The Columbus dispatch. (Columbus, Miss.) 19??-1922, 1919-10-26

marked and so general Throughout the
United States as to point very clearly
to definite relation. Everything in
dcates that the increased mortality
from pneumonia in March and April
Of 1918 was the consequence Of be-
ginning and largely unuoticed epi-
dcmic which developed in the autumn
Of that year,
In the British cities The epiiemie
ma ifestcd three distinct waves the
first and slightest in point Of mortal
+ ity occurring in June and July, the
second and most severe iH November
the third in February and March
Data which need not be citel here in
detail indicate that the course Of the
epidemic in western Europe general
/ ly was similar. In cities Of India
/ the sequence was similar bat the NOR
tally far greater. In the United
/ States the epidemic developed more
/ largely in a single wave during Sep
tcmlcr. October and November. II
however, the epidemica already men
toned as occurring in the spring be
considered the first phase and the
explosive outbreak Of the aatlmu the
second, third phase Of Troublesome
is quite evident in many eases. IN
general, this winter re erudesseace was
less marked in these cities which suf-
fcred most severely in the autumn
epidemic.
The prevalence OF a serious epldem-
ic Of influenza was first re .og lied IL
and around Boston in September Of
1918. Within about two weeks il was
general in the Atlantic Seabord, de-
veloping little later among cities
further west Rural districts were
unusually attacked somewhat later
than large cities in the same sectors.
In the cities east Of the line Of the
Appalachians the excess mortality
from pneumonia and Influenza during
the weeks ended September II, 1918
to March /, 1919, was approximately
SO per l,00oA in cities between the
Rocky mountains and the Appalach
lars, 1875; and in those Of the Pacific
coast, 5,55 per 1000
Notwithstanding this general geo.
graph, relation, there are notably
wide difference in the mortality rates
Of the individual cities in the same
together. differences which ap not IS
yet explained on the basis Of climate
density of population, character G
preventative measures exercised,
any other determined enyironmcntal
More details can be given only the
brefcst mention here In order 70 Sc
cure reliable statistics Of mortality
the Public Health Service has made
special house house surveys in
number of localities, ns-ertaning the
number of persons affected, the
dates Of onset and a few other simple
facts in accurately enumerated groups
representative of the general popu-
lation. Partial analysis Of TIE results
Of these surveys in eight localities
giving an aggregate Of 1929 per-
sons canvassel shows the following
as the chieft facts of interest;
The percentage cf the population
attacked varied from is per cent IN
Louisville to 533 per cent in San An
tonic, Texas. the aggregate for the
whole group being about Is per cert.
This agrees with scattered observa-
tions in the first phase Of the 18S9-90
epidemic, when the attack rate seems
to have varied within about these
limits
The case incidence was found to be
uniformly highest in childreu from
lower in each higher age group. 1t
was slightly higher in females than in
males Of corresponding age; usually
higher in white men than the colored
population.
The ratio Of pneumonia cases to
total population varied from 5.3 per
thoussiid in Spartanburg, S. c., to
24,G per 1000 in the smaller towns of
Maryland Thr pneumonia rate show
ed little correlation with the Influenza
attack rate.
The ration of deaths to population
varied from 10 per LOCO in Spartan
burg to 6.8 in Maryland towns. The
death rate was by no mems parallel
to the influenza attack rate. but was
closes correlated with the pneumonia
rate. In other words the case fatality
Of pneumonia seems to be fairly con
slant, around 30 per cent. The death
rated was notably high in chill lren un-
der che year old, in adults from 20 to
40 and in persons over so; higher in
males than in females Of comp -able
ages; higher among the whites than
the colored
Concerning the impOrtart question