150 N. J. Mosquito Extermination Association 



and, when no physician is in attendance, the householder to report 

 cases of malaria. To what extent the law and regulations of the 

 state sanitary code insofar as they relate to malaria have been 

 obeyed by physicians, and to what degree enforced by local health 

 ofificials is, in a measure at least, reflected in morbidity and mortality 

 reports from this disease during the past nine years, 1912 to 1920, 

 inclusive. 



The accompanying table showing the number of cases of malaria 

 reported to the state department of health from * each county 

 in this state, and the number of deaths decorded is due to malaria 

 in each of these counties, from 1912 to 1920 inclusive. A superficial 

 examination of this table is sufficient to show that cases of malaria 

 are poorly reported in New Jersey or that the diagnosis has been 

 erroneous in the case of many deaths attributed to this disease. In 

 all probability, both are true. Therefore, in presenting this tabula- 

 tion, no claim is made that it presents a true picture of the malaria 

 situation in New Jersey for the years which it represents. The 

 tabulation is, however, correct in respect to the number of cases and 

 deaths officially reported and shows : 



1. A substantial diminution in the number of both cases and 

 deaths from this disease since the first year case reports were oblig- 

 atory. 



2. That the case rate has been relatively higher in some counties 

 than in others. 



3. That there has been an excessively high indicated fatality rate 

 in certain counties. 



In regard to the first deduction, i. e., that malaria has been grow- 

 ing less prevalent, particularly since 1914, it should be stated that 

 •this reduction may be more apparent than real. That this is true 

 in some localities has been shown quite conclusively by surveys and 

 special investigations conducted by the state department of health 

 from time to time during the period over which the table extends. 

 It will be noted that one hundred nineteen cases of malaria have 

 been reported from Middlesex County during the past nine years, 

 with two deaths. According to the federal census, the population 

 of this county in 1920 was 162,334. An investigation made during 

 the fall of 1920 in one of the largest municipalities in the county, 

 in which the population is about 32,000 brought out the fact that 

 malara had been unduly prevalent there during the summer and 

 fall for at least two years past. Estimates based on reliable informa- 

 tion placed the number of cases treated by local physicians during 



