areas not of interest to the State of North Carolina, and he suggested adding to that sentence the words "as approved by the State Board of Health". Dr. Baker moved that this change be made. Seconded by Mr. Lutz, and carried. February 14, 1957. The meeting was called to order by Dr. G. Grady Dixon, President, presiding. The new member of the Board, Dr. Roger W. Morrison, (replacing Dr. Curtis Crump) was sworn in by Justice William H. Bobbitt. The minutes of the October 17, 1956, meeting were approved as read. Dr. Norton gave a further report on polio vaccine. Dr. Foard had made available a folder of material for the information of the members. One of the problems facing us now is that federally purchased vaccine can only be given to those under twenty and pregnant women. With that in mind, the American Medical Association called in the President of the State North Carolina Board of Health 21 Medical Societies and Dr. Sam Ravenel, Chairman of the Special Com-mittee on Polio Vaccine also attended a meeting- in Chicago on January 26. At that time, it was felt that something should be done to try to get the people between twenty and forty protected. In the discussion, it was suggested that the Board of Health and the Medical Society go in together and make a request of the Governor and Council of State for funds from the Contingency and Emergency Fund to provide polio vaccine for this age group between now and June 30. It was suggested that a rough draft of a letter to the Governor and Council of State be prepared requesting funds from the Contingency and Emergency Fund. Dr. Norton asked that the Board approve this action. The Executive Council of the Medical Society has already approved. They also approved support by the Legis-lative Committee of our budget request and also request for recodification. Early reports on intradermal vaccine indicate that it is of no value, or of so much lower value, that it is well to stick to what we have been doing. In answer to another question brought up, information gathered by Dr. Salk indicates that it does not matter if the third inoculation is given more than seven months after the second inoculation. Dr. Baker moved that the Board join the Medical Society in a request for funds from the Contingency and Emergency Fund. Dr. Current seconded the motion. Unanimously carried. Dr. Foard added that within the last two or three weeks, the vaccination program over the State has been greatly stimulated. Dr. Norton said that the Executive Council, on February 3, also asked the President to get out a letter to all local medical societies and request the Editor of the Medical Journal to do everything they could to stimulate getting this protection prior to the opening of the warm season. The State Board of Health staff is to provide background information to Dr. Koonce and Dr. Johnson for these. Dr. Charles F. Cameron gave a report on the accident prevention pro-gram and gave comparative figures on home accidents with other accidents and communicable diseases of children and other diseases. Dr. Cameron expressed the hope that since the three-year Kellogg Foundation support of the accident prevention program rapidly draws to a close, there might be some procedure whereby this activity can be continued. Mr. Hasson of the Foundation is to come for a visit February 20. Dr. Norton advised the Board that the Advisory Budget Commission did not recommend any funds for continuation of this work. Dr. Baker moved, seconded by Dr. Lawrence, that the Board make an appeal to the Joint Appropriations Committee. Approved. Dr. Dixon introduced Dr. Morrison to the division directors who were present, and also two health officers, Dr. H. W. Stevens of Asheville and Dr. G. O. Moss of Rutherfordton. Miss Reynolds was called on to make a report on the budget. She in-formed the members of the budget requests that were approved by the Advisory Budget Commission and those that were denied, and explained each item. Dr. Norton stated that copies of the summary which she pre-sented would be mailed to the members. Dr. Applewhite gave a report of the Health Officers' Conference held on 22 Thirty-Seventh Biennial Report February 13, the main purpose of which was to discuss the results of the Advisory Budget Commission's recommendations in the hope that the health officers might be of assistance in getting appropriations for local health work. Dr. Norton gave a report on staff changes. Dr. Robert D. Higgins has succeeded Dr. Benjamin M. Drake as Assistant Director of the Local Health Division, and Dr. Charles F. Williams has replaced Dr. Madeleine E. Morcy, now with the Children's Bureau, as pediatric consultant in the Maternal and Child Health Section. Dr. Bertlyn Bosley, who has been away for a year helping with the nutrition program for the Indian Health Service, has asked for a few more months, perhaps a year, to complete her work before coming back to the State Board of Health, and she has been written that such a recommendation will be made to the Merit System Council. Dr. Norton explained some of the recommendations in the report of the Reorganization Committee, and suggested each Board member request a copy of the report. Dr. M. T. Foster, Health Officer, and Dr. Richard Knight, Veterinarian from Fayetteville, were introduced. Dr. Hines was called on to make a brief report on the proposal to recog-nize rabies vaccine of chick-embryo origin for a period of three years. He read a statement from the Communicable Disease Center of the U. S. Public Health Service and presented a resolution passed by the State Veterinary Association in June of last year for the Board's consideration. This resolution requests that the State Board of Health recognize the vaccine for a period of three years, allowing the counties, in which there are no veterinarians to administer the chick-embryo vaccine, to continue the use of vaccine of nervous tissue origin to be administered every year. The health officers at their meeting on February 13 voted 44 to 3 requesting this action by the State Board of Health. Dr. Foster and Dr. Knight explained their positions. Dr. Foster pre-sented a letter to Dr. Norton from Mr. Roscoe Blue, Chairman of the Cumberland County Board of Commissioners and of the County Board of Health, which Dr. Norton read to the group. They are of the opinion that in two or three years it might be fine to change their vaccination program, but wonder if it would not be a little premature at this time. After some discussion, Dr. Baker moved that the resolution be adopted with the exception that in the last sentence of No. 2, after "when a district or county board of health", "or the State Board of Health" be inserted. Dr. Current seconded and the motion carried. (Copy filed in Minute Book) The meeting adjourned for lunch at 12:30 p.m. In the afternoon meeting, Mr. Jarrett presented three items for consideration of the Board. Dr. Bender moved that the Saw Mill Sanitary District in Caldwell County be created, seconded by Mrs. Latta. Unanimously carried. (Copy filed in Minute Book) Dr. Baker moved that the extension of the Rural Hall Sanitary District in Forsyth County be approved, seconded by Dr. Henderson. Approved unanimously. (Copy filed in Minute Book) Dr. Baker moved that the State Board of Health order a new sewage North Carolina Board of Health 23 collection system for the Town of Parkton, seconded by Mrs. Latta. Ap-proved unanimously. (Copy filed in Minute Book) Mr. Jarrett explained that the new Stream Sanitation law is written in such a way that the State Board of Health will be the administrative agent and the State Stream Sanitation Committee will set the policies, which is what was originally intended when the law was passed. Stream Sanitation would be a unit of the State Board of Health, retaining its own board. Senator Whitfield, who is Chairman of the State Stream Sanitation Committee, read a resolution passed by the Committee, approving the new law which will be presented to the Legislature if approved by the State Board of Health. He explained that the purpose of the law is to eliminate duplication that industry has complained of and put all Stream Sanitation under one agency. He said that the Reorganization Committee has drawn up a similar bill. Mr. Hubbard read portions of the Stream Sanitation Committee's proposed bill and gave a copy to each member of the Board. Dr. Dixon suggested a called meeting of the State Board of Health, or Executive Committee, and the State Stream Sanitation Committee. Dr. Baker commented: "it appears that the changes outlined by Mr. Whitfield cannot possibly be reviewed today as to details. It also appears that some early tentative approval is needed in order that they may pro-ceed with their preparation for introducing the bill. I, therefore, move that the State Board of Health approve of the principles as outlined by Mr. Whitfield concerning the proposed legislation but until the members of the Board of Health have had an opportunity to read the bill, this approval is not to be interpreted as approving the details thereof. Also that we concur in principle with the resolution of the State Stream Sanitation Committee passed at the meeting on February 12, 1957 regarding the establishment of a Stream Sanitation Unit within and administered by the State Board of Health." Dr. Current seconded the motion. Approved unanimously. It was decided that the Executive Committee of the State Board of Health, and any of the other members who could be present, would meet with the State Stream Sanitation Committee at two o'clock Thursday, February 28. Mr. Ligon was also asked, and promised to be present. Mr. Ligon gave a further report on the recodification of public health laws. The following changes were made since the last revision by the Board. Page 7: The last sentence of the last paragraph 130-6, "He shall be subject to the provisions of Chapter 126 of the General Statutes of North Carolina" was added so that the Assistant State Health Director will be under the Merit System. Page 7: In 130-7, "1958" was changed to "1959". Page 8: In 130-9, (1) Poivers and duties of the State Board of Health, "facsimile of the signature of the State Health Director" was added. The same phrase was added in 130-11, 8. Page 8: 130-11,10, after "State Board of Public Welfare or other state agency or institution", "of public institutions and facilities including those subject to license or inspection by such State Board of Public Welfare or other state agency or institution" was added. Page 15: "the ex-officio member shall name the four public members" was added. 