A STUDY OF PNEUMONIA IN A RURAL AREA IN SOUTHERN ALABAMA

1. Pneumococcus Type IV of low virulence was the prevailing organism in fifty-eight cases of pneumonia studied in southern Alabama. Fixed types of pneumococci were not common. 2. Pneumoma was more prevalent in children from 5 to 15 years of age than in adults. As a rule, the disease ran a mild course. 3. Most of the cases of pneumonia gave a definite history of an acute cold antedating the attack of pneumonia by a period of 5 to 8 days. Exposure alone did not seem to predispose to pneumonia, but those with an acute cold who were exposed to chilling of the body surface frequently developed pneumonia. 4. There were seven "family epidemics" of pneumonia. In each instance there was a family epidemic of colds antedating the pneumonia. The pneumococcus was found in large numbers in the nasopharynx of those suffering from colds as well as in the pneumonia patients. 5. The epidemiology of pneumonia in the pioneer days of American history has many points in common with the epidemiology of pneumonia in a rural isolated area in southern Alabama today. This suggests that the crowded conditions and frequent contacts of modern city life have built up a community resistance to avirulent strains of pneumococci.