London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Paddington 1910
[Report of the Medical Officer of Health for Paddington, Metropolitan Borough of]
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The average duration of the cases in the first group (32 cases) was 13.06 days, and in the latter (33 cases) 16.06 days, the average duration of the cases which were under the supervision of the Department being no less than three days shorter. Such unexpected difference is, however, largely explained by the following statement of the ages of the deceased persons in each group.
| Ages | 0- | 1 | 9 | 3 | 4 | 5 | 6 | 7 | 33 | Totals. | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Reported early | 1 | 6 | 4 | - | 1 | - | - | - | - | 12 | |
| Females | 4 | 11 | 1 | - | 1 | 1 | - | 1 | 1 | 20 | |
| Reported late | Males | 1 | 10 | 7 | 1 | 1 | - | - | - | - | 20 |
| Females | - | 4 | 2 | 1 | 2 | 3 | 1 | - | - | 13 |
Deaths and Mortality (per 1,000 persons of all ages.)
| D. | M. | D. | M. | D. | M. | D. | M. | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891 | 7 | 0.05 | 1896 | 123 | 0.86 | 1901 | 9 | 0.06 | 1906 | 16 | 0.11 |
| 1892 | 89 | 0.65 | 1897 | 0.01 | 1902 | 82 | 0.55 | 1907 | 37 | 0.24 | |
| 1893 | 35 | 0.25 | 1898 | 112 | 0.79 | 1903 | 39 | 0.26 | 1908 | 36 | 0.23 |
| 1894 | 76 | 0.54 | 1899 | 0.05 | 1904 | 39 | 0.26 | 1909 | 36 | 0.23 | |
| 1895 | 19 | 0.13 | 1900 | 53 | 0.36 | 1905 | 63 | 0.42 | 1910 | 75 | 0.49 |
D.— Deaths. M.—Mortality per 1,000 persons.
The mean rates should be considered in conjunction with the maximum and minimum
rates recorded in each period.
There was an increase in the mean rate for the second quin-quennial period, and decreases in those of the third and fourth. The extent of the " swing of the pendulum" of prevalence in each period is shown in the following summary:
| Period. | Mean rate. | Maximum. | Minimum. |
|---|---|---|---|
| 1891-1895 | 0.32 | 0.65 | 0.05 |
| 1896-1900 | 0.41 | 0.86 | 0.01 |
| 1901-1905 | 0.31 | 0.55 | 0.06 |
| 1906-1910 | 0.26 | 0.49 | 0.11 |
| 1891-1900 | 0.37 | 0.86 | 0.01 |
| 1901-1910 | 0.28 | 0.55 | 0.06 |
Those figures afford evidence of a change in the habits of the disease during the latter
portion of the period under review, evidence which is strengthened by an examination of the
figures for the individual years. Broadly speaking the change dates from 1903, since which
year the earlier experience of alternate years of high and low mortality—with wide ranges
in the rates—has been replaced by a more uniform prevalence year after year, the years of
maximal prevalence not attaining to the levels noted in earlier years. Can any reason be
assigned for the change? It happens that 1903 was the year in which the Department
commenced to deal systematically with the disease, searching out and visiting the cases,
giving such advice which was thought might be useful, and securing disinfection of premises
The "early" group not only contained an excessive proportion of females, who
appear to be subject to earlier death, but was also characterised by a fairly considerably
larger proportion of children under 2 years of age, such children constituting nearly 70 per
cent, of the "early" group as compared with 45 per cent. in the "late."
It is usually stated that one-fourth of the deaths occur within 6 days of onset of the
illness. In the whole group of 65 deaths here dealt with only 4 deaths 6.1 per cent. as compared
with 25 per cent.) occurred within six days, and one-fourth of the cases had not
terminated at the end of the eighth day.
The 75 deaths certified as due to measles during the past year were equal to a mortality
of 0.49 per 1,000 persons of all ages, a rate higher than any observed since 1902, and
practically double the mean rate for the five years 1905-9 (0.25). Below are set out the
deaths and death-rates for each of the twenty years 1891-1910.