24 Thirty-Seventh Biennial Report Page 17: "meeting jointly" was added in the sentence "The ex-officio members shall be selected by the chairmen of the boards of county com-missioners, meeting jointly, of the counties concerned". In the next sentence "at least" was added after "Shall include". In the same paragraph, the sentence "If more than four counties form a district, an additional public member may be added for each county in excess of four." was also added. Page 18: In the last paragraph "by the chairmen of the boards of county commissioners of the counties within the district, meeting jointly" was changed. Page 19 : 130-16, "plus necessary travel expenses" was added. Page 21: 130-18, Health Director. Page 21 : 130-19, "principals and teachers" was added after "The county and city boards of education, the county and city superintendents of schools". Page 23: Plural was changed to singular to conform. Page 23: The last sentence "The person employed as county physician may be appointed as county medical examiner under the provisions of G. S. 130-197." Page 38: 130-47, "shall" was changed to "may" in the sentence "the board of county commissioners may pay the coroner a fee or salary." Page 43: All of 130-57 was added. Page 51: 130-70 was changed so that birth and death records will be confidential except to certain persons. Page 65: The last sentence of 139-94, "All applicants for a marriage license must obtain a health certificate in accordance with the px-ovisions of Chapter 51 of the General Statutes of North Carolina." was added. Page 65: 130-95, "and local boards of health" was added after "and shall cooperate with the State Board of Health". Page 89: 130-128, 15, after "and to provide fire protection in said district" "such taxes to be levied and collected at the same time and in the same manner as taxes for debt service" was added. Pages 116 and 117: The whole paragraph beginning "In addition to the above-stated method of dissolving a sanitary district" was added. Page 124: 130-166, 1. is completely new. Page 157: 130-200, (d) was deleted. Dr. Baker moved that as the report was read, it be automatically ap-proved, unless said otherwise. Dr. Bender seconded. Approved unanimously. Dr. Baker moved that his thanks and appreciation be put in writing in the form of a letter and if feasible be turned over to the public relations department and be made public. Dr. Current seconded. Dr. Baker again referred to the Stream Sanitation Law and asked Mr. Jarrett to comment on certain items. Mr. Jarrett said that he has some minor reservations but that he approves of the proposal. February 28, 1957. There was a joint meeting of the State Board of Health Executive Committee and the State Stream Sanitation Committee held on February 28th, with President Dixon presiding. Senator Whitfield explained that the purpose of the bill, Chapter 143, is to establish State Stream Sanitation under the State Board of Health, the State Board of Health to be the administrative agency and the State North Carolina Board of Health 25 Stream Sanitation Committee to be the policy-making agency, in order to avoid duplication in the two agencies and criticism on the part of the public. This is similar to the Tennessee plan, which is working very satisfactorily. Mr. Jarrett, at the request of Dr. Norton, presented changes in Chapter 143 suggested by Dr. Lenox D. Baker, a member of the State Board of Health who could not be present, along with Mr. Jarrett's comments on those changes. After lenghty discussion of all items referred to by Dr. Baker in his letter to Dr. Norton and members of the Executive Com-mittee, the following changes were approved by the groups: Section 143-211 was amended by adding after the work "methods": subject to the approval of the State Board of Health, designed to protect the water requirements for health. Further, this agency is authorized to establish methods designed to protect the water requirements for recrea-tion." Section 143-213 (e) was amended to read as follows by inserting after the word "nominees": "acceptable to both the Board and Committee". Section 143-214 (d) 2, page 6, was amended by adding after the word "economic": "or health". Section 143-215 (a) 4, was amended by adding after the word "com-mittee": "or State Board of Health". Amend Section 143-215 (a) 5, third paragraph by adding after the word "section": "and under provisions of Chapter 130 of the General Statutes". Amend Section 143-215.2 (a), page 14 by inserting after the word "may": "under provisions of this article". Amend Section 143-215.2 (b), page 15, by inserting after the word "ap-proval": "pursuant to this section." Amend Section 143-215.3 (b), page 17, by inserting after the word "Board" in lines 4 and 8 the words: "or committee". Amend Section 143-215.6 (a) 2, page 21 by changing the word "has" to "had". Mr. Ligon also discussed the legal language of a number of sections questioned by Dr. Baker and agreed that slight changes in language in some instances might tend to clarify, but since the wording used in this bill was copied from the existing law, it was thought best to not suggest any drastic changes at this time to the Reoi'ganization Commission. Senator Whitfield asked if items 159-161 in Chapter 130, pages 121 and 122 of the re-write of public health laws would not be a duplication in Chapter 143, if both bills are passed by the Legislature. Mr. Jarrett ex-plained that since the State Board of Health is to be the administrative agency, this part of Chapter 130 would strengthen the Stream Sanitation program. Mr. Hubbard agreed. It was decided that these suggested changes would be presented to the Reorganization Commission for their approval. Senator Whitfield explained that the Reorganization Commission has drawn up a similar bill which will be presented to the General Assembly, but this bill will be presented as a substitute bill. April 25, 1957. A regular meeting of the North Carolina State Board of Health was held in the Board Room of the Cooper Memorial Health Build-ing on Thursday, April 25, with President Dixon presiding. 26 Thirty-Seventh Biennial Report Upon motion duly made and seconded, the minutes of the February 14, 1957, meeting were approved without being read, since all members had previously received copies. Also, the minutes of the Executive Committee meeting, held on February 28, 1957, were approved as circulated. Secretary Norton gave a further progress report on the budget request for the biennium which had been presented to the Advisory Budget Com-mission and Joint Appropriations Committee with the order of priority determined according to most vital need such as—aid to local health de-partments, training, accident prevention, visual aid films, additional funds for cancer, nutrition, bacteriologists, etc. Dr. Norton also gave a report of progress made so far in the recodifica-tion of Public Health Laws. He stated that the Bill had been introduced in the House and Senate and was referred to the Health Committees of both Houses. The Committees have been meeting jointly; also, a joint sub-committee has been appointed by the House and Senate Health Committee Chairmen. This subcommittee was reported to be progressing very nicely. Dr. Norton pointed out that Dr. Baker had met with the Committees several times and had been able to explain a good many things in such a way that they have been accepted very well. When the Bill is completed by the sub-committee, then it goes to the Health Committees of the House and Senate ; then to the floor of the General Assembly. Mr. Reid Thompson, House Member from Pittsboro, is Chairman of the joint subcommittee and has done a superior job. During the meeting, a discussion developed regarding a change in the hour for the Conjoint Session of the State Board of Health and the State Medical Society meeting. It was pointed out that while the statute provides that such a meeting shall be held on the second day of each annual meeting of the State Medical Society there is nothing mandatory about the hour which must be decided now solely by the Program Committee of the Medical Society. It was the consensus that the State Board of Health should be consulted as to its convenience in the matter. The discussion led to the passage of the following motion, made by Dr. Baker :—There shall be four regular meetings of the State Board of Health each year, one of which shall be held conjointly with a general session of the annual meeting of the Medical Society of the State of North Carolina, at a time and place designated by the State Board of Health and the Program Committee of the Medical Society of the State of North Carolina at which time the State Director of Health's annual report shall be submitted. The motion was seconded by Dr. Bender, and carried unanimously. Dr. Norton announced that Dr. John H. Hamilton, the Assistant State Health Officer and Director of the Laboratory, would present the Conjoint Report for this year. Dr. Fred T. Foard, Epidemiologist, gave a statement on the present status of the poliomyelitis vaccination program and a summary on polio vaccine inoculations given in North Carolina from 1954 to the present. Dr. John H. Hamilton, Director of the Laboratory Division, discussed the method and way in which the Laboratory has been receiving gamma globulin from the NFIP and the American Red Cross, and how it has been distributed. Also, as of December 1955, the National Institute of Health North Carolina Board of Health 27 discontinued the allotment of gamma globulin to North Carolina and that the American Red Cross has reduced its allotment. Dr. Hamilton stated that the Laboratory is receiving requests for more gamma globulin than its allotments. After discussion, it was the consensus to restrict its use to the control of measles and hepatitis and that a policy be adopted for a method of procedure for distribution was presented. Upon motion of Dr. Lawrence, seconded by Mr. Lutz, the following motion was unanimously passed:—"(1) That gamma globulin made available by the American National Red Cross and distributed by the State Laboratory of Hygiene be distributed to local health officers. (2) That all such gamma globulin be limited to the control of infectious hepatitis and the attenuation of measles in children, provided that for debilitated children it may be used to prevent measles." Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, was present and discussed a request for an order to construct a new sewage treatment plant and sewage collection system at Red Springs, N. C. He stated that documents and other pertinent data had been examined by his office, and in his opinion, were in order. He, therefore, recommended that the Board act favorably upon this request. Dr. Baker moved that the resolution ordering the Town of Red Springs to make necessary sewerage and sewage disposal improvements be adopted. Motion was seconded by Mrs. Latta, and unanimously carried. (Resolution filed in Minute Book) Mr. Jarrett also discussed an order for Spring Hope, N. C, to construct a new sewage treatment plant and collection system. He recommended favorable action by the Board on this request, stating that all documents and transactions had been carefully examined and found in order by his office. On motion of Dr. Lawrence, seconded by Mrs. Latta, the resolution ordering the Town of Spring Hope to make necessary sewerage and sewage disposal improvements was carried unanimously. (Copy of Resolution field in Minute Book) Mr. Jarrett presented a request from Mr. P. J. M. Bayne, Chairman of the Dare Beaches Sanitary District, to promote temporary relief from the mosquito menace by fogging on the ground and also spraying from the air. The matter was discussed in full. Mr. Lutz moved, seconded by Dr. Baker as follows: "That approval be given the Dare Beaches Sanitary District to engage in a program of mosquito and malaria eradication by the applica-tion of space spraying from ground equipment, in accordance with Para-graph 11, Section 130-39 of the General Statutes of North Carolina." Motion carried. Dr. Baker then asked Mr. Jarrett if he was satisfied with the rewrite of the Stream Sanitation Law. He stated that he was not in favor of the amendment as suggested by Mr. Whitfield and gave his reasons as to why, in his opinion, it would be bad administrative policy to have two engineer-ing units at the State Board of Health. Mr. Jarrett stated that his recom-mendation would be that a section of Water Pollution Control be established in the Sanitary Engineering Division as he felt that in this way the pro-grams could be more closely coordinated and less friction and overlapping of responsibility would follow. Mr. Reid Thompson, representative from Chatham, who is a member of 28 Thirty-Seventh Biennial Report the House Health Committee and Chairman of the Subcommittee of the House group, was introduced to the Board. Secretary Norton complimented him very highly for the wonderful job that he and his co-workers are doing on the recodification of the Public Health Laws. April 25, 1957. There was a joint session of the State Board of Health with the Executive Committee of the State Stream Sanitation Committee held at noon, Thursday, April 25, 1957, in the Board Room of the Cooper Memorial Health Building, President G. Grady Dixon, presiding. Mr. Whitfield opened the discussion by stating that the purpose of this joint session was to consider ways and means of bringing about closer cooperation of policies for both industrial and municipal wastes and the avoidance of duplication and confusion. An open discussion then followed —participated in by all present. The general conclusion was that the Stream Sanitation Law should be amended so as to bring about closer cooperation between the Stream Sanitation Committee and the State Board of Health and that the administrative staff on the State Stream Sanitation Committee would serve under the State Board of Health. By clarifying the duties of each it is proposed to eliminate actual duplication of work. The unit carrying out policies determined by the State Stream Sanitation Committee would be known as the Division of Water Pollution Control. Whereupon, Dr. Baker made the following motion. "(e) A Division of Water Pollution Control shall be established within the State Board of Health to do stream sanitation work. This Division shall be responsible for administering the provisions of this Act and shall be responsible for performing such other duties as may be as-signed to it by the State Board of Health relating to the control of municipal institutional and industrial sewage and waste collection and disposal systems. The director of such Division shall be selected by the State Board of Health from nominees acceptable to both the Board and Committee. He shall be a well-qualified sanitary engineer, fully trained and experienced in the field of waste disposal. He shall: (1) serve as the administrative officer of the Committee and shall attend all meetings of the Committee, without voting power, and shall keep an accurate and complete record of all meetings, hearings, correspondence, laboratory studies, and technical work and shall make these records available for public inspection at all reasonable times; (2) review and approve plans, specifications and such other documents as may be required in connection with applications filed for certificates of approval, permits, or other documents of approval under the pro-visions of this Act; (3) and perform such other related duties as the Committee or State Board of Health may from time to time direct." The motion was seconded by Dr. Lawrence, and carried unanimously. May 8, 1957. The State Board of Health and the Medical Society of the State of North Carolina met in Conjoint Session, as required by law, in the Municipal Auditorium in Asheville, Wednesday, May 8, 1957, at 9:05 a.m., Dr. G. Grady Dixon of Ayden, President of the Board, presiding. President Dixon presented Dr. J. W. R. Norton, State Health Officer and he in turn presented Dr. John H. Hamilton, Director of the State Laboratory of Hygiene and Assistant State Health Officer, who, at the request of Dr. Dixon and Dr. Norton, gave the annual conjoint report of the Board of Health to the Medical Society. North Carolina Board of Health 29 Dr. Dixon announced that the Medical Society had set its approval on three members of the Board. Dr. John R. Bender, of Winston-Salem, was re-elected. Dr. Roger W. Morrison, of Asheville, appointed by the Execu-tive Council of the Medical Society of the State of North Carolina to serve until the next meeting of the Society, was elected to fill out the remain-ing two years of the unexpired term of Dr. Curtis Crump, also of Ashe-ville. Dr. Charles R. Bugg, of Raleigh, was elected to succeed Dr. Ben J. Lawrence, whose term had expired. Dr. Dixon recognized Board members present at the Conjoint Session and noted that Dr. Lenox D. Baker, member of the Board was elected President-Elect of the Medical Society of the State of North Carolina. No separate session of the Board was held. July 18, 1957. The North Carolina State Board of Health met in regular quarterly session, Thursday, July 18, 1957, in the Board Room of the Cooper Memorial Health Building. Associate Justice Emery B. Denny, of the Supreme Court of North Carolina, administered the oath of office to the following for four-year terms, expiring in May, 1961 : Governor Luther H. Hodges' appointees: Zeno L. Edwards, Sr., D. D. S., (new appointee), Washington Elected by the Medical Society of the State of North Carolina: Charles R. Bugg, M. D., (newly elected), Raleigh John R. Bender, M. D., (re-elected), Winston-Salem Roger W. Morrison, M. D., (re-elected), Asheville. (Two years to run on term of Dr. G. Curtis Crump, resigned) The meeting was called to order by President Dixon. President Dixon announced that, due to changes in the Board, a Vice- President and Executive Committee should be elected. Dr. Baker moved that, since the Governor had not named all of his appointees, the Board elect a temporary Vice-President until the two new remaining members are appointed. Motion seconded by Dr. Bender, and unanimously carried. Dr. Henderson moved that Dr. John R. Bender be nominated temporary Vice President. Motion seconded by Mr. Lutz, and unanimously passed. President Dixon appointed Dr. Lenox D. Baker to serve on the Execu-tive Committee until he is re-appointed or his successor named. Upon motion duly made and seconded, the minutes of the Board meet-ings held on April 25, 1957, were approved without being read, as copies had been circulated to members. It was moved and seconded that minutes of the Board meeting held on May 8, 1957, be approved as circulated. Dr. Fred T. Foard, Director of the Division of Epidemiology, presented a further progress report on the Salk poliomyelitis vaccine and the vac-cine program in North Carolina. He distributed information to the Board members on the amount of vaccine purchased and distributed, also perti-nent further breakdown information on inoculations, as of July 18, 1957. In summarizing, Dr. Foard stated that "of 46 poliomyelitis cases reported to date this year, 10 were paralytic and two of these had three inocula-tions of vaccine. Thirty-six were nonparalytic. Of the nonparalytic, 10 had three inoculations, two had two inoculations, 24 had no vaccine. Onlv 30 Thirty-Seventh Biennial Report 21.7 per cent of all cases have been paralytic in 1957 as compared with 56.8 per cent in 1956." As further information for the Board, Dr. Foard discussed the temporary release of Mr. William H. Hudson of Dobson, from the Carville, Louisiana, Leprosarium, to visit his home in Surry County, for a 30-day period. Mr. Hudson, a patient at the USPHS Hospital in Carville, requested permis-sion to return home last year. This request was denied by the Board of Health until such time as Mr. Hudson could be released with assurances of safety by the Hospital authorities at Carville. Mr. Hudson made a second request about two months ago to the State Health Officer, and he was advised that the matter would have to be deferred for further considera-tion and action by the Board. In the meantime, the State Health Officer was advised by Dr. Rolla R. Wolcott, Clinical Director of the Leprosarium, that Mr. Hudson was leaving for Surry County by auto. He also stated that there was "no contraindication to the patient's leave of absence from the Leprosarium and that the hospital could not hold the patient under present circumstances." The Health Officer of Surry County advised that the patient had arrived, was very cooperative in maintaining isolation, and will return to the Leprosarium after 30 days. Dr. Foard also reported briefly on the rapid spread of influenza through-out the Far East and Asia, and of the recent outbreaks of a similar type in California, New England and Iowa. All contacts who attended the Grin-nell, Iowa meeting in North Carolina are being followed through and there have been some cases of influenza reported in North Carolina. Dr. Foard stated that this is definitely a different type of strain A influenza and the PHS is studying, typing and using sera collected from influenza-like in-fections occurring in different parts of the country with the view of determining the extent to which the Asiatic type of influenza has spread. A vaccine is being prepared to include this new strain. Mr. J. M. Jarrett, Director of the Division of Sanitary Engineering, outlined and discussed the proposed revisions to the Restaurant Sanitation Regulations. He stated that these revisions were necessary, in order to clarify requirements for food stands and drink stands. Dr. Bender moved that the Board approve the Restaurant Sanitation Regulations as sub-mitted. Motion seconded by Dr. Baker, and carried. (Copy filed in Minute Book) Mr. Jarrett presented a request from the Town of Graham for permis-sion of the State Board of Health to permit controlled fishing in Town Lake, the municipal water supply lake, located on Back Creek. He