PNEUMONIA IN A NAVAJO COMMUNITY - 2 YEAR EXPERIENCE

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Abstract
This report describes surveillance of pneumonia in an entire community during a 2-yr interval. The study, which was performed on the Navajo reservation, included those who sought care for defined clinical manifestations and who showed pulmonary infiltrate(s) on roentgenographic examination. Approximately 10 bouts of pneumonia/1000 persons required hospitalization, and an equal number were treated at home each year. Rates were highest at the extremes of age and were higher among males. Multiple attacks were observed in 14.5% of infants and children and in 7.6% of adults. Most illnesses were associated with pneumococci. The proportions of these illnesses were smaller among hospitalized children than among adults. Pneumococcal bacteremia was uncommon in infants and children. Most pneumococcal serotypes isolated are included in currently proposed antipneumococcal vaccines. The 2-yr case fatality rate was 2.2%. None of those who died were previously well. Factors associated with multiple occurrences need further study. Efforts at prevention should be directed to life''s extremes, especially to those already infirm.