New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1916-08-27
EPIDEMIC BATTLE
PUT ON NEW BASIS
DR.. North Says City Should
Lead in Scientific
Prevention.

Declaring that New York City should
take the lead in preparing TO prevent
future epdemics. DR.. Charles +. North,
of 80 Church Street, urges that per-
manent bureau of epidemiology be es-
tablished as part Of the Health De-
partment He expresses his views IN
"The Medical Record"
"The discovery that persons in APP
parently perfect health may be the
carriers Of bacteria Of infectious dis
eases has entirely changed our point
Of view regarding the prevention OF
these diseases says DR.. North mot
only carriers, but mild cases and
missed cases, are now known TO be the
means of spreading infection.
The transfcrrence OF injection ire
quently occurs before disease is recog-
nized. Thus each case becomes focus
and the centre Of "a small, localized
epidemic all its own.
"However. the health authorities,
even of our largest cities. still cling
10 sanitation as their most important
weapon, and make the control over car
riers, mild cases, missed cases and per
sons who have come into contact with
the recognized cases secondary and
incidental matter.
"The science Of epidemiology itself
is so new that even a definition has
not been formulated. II deals primar-
lily with the Investigation and control
of epidemics Of infectious diseases
There is no such thing as a first
class bureau Of epidemiology in
America. No Municipality employs a
specialist in epidcmiology, qualified by
experience to take active control of
epldemics. II is small wonder that
epidemics catch municipal health de-
partments mapping, and almost panic
stricken.
"New York City illustrates by its
own career instance after instance of
this sort of unprcparedncss. A re-
view Of the epidemics from which the
city has suffered shows the imperfec
ton Of methods of investigation and
control. A health department which
in other respects is excellent has been
peculiarly weak in its control of epi-
denies.
"The department undertook ener
gency measures TO suppress this cpl
demic Cnfantile paralysis the first
week in July 1t laid emphasis on the
cleaning of streets, disposal of garbage
and sanitation. The reporting of cases
and the isolation of discovered eases
seems 10 have been carried out as far
as possible But most remarkable
omission was the failure of the de-
partment to take any steps for the
control of contact cases until July "a.
warfare against infectious dseases
requires a preparedness all its own. II
is necessary 10 maintain an emergency
form of organization, just as fire de-
partment is organized. There must be
not only "a perfect alarm system. but
force capable of quick and intelligent
action in the location where the con-
hagration starts.
"The ordinary type of bureau Of in
fectious diseases cannot answer TINS
IL demands special bureau
of epidemiology, with a man al its
head who has specialized in that
science. and with a consulting board,
making available 20 him instantly and
regularly the best consulting service.
"Such an organization might well be
included within the regular Health De-
partment, but so connected with the
various special departments that all Of
these can be instantly swung into line,
not aimlessly, but as instruments IN
the hands of the epidemiologist.
"A real, strong bureau Of epidemi-
OlOgy might seem 10 De inactive be
tween epidemics. but when one esti-
mates the cost TO the community Of
such confagrations of disease as oc-
cur it will appear that communities
are justified in keeping modified con-
stantly an adequate force, properly IN
formed and equipped. and capable Of
acting intelligently and with a strong
hand 20 suppress instantly a conhagra-
ton of disease.
"The immediate application at the
beginning Of an outbreak Of the very
best measures for the suppression Of
the epidemic would result from an
adequate study Of each of the infec
.ious diseases causing these irregular
outbreaks and a comprehensive plan of
action ready made for immediate APP /
olication when emergency calls New
York City should take the lead in such /
Each state should have a first class |
department. of epidemiology. Above |
ali. the United States Public Health |
Service should have national depart
nent Of epidemiology so thoroughly !
competent that IL can act IN interstate |
outbreaks, and, when called upon, in
oeal outbreaks |