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INTERSTATE AND FOREIGN COMMERCE
HOUSE OF REPRESENTATIVES

NINETY-SECOND CONGRESS

SECOND SESSION

ON

H.R. 14030

STANFORD

UNIVERS

A BILL TO AMEND THE PUBLIC HEALTH SERVICE ACT TO
EXTEND FOR THREE YEARS THE AUTHORIZATION FOR
GRANTS FOR COMMUNICABLE DISEASE CONTROL AND

VACCINATION ASSISTANCE

AND

H.R. 14455

DOCUMEN

1972

A BILL TO AMEND THE PUBLIC HEALTH SERVICE ACARTMENT

EXTEND AND REVISE THE PROGRAM OF ASSISTANCE
UNDER THAT ACT FOR THE CONTROL AND PREVENTION
OF COMMUNICABLE DISEASES

APRIL 27, 1972

Serial No. 92-66

Printed for the use of the Committee on Interstate and Foreign Commerce

78-832 O

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON: 1972

COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE

HARLEY O. STAGGERS, West Virginia, Chairman

TORBERT H. MACDONALD, Massachusetts WILLIAM L. SPRINGER, Illinois

JOHN JARMAN, Oklahoma

JOHN E. MOSS, California

JOHN D. DINGELL, Michigan

PAUL G. ROGERS, Florida

LIONEL VAN DEERLIN, California

J. J. PICKLE, Texas

FRED B. ROONEY, Pennsylvania
JOHN M. MURPHY, New York

DAVID E. SATTERFIELD III, Virginia
BROCK ADAMS, Washington
RAY BLANTON, Tennessee

W. S. (BILL) STUCKEY, JR., Georgia.
PETER N. KYROS, Maine
BOB ECKHARDT, Texas
ROBERT O. TIERNAN, Rhode Island
RICHARDSON PREYER, North Carolina
BERTRAM L. PODELL, New York
HENRY HELSTOSKI, New Jersey
JAMES W. SYMINGTON, Missouri
CHARLES J. CARNEY, Ohio
RALPH H. METCALFE, Illinois
GOODLOE E. BYRON, Maryland
WILLIAM R. ROY, Kansas

SAMUEL L. DEVINE, Ohio

ANCHER NELSEN, Minnesota
HASTINGS KEITH, Massachusetts

JAMES T. BROYHILL, North Carolina
JAMES HARVEY, Michigan

TIM LEE CARTER, Kentucky
CLARENCE J. BROWN, Ohio
DAN KUYKENDALL, Tennessee
JOE SKUBITZ, Kansas

FLETCHER THOMPSON, Georgia
JAMES F. HASTINGS, New York
JOHN G. SCHMITZ, California
JAMES M. COLLINS, Texas
LOUIS FREY, JR., Florida
JOHN WARE, Pennsylvania

JOHN Y. MCCOLLISTER, Nebraska
RICHARD G. SHOUP, Montana

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Reichman, Dr. Lee B., director, bureau of tuberculosis, New York

City Department of Health.

Sellers, Clyde A., director, bureau of communicable disease control,

Jefferson County (Alabama) Department of Health

Sencer, Dr. David J., Director, Center for Disease Control, Health

Services and Mental Health Administration, Department of Health

Education, and Welfare..

Webster, Dr. Bruce P., president, American Social Health Association
Zapp, Dr. John S., Deputy Assistant Secretary for Legislation
(Health), Department of Health, Education, and Welfare____
Additional material submitted for the record by-

American Medical Association, letter dated May 8, 1972, from Ernest
B. Howard, M.D., executive vice president, to Chairman Rogers---

American Nurses' Association, Inc., letter dated May 3, 1972, from

Eileen M. Jacobi, R.N., Ed. D., executive director, to Chairman

Rogers.

American Social Health Association:

Letter dated May 3, 1972, from Dr. Bruce Webster, chairman,

National Commission on Venereal Disease, to Chairman Rogers

re amounts of Federal money expended on venereal disease

research

Report of the National Commission on Venereal Disease to the

Assistant Secretary for Health and Scientific Affairs, Depart-

ment of Health, Education, and Welfare.......

"Today's VD Control P. oblem-1972," joint statement written

and published by the American Social Health Association and

co-sponsored by the American Public Health Association, the

American Venereal Disease Association, and the Association of

State and Territorial Health Officers..

Association of State and Territorial Health Officers, Dr. Raymond L.

Standard, statement__

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Additional material submitted for the record by-Continued

Carver, Dr. David H., director, division of infectious diseases,
department of pediatrics, Johns Hopkins University School of
Medicine:

"Current status of measles in the United States," from the Journal
of Infectious Diseases, Vol. 124, No. 6, December 1971__
Figure 1-"Best available paralytic poliomyelitis case count," by
year, United States, 1958-1970..

