Proceedings of Eighth Annual Meeting 149 



suffice to prevent any transmission of malaria, and finally to exter- 

 minate the disease. 



Unfortunately in practice it is usually possible only very imper- 

 fectly to reach the desired result by any one of these directions. 

 It must be decided by the health officer in any given case which line 

 of action is most appHcable, or what combination of methods prom- 

 ises to be most effective. 



The control of malaria in public health administration requires the 

 reporting of recognized cases. In fact this is true in the control 

 by any communicable disease. It may be stated without fear of con- 

 tradiction that where there is poor reporting there will be found a 

 lack of activities along the lines of enforcing preventative measures 

 against the spread of diseases. This applies to all of the so-called 

 preventable diseases. As a matter of fact, the completeness of mor- 

 bidity reports may be taken as a fairly reliable index to the efficiency 

 of the health department of any community. In diseases accom- 

 panied by any considerable mortality, indicated fatality rates, based 

 on reported cases and recorded deaths, are commonly accepted as 

 showing the completeness or incompleteness of morbidity reports. 

 Where the indicated fatality rates are relatively high, morbidity 

 reporting will be found to be correspondingly poor. Where they are 

 relatively low, the reverse will be true. 



In 191 1 the State Board of Health of New Jersey publicly declared 

 malaria to be preventable and especially dangerous to the public 

 health. This declaration was made pursuant to a provision con- 

 tained in an act of 1895 and automatically made this disease report- 

 able universally throughout the state. Furthermore, malaria is made 

 reportable under the provisions of a regulation contained in the 

 state sanitary code. In this connection it might be well to empha- 

 size at this time two specific provisions of the act under which the 

 present State Department of Health was created. These provisions 

 are — First, a requirement in the law which makes it the duty of the 

 State Department of Health to enact a state sanitary code, the 

 provisions of which code (to quote the law) ''Shall contain such 

 regulations as, in its judgment, will promote health and prevent dis- 

 ease." Second, a part of the same act which makes it the duty of 

 all local health officials to enforce the laws (meaning all statute laws 

 enforceable by public health officials) and the regulations of the 

 state sanitary code. 



One of the first chapters of the state sanitary code to be enacted 

 (effective June i, 191 7) contained a regulation requiring physicians, 



