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|¿ilminoque quosynon në DWTIMODO SVASİ ÇARE KOKAo sibareqa ZALI DUENDA n04 Lig40 30 ĐÁ BÁT Ta cho ai đi int xoài sót 1 mly nà BEST STRİNysáva mort azognorang 2a abrimosodt ham bizow edit at

through annually. He epidemics, however, were known until this

outbreak.

During January 1918, increased numbers of cases vore reported at the mortuary but no sotual, diagnosis of epidemio meningitis was made until February 9th, 1918. As I have already stated, the assumption that the epidemic started at least a month before this time seems to be well grounded. During the rest of February the cases were increasing in number (six to eighteen ware reported daily). During Harch there were as a

rule ten to twenty-four oases per dien reported; during April,

six to fifteen; during Hay, three to seven and during early June the average number was about three. The epidemio started in

January, reached its height March, and declined gradually in

April, reaching its low level in June.

b. The number of cases and the mortality. Up to June 1st, 1918 there were 1041 patients reported. Of these only four were

Suropean. The 1037 cases include, with the exception of a few

Portuguese, Chinese exclusively. For the purposes of epidemio-

logical study the Portuguese and Chinese are grouped together

on the basis that the former although living apart from the

natives exist under very arowded conditions. This number, 1041,

does not represent the actual number of cases, Hany of the

patients were "missed", On secount of the mildness of the

disease in many individuals, the diagnosia may have been over-

looked. On the other hand, many Chinese who sought rekatizes

native healers and subsequently recovered were never placed on

record. The actual number is undoubtedly much greater but it is

impossible to approximate the figures.

+

Therefore the total mortality which is computed at 76.1

per cent for the first 1000 cases, does not represent the actúad

mortality, which, of course, would lowered in view of the number

of missed cases.

The influence of age and sex. From the Tung Wah Hoapi tal

(84)

(13)

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