stated that an investigation had been made by the Division and with strict regulations controlling fishing activities, that no adverse effects would be experienced in the quality of water and that fishing from boats would be feasible and safe from a public health standpoint. Also, Mr. Jarrett presented and discussed a similar request from the Town of Kernersville for permission of the Board to allow controlled fishing in Kernersville Lake, the municipal water supply lake. Mr. Jarrett stated that this request also had been thoroughly investigated by his Division, and in view of all the information, he recommended approval by the Board. On motion of Dr. Baker, seconded by Dr. Henderson, the resolutions authorizing both the Town of Graham and the Town of Kernersville to permit controlled fishing in their respec- North Carolina Board of Health 31 tive municipal water supply lakes, were passed. (Copy of resoultions filed in Minute Book) Mr. C. M. White, Chief of the Insect and Rodent Control Section, gave a report on the activities and work of the Salt Marsh Mosquito Control Commision since 1955. The 1957 General Assembly placed mosquito con-trol in North Carolina within the State Board of Health, and in his dis-cussion Mr. White submitted for the Board's consideration, proposed rules and regulations governing State aid to mosquito control districts and other local governmental units engaged in mosquito control undertakings. After discussing these regulations, Mr. White, as Chairman of the Salt Marsh Mosquito program, recommended the adoption of the resolution. Dr. Baker moved the acceptance of the proposed rules and regulations relating to the allocation of State and federal aid to assist local governmental units in carrying out mosquito control projects. Motion seconded by Dr. Bugg, and unanimously carried. (Resolution filed in Minute Book) Dr. Wm. M. Peck, Assistant Director of the Division of Epidemiology, reported briefly on public health responsibilities in radiation hazards. He pointed out certain potential radiological health hazards and their implications for control regulations and other control methods, particularly education. Recommendations made previously by the National Committee on Radiation Protection (National Bureau of Standards Handbook 61, issued December 9, 1955) were discussed in some detail. Dr. Baker moved that the North Carolina Radiological Society be invited and requested to set up a Committee to study radiation health hazards, and to suggest to the State Board of Health a framework of regulations to eliminate or minimize harmful exposure. Motion seconded by Dr. Bugg and unanimously carried. Dr. John H. Hamilton, Assistant State Health Officer and Director of the Laboratory Division, presented a progress report on the Postmortem Medicolegal Examinations Committee. This law becomes an integral part of the public health code. Rules and regulations of the Committee are to be subject to the approval of the State Board of Health, effective January 1, 1958. Secretary Norton read a letter addressed to him from Senator J. V. Whitfield, Chairman of the State Stream Sanitation Committee, regarding the setting-up and suggested duties and responsibilities of the Water Pol-lution Control Division and the Engineering Division in the field of stream sanitation, also a copy of a letter from Governor Hodges to President Dixon. These were discussed. President Dixon presented for the Board's considera-tion, a proposed plan of procedure in the administration of the State Stream Sanitation program within the Board of Health. After a full discussion, the Board adopted President Dixon's suggestions as constituting a good working program for the present time. At 3.00 p.m. Senator J. V. Whitfield, Chairman and members of the State Stream Sanitation Executive Committee composed of Mrs. Karl Bishopric. Mr. Walter Clark and Mr. J. N. Vann, appeared for participation in the joint session with the State Board of Health. Mr. E. C. Hubbard, previously Executive Secretary of the State Stream Sanitation Committee, was unanimously agreed upon by the Executive Committee and the Board for the new position of Director of the Division of Water Pollution Control. 32 Thirty-Seventh Biennial Report The State Stream Sanitation Committee is to determine policy and the State Board of Health is to administer this Division, effective July 1, 1957. The Board heard the discussion of the Executive Committee on the plan proposed in the letter, Whitfield to Norton, referred to above, and then President Dixon read the plan of procedure proposed by the Board of Health. This was discussed jointly by members of the Executive Committee and Board members. Dr. Baker moved that the resolution be adopted by the joint group—State Board of Health and State Stream Sanitation Ex-ecutive Committee,—as read. Motion seconded by Dr. Bender. There was some discussion and Senator Whitfield said he did not feel his Executive Committee was prepared to take action then and that he would like to bring the matter before his entire Committee at a meeting in the near future. In a vote on the motion of Dr. Baker, the Board members favored and the Executive Committee (Stream Sanitation) abstained from voting. The Board delegated its Executive Committee to work out an agreement with the State Stream Sanitation Committee. September 19, 1957. The North Carolina State Board of Health met in regular quarterly session Thursday, September 19, 1957. The Board as-sembled first in the Senate Chamber at the Capitol, where at 10:00 a.m., Associate Justice Emery B. Denny of the Supreme Court, administered the oath of office to both Mrs. J. E. Latta, Hillsboro, Rt. 1 (re-appointment) and to Lenox D. Baker, M. D., Durham (re-appointment) for four-year terms, expiring May, 1961. Following the exercises in the Senate Chamber, the Board went into regular session in the Board Room of the Cooper Memorial Health Building. President Dixon called the meeting to order at 10:30 a.m. He asked that Dr. Bender, the Vice-President, take the Chair. The first business of the meeting was to re-organize the Executive Committee which consists of a President, Vice-President and one member of the Board. The Board unani-mously re-elected Dr. G. Grady Dixon as its President for a four-year term, ending May, 1961. Dr Dixon then took the Chair and called for nominations for Vice-President. On motion of Dr. Baker, seconded by Dr. Morrison, Dr. John R. Bender was unanimously elected as Vice-President. On motion of Dr. Baker, seconded by Dr. Morrison, Dr. Charles R. Bugg was unanimously elected as a member of the Executive Committee. The Execu-tive Committee now consists of Dr. Dixon, President, ex-officio, Dr. Bender, Vice-President, Dr. Bugg and Secretary Norton. It was also voted to make Dr. Baker an ex-officio member of the Executive Committee with the request that he attend as many meetings as possible. Dr. Baker explained, however, that his duties and activities as President-Elect followed by a year as President of the Medical Society of the State of North Carolina, together with his medical practice, would not leave him much time for other activities but he would promise to attend all the meetings he could. Minutes of the Board meeting held on July 18, 1957, were approved as circulated to Board members by the Secretary. Progress report on radiation protection. Dr. Wm. M. Peck of our staff presented Dr. Ernest Wood, Professor of Radiology of the University of North Carolina, to give a report of the action of the Committee appointed by Dr. Raper, President of the Radiological Society, to consider the problem North Carolina Board of Health 33 with Dr. Peck. Dr. Wood reported that at a meeting of the N. C. Radiological Society last week, recommendations were prepared as requested by the State Board of Health. These recommendations have been passed on to Dr. Norton through Dr. Sprunt's letter of September 17, 1957, which Dr. Wood read. (Dr. William H. Sprunt III, Secretary of the Radiological Society and Dr. Robert Reeves had hoped to be present but were unable to come.) This Committee thought very strongly that it would be advisable to avoid asking for new legislation in this field because they feel that the existing powers of the State Board of Health are quite sufficient to cope with the problem. The Committee specifically recommended certain in-dividuals for the suggested Committee, although it is up to the Board as to whether or not they accept the individuals recommended. Dr. Baker suggested that instead of a "member" of the State Board of Health the word "representative" be used so that either a member or a former member could be on the Committee. He moved that the recommenda-tion be adopted by the Board with this change. Dr. Henderson seconded the motion. After Dr. Edwards' observation that the dental profession takes more X-rays than the medical profession, Dr. Baker amended his motion to include a representative from the State Dental Society on the Committee. Dr. Henderson seconded that motion, and it was carried. Dr. Norton was instructed to get in touch with the presidents of the State Dental and Medical Societies for a nomination by each Executive Committee for the Radiation Study and Advisory Committee of the State Board of Health. Senator J. V. Whitfield, Chairman of the State Stream Sanitation Com-mittee, was called on to give a progress report on the stream sanitation program. He reported that they have already classified the Yadkin, New River, White Oak, Roanoke and Chowan River Basins, and next month they plan to classify the French and Pigeon River Basins. In March they plan to classify Cape Fear River and sometime next fall the Neuse River Basin. That leaves Catawba, Tar and Pamlico Rivers. They will probably have the field work done on the Pasquotank and Catawba this fall, not later than the spring of 1959. Next year they will also do the field work on the Tuckasegee. They hope to have all the river basins classified by 1961 or not later than 1962, which will be a ten-year job completed. Mr. Whitfield also announced that they do not have enough room in this building and he has spoken for part of the third floor of the old Health Building. Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, pre-sented a request for the extension of the boundary lines of the Walker-town Sanitary District, Forsyth County. He stated that all documents had been carefully reviewed and checked and that proper procedures had been followed in accordance with the requirements of the General Statutes for the extension of boundary lines. Mr. Jarrett recommended favorable action by the Board. On motion of Dr. Baker, seconded by Dr. Henderson, the request for extension of boundaries of the Walkertown Sanitary District, Forsyth County, was unanimously passed. (Copy filed in Minute Book) In making his progress report on the poliomyelitis vaccination program, Dr. Fred T. Foard, Director of the Epidemiology Division, gave figures to show the number of doses already administered and the number of persons 34 Thirty-Seventh Biennial Report who have received these doses for the first, second and/or third time. He stated that just now there is practically no demand for Salk vaccine in-jections but that he looked for a marked upsurge with further advance of fall. Also, Dr. Foard informed the Board that of the 177 poliomyelitis cases reported in 1957 through September 18, only 22 have been paralytic. In 1956, through September 18, a total of 206 cases had been reported with 99 of them paralytic. The decrease in the number of paralytic cases re-ported in 1957, to-date, as compared to the number of paralytic cases re-ported in 1956, to-date, is 77.8 percent. Dr. Bugg suggested that all local health officers should be advised that now is the time to urge vaccination against poliomyelitis for next year, and that three injections must be given before the desired immunity can be expected. The Board returned to discussion of the radiation program. Dr. Edwards moved that the Executive Committee of the North Carolina Dental Society be permitted to name their member of the Committee. Dr. Morrison seconded the motion, and it was unanimously passed. Dr. Baker moved that the suggestion for this Committee be made as recommended by Dr. Wood, subject to the approval of the Executive Com-mittee of the State Board of Health. Motion seconded by Mrs. Latta, and was unanimously carried. Doctors Foard and Norton reported on the situation of the Asian In-fluenza strain and vaccine. Only 49 cases have been laboratory confirmed by our Laboratory as Asian Strain Flu. This is not representative of the prevalence of the disease in North Carolina, as it is not a reportable disease. No outbreaks have occurred but it is endemic quite widely throughout the State. Beginning this week, estimates will be made to the Public Health Service and each Health Officer has been asked to submit each week a report of the estimated number of flu-like diseases. These reports will be based on interviewing principals of schools on absentees because of flu-type diseases, by interviewing general practitioners, internists and pedia-tricians as to how many are seen in private practice, and by reporting on known conditions where a considerable number of occupational workers are out of their usual work because of a flu-like disease. There are not enough laboratories in the State to make laboratory examinations for confirmation of all cases occurring. Dr. Norton attended the conference called by the Surgeon General of State and Territorial Health Officers. Prior to that a conference was called by the Surgeon General with representatives of the American Medical Association, American Academy of Pediatrics, American Academy of General Practice, and other groups. Early recommendations of the AMA and other groups with the Surgeon General was that there be no federal or state control, and that it be handled on a general understanding with the manufacturers that they would distribute the vaccine to the states on the basis of population. It was recommended by the earlier groups and by the State and Territorial Health Officers that first consideration, primarily encouragement, be given to those people who are responsible for looking after the health and medical care of people, physicians, dentists, nurses and other assisting personnel, and that second consideration and encourage- North Carolina Board of Health 35 ment be given to others whose absence would interfere with the carrying on of normal business activities, such as those who have charge of com-munications, transportation, and those who are taking care of property such as firemen, policemen, guards at the prisons, etc., and that the third group would be those who have had some chronic disease, particularly heart, chronic tuberculosis and other chronic diseases, and the very young and very old in whom complications are more frequent. This particular strain so far has been uniformly relatively mild all over the world. Dr. Norton attended a conference here of representatives of the State Medical Society, Mr. Barnes and Dr. Bugg who is also a member of our Board, the Budget Office, State tuberculosis hospitals, State Mental hospitals, State prison, State correction homes and the State Highway Patrol, and it was agreed that these State agencies would buy vaccine, which would cost around 35 cents each, just as they would buy raincoats, etc., for policemen and guards and others. He has also had conversations with people in charge of student health at Chapel Hill, State College, and hospitals other than those particular ones, and most of them are going ahead and putting in their orders. Also, the National Guard is going ahead with it so that they would not be handicapped in case of hurricanes or any other kind of emer-gency. Dr. Norton's suggestion to the Board would be that such an agree-ment by the Board would take care of what we are being asked for. The Executive Committee of the State Medical Society will meet Sunday and the matter will be brought up at that time to determine what the recom-mendation of the State Medical Society will be. Dr. Norton stressed home treatment of uncomplicated cases of flu, and recommended that sulfa drugs and antibiotics be withheld, since they have no effect on the flu virus, and should be reserved for complications, such as pneumonia, meningi-tis and other complications. Dr. Foard commented on the administrative end of flu vaccine. He has been having calls from health officers as to whether or not they should obligate themselves to give this vaccine. The industries in particular are calling on the health offiicers to give it. He thinks this should be left as far as possible to the private physician. He has advised every health officer that it should be left entirely to the discretion of the local boards of health and the county health officers themselves. Dr. Baker moved that the Board not establish any rule of priority but make every effort possible to encourage those people in strategic positions to take the vaccine. Motion seconded by Mrs. Latta, and was unanimous. Dr. C. C. Applewhite, Director of the Local Health Division, was called on for a report on the chronic disease budget. The General Health Fund was increased by Congress by $3,000,000 with a sort of quasi proviso that this extra money be used to stimulate state and local health departments to do something about the chronic disease and aged. Dr. Norton called the Division Directors together and asked them to submit projects for the $113,000 allotted to North Carolina. The Directors submitted projects and Dr. Norton called the Directors together again to go over these proj-ects. At the end of the meeting Dr. Norton appointed a Committee con-sisting of Dr. Hamilton, Dr. Foard and Dr. Applewhite, Chairman, to go over these projects to determine which ones would most come in line 36 Thirty-Seventh Biennial Report with the intent of Congress. He had distributed to the Board members a memorandum listing these projects, which are merely recommendations because the Budget Officer is going to have to go over them and adjust figures in accordance with the work of other parts of the State Board of Health. Dr. Applewhite explained each of these projects. Dr. Baker suggested that we look and see if we have heart funds for continuing and improving the program set up by the State Board of Health in the outpatient clinic at Duke Hospital, where 4" x 5" stereo chest X-ray films are filed in each patients' record. Last year through that unit about 18,000 X-rays were made. He recommended that the Board think along these lines not only at Duke but in our whole program. Dr. Morrison recommended studying these projects more carefully, and Dr. Hamilton explained in more detail the laboratory projects. Dr. Baker moved that, with Dr. Norton's approval, Board approval be given in general that the State Board of Health offices go ahead and search ways and means of using these extra funds in the most economical and best way. Motion seconded by Dr. Bugg, and was unanimous. Dr. Baker brought up the fact that while discussing recodification of health laws, we took up those diseases for which we thought we should have compulsory vaccination. At the time polio was mentioned and it was agreed that there was not enough information to make any recommenda-tions at that time. He thought it should show that at this meeting the ef-fectiveness of polio vaccine was further discussed again and it was felt that it was a very effective means of controlling the paralytic phase of polio. We should give further consideration to the possibility of compulsory vaccination in the future, so that if we decide to make some request after this year's study and 1958 study, then in the 1959 General Assembly we should be able to give legislators better information as to why polio vac-cination should or should not be made compulsory. For information and discussion by the Board, Mr. Jarrett presented a descriptive leaflet and research report on a new glasswasher and sanitizer developed by the Kidde Manufacturing Company, Inc., Bloomfield, N. Y. for use in taverns, restaurants, etc. Mr. Jarrett stated that this material and report had been carefully studied by his division. The Kidde Glasswasher and Sanitizer has been developed over a period of five years and is now on the market following tests in New York City, Pittsburgh, and con-clusive tests in the School of Public Health Engineering at the University of Michigan with final acceptance and approval of the National Sanita-tion Foundation. Also, he believes that this device is acceptable in view of the extensive tests made and the approval of the NSF. Mr Jarrett stated that our restaurant sanitation regulations concerning this item will require no charge since they now read as "where it is deemed neces-sary, mechanical glass and dishwashing equipment shall be required and such equipment shall meet National Sanitation Foundation standards or equal." There was no objection raised to the use of this machine. No official action was necessary. Mr. E. C. Hubbard, Director of the Water Pollution Control Division, was present but he had no report. However, it was suggested by Dr. Dixon that since all divisions and section chief of the State Board of North Carolina Board of Health 37 Health make monthly reports of activities to the Board members, that his Division report along with all others. Mr. Hubbard stated that this re-quest would be gladly complied with. Dr. Dixon also instructed Dr. Norton to notify the Chairman of the State Stream Sanitation Committee that he is invited to all State Board of Health meetings. For information, copies of correspondence was given to each member of the Board relative to policies, etc. from