Urban hospital and rural village smallpox in Bangladesh

Smallpox mortality at Dacca, Bangladesh Infectious Diseases Hospital during 1972 and 1973 was 46 per cent. To determine if this was the actual rate within the population, data were compared to those collected from village populations in Noakhali District. Age/sex adjusted smallpox mortality for the rural population was 23 per 100 cases as compared to 52 per 100 for the hospital population. Analysis of the difference identified a selection bias of the hospital for severe disease.