THE AGE INCIDENCE OF POLIOMYELITIS IN CLEVELAND

[摘要] An apparent increase in the number of older children and adults attacked by poliomyelitis has been reported by a number of observers who have compared age distribution data of more recent epidemics (after 1930) with those of the years before 1920. Such reports have come from the northeastern, midwestern, and north central states,1,2,3 from California,4 from Sweden and Australia5 and from Germany.6 Relatively fewer infants and pre-school children have been affected, while the percentile participation of older children and adults has increased. Of course, adults have still remained a minority of patients everywhere.Maxcy7 has questioned the reality of such an age shift for several reasons: (1) the shift may be merely an expression of the changing age distribution of the general population; (2) diagnosis may have become more accurate, especially for abortive forms; (3) selective under-reporting may obscure real conditions.That the epidemiologic pattern of poliomyelitis can be badly distorted by under-reporting was shown by Nelson and Aycock8 in a thorough analysis of the data for Massachusetts. In brief, they found that of 2300 patients who were registered between 1928 and 1941 with the Harvard Commission for Infantile Paralysis for the treatment of paralysis due to poliomyelitis, 23.1% or almost 1 out of 4 were not reported to the authorities at the time of their acute illness, although most of these unreported patients were attended by a physician. The greatest percentages of unreported cases occurred in non-epidemic years, off season months, small towns, and among infants and adults. One-third

[学科分类] 儿科学