the Attorney General's office to Sen. J. V. Whitfield, Chairman of the State Stream Sanitation Com-mittee, at various times, regarding clarification and duties of the newly created Division of Water Pollution Control and the Sanitary Engineering Division as enacted by the 1958 Legislature. Secretary Norton announced the receipt of a new film on Asian In-fluenza. He was prepared to have the picture shown, but due to lack of time this was not done. December 5, 1957. A regular quarterly meeting of the North Carolina State Board of Health was held Thursday, December 5, 1957, beginning at 11:00 a.m., in the Board Room of the Cooper Memorial Health Build-ing, with President Dixon presiding. Upon motion of Dr. Henderson, seconded by Dr. Bugg, the minutes of the meeting held on September 19, 1957 which had previously been circulated to Board members, were unanimously approved without further reading. Dr. Fred T. Foard, Director of the Epidemiology Division, gave a report on the poliomyelitis vaccination program in North Carolina. He stated that the polio vaccine, at the present time, was being distributed very slowly. Of the total vaccine purchased for North Carolina under Federal program of 3,435,975 ccs. there is 144,486 ccs. at the Laboratory of Hygiene which would become out-dated in January. Local Health Officers, through several letters, and the public, through news releases, have been urged to use the vaccine but there seems to be a decrease in the demand. Dr. Foard reported also that of the 213 poliomyelitis cases reported in 1957 through December 4, only 40 have been paralytic. In 1956 through December 4, a total of 299 case had been reported, with 151 of them paralytic. With ap-proximately 100,000 ccs. of polio vaccine becoming out-dated in January, 1958, he asked that the Board consider how to dispose of the supply of vaccine left on hand. Dr. Lenox D. Baker moved that the Board authorize Secretary Norton, through Dr. Foard, to dispose of the surplus vaccine in any manner to the best interest of our people and in a manner through which it would do the most good. Motion seconded by Dr. John R. Bender, and passed unanimously. Also, Dr. Foard informed the Board that he had placed an order for 452,000 ccs. poliomyelitis vaccine, but it was not to be shipped until notified by the State Board of Health to do so. Dr. Jacob Koomen, Jr., Assistant Director of the Division of Epidemi-ology, reviewed the present status of influenza and influenza vaccine in North Carolina. Approximately 550,000 cases have occured since onset of the outbreak in late September. The "peak" of the epidemic, 150,000 cases reported per week, was seen in the last week in October and the first week in November. In the past week 13,000 cases were reported. The State La-boratory of Hygiene has processed 1,455 blood specimens of which 477 have 38 Thirty-Seventh Biennial Report shown measurable antibody to Asian influenza virus. Several Asian virus isolations have been made. To-date, U. S. influenza vaccine manufacturers have produced 51,655,589 ccs. of vaccine; approximately 38.5 million ccs. have been shipped to the various states. North Carolina with allotment of 2.6% has received about 750,000 ccs. Dr. Koomen briefly discussed the problems concerning con-centration of virus in the vaccine, route of administration, dosage and sche-dule of inoculations. The present recommendations were reviewed. Also, Dr. Koomen summarized by pointing out the iniqueness of the epidemic in that a new strain of virus, Asian strain, was involved and that for the first time some vaccine of the specific type, was available before the out-break reached epidemic proportions. While generally the disease continues to be relatively mild, some deaths have occurred. In making a report on responsibilities and authorities in stream sanita-tion between the Divisions of Water Pollution Control and Sanitary En-gineering, Mr. E. C Hubbard, the Director, called attention to the memo issued by Secretary Norton on October 28, 1957, dividing responsibilities for both divisions. This was presented to the Stream Sanitation Committee at a special meeting on October 29 and was approved unanimously. Since that time, Mr. Hubbard, Mr. Jarrett and Dr. Norton have agreed that certain changes will improve this division of responsibilities. Mr. Hubbard read both changes, one on page 2, the other on page 3 of the October 28 memo. Mr Jarrett agreed that these changes would be an improvement, especially from the viewpoint that it was the stated intent of the Legis-lature to eliminate duplication in the transfer of these activities to the State Board of Health. Mr. Jarrett pointed out that this is not the answer to all administrative problems that might eventually come up, and that they will still need help from the Board and Dr. Norton in separating an activity much of which for so many years has been a responsibility of the Sanitary Engineering Division. Dr. Baker moved that, for the present, and "not as an interpretation of the law and not setting a precedent", that the Board approve the recom-mendations made by the memo of December 5 concerning separation of the responsibilities and authorities between the Water Pollution Control and Sanitary Engineering Divisions. Motion seconded by Dr. Henderson, and unanimously passed. Secretary Norton distributed to the Board members a copy of a pro-posed draft of a statement that he had prepared at the Governor's invita-tion for the North Carolina State Board of Health to be submitted to the Subcommittee on intergovernmental Relations, U. S. House of Representa-tives, Hon. L. H. Fountain, Chairman, in Raleigh, December 10-12, 1957. This was read and discussed. Mr. Hubbard also presented a draft of statement which he had prepared for Dr. Norton concerning the administra-tion of the Federal Water Pollution Control Act and Grant Programs au-thorized by the Act. After discussion, on motion of Dr. Baker, seconded by Dr. Bugg, the Board unanimously approved the Statement for presenta-tion to the Subcommittee on Intergovernmental Relations. In discussing the "Third Party Encroachment on Private Medical Prac-tice", it was agreed that the letter originating from Professional Manage- North Carolina Board of Health 39 ment is a $5,000 survey by the Medical Society of the State of North Caro-lina and not necessarily intended to be critical, and since there are no specific charges against the State and Local Boards of Health, Dr. Baker moved that discussion of this question be deferred until some specific charge is directed at the State or Local Boards of Health. The motion was seconded by Dr. Bugg and carried unanimously. Secretary Norton reported that the State Board of Health has been losing members of its staff here, and also local health officers, because they are going to higher paying positions. He cited Dr. Cameron as an example. Dr. Cameron used to be full-time here at the State Board of Health and went over to the University, with one day a week here. Dr. Baker moved that Dr. Norton be authorized to take necessary steps in any cooperative program that he sees fit for aiding in keeping the Department well staffed. Motion seconded by Dr. Bender, and was unanimous. Dr. Norton discussed a directive issued by Mr. Wilson, former De-fense Secretary, just before he left office, discontinuing the Veterinary corps in the Armed Forces. Dr. Edwards moved that the Board look with disapproval on the action and that a letter expressing this be sent to Secretary Neil McElroy with copies to our North Carolina Congressional Delegation. It was seconded by Dr. Baker, and carried unanimously. Dr. Wm. M. Peck presented a progress report on Radiation Protection, including work of the Study and Advisory Committee. Progress has been made in obtaining equipment and training personnel. Considerable equip-ment is on order and some has been promised from Civil Defense, Dr. Peck reported. Civil Defense is also considering the possibility of paying half the cost of the equipment on order. With reference to training, a course is being given in nuclear physics every Monday night at State College, a joint course between the State Board of Health and the School of Public Health at Chapel Hill is planned, and the Sanitary Engineering Division is embarking on a training program. Dr. Peck read the list of eleven members of the Radiation Study and Advisory Committee with Dr. Robert Reeves of Duke as temporary Chairman of the Committee. Dr. Edwards is a member representing the State Board of Health. Miss Mae Reynolds, Budget Officer, gave a brief report on the budget. This year the total state, federal and local budget is a little less than eleven million dollars. The counties are putting up more than five million dollars and are in need of additional State aid. We are hoping that the counties will begin now to alert their legislators to the needs, so that when they come to Raleigh they will come prepared to vote for it. There are three problem funds, the allotment of $113,500 for chronic diseases, which came late in the year and is not going full blast yet, mental health which cannot get people to staff the clinics, and heart. Dr. Elliot has been using heart money largely for seminars at Bowman Gray and Duke for the doctors helping in some of the clinics already established, and one clinic connected with the health department and run by doctors at Sylva. Miss Reynolds said that we are very proud of the clinic at Sylva and wish that more doctors were interested in the heart program and would get more clinics started. Dr. Dixon reported to the Board that Mr. George B. Cherry, Director of General Services Division of the State, had assured him that contracts 40 Thirty-Seventh Biennial Report have been completed for air-conditioning the Health Building and that the work would be finished by spring. Dr. Norton introduced to the Board Dr. Bernard F. Rosenblum, V. D. Control Officer and Dr. E. A. Pearson, the Assistant in the Oral Hygiene Division. February 7, 1958. A meeting of the North Carolina State Board of Health was held on Friday, February 7, 1958, at 12:30 p.m. in the Board Room of the Cooper Memorial Health Building. The meeting was presided over by Dr. John R. Bender, Vice-President, in the absence of the President, Dr. G. Grady Dixon, who called on Dr. Edwards to open the session with prayer. Dr. Henderson moved that the minutes of the Board meeting held on December 5, 1957, be approved as circulated to Board members. Motion seconded by Mr. Lutz, and carried. Dr. Fred T. Foard, Director of the Division of Epidemiology, gave a progress report on the poliomyelitis vaccination program in North Carolina. According to the latest reports from counties through January 25, 1958, 3,019,908 inoculations had been given. They include 1,214,904 first inocula-tions; 1,056,890 second and 748,114 third. The figures are on children under 20 