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116
During the five years under survey, 62 cases of the enteric
group of fevers were notified, compared with 212 in the quinquennium
1901-1905.
PNEUMONIA.
All acute primary pneumonias are notifiable, but no acute
secondary pneumonias except influenzal are notifiable. During
the year 277 notifications were received, of which 40 were
influenzal. 97 deaths occurred from primary pneumonia and
13 from influenzal pneumonia.
The objects of notification are twofold: (1) to enable
methods of controlling the disease to be put into action;
and (2) to collect data from whch measures of control can be
deduced. The Regulations have now been in operation for
over six years, and it may be that the time is now opportune
to consider how far they have been effective. If we examine
the figures published in the Annual Report of the Medical
Officer of Health for London for the year 1924, we find that
in London County in that year there was a notification rate
of 147 per 1,000 and a death rate of 1.16 per 1,000, giving a
case mortality rate of 79 per cent., a figure which every
practising physician knows is ridiculous. Examined in detail
the figures are even more interesting, for in fourteen London
boroughs the death rates exceed the notification rates.
Similarly, in England and Wales, we find that for the year
1924, 60,723 cases were notified and 38,970 deaths occurred.
As it is generally accepted that the case mortality rate of
pneumonias is somewhere between 20 and 30 per cent., it
is obvious that many cases of pneumonia escape notification.
In this way we see that methods of controlling the disease
can only be put into action in a limited sort of way and the
data which is being collected is inadequate and unreliable.