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
London County Council 1897
[Report of the Medical Officer of Health for London County Council]
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Diagram IX. shows the number of cases notified in each month during the years 1891-7 in
relation to the mean of that period, and the case mortality of each month, also in relation to the mean.
No correction has been made for differences in age and sex constitution of the cases notified in the
several months.
Diphtheria.
The cases of diphtheria notified in the Administrative County of London in 1897 numbered
13,217, compared with 13,825 in 1896. The number of deaths registered from this cause in 1897 was
2,245, compared with 2,666 in 1896. The figures quoted for 1897 give an annual case rate of 3.0
and an annual death rate of 0.50 per 1,000 living.
The diphtheria case and death rates in 1897 and preceding periods are shown in the following table—
| Period. | Death rate per 1,000 living. | Case rate per 1,000 living. | Case mortality per cent. |
|---|---|---|---|
| 1861-70 | 0.18 | —* | — |
| 1871-80 | 0.12 | —* | – |
| 1881-90 | 0.26 | —* | – |
| 1891 | 0.311 | 1.5 | 22.5 |
| 1892 | 0.441 | 2.0 | 22.2 |
| 1893 | 0.741 | 3.2 | 23.3 |
| 1894 | 0.611 | 2.6 | 23.6 |
| 1895 | 0.521 | 2.6 | 20.4 |
| 1896 | 0.591 | 3.1 | 19.3 |
| 1897 | 0.501 | 3.0 | 17.0 |
The death rate in each year since 1858 in relation to the mean death rate of the period 1859-97
is shown for diphtheria, and for diphtheria and croup combined, in diagram X.
There was decrease of death rate, case rate, and fatality in 1897 compared with the rates of
1896.
If the London death rate from diphtheria be compared with the death rates of other large
towns in England having populations of more than 200,000 persons, it will be seen that in the period
1887-96 and in 1897 the London rate exceeded the rates of any of these towns.
| Towns. | 1887-96. | 1897. | Towns. | 1887-96. | 1897. |
|---|---|---|---|---|---|
| West Ham | .43 | .37 | |||
| Manchester | .27 | .09 | Bristol | .13 | .15 |
| Liverpool | .16 | .20 | Nottingham | .07 | .09 |
| Birmingham | .19 | .29 | Bradford | .07 | .07 |
| Leeds | .10 | .16 | Hull | .11 | .14 |
| Sheffield | .15 | .13 | Salford | .41 | .15 |
It will be seen from the following table that the London death rate from diphtheria was in the
period 1887-96 lower than the death rates of any of the undermentioned foreign cities, except Brussels,
Amsterdam and Rome, while in 1897 the London death rate was only exceeded by the death rates of
St. Petersburg and New York.
| Towns. | 1887-96. | 1897. | Towns. | 1887-96. | 1897. |
|---|---|---|---|---|---|
| St. Petersburg | .59 | 1.77 | |||
| Paris | .53† | .12† | Berlin | .74 | .29 |
| Brussels | .13† | .07† | Vienna | .72† | .36† |
| Amsterdam | .32 | .25 | Rome | .32 | .04 |
| Copenhagen | .79 | .18 | New York | 1.01 | .68 |
| Stockholm | .79† | .15† |
In the distribution of diphtheria mortality the eastern districts suffered most, and the western
least during the year 1897. Of the several districts Woolwich had the highest death rate, 0.80 per
1,000 living, and St. James, Westminster, the lowest, 0.13 per 1,000 living. In the first quarter the
eastern group of districts had the highest, the central the lowest death rate. In the second quarter
the eastern group had the highest, the northern the lowest. In the third quarter the central group had
the highest, the northern the lowest. In the fourth quarter the eastern again had the highest, and
the western the lowest.
* The Infectious Diseases (Notification) Act only came into force in 1889.
† Including deaths from croup.
1 See footnote (1), page 7.
2 See footnote (2), page 7.
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