Poliomyelitis : a survey of the outbreak in Scotland in 1947.

Date:
1950
Catalogue details

Licence: Public Domain Mark

Credit: Poliomyelitis : a survey of the outbreak in Scotland in 1947. Source: Wellcome Collection.

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    selection of notified cases for entry in the summary cards, the exception being an urban area with 0-8 per cent. of the Scottish population, for which cards were not returned for cases finally diagnosed as “ not poliomyelitis.” It can be stated that this omission did not seriously affect the characteristic of the “ not polio- myelitis ” group. (d) Deaths. Of the 2,002 notified cases, 162 (8-09 per cent.) were fatal. Fatality rates will be discussed in detail in later sections. Here it may suffice to state that figures of deaths in a special survey of this nature do not necessarily tally completely with the official figures to be published in the Annual Report of the Registrar-General (Scotland) for 1947. According to the Quarterly Returns of the Registrar-General, 123 deaths were certified as from poliomyelitis in Scotland in the second half of 1947; the figure is almost identical with that given in the present survey for accepted cases (i.e. 122). 3. TYPES OF ILLNESS (a) General. The five types of illness included in the survey are given in section 13 (Final Diagnosis) of Appendix I. It was expected that types ii and i respectively. ‘They have therefore been grouped in all tables with type iv, so that three principal groups of final diagnosis have remained—poliomyelitis without paralysis, poliomyelitis with paralysis and “‘ not poliomyelitis.’ The numerical relationships between the groups are of some importance. Of all cases in the present survey, 31-3 per cent. did not have poliomyelitis. Of all cases accepted as poliomyelitis, 23-9 per cent. did not have paralysis. These facts will be com- The “ not poliomyelitis’ group is important, consisting as it did of 626 patients whose clinical condition so closely simulated poliomyelitis that they had been notified as suffering from the disease. ‘They provided a comparison group, the characteristics of which have been contrasted with those of the two polio- myelitis groups. ‘The “ not poliomyelitis ’ group included patients with severe and sometimes fatal illnesses ; a summarisation of the final diagnoses and outcomes of the illnesses is given in Table 3. The 40 deaths provided a fatality rate of 6:39 per cent. at all ages. _ (6) Type of illness and fatality rate. The group of 1,047 patients with paralytic poliomyelitis suffered 118 deaths (11-27 per cent.) ; while of 329 patients with non-paralytic poliomyelitis 4 died (1-22 per cent.). This profound difference in fatality rates, apart from other differences which will be found in later sections of this survey, was enough to make it imperative, in later tables, to continue to distinguish between these two forms of the disease. 4. AGE (a) Age and type of illness. The age distributions of the three main types of illness under consideration were most significantly dissimilar. To begin with the ‘“ not poliomyelitis ” group, it contained a highly significant excess of adults. Comparisons of the age distributions of the two forms of accepted poliomyelitis showed that the highly significant differences were in the main due to there being relatively too many paralytic cases at ages under 6 and relatively too few at ages between 6 and 30. The proportions were fairly stable at ages over 30. These differences in age distributions have provided another reason—if one were needed— for continuing the distinction between the three groups throughout the survey.