years of age and expectant mothers of all ages as done by or through local health departments with vaccine purchased from Federal Funds. Of the 231 poliomyelitis cases reported in 1957, as of December 31, only 51 were paralytic. In 1956, through December 31, a total of 315 cases had been reported, with 162 paralytic and for the period 1952 through 1956 there was an average of 233 paralytic cases annually. Dr. Foard stated the Laboratory has about 63,261 ccs. of vaccine and that most of the health directors were using it. Also, he reported that North Carolina's citizens are "about as well vaccinated" against poliomyelitis as any other State, but we should push the program of immunization vigorously between now and the 1958 polio season. Secretary Norton recognized Dr. C. C. Applewhite who has been Director of the Local Health Division for nearly nine years, having come to this position from 34 years with the USPHS. Dr. Applewhite, who resigned his position effective as of January 31, 1958, expressed his sincere thanks for the welcome and cooperation given him throughout the State. The Board of Health regrets to lose Dr. Applewhite due to retirement, and the members expressed appreciation for his loyal and effective services. Secretary Norton reminded that "G.S. 130-9 provides that the Board is required to hold public hearings prior to the adoption of any rule or regula-tion. Therefore, he suggested that before the Board adopts any rule or regulation the President of the Board announce that the Board is about to consider the adoption of regulations concerning so and so, and that the Board meeting be announced as a public hearing for the purpose of receiving the views of any persons concerning the proposed regulations " Dr. Bender then declared the meeting to be a public hearing in accordance with Section 130-9 of the General Statutes for the purpose of discussion of proposed rules and regulations governing the manufacture of bedding and for the allocation of funds under the Salt Marsh Mosquito Control North Carolina Board of Health 41 program. Both these items have been discussed fully with the people closely concerned with these matters. Mr. J. M. Jarrett, Director of the Division of Sanitary Engineering, presented rules and regulations governing: the sanitizing of mattresses previously-used materials, second-hand bedding, and bedding containing previously-used materials; the storage of previously-used materials, the issuance of stamp exemption permits; and the transfer of manufacturer's licenses and sanitizer's licenses. These rules and regulations had previously been forwarded to each member of the Board. They were discussed by Mr. Jarrett and members of the Board. Dr. Baker moved, seconded by Dr. Henderson, that the RULES AND REGULATIONS GOVERNING SANI-TIZING OF MATTRESSES, PREVIOUSLY-USED MATERIALS, SECOND-HAND BEDDING, AND BEDDING CONTAINING PRE-VIOUSLY- USED MATERIALS: THE STORAGE OF PREVIOUSLY-USED MATERIALS: THE ISSUANCE OF STAMP EXEMPTION PER-MITS: AND, THE TRANSFER OF MANUFACTURER'S LICENSES AND SANITIZER'S LICENSES, as amended by the 1957 General Assem-bly be adopted. Motion carried. (Copy filed in Minute Book) Mr. Charles M. White, Chief of the Insect-Rodent Control Section, was present and presented rules and regulations to replace those adopted by the Board on July 18, 1957 governing the allocation of State funds received by the State Board of Health to aid mosquito control districts or other local governmental units engaged in mosquito control projects. These rules and regulations also had previously been forwarded to the members for their review and study. These regulations were discussed by the Board members with Mr. White. On motion of Dr. Baker, seconded by Dr. Bugg, RULES AND REGULATIONS GOVERNING STATE AID TO MOS-QUITO CONTROL DISTRICTS OR OTHER LOCAL GOVERNMENTAL UNITS ENGAGED IN MOSQUITO CONTROL UNDERTAKINGS, were unanimously adopted. (Copy filed in Minute Book) Mr. E. C. Hubbard, Director of the Water Pollution Control Division, presented a report covering an investigation of the need for sewer extension and sewage disposal facilities in the Town of Jonesville, North Carolina, together with a resolution from the Town requesting that the State Board of Health issue an Order requiring said municipality to install the neces-sary facilities. In presenting the request, Mr. Hubbard stated that in-sanitary conditions exist due to inadequate sewage collection and disposal facilities and that these condtions had been thoroughly investigated and studied. In view of these findings, he recommended that the Boai'd adopt the necessary resolution ordering Jonesville to install necessary sewer ex-tensions and to provide adequate sewage disposal facilities. On motion of Dr. Baker, seconded by Mrs. Latta, a resolution ORDERING THE TOWN OF JONESVILLE, NORTH CAROLINA, TO MAKE NECESSARY SEWERAGE AND SEWAGE DISPOSAL IMPROVEMENTS, was unan-imously adopted. (Copy of Resolution filed in Minute Book) Mr. Hubbard also presented a report covering an investigation of the sewage disposal facilities in the Town of Norwood, North Carolina, to-gether with a resolution from the Town officials requesting that the State Board of Health issue an Order requiring the Town to proceed with the design and construction of adequate sewage treatment facilities. He further 42 Thirty-Seventh Biennial Report pointed out that such facilities are necessary for the prevention of excessive pollution of waters into which the treated wastes are to be discharged and that an Order from the State Board of Health would be necessary to permit the Town to finance proposed sewage treatment works. On motion of Dr. Baker, seconded by Dr. Henderson, a resolution was unanimously adopted ORDERING THE TOWN OF NORWOOD, NORTH CAROLINA, TO CONSTRUCT AND PUT INTO OPERATION AN ADEQUATE SEWERAGE AND NECESSARY SEWAGE TREATMENT FACILITIES. (Copy of Resolution filed in Minute Book) Dr. Z. L. Edwards and Dr. William M. Peck, members of the Advisory Committee to the State Board of Health on Radiation Protection, made brief reports on a meeting held in Durham on Sunday, February 2. They reported that the discussions were interesting and that the assignment deserves and requires serious study before the subject comes for intelligent and concrete recommendation. Dr. Robert Reeves, Professor of Radiology, Duke University, was elected Chairman. Two subcommittees were ap-pointed— one on X-ray and another on isotope radiation. Dr. Jacob Koomen, Jr., Assistant Director, Division of Epidemiology, reported briefly on the Asian Influenza situation. There seems to be a slight recent increase in influenza cases but no large outbreaks, he said. Vaccination against Asian Influenza as a protective measure continues to be recommended. He pointed out the increase in the death rate from pneumonia and influenza, especially pneumonia, in the age group of 65 years and older as much in some areas as three times that for the previous three year average. For consideration of the Board, Secretary Norton presented some samples of slogans for a stamp or plate to be used on envelopes of the State Board of Health. They will be printed by the postage meter in the same operation with the stamp and postmark. He pointed out that a good many health departments and private firms are using this method of ed-ucating the public to the value of their services—at a cost of approxi-mately $15.00 per plate—which are easily interchangeable. Dr. Baker moved, seconded by Dr. Edwards, that the Board approve the plan to attach to the mailing machine a plate bearing some type of a public health slogan. Motion carried. Miss Mae Reynolds, Budget Officer, explained the change in budget preparation for the new biennium, according to instructions sent out by the Budget Bureau. The budgets will be in two sections: the (A) or Continua-tion budget is for continuing programs at the current level. This budget is to be submitted by March 1, 1958. The (B) budget will carry improvements, expansions and salary increases, and is to be submitted by May 1, 1958. Secretary Norton made a brief report on the printing of the compila-tion of revised Public Health Laws, Rules and Regulations, and of the need of getting them together and incorporating them in a reprint. Dr. Edwards moved, seconded by Dr. Bugg, that this reprint of Public Health Laws and related statutes, be left to the discretion of the Secretary. Motion carried. Dr. Norton reported on the Automotive Crash Injury Research Project being conducted in North Carolina by Cornell University Medical College. He spoke particularly in regard to automobile crash injury and deaths, and North Carolina Board of Health 43 stated that Cornell had been requested by two motor manufacturers asking that they be allowed to have information that had been gathered through these investigations that might assist in making justified safer changes in the designing for more and better safety in automobiles. He pointed out that the Motor Vehicles Bureau had approved the use of their information with the understanding that no place, physician or individual in North Carolina could be identified; also, that the matter had been brought to the attention of the Executive Committee of the Medical Society of the State of North Carolina on January 26 and that they approved accordingly. Dr. Baker moved, seconded by Dr. Henderson, that approval of releasing this impersonal and objective information for the purpose of improving safety in the manufacture of automobiles be granted. Motion carried. Dr. Norton discussed the change in the law relative to the conjoint meeting of the State Board of Health with the general session of the Medical Society of the State of North Carolina at a time and place desig-nated by the State Board of Health and the Program Committee of the Medical Society, and asked if there was any preference as to time. On motion of Dr. Baker, seconded by Mrs. Latta, the matter will be left to Dr. Norton, Dr. Dixon and the Chairman of the Program Committee. Motion carried. The Secretary made a brief report on the Civil Defense Survival Plan. He stated that plans were being worked out as to what vital records, Board minutes and equipment should be carefully protected and moved to a place of greater safety and use in case of an emergency. Also, he com-mended Dr. Charles B. Kendall on the good work he has done on preparing the State Board of Health's Civil Defense Plan. Dr. Norton reported on the Health Officers' Conference held at Chapel Hill, January 24, 1958. He stated that much of the time was taken up on briefing regarding changes in Public Health Laws by the last General Assembly, and paid tribute to Mr. Roddey Ligon, Assistant Director of the Institute of Government for the excellent job he had done in explaining the revisions. Due to the bad weather which kept many local health directors away Dr. Norton said there probably