. Fièvre typhoïde; sa causalité, sa transmission et sa prévention . la stribution. Les lignes pour le taux de mortalité par âge et le taux de cas (taux d'attaque) sont fondées sur des données inadaptées et doivent être considérées comme simplement indicatives. Une étude plus approfondie de ce sujet pourrait s'avérer très instructive. Le fait que si peu d'enfants meurent de la fièvre typhoïde,alors, ne montre pas que la maladie n'est pas acquise à cet âge. Il y a sans doute beaucoup plus de cas de marche chez les enfants que chez les adultes. Cette aide explique pourquoi les enfants sont un facteur si important dans la propagation de la maladie. Les nourrissons et les très jeunes enfants sont en g

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. Typhoid fever; its causation, transmission and prevention . stribution. The lines for percent-age fatality and case-rate (rate of attack) are based oninadequate data and are to be regarded merely asillustrative. A further study of this subject wouldprove very instructive. The fact that so few children die of typhoid fever, then, does not show that the disease is not acquired atthat age. There are doubtless many more walkingcases among children than among adults. This helpsto explain why children are such an important factorin the spread of the disease. Infants and very young children are in general lessexposed to typhoid infection than persons in middle life;their diet is much simpler, and their environment ismore limited. Yet typhoid fever is by no means DISTRIBUTION OF TYPHOID FEVER. 107 unknown among the very young, as the diagramshows, and physicians are coming to believe that itis more prevalent than has been generally supposed, many cases in the past having been set aside merelyas infantile diarrhea, summer complaint, and other dis- COO 40. Fig. s.Diagram Illustrating the Age Distribution of Typhoid Fever. eases of an indefinite character. It is at the age whenyoung men and women come to maturity, and whenthey are likely to change their environment in manyways, that there is a sudden increase in the typhoiddeath-rate. Between the ages of 20 and 25 it reaches itshighest point. It then declines gradually until aboutthe age of fifty, after which it remains nearly constant io8 TYPHOID FEVER. until the age of 75, when it drops again to the same rateas that of infancy. How much these changes are due to relative suscepti-bility at different ages, how much to acquired immunityand how much to environment, cannot be told. All ofthese factors are probably involved, but it is quite aslikely that the maximum number of typhoid deaths atthe age of about 25 years results from certain mathe-matical relations of the curves for age distribution ofpopulation, percentage fatality,

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