Cases reported, and case and fatality rates, in States in which the prevalence of measles is recorded, 1913 and 1914. MENINGITIS (EPIDEMIC CEREBROSPINAL). There has always been considerable difficulty in ascertaining in a satisfactory manner the relative prevalence and geographic distribution of this disease. This is due probably largely to the difficulties of diagnosis and in part to negligence on the part of those whose duty it is to report cases. The States reporting the greatest number of cases were California, with 70 reported cases; Connecticut, with 31; Illinois, with 196; Indiana, with 72; Kansas, with 31; Louisiana, with 66; Maryland, with 39; Mississippi, with 61; New York, with 440; Ohio, with 201; and Wisconsin, with 75. Among the larger cities there were 99 cases reported in Chicago, 318 cases in New York, 56 in Boston, and 42 in Cleveland. The disease was reported to some extent from practically all parts of the country. Cases reported, and case and fatality rates, in States in which the prevalence of meningitis is recorded, 1913 and 1914. 5 Exclusive of the city of Baltimore. PELLAGRA. Apparently the prevalence of pellagra has remained undiminished. It is being constantly reported from new localities in which it had not hitherto been recognized. In many sections increasing numbers of cases are being reported. However, neither the reported cases of the disease nor the registered deaths can be relied upon to give even an approximately correct idea of the relative prevalence and geographic distribution of the disease. A large proportion of the cases occurring are being reported in localities where the disease is comparatively rare, while few, if any, cases are being reported in some sections where the disease is prevalent. Nor can the causes of death registered in death certificates be relied upon, in part because of the frequent failure to recognize the disease and in part because a considerable portion of the territory in which pellagra prevails to the greatest extent has unsatisfactory registration of deaths. In California there were 11 cases and 28 deaths from pellagra reported; in the District of Columbia, 21 cases and 14 deaths. This would indicate very defective notification of cases. In Kansas there were 22 cases reported and 19 deaths, also showing apparently defective notification of cases. In Louisiana there were 115 cases reported and 17 registered deaths; in Maryland, 3 registered deaths; in Michigan, 4 deaths; in Minnesota, 5 deaths; in Mississippi, 10,954 cases and 1,204 deaths, giving a case rate of 5.76 per 1,000 population and a fatality rate of 10.99 per 100 cases. In Oregon there were 3 registered deaths; in Rhode Island, 12; in South Carolina, 448 cases; and in Virginia, 386 cases and 247 deaths. In Virginia the notification of cases was apparently incomplete. The same is true of South Carolina and probably of all the other States, with the possible exception of Mississippi. PLAGUE. Although well under control, plague infection has continued to persist during the year to some small extent in California among the ground squirrels, in Seattle in rats, and in New Orleans for a time in man and later in rats. CALIFORNIA. Some small amount of plague infection seems still to linger among the ground squirrels in California in certain localities. The dates and localities where infected squirrels have been found since June 30, 1914, are shown in the table on page 307. Localities in which plague-infected squirrels were found in California from July 1, 1914, to June 30, 1915. Wither's ranch, 4 miles northeast of Lafayette... Burgess ranch, 1 mile east of Walnut Creek.. Walker ranch, 14 miles east of Walnut Creek. Bruno ranch (formerly Geo. Silva ranch), People's Water Co., 7 miles east of San D. J. Watson ranch, 6 miles south of Hollister, Rancho San Justo, Bird Creek grant. June 17 1 ...do... Mary Sally estate, 5 miles southwest of Hollister. June 21 Mary Sally estate, Bird Creek district, 4 miles southwest of Hollister. June 23 Total. 8 Making a grand total of 39. NEW ORLEANS, LA. On June 27, 1914, a case of plague in man was reported in New Orleans, La., in the person of C. N., a native of Sweden, 49 years of age, who had been in the city since June 16. A history of his previous residence was unobtainable. The patient died June 28. The diagnosis was confirmed by necropsy and bacteriological examina |