would be other meetings of this nature in the near future. Secretary Norton presented for discussion a proposal to change Nutri-tion Section to a Division status. There was much discussion, but it was the consensus of the Board that the Section should remain unchanged at least for the present. The Governor's Conference on Occupational Health, held in Chapel Hill on February 6, was discussed by Dr. Norton. He stated that the Conference was well attended and very interesting. It has as its objective the bringing together of a group of leaders in industry, business, labor, the medical profession, and state officials who are concerned with exploring more effec-tive ways of providing occupational health protection in North Carolina. The Secretary called the Board's attention to the matter of a full-time Assistant State Health Director as provided for in the revision of our Public Health Laws passed by the General Assembly of 1957. He point-ed out that such a person should be a young physician, experienced in public health work, and familiar with North Carolina. In speaking of 44 Thirty-Seventh Biennial Report the need for such a position, Dr. Norton paid high tribute to Dr. John H. Hamilton who has been serving part-time in this capacity since January 19, 1951. Dr. Hamilton has been carrying this "load" in addition to his many other duties and responsibilities. After a full discussion, Dr. Edwards made a motion that the Executive Committee, with Dr. Norton, be instruct-ed to select a candidate for Assistant State Health Director, and then recommend the candidate to the full Board and the Governor. Motion seconded by Dr. Baker, and carried unanimously. Dr. Robert D. Higgins who has been Assistant to Dr. Applewhite in the Local Health Division since February 1, 1957 was present. Dr. Higgins was welcomed to the "official family" and is to carry on as Director of the Local Health Division. May 7, 1958. The State Board of Health and the Medical Society of the State of North Carolina met in Conjoint Session, Wednesday, May 7, at 9:00 a.m. in the Sun Dial Room of the George Vanderbilt Hotel in Ashe-ville, N. C, Dr. G. Grady Dixon, presiding. Upon motion of Mr. Lutz, seconded by Dr. Baker, the minutes of the last Board meeting, February 7, 1958, which had been circulated, were approved. Dr. J. W. R. Norton, State Health Director, then made a report on the Governor's Advisory Committee on Poliomyelitis Vaccine. He informed the Board that there had not been a meeting of this Committee since June 21, 1956, but that the members had been kept advised on all developments. Dr. Norton advised the Board of the State Medical Society's official decision to ask the next Legislature to make vaccination against poliomye-litis compulsory. On motion of Dr. Bugg, second by Mr. Lutz, the following resolution was unanimously passed: "WHEREAS, the House of Delegates of the Medical Society of the State of North Carolina, upon recommendation of the Executive Council, voted, without dissent or discussion, to ask the next General Assembly to make compulsory the vaccination of all children between the ages of two months and six years against poliomyelitis; therefore, be it "RESOLVED, That the North Carolina State Board of Health pledge its support of such legislation and its strict enforcement." Under the head of new business, Dx*. Norton made a report on the State Board of Health's activities during the recent influenza outbreak at Ocracoke. Dr. Norton then reported on a conference held March 26 concerning visual screening of school children in the Board Room, at the request of the Governor's Office. This conference was attended by representatives of the Board of Education, Board of Health, Medical Society of the State of North Carolina, Commission for the Blind, the Motor Vehicles Bureau and the North Carolina Optometric Society. Officials of the last named group had requested a conference with Governor Hodges. Officials of the Opto-metric Society discussed some work done in Onslow County (reported in State Magazine November 16, 1957, page 17), the study made by the Psychology Department of State College with a $30,000 grant from the State Optometric Society and proposed that visual screening of school children utilizing optometrists be extended throughout the State. The Optometric Society officials were requested to submit their detailed pro-posals in writing to the Governor's Office and to the agencies represented North Carolina Board of Health 45 at the conference for further consideration. So far this request has not been complied with. Dr. Norton made a report on the refinement and dependability of tests for intoxication. He also reported the employment of Mr. Ben Eaton, Jr., on April 28, 1958, as Director of Administrative Services in the State Health Department. On motion of Dr. Bender, seconded by Dr. Bugg, the North Asheboro- Central Falls Sanitary District was extended. (Copy of Resolution filed in Minute Book) On motion of Mr. Lutz, seconded by Dr. Bugg, the Catawba Heights Sanitary District wras extended. (Copy filed in Minute Book) A resolution was adopted permitting certain recreational uses of water supply reservoirs of Raleigh, Lexington and Reidsville. Motions concerning uses of water supply reservoirs were made and seconded as follows: Raleigh —Dr. Bugg, Dr. Bender; Lexington—Dr. Bugg, Dr. Bender, and Reidsville —Mr. Lutz and Dr. Bugg. Although he presided over the Conjoint Session of the State Board of Health and the Medical Society of the State of North Carolina, this was the last meeting of the State Board of Health over which Dr. Dixon pre-sided. His death occurred within a matter of hours after he left Asheville about three o'clock riding with Dr. A. M. Mumford of Winterville and was stricken as the car approached Hickory. He died in the ambulance on the way to the hospital there. He probably served longest on the Board of any member (1931-1958) since its formation in 1877. On motion duly made and seconded, the meeting adjourned at 10:00 a.m. 46 Thirty-Seventh Biennial Report CONJOINT REPORT * By John H. Hamilton, M.D.* :;: In order to visualize the public health program in North Carolina one must realize that it is primarily local health departments which perform a major portion of the work and that the State Board of Health plays a secondary but important role. Whether this importance of the local health department is traditionally due to the place which counties and munici-palities occupy in North Carolina's plan for government or whether it is due to the vision and foresight of the men who laid the foundation for public health work in the State is a discussion into which we will not enter here. Beginning in 1877 Dr. Thomas Fanning Wood worked deligently to set up a plan whereby county boards of health would lead the way. Upon his death in 1892, Dr. Richard H. Lewis continued to lay a firm foundation. He was succeeded in 1909 by North Carolina's first whole-time State health officer, Dr. Watson S. Rankin, who after he took office persuaded the next General Assembly to enact a law providing for whole-time county health work. We in North Carolina claim that Guilford County had the first whole-time county health department in the United States, being established June 1, 1911. It was not until 1949 that all of the one hundred counties in North Carolina had a whole-time health program. Today over $6,600,000 are expended annually by local departments of health. That the people themselves believe in local health work was shown by the fact that the sum of nearly $5,000,000 is appropriated by boards of county com-missioners and city governing boards while $1,132,000 is appropriate
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|Title||Biennial report of the North Carolina State Board of Health|
|Other Title||Report of the North Carolina State Board of Health.|
|Creator||North Carolina. State Board of Health.|
|Date||1956; 1957; 1958|
North Carolina. State Board of Health--Statistics--Periodicals
Public health--North Carolina--Statistics--Periodicals
Public Health--North Carolina
|Place||North Carolina, United States|
|Time Period||(1945-1989) Post War/Cold War period|
|Description||Report covers two calendar years (13th-18th); (19th) covers Dec. 1, 1920-June 30, 1922; thence each covers July 1-June 30 years.; Printer: 13th (1909/10)-18th (1919/20) by Edwards & Broughton; 19th (1921/22)-20th (1923/24) by Bynum; 21st (1925/26)-<44th (1970/72)> unnamed.|
|Publisher||Raleigh :The Board,1911-|
|Agency-Current||North Carolina Department of Health and Human Services|
|Rights||State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754|
|Physical Characteristics||v. ;24 cm.|
|Collection||Health Sciences Library, University of North Carolina at Chapel Hill|
|Digital Characteristics-A||8,324 KB; 160 p.|
|Series||Biennial report of the North Carolina State Board of Health|
Ensuring Democracy through Digital Access, a North Carolina LSTA-funded grant project
North Carolina Digital State Documents Collection
N.C. Public Health Collection
|Related Items||Printer: 13th (1909/10)-18th (1919/20) by Edwards & Broughton; 19th (1921/22)-20th (1923/24) by Bynum; 21st (1925/26)-<44th (1970/72)> unnamed.|
|Title Replaces||North Carolina. Board of Health../1|
|Pres File Name-M||pubs_edp_biennialreportboardofhealth19561958.pdf|
|Pres Local File Path-M||\Preservation_content\StatePubs\pubs_edp\images_master\|
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Thirty-Seventh Biennial Report
STATE BOARD OF HEALTH
July 1, 1956-June 30, 1958
MEMBERS OF THE STATE BOARD OF HEALTH
Appointed by the Governor
H. C. Lutz, Ph.G.
Term expires 1959
Mrs. J. E. Latta
Term expires 1961
John P. Henderson, Jr., M.D.
Term expires 1959
Lenox D. Baker, M.D.
Term expires 1961
Z. L. Edwards, D.D.S.
Term expires 1961
Elected by the Medical Society of the State of North Carolina
John R. Bender, M.D., Vice-President
Term expires 1961
Charles R. Bugg, M. D., President
Term expires 1961
"Roger W. Morrison, M.D.
Term expires 1959
—Earl W. Brian, M.D.
Term expires 1959
Charles R. Bugg, M.D., President
John R. Bender, M.D., Vice-President
Z. L. Edwards, D.D.S.
J. W. R. Norton, M.D., Secretary
EXECUTIVE STAFF AS OF JUNE 30, 1958
J. W. R. Norton, M.D., M.P.H., Secretary and State Health Director
John H. Hamilton, M.D., Assistant State Health Director and Director
of Laboratory Division
Ernest A. Branch, D.D.S., Director Oral Hygiene Division
J. M. Jarrett, B.S., Director Sanitary Engineering Division
A. H. Elliot, M.D., Director Personal Health Division
Fred T. Foard, M.D., Director Epidemiology Division
Robert D. Higgins, M.D., Director Local Health Division
E. C. Hubbard, B.S., M.P.H., Director Water Pollution Control Division
Ben Eaton, Jr., Director Administrative Services
Dr. Morrison elected to fill unexpired term of Dr. Crump.
Dr. Brian elected to fill unexpired term of Dr. Dixon, deceased May 7, 1958.