WINTER EPIDEMICS

Evening Post, Volume CXII, Issue 58, 6 September 1926, Page 10

WINTER EPIDEMICS

WHOOPING COUGH AND

INFLUENZA

OFFICIAL FIGURES AND MEDI-

CAL COMMENT

WIDER REVIEW DESIRABLE.

During the recent influenza epi•demic there has been a tendency to overlook the fact that there has been a smaller but in its way an equally severe epidemic of whoop-ing-cough, as shown in an article by Mr. J. W. Butcher, ActingGovernment Statistician, in this month's "Monthly Abstract of Statistics." The number of doaths from whoop-ing-cough registered in the fourteen urban areas during the month of July was 20, a figure considerably in advance of the usual monthly total recorded, 'states the Acting-Government j Statistician. This is an exceedingly unusual occurrence, as the experience of past years has been that the greatest number of deaths from whoopingcough occur during the summer months of October to March. During the previous quinquennium, only four deaths from this disease were registered in July, two of these being in 1922 and two in 1924. A general conception of the importance and magnitude of the present outbreak of whooping-cough may be gathered from a survey of a j table, whifeh shows the number of ! deaths from the disease in the urban areas for every month from January, 1921, to July, 1926. The table shows that for the seven months ending 31st July, 1926, there were 42 deaths from whooping-cough in the fourteen urban areas, as compared with 13 deaths for the whole of the year 1925. The deaths for July, 1926, were equally divided between the two sexes, males and females contributing ten each. All of the deaths were of children under ten years of age, while nine were of infants under one year of age. The outbreak appears to be largely confined to Christchurch, no fewer than 16 out of the total of 20 deaths being recorded for Christchurch urban area. It is interesting to note that all of the deaths from whooping-cough were associated with some disease of the respiratory system. Broncho-pneu-monia was the complicating cause of death in thirteen cases, bronchitis in five cases, and pneumonia in two.

INFLUENZA.

In view of the slight epidemic of influenza which has been prevalent in the Dominion during the last few months, a review of the position is interesting. The outbreak appears to have commenced in June, there being eight deaths from influenza recorded in the fourteen' urban areas for that month. A rapid advance occurred the following month, the total' number of deaths for July reaching 65. This latter number compares very unfavourably with the experience of' the past five years, approximating as it does the total recorded for the month of July, 1923, which was the year of I the last epidemic. Thirty-one of the deaths registered during July, 1926 were of males and 34 of females. The number of deaths from influenza in the fourteen urban areas during the five years 1922-26 was. as follows:— 1922, 2; 1923, 82; 1924, 8; 1925, 5; 1926, 65. Wellington urban area appears to have been the origin of the outbreak, no fewer than seven of the total of oight deaths in urban areas during June being recorded therein. Christchurch, however, as in the case of whooping-cough, thereafter suffered most, the number of deaths from influenza recorded within this urban area for July being 29, or nearly 45 per cent, of the total. AVellington _ and _ Auckland were next in numerical importance, with totals of 12 and 9 deaths respectively. A comparison of the distribution of deaths from influenza over the Dominion in recent years shows that in normal circumstances Auckland urban area has predominated, Mjjiile in times of epidemic the districts in the South Island, appear to be chiefly affected. Of'the total of 65 deaths for July, 1926, pneumonia was specified as a complicating cause in 34 cases, bronchitis in nine cases, bronco-pneumonia in three, and other diseases of the respiratory system in three cases. Influenza lessens the resistive power to other diseases, death frequently being hastened by it in the case of persons already suffering from degenerative diseases in particular. The' total number of deaths from influenza recorded for July would be greatly augmented wero the number of eases included in which this disease was itsetf a contributory cause. The diseases with which it was chiefly associated were heart disease in ten cases, chronic nephritis in six, cerebral hemorrhage in four, and other diseases in six cases.

FACTS FROM MEDICAL INFORMANTS.

Inquiries made show that the Department of Health is aware that the Dominion is experiencing an epidemic of whooping-cough this year,* the last epidemic having occurred in 1920. The cities of Christchurch and Wellington particularly have suffered in this respect. The disease is not one which is notifiable by medical practitioners* to the Health Department, the experience in all countries having shown that owing to the fact that a large number of the patients suffer from an ordinary cough before the whoop establishes itself. This so limits the notifications that for practical purposes notification has been regarded as of very little value. Parents will be well advised, adds tho Department, when they knbw that a child is suffering from whoop-ing-cough, to keep young and susceptible children away from such patients.

FACTORS TO BE CONSIDERED.

Tho summary prepared by 'the Act-ing-Government Statistician with respect to the influenza epidemic is regarded by the Department of Health as being a useful and interesting one; but, since it includes only 14 urban areas, is confined to a very short period, and deals with influenza only as causing death from acute pneumonic symptoms—not taking into account pneumonia, broncho-pneumonia, ' and bronchitis deaths, a number of which occurring in the period June to August were undoubtedly of influenzal origin —the summary while useful does' not estimate fully what has been the effect upon tho Dominion of the recent influenza epidemic. There is no. doubt when tho Government Statistician in a few months prepares his vital statistics for the whole Dominion, it will be possible 'by comparing the number of deaths from all acute pneumonic causes which occurred during this winter with normal years and with .the years 1920 and 1923, which wero influenza years, an exact statement can be given as to the severity of the epidemic this year. It may bo mentioned that tho year 1920, like 1926, showed a great increase in the number of deaths from whooping-cough, influenza, pneumonia, broncho-pneumonia, and bronchitis, the latter being undoubtedly due in large measure to influenza as a primary cause.