Hepatitis—reported as infectious 1970 and 1971; and reported as
serum 1970 and 1971___

Morbidity and mortality weekly report-Annual number of cases:
Measles-1962-1971; Diphtheria-1964-1971__

Morbidity and mortality weekly report-December 4, 1971;
Measles, Polio, DTP, and Rubella_

Morbidity and mortality weekly report-April 15, 1972-
Morbidity and mortality weekly report-April 15, 1972-
Tetanus, 1966-1971; Pertussis, 1967-1970_

Table 1.-Poliomyelitis cases reported to CDC in 1970..
Tuberculosis, new active reported cases 1966-1970__.
Venereal disease-syphillis and gonorrhea-1966–1970---

Health, Education, and Welfare Department:

Appropriations requested under sections 314(e), 317 and Public
Law 91-695-1971, 1972, 1973.

California policy re nurses and paramedics administering vaccine
Center for Disease Control, positions and appropriated funds
adjusted to include grants-fiscal year 1963-1973 (estimated).
Federal funds provided to the Los Angeles area for immunization
program_.

Section 314(d)—Health services delivery allocations of grants for
comprehensive public health services-1971 (actual), 1972
(allocation), and 1973 (estimated).

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State plan for public health and mental health services under
section 314(d) of the Public Health Service Act

47

States which indicated insufficient resources for DPT vaccine
from State funds.

30

Jefferson County (Alabama) Department of Health:

Figure 1-Syphillis and gonorrhea case rates per 100,000 popula-
tion, Jefferson County, Alabama-1961, 1966, 1971..
Figure 2-Measles cases, Jefferson County, Alabama-1960–61,
1965-66, 1970-71__

92

93

Figure 3-Tuberculosis: 1971 new active case rates per 100,000
population-U.S., Alabama, Jefferson County, and Birming-

94

ham

Koch, Hon. Edward I., a Representative in Congress from the State
of New York, reported cases of tuberculosis in cities of over 500,000
persons-rate per 100,000 _ -

New York City Department of Health, Appendix I-New active
tuberculosis cases reported, by Borough and health district, of
residence numbers and rates, New York City, 1969-71..
New York State Department of Health:

Gonorrhea, New York State 1950-71.

Number of measles immunizations in public clinics, New York
State, 1966-70_ .

Primary and secondary syphilis, New York State, 1950-71-
Primary and secondary syphilis and average annual complement
of VĎ investigatory, New York State (exclusive of New York
City) 1956-71__.

Quarterly cases of measles and cumulative doses measles vaccine
administered, New York State (exclusive of New York City),
1966-70.

Resolution of the Action Committee for Childhood Immuniza-
tions-signed in Atlanta, Ga., August 24-25, 1971...

U.S. Conference of City Health Officers:

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Appendix C-Primary and secondary syphillis, urban-rural dis-
tribution, United States, calendar year 1970-

Appendix A-U.S. immunization survey-1970–71.
Appendix B-Gonorrhea—cities over 200,000, fiscal year 1971,
cases and rates_

98

99

99

COMMUNICABLE DISEASE CONTROL AMENDMENTS

1972

THURSDAY, APRIL 27, 1972

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON PUBLIC HEALTH AND ENVIRONMENT,
COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D.C. The subcommittee met at 10 a.m., pursuant to notice, in room 2322, Rayburn House Office Building, Hon. Paul G. Rogers (chairman) presiding.

Mr. ROGERS. The subcommittee will come to order, please.

We are considering legislation to extend and revise the Vaccination Assistance Act. For the past 5 months we have developed legislation to mount an attack on the Nation's two great killers: cancer and heart. We have passed into law the cancer legislation and have just concluded hearings on heart, lung, and blood legislation. During hearings on both we heard talk of the eventual magic bullet which some day we hope will be given us by the scientific research. In the meantime, we should use available tools of early detection and prevention, for these are about the only magic bullets we have now. We speak of prevention in medicine.

I firmly believe in this concept, and I think the subcommittee does. Certainly this is the approach we need to begin to emphasize more. I think great neglect has been shown in using the tools of prevention in medicine which even now are available to halt the majority of communicable diseases. This is amazing to me. We can prevent measles, rubella, polio, tetanus, diphtheria and yet we really are not doing an adequate job. We have all but eradicated smallpox, but we have not taken the proper action against the other diseases, particularly childhood diseases.

It is amazing that children are still dying from measles here in this country when there really is no reason for this. We fight to restore those who are mentally retarded, often as a result of measles, but fail to act against the diseases which could have prevented it. There is also the tremendous financial burden that is placed on those people who get these diseases. The measles epidemic in Los Angeles which is just now subsiding will cost people there almost $3 million. Just recently three people died there of measles or measles-related illness. It is estimated 18 to 20 will be retarded and will require lifetime care.

Three years ago we were on the brink of eliminating measles with reported cases down to 22,000 in 1968. But a lack of commitment has allowed this disease to spread to over 75,000 reported cases in 1971.

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