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INFLUENZA. 17
Acute Poliomyelitis.—In contrast with cerebro-spinal meningitis this disease was more
prevalent during 1919-20 than during 1914-18—7 cases (one error) being reported in the two
years as compared with 9 (no reported errors) in the quinquennium. In one of the cases
reported in 1919 the disease began in the country. Five of the 7 cases (1919-20) were males.
Six of the patients received institutional treatment and 5 had some paralysis after "recovery."
There were no fatal cases during the two years, the fatality during the quinquennium being
22.2 per cent.
Encephalitis Lethargica.—Notification of this disease was required from January, 1919.
During the years 1919-20 5 cases (3 in 1919 and 2 in 1920) were notified, all the patients being
females. Both the 1920 cases were "errors." Four patients received institutional treatment
and one died (1919) giving a fatality rate of 33.3 per cent. One death from this disease was
"transferred" to the Borough, the case having been notified in the country.
The Pneumonias.
Since January 1, 1919, notification of pneumonia—both "primary" and "influenzal"—has
been required—an aftermath of the epidemics of influenza of 1917 and 1918.
Influenzal Pneumonia.—In 1919 87 cases were notified—42 among males and 45 among
females—and in 1920, 45—males 28, females 17. The age distribution of the notified cases is
given below in four comprehensive groups.

The numbers reported from each Ward in each year were:—

Institutional treatment.—During the two years 37 of 132 cases—equal to 28.0 per cent.—
were removed, 23 to infirmaries (with 11 deaths) and 14 to hospitals (with 7 deaths). In
addition, 7 patients were removed to nursing homes, of whom 5 died.
Fatality.—Of the 87 cases reported in 1919, 36 proved fatal, and of the 45 reported in
1920, 14. For reasons which will appear later it is useless to calculate any fatality rates
from those figures.
Of the 36 deaths in 1919, 33 were certified as due to influenza (with or without
pneumonia) anri 3 to pneumonias—broncho-pneumonia, 1; "pneumonia," 2. In 1920, 13 out
of the 14 deaths were certified as due to influenza and one to broncho-pneumonia.
Among the 46 patients removed from their homes there were 23 deaths, showing a fatality
of 50 per cent as compared with one of 31.4 per cent, among those (86 patients, 27 deaths) who
remained at home.
It is somewhat unsatisfactory to record that of the 50 fatal cases, 21 (18 in 1919, 3 in
1920) died before notification was effected. Those figures imply that in 42 per cent, of the
fatal cases, no opportunity was afforded of offering any assistance e.g. services of the District
Nurses.
Epidemic Influenza.—Notification of influenzal pneumonia was introduced to serve as
some guide to the prevalence of influenza. In the following figures an attempt has been made
to find out to what extent notification has been successful as such guide.
The deaths from epidemic influenza during 1919 numbered 164 and during 1920, 28.
During 1909-13, the deaths from this cause averaged 37 per annum, the average rising to 102
in the following quinquennium, the maximum for any year since 1909 being 358 (in 1918) and
the minimum 23 (in 1912). On page 18 are set out the sex-age-group and Ward distributions of
deaths from epidemic influenza, which should be contrasted with the corresponding distributions
given under Influenzal Pneumonia (vide supra).