The following alphabetical list details the major epidemiological sources for the countries of the world in which our 100 cities are located (see tables 3.3 and 3.4). Within each country, the material is arranged under three headings: (a) sources of morbidity data, (b) sources of mortality data, and (c) sources of population data. Information is listed under the current (1995) names and jurisdictions of the respective countries. Where necessary, these are cross-referenced with the 1888–1912 names and jurisdictions indicated in tables 3.3 and 3.4.

The countries listed fall in one of six World Health Organization regions, viz. (a) European Region, (b) Eastern Mediterranean Region, (c) South East Asian Region, (d) Western Pacific Region, (e) African Region, and (f) American Region. Readers should refer to the WHO Regional Offices or to the national epidemiological agencies whose addresses are given in appendix D for recent changes.

AUSTRALIA. Commonwealth of Australia. WHO Western Pacific Region (WPR). Area: 2,974,581 miles. Population: 18.3 million (1995). European colonisation from late eighteenth century with the six colonies federated into the Commonwealth of Australia from 1901. (a) Sources of morbidity data: Reported cases of notifiable infectious diseases are regularly reported in: Notification Diseases Report (weekly); Communicable Diseases Intelligence (fortnightly). Annual information on the incidence and immunisation coverage of eight vaccine-preventable diseases (diphtheria, measles, pertussis, poliomyelitis, tetanus, neonatal tetanus, tuberculosis, and yellow fever) from 1974 is given in the Information System Summary Volume, WHO Western Pacific Region (WHO, Expanded Programme on Immunization (EPI), Geneva, annual), (b) Sources of mortality data: Standardised mortality tables giving 178 causes of death for males and females are given for Australia by quinquennial periods for the period 1906 to 1975 in International Mortality Statistics (Alderson, 1981, tabs. 1–178, pp. 113–477).

These appendices are intended as a guide to the main sources of commentary and of epidemiological and demographic data for the countries whose cities have been analysed in this book. The work described in chapters 2–6 has been based upon data published in the United States's Weekly Abstract, 1888–1912, cross-checked against selected records of the United Kingdom's registrar general. Accordingly, appendix A lists in detail these primary sources of information. For completeness, the relevant sources are outlined for the entire life of the foreign city tables, 1878–1912.

But we have examined material in detail for only a relatively brief window of time from 1888 to 1912. Accordingly, the sources listed in appendices B–D cover both earlier source material and run through to the present day. Appendix B deals with international sources and appendix C with national sources. Names and addresses of international and national epidemiological agencies responsible for collecting and publishing disease data at these levels appear in appendix D. We do not claim to have been exhaustive in our coverage. Whilst we hope we have captured the most important sources, readers will be able to complement our lists from their own knowledge, and we would be pleased to receive details of such additions.

The public health community can trace its roots to fourteenth-century Italy, when fear of the Black Death prompted the government of Venice to exclude from their ports those ships with persons reported to have pneumonic plague. More recent epidemics of acquired immunodeficiency syndrome, vaccine-preventable diseases, and drug-resistant conditions pose imminent threats. The public health approach to such problems is fourfold: (1) define the problem; (2) identify risk factors; (3) develop and test prevention strategies; and (4) implement prevention programmes. Disease eradication, the ultimate disease control measure, is simple in concept (focusing on a single unequivocal outcome), but extraordinarily difficult in implementation.

Public health uses the sciences of geography and statistics, as well as epidemiology, the laboratory, and the behavioural and social sciences, to detect health problems in communities of people and to intervene and prevent further illness, disability, and premature death. Variations in the usual incidence of health events in different geographical areas or in different time periods may provide important clues to the aetiology of the disease or to specific risk factors for the event. A foundation of the science of epidemiology is a study of the departure of observed disease experience from the expected occurrence.

Public health surveillance provides much of the data needed for modern public health. The term surveillance is derived from the French word meaning ‘to watch over’ and, as applied to public health, means the close monitoring of the occurrence of selected health events in the population.

One of the most familiar journals in the epidemiological world is the Morbidity and Mortality Weekly Report. Universally abbreviated as the MMWR, it lands on many thousands of desks early each week with clockwork regularity (or increasingly is drawn down through an electronic web). Published by the Epidemiology Program Office of the United States Centers for Disease Control and Prevention in Atlanta, it contains a mix of invaluable information on the distribution of epidemics and plagues around the world, advice about new vaccines or protective devices, the eruption of a new influenza strain here, an outbreak of Oropouche fever there.

At its heart lie a series of tables that record the data returned by the state epidemiologist for each of the states and territories of the United States on the numbers of reported cases of fifty-two notifiable diseases. To provide perspective, the data for the current week are compared with the cumulative totals for both the current and the preceding years. The morbidity tables are supplemented by a mortality table that gives, for 121 of its great cities, from Boston to Washington, DC, the pattern of pneumonia and influenza deaths reported for the current week.

The MMWR is valued for its timeliness and its immediacy. As with a weather bulletin, the main interest is in the most recent readings and what they presage for the weeks and months ahead. Will a new influenza strain be sweeping the world?

The systematic international recording of information about mortality and morbidity from disease begins with the Health Section of the League of Nations established in the aftermath of the Great War. To promote comparability of recording between nations, the International Classification of Diseases (ICD) has been developed. The origins of this classification system are discussed in Benjamin (1968, pp. 8–86). The first edition of the ICD list was prepared by the International Statistical Institute, and it appeared in 1911 under the title International List of Causes of Death. Revisions have appeared roughly decennially to keep abreast of advances in medical science. The tenth edition (1992) is currently used. Initially, the list formed a basis for the recording of mortality data alone, but it was extended to cover morbidity from 1948 when responsibility for revision of the list was passed from the International Statistical Institute to the World Health Organization. From that date, the ICD list has been entitled International Statistical Classification of Disease, Injuries, and Causes of Death.

The following list gives the major sources of international epidemiological data and associated information. It is arranged historically.

League of Nations

The first meeting of the Health Committee of the Health Section of the League of Nations took place in August 1921 to consider ‘the question of organising means of more rapid interchange of epidemiological information’. To meet this need, a series of publications were instituted and are described below.

United States marine hospital service/public health service

Weekly Abstract

The National Quarantine Act of 1878 granted the US Marine Hospital Service, forerunner of the US Public Health Service, powers of quarantine against vessels from infected ports overseas. As described in chapter 2, the Service prepared weekly abstracts of sanitary reports received from foreign locations to assist in the exercise of the quarantine powers, and these were begun as Bulletins of the Public Health in 1878. The publication was subsequently renamed twice, first in 1887 (Weekly Abstract of Sanitary Reports) and then in 1896 (Public Health Reports), and it was to remain a principal weekly source of international (and domestic) morbidity and mortality statistics until 1912. Thereafter, international statistics continued in reduced form until 1951. In these appendices, all general references to the publication under its various aliases are as the Weekly Abstract.

The structure and content of the Weekly Abstract is outlined in chapter 2. In brief, a typical edition from the turn of the century was divided into two parts along geographical lines: United States; and Foreign and Insular. Each section was further divided into tabular and written reports. United States section: This consisted of tabulated statistics of: immigration at major ports during the week; the transactions of national, state, and municipal quarantine and inspection stations; reports of cases and deaths from quarantine diseases by state and county; estimated population and deaths from all causes, and selected infectious diseases (cholera, diphtheria, enteric fever, measles, scarlet fever, smallpox, tuberculosis, typhus fever, variola, yellow fever, and whooping cough) by city; and meteorological conditions for major cities.