1942: Public Health Service

The United States Public Health Service, a unit of the Federal Security Agency, carries the broad general responsibility of protecting the health of the American people. Its functions include: Enforcement of national quarantine laws and regulations for the exclusion of certain communicable diseases from ports of entry by sea or air; provision of medical, dental and hospital care to specified legal beneficiaries of the Federal Government; pursuit of scientific research on many fronts, ranging from the diseases of man and the pollution of inland waters to industrial hygiene and special problems of military medicine; control of the manufacture and sale in interstate commerce of biologic products such as vaccines, toxoids, serums, etc.; control of the interstate spread of diseases; provision of hospital and custodial care to the drug addicts among Federal prisoners and of medical and psychiatric service in all Federal prisons and correctional institutions; and the dissemination of health information.

Civilian and Military Health Program.

For the fiscal year ending June 30, 1942, the work of the Service in each of its divisions has been geared up to render the fullest health protection possible under war conditions to citizens of the 48 states, the District of Columbia, the territories, and the island possessions, through the Federal-State cooperative program administering funds appropriated by authority of the Social Security Act, Title VI. In addition, there has been direct cooperation with the military services on many sectors involving joint responsibility.

Liaison service was continued between civilian health authorities and the Medical Corps of the armed services to safeguard the health of troops in areas outside the jurisdiction of the Army and Navy. Facts based on the reconnaissance surveys undertaken during 1940-41, and continued to date, have guided certification by the Public Health Service to the Federal Works Agency for the construction of health and sanitation facilities in critical areas. Similar assistance was given to the War Production Board to determine priorities governing the release of health supplies and equipment.

More than 700 professional and technical personnel have been assigned to State health departments for duty in communities with war industry or extra-cantonment problems. Special attention has been given to the health and sanitation services in maneuver areas, as well as the task of securing safe and adequate local milk supplies for military authorities.

An extensive program for the control of malaria was initiated on the basis of careful preliminary study and was well under way before the 1942 breeding season of the malaria mosquito. Dog fly breeding was controlled in areas along the Florida Gulf Coast where it would have hindered the Air Corps training program; plague control operations were carried on in and near military areas in the west; and typhus fever control measures were instituted in rat-infested areas of the south.

With the help of Federal funds administered by the Public Health Service to relieve the shortage of trained nurses for both military and civilian needs, 214 schools of nursing increased their enrollment by 6,242 over the preceding year, and 44 institutions gave refresher courses or post-graduate training to 1,393 graduate nurses.

Emphasis was placed on the development of better industrial hygiene programs by the states, with special attention to disease of non-occupational origin such as tuberculosis and venereal disease. Medical and engineering personnel were assigned to develop the Emergency Medical Services of the Office of Civilian Defense, setting up blood and plasma banks on a country-wide scale for the emergency treatment of civilians as well as organizing for the medical and hospital care which must be available in the event of enemy action.

The Service also supervised medical aspects of the relocation of Japanese aliens from the West Coast.

The 26 Marine Hospitals and 124 relief stations were severely taxed during the year by the increase in the number of patients treated which rose from 547,178 in 1941 to 752,994 in 1942; and also by the growing difficulty of obtaining and retaining qualified hospital personnel especially in the less skilled categories.

In the District of Columbia, 17 medical units were operated for first-aid treatment of 39,048 Government employees among various units of the Treasury Department, the Reconstruction Finance Corporation, Labor Department, the War Production Board and the Office of Government Reports.

Medical, dental and nursing care is provided at various alien detention camps and a medical and sanitary program has been maintained in connection with the Alaska Highway Project of the Public Roads Administration. Prompt care has been made available for sailors wherever they come ashore from vessels destroyed by enemy action.

Nearly 100 medical and dental officers have been detailed to the War Shipping Administration for duty in connection with the examination of Merchant Marine candidates and with medical care at the Maritime training stations. A substantial number are on duty with the Coast Guard.

National Institute of Health.

Among many of the important accomplishments of this research arm of the Public Health Service, have been the results of projects undertaken at the request of the Army and Navy which must remain confidential. This is aside from the assistance of the Institute to the two Medical Corps in securing enormous supplies of biologic and chemical products needed for the protection of the armed forces, including dried normal human plasma, tetanus toxoid, vaccines for cholera, plague, typhus and yellow fever, and various arsenical compounds.

