Tuberklarnir í Føroyum í 19. og 20. øld Eitt yvirlit

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Published Jan 1, 1956
Hans Debes Joensen

Abstract

The present study sets out to evaluate critically the incidence of tuberculosis in the Faroes in the 19th and 20th centuries on the basis of the literature available, the evidence contained in death certificates (introduced in 1879) and in notifications of new cases of tuberculous infection in lungs and larynx (in use since 1899). Concerning the information set out in the death certificates, however, we can show by reference to the special studies by Boeg (1902) and Rasmussen (1931 a) that the figure in the offical return for the period 1879-99 (Table 2) must be raised by about 10°/o, and for the period 1899 til some time into the twenties by about 33°/o. From shortly before 1930 death certis ficates appear to cover all cases of death from (with) tuberculous infection. The official notifications of new cases for the period 1899—1930 must be regarded as quite unreliable. But since 1930 the figures seem to be more trustworthy and, on the whole, appear to give a good picture of the incidence of tuberculosis. As a point of contrast with practice in other countries it should, however, be noted that during the past 20 years in the Faroes many of the earliest manifestations of tubcrculosis (especially initial fever) have been included in the returns; these are hardly recorded to the same extent in the tuberculosis statis stics of other countries. The official figures are set out in Table 2 and in Figures 1 and 2, but these must definitely be judged in the light of the critical remarks above.

A critical examination of the present materials shows that tubercus losis was, with certainty, known in the Faroes in the 18th century, but there is nothing from which one could infer that it was not an old and familiar disease even then. Throughout the 19th century mors tality due to tuberculosis was very likely about 10—15 per 10,000 of the population, presumably on account of the relatively poor communications between the villages. At the close  of that century, how« ever, mortality rises rapidly, approaching a maximum of about 25 per 10,000 in the years just after 1900. Starting from the corrected number of deceased, various considerations and calculations will result in the probable number of new cases of tuberculosis in the last quarter of
the 19th century (Table 3), so that the result can be depicted in Figure 3. By this it is shown, then, that if the statistics relating to the notification of new cases were as exact at the beginning as they are for later years, one would for the years just before the turn of the century very likely have found something like 90 cases of tuberculosis annually per 10,000 of the population. This sudden increase of the tuberculosis in the Faroes at the end of the 19th century can only be the result of the rapid development of deep sea fishing, at which men from everywhere in the islands are crowded together in confined crew accomodations (see Figure 3). Throughout the past half the 20th century tuberculosis in the Faroes has been on the decline. As for the first
quarter of the century, this decline, however, cannot presumably, to any great extent, be due to any deliberate work against the tubercus losis (already in 1908 a T. B. sanatorium was established), but is more likely a mere consequence of the fact that infection of new classes of birth is no longer able to keep the disease on the same high level as in the end of the 19th century when the disease pervaded a partly virgin area. On the other hand, however, the steady and regular decline of the disease during the past 25—30 years is no doubt a result of the highly intensified work against the tuberculosis. As important factors
here one may mention the building of a chest clinic (1928), and, quite especially, a statute prescribing compulsory examination of fishermen before being allowed to sign on (1939) — by which several infectious cases have been isolated every year, and finally the introduction of B. C. G. vaccination in 1946. In the years 1946—1955 a totai number of 17.790 persons were vaccinated. Among these, 19 new cases of tuberculosis occurred, and 3 deaths. Among the rest of the population — a total number of 14,699 persons — 355 new cases of tuberculosis occurred, and 126 deaths. 

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Section
Health and Medicine