Recent studies1 on the geographic distribution of rheumatic fever in the United States have shown that the incidence of the disease is greater in the northern than in the southern regions of the country. Owing to the fact that rheumatic fever is not a reportable disease, it is necessary to utilize hospital records or mortality statistics to obtain information regarding its frequency. Therefore Harrison and Levine studied hospital admission rates for rheumatic fever in a number of cities in the Northern and Southern states and found that "rheumatic fever and rheumatic heart disease are much more common in Boston than in Richmond, Oklahoma City, New Orleans and Galveston. Baltimore and St. Louis occupy intermediate points." Faulkner and White, in their studies, have investigated hospital reports from different parts of the world. They state that their observations "are valuable chiefly in showing what wide differences do exist in different parts,
SEEGAL D, SEEGAL BC. STUDIES IN THE EPIDEMIOLOGY OF RHEUMATIC FEVER: ANNUAL INCIDENCE IN SOME HOSPITALS IN THE UNITED STATES, ITS POSSESSIONS, AND CANADA. JAMA. 1927;89(1):11–17. doi:10.1001/jama.1927.02690010011004
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