Research in chemotherapy and nutrition produced interesting results, indicating that diets deficient in riboflavin or thiamine increased the susceptibility of experimental animals to infection with pneumococcus, Type I. Sclerosis and calcification of the blood vessels occurred in animals given sulfaguanidine in purified diets over a long period. Liver cirrhosis produced in rats on deficient diets was prevented and successfully treated by use of choline.

Compounds related to sulfanilamide were synthesized and their chemotherapeutic properties studied. Sulfone derivatives showed bacteriostatic action against the tubercle bacillus in vitro.

A new disease of man and its cause was discovered. An organism found in low-grade stained cotton was shown to be the cause of a disease tentatively termed 'cotton sickness' which has been observed among workers in textile mills.

An improved antigen was developed for the complement fixation test for amebiasis and is expected to simplify diagnostic procedures. Studies on water chlorination pointed to new methods in preventing the transmission of amebic dysentery from emergency water supplies.

In the field of cancer research, the production of cancer cells outside the body was demonstrated for the first time. Evidence was obtained to show that certain types of cancer in mice can be inhibited by a diet low in organic sulphur and that various types of vitamin-deficient diets retard the growth of malignant tumors.

Venereal Disease Control.

Activities during 1942 were accelerated by the routine testing of Selective Service candidates and other special groups; by expansion of treatment centers in war areas; and by the greatly augmented program for the control of gonorrhea.

More than 20,000,000 serological tests were made for syphilis, which is about a 25 per cent increase over 1941. Laboratory tests for gonorrhea increased by nearly 12 per cent. The number of clinics treating venereal disease now totals more than 3,500. Notable progress has been made in the evaluation and increased application of the newer methods of treating both syphilis and gonorrhea. The Eagle intensive treatment of syphilis was employed at a number of Marine Hospitals without serious complications. At another hospital, the 5-day massive intravenous-drip method with mapharsen was used in treating 52 carefully selected patients. Typhoid-vaccine therapy, massive-drip technique, was used successfully for gonorrheal patients.

Morbidity and Mortality.

As indicated by reports of communicable diseases and of mortality rates, the health of the nation remained good during 1941, the last year for which complete figures are available.

Epidemics of influenza and measles occurred in 1941. Reported cases of influenza numbered 681,969 as compared to 429,837 in 1940. Reported cases of measles numbered 891,652 as compared to 291,162 in 1940. A total of 9,057 cases of poliomyelitis was reported in 1941 as compared to 9,826 in 1940.

Diphtheria cases numbered 18,061; 1,374 cases of smallpox were reported, the lowest number in the records of the Public Health Service. As usual the prevalence of smallpox was greatest in the states which have resisted control measures.

The general death rate in the United States was 10.5 per 1,000 population, the lowest ever recorded. The maternal mortality declined for the twelfth consecutive year, reaching a new low of 3.0 per 1,000 live births. The infant rate, 45 per 1,000 live births, showed no change.

The death rate from tuberculosis was 42.2 per 1,000 population as compared to 43.8 for 1940. Heart disease and cancer continued to take the highest toll, the rates being 295.4 and 121.2 per 1,000 population, respectively. The death rate from automobile accidents increased from 24.3 in 1940 to 27.5 in 1941.

The epidemics of measles and influenza resulted in slightly higher mortality from these causes, but it is significant that the death rate from pneumonia (a common complication of these diseases) declined sharply from 53.2 per 100,000 in 1940 to 46.6 per 100,000 in 1941.

Mortality from diphtheria, digestive diseases, malaria, pellagra and scarlet fever declined for the fifth consecutive year.

At the close of the fiscal year, 524 officers of the regular commissioned Corps of the Public Health Service and 402 reserve officers were on active duty. The staff of the National Institute of Health totalled 1,615. As of Mar. 31, 1942, the total personnel of the Public Health Service numbered 17,053, of whom 5,152 were collaborating epidemiologists and assistant collaborating epidemiologists receiving only nominal compensation for the collection of morbidity data.

Approximately $34,500,000 was available for the work of the Public Health Service in 1942. In addition, $11,500,000 was allocated to the states under Title VI of the Social Security Act.