154 N. J. Mosquito Extermination Association 



state in which the Anopheles mosquito is known to breed, but which 

 have been comparatively free from malaria in recent years. This 

 has already occurred to some extent in other diseases and is quite 

 likely to occur with respect to carriers of the malaria parasite. If 

 it does, New Jersey's malaria rate may reasonably be expected to 

 show a marked rise in the near future, unless local health officials 

 become more active in performing the duties imposed upon them 

 by the law ; duties which include requiring physicians to report 

 cases and to enforce accepted modern methods against the spread 

 of this disease. Taking cognizance of this danger, might not county 

 mosquito commissions well consider the advisability of giving more 

 atttention to the extermination of Anopheles than has been given 

 heretofore? Members of the association should at least impress 

 upon the minds of local health districts which they represent the 

 necessity of using every legitimate means of bringing about more 

 trustworthy morbidity and mortality statistics on malaria. 



Mr. Bowen : If I can elucidate that rather simple chart, of 

 course there is no rhyme or reason to it, why, for instance, 

 Hudson County should have a twenty-five per cent, death rate in 

 malaria. It simply means that the reporting is poor. Now if their 

 death returns in the cases of death give the death returns as correct 

 there must be some malaria in Hudson County. 



Mr. Hull : Don't you believe that with a county like Hudson 

 there are many cases of malaria that the physician never sees until 

 perhaps the fatal day, if there is a fatal day? 



Mr. Bowen : No doubt many, but if they have twenty-five per 

 cent, of deaths in that period there are many hundreds that he never 

 says anything about. 



Dr. Lipman : How about the cases that are brought in? Hud- 

 son County has a large floating population and I dare say in quite 

 a number of those cases the disease does not originate in Hudson 

 County, though the man dies in Hudson County. 



Mr. Bowen : In the Bureau of Local Health administration, that 

 handles morbidity reports, they also receive from the Registrar of 

 Vital Statistics Office deaths from reportable diseases. In making 

 those charges we exclude cases that do not belong to the municipality 

 fairly. That is, if a man comes in there with an infection from 

 which he dies, we do not charge it to that county, because he did 

 not contract it there. On the other hand, if he has been there long 

 enough to have contracted an infection, that is, the incubation period 



