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21
1929
registered as due to Influenza, yet a large number of the deaths
from Bronchitis and Pneumonia were directly or indirectly caused
by the Influenza epidemic which occurred in the spring of the year.
It has been explained in former reports that the altered age
distribution of the population will tend towards a higher death-rate,
but this factor will produce a steady, but hardly perceptible rise.
Last year the sharp rise was chiefly due to the outbreak of Influenza
which occured in the first quarter. The epidemic was the
most serious experienced since the pandemic of 1918-1919 and
made its appearance in London about the end of January, the
maximum death-rate being reached about the middle of February.
Throughout the months of November and December, 1928, the
Registrar General's returns gave no cause to anticipate the advent
of a severe epidemic of Influenza. It will be remembered that in
the Annual report of 1928, I remarked upon the favourable statistics
for the fourth quarter and especially the very low infantile mortality.
But there was disquieting news from America, and it is
surmised in some quarters that the disease was imported from that
country. The mode of transmission of Influenza is necessarily
inferential, but there is no mystery about it and it follows the
normal laws of an ordinary infectious disease. The rapidity,
though, with which epidemic influenza travels and the large number
of persons attacked within a short period gave rise to early conjecture
that the disease was borne by the wind, or at least that it was
dependent on general atmospheric or even cosmic conditions which
affected nearly simultaneously large masses of people. Others have
called Influenza a blast from the stars. These beliefs have died
nard, and there are still to-day observers who maintain that the
occurrence of widespread and mysterious flutcuations in susceptibility
furnish and adequate explanation for the rise of pandemics.
Modern students of Influenza, however, regard Influenza as
a typical infectious disease due to a living, if yet unknown microorganism.
Whatever the origin of pandemics, whatever the possible
predisposing effect of ocscure factors, there need be no hesitation
in accepting the fact that Influenza is a germ disease spread largely
if not wholly, by human agency There is no evidence that water
or milk ever serves as a vehicle of infection, or that the virus
resists drying for a considerable period and is transmitted In dust.
While no precise information exists as to the relative importance
of active cases, convalescent cases or healthy carriers, in spreading
infection, there is reason to believe that persons suffering from the
disease in its early stages are particularly likely to convey the
infection to others.
It cannot be said that the epidemic took the authorities
unawares. The disquieting news from America made it desirable
for the Ministry of Health to draw the attention of local sanitary