City chief administrative officer Thomas J. Heier Jr. Tuesday promised consideration as soon as possible" of recommendations of a special committee aimed at reducing the incidence of syphilis in New Orleans, in which it leads the cities of the nation, according to United States public health service reports.
"As soon as we get time, we are going to get to it,'* Heier said when questioned regarding the committee's recommendations. They included a study of the venereal disease control activities of the city health department by an expert from out of the city.
In a letter dated Aug. 20 to Ivor A. Trapolin, a committee member, Heier wrote that Mayor Victor H. Schiro had referred to him an Aug. 7 letter foy Trapolin to the mayor inquiring as I to what action the city aclmin-i istration was contemplating with regard to the committee's report.
ACTION PROMISED Trapolin wrote that Dr. William Mogabgab, chairman of the committee, had submitted the report to the mayor "some months ago." Committee members include Dr. Mogabgab, Trapolin, an attorney, and-Drs. W. H. Harris Jr., C. C. Haydel, Edward Matthews and Robert Simmons.
"We are presently in the midst of budget preparations and departmental reviews," Heier wrote Trapolin. "The health department will be reviewed at our first opportunity and we will certainly work closely with the committee in regard to the 'V-D clinic.' "Time permits us to do only so much and we ask you to bear with us until such time as we can review the city's entire public health services."
Trapolin said Tuesday that the committee's report was submitted to the mayor by the letter on May 14.
'LIKE LAKE SITUATION'
"This major health problem is1 very much like the situation of the pollution of Lake Pontchar-train," Trapolin said in his Aug. 7 letter to Schiro. "A member of our committee tried to determine from the New Orleans health department the condition of the water at Pontchartrain Beach weeks before the dead fish were found in that area.
"We found that no tests were being made by our health department. Actually, it took the incident of the dead fish to get our health department to test the lake water.
"In the field of infectious syphilis, we have had our incident of being labelled nationally as the 'Syphilis Capital of America.' Surely, strong action is called for by our city officials to combat this major health problem.
"I would appreciate it very much if you would acknowledge receipt of the report by the committee since we are not certain that this actually has come to your attention. Dr. Mogabgab has received no word of your reaction to this committee report and therefore has thought probably it never reached your desk.
RESPONSIBILITY SEEN "The committee's concern about this problem would be greatly relieved if they were informed as to what action is being taken by your office. Meanwhile, if there is anything you wish me to do in connection with this matter, please let me know."
Questioned with regard to the committee's report, Dr. Walter P. Gardiner, city health director, said: "I don't know anything about it"
He added, however, that Dr. Frank R. Gomila, director of the health department's venereal disease control clinic, might be familiar with the contents of the report.
Apprised of the health director's statement, Mayor Schiro asserted: "Dr. Gardiner should know what's ^oing on. It's his responsibility.'j
In its report the committee said, "Most of the information on incidence of syphilis in this area is based on cases appearing at the veneral disease control clinic. This necessarily modified the scope and limited the statistics since most of these patients are Negroes with low incomes.
HIGH INCIDENCE NOTED "Statistical information on incidence of infection in the rest of the population was not adequate and did not include analysis of the contribution of the teen-aged group, homosexuals or patients handled by private physicians. Moreover, very little was determined about the incidence of disease in prostitutes. The latter appears to be the result of lack of study of these individuals, especially the 'amateur'; prostitutes.
"Despite inadequacies of the information available there seemed little doubt that there was a high incidence of syphilis in the community. It did not seem to be pertinent to determine whether the national ranking as the city of highest incidence was accurate, because the problem was sufficiently serious as it stood. Also, various sections of the country have different methods of obtaining data. "There was no clear indication that an aggressive or intensive program had been initiated by the New Orleans health department in response to the increased rate of the disease
However, there were many suggestions that appeared to be based on the fact that venereal disease control was not receiving financial or personnel support. "AMATEUR PROSTITUTES"
"The problem of amateur prostitutes appeared to be an untouched area of investigation. Possibly much of the latter difficulty might be due to inadequacies of legal statutes in dealing with these individuals.
"Information was lacking on the amount of disease being diagnosed and treated by pri-
vate physicians. Possibly many of these cases are not reported. Obviously this prevents contact tracing. It also seemed likely that the practicing physicians might not be completely aware of the. magnitude of the problem."
The committee's recommendations were as follows:
1. A study should be initiated of the VD control activities of the health department by "an expert from another section of the country who should determine adequacy of the program and make compari sons to other cities of equal size. Since this in an integral part of the functions of the health department it might be
necessary to include the whole department in this survey and to determine the degree of unnecessary overlap with functions of state and federal health services." 2. An "intensive program of
education of practicing physicians" into the responsibilities and procedures in reporting and working with VD control personnel of the health department should be initiated by the department and the Orleans Parish Medical Society.
ACTION RECOMMENDED 3. Support and assistance by the United States public health service should be requested.
4. Activities of the police department's vice squad should be increased and closer cooperation should be initiated between it and the VD control officers of the health department and "more vigorous efforts against prostitution should be requested from the city attorney's office, the district attorney and city and state judges."
5. A Study should be made by the city or state health departments or the public health service "to determine accurately the incidence of infectious syphilis in various socio-economic groups" as "especially desirable to prevent further spread of the disease to teen-aged children and other unsuspecting seg-
ments of the population."
6. "That any expenditure of funds be considered a sound investment since treatment of the late complications of syphilis is far more expensive."
According to United States public health service reports, during the fiscal year ending June 30, 1962, there were 642 cases of early syphilis reported in New Orleans for an average
for an average of 101.6 per 100,000 population. This was, a lower figure in number of cases and case rate than in the pre-
ceding fiscal pear, but still left New Orleans at the top of the list among the nation's cities. In the fiscal year ending June 30, 1961, New Orleans had 770 cases reported for a case rate of 126.6.
