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death rate is frequently a measure of the extent of infection. We
may ask why the local death rates were so comparatively low in
the years 1924 and 1927. Much discussion has centred round the
question whether an attack of influenza gives immunity to later
infection, and a commonly accepted view is that it may do so—but
only for a short period. In the period 1916-1920, and again in the
year 1922 this area suffered more severely from influenza than did
the country as a whole. There is perhaps a suggestion here that
the immunizing effect was of a more prolonged character, and that
this accounted for the comparatively low local rates in the succeeding
epidemic years.
Throughout this tabulated history of influenza males have
invariably had a higher death rate than females, but in West Ham
in the period 1916-1925 the opposite was the case.
The behaviour of influenza resembles that of several other
infectious diseases which affect primarily the throat or the respiratory
passages. Even the most enlightened community can do little
to prevent the introduction of a new strain of the virus into its
midst, with consequences which on a smaller scale resemble the
catastrophe which ensues when a new disease finds its way into
virgin soil.
PNEUMONIA.
The number of notifications of acute pneumonia—primary
and influenzal—which were received during 1937 was 354, of
which 209 were in respect of males and 145 of females. The case
rate was 1.36 per 1,000 living. The corresponding number of
cases in the years 1934, 1935, and .1936 were 453, 290 and 320
respectively, and the case rates for these years were 1.64, 1.07, and
1.20. Of the 354 cases, the number removed to hospital was 157.
This gives a removal rate of 44.35 per cent.
The distribution of these cases by season, age, and wards
is given in Tables I.—III. inclusive. Almost half the cases
occurred in the first quarter of the year, and after that the second
and fourth quarters were almost equally affected. It should be
noted that the number of cases in the first four weeks of the year
were so large as to constitute epidemic prevalence in these weeks.
The percentage of the cases which occurred in the age groups
under 5, 5—15, 15—25, 25—45, and over 45 years, were 24.9,
14.4, 11.3, 22.3, and 27.1 respectively.
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