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 1899
[Report of the Medical Officer of Health for London County Council]
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25
Diphtheria.
The cases of diphtheria notified in the Administrative County of London in 1899 numbered
13,711, compared with 11,883 in 1898. The number of deaths registered from this cause in 1899
was 1,946, compared with 1,760 in 1898.
The diphtheria case rates and death rates in 1899 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 | 23.0 |
| 1895 | 0.521 | 2.6 | 20.4 |
| 1896 | 0.591 | 3.1 | 19.3 |
| 1897 | 0.501 | 3.0 | 17.0 |
| 1898 | 0.391 | 2.6 | 14.8 |
| 1899 | 0.431 | 3.0 | 14.2 |
The death rate in each year since 1858 in relation to the mean death rate of the period
1859-99 is shown for diphtheria and for diphtheria and croup combined in diagram IX.
If the London diphtheria death rate be compared with the death rates of the following large
English towns, it will be seen that in the period 1889-98 the London rate exceeded the rates of all
these towns, and in 1899 exceeded the rates of all except Leeds, Sheffield and West Ham—
| Towns. | 1889-98. | 1899. | Towns. | 1889-98. | 1899. |
|---|---|---|---|---|---|
| London | 0.492 | 0.432 | Bristol | 0.14 | 0.10 |
| Manchester | 0.24 | 0.15 | Nottingham | 0.07 | 0.13 |
| Liverpool | 0.18 | 0.34 | Bradford | 0.07 | 0.11 |
| Birmingham | 0.22 | 0.29 | Hull | 0.12 | 0.12 |
| Leeds | 0.16 | 0.78 | Salford | 0.39 | 0.34 |
| Sheffield | 0.18 | 1.28 | West Ham | 0.47 | 0.61 |
It will be seen from the following table that the London diphtheria death rate was, in the
period 1889-98, lower than the death rates of any of the undermentioned foreign cities except
Paris, Brussels, Amsterdam and Rome, while in 1899 the London rate was only exceeded by the
rates of Stockholm, St. Petersburg and New York. The inclusion of deaths from croup, however,
in the case of several of these towns makes comparison of the death rates of little value f—
| Towns. | 1889-98. | 1899. | Towns. | 1889-98. | 1899. |
|---|---|---|---|---|---|
| London | 0.492 | 0.432 | St. Petersburg | 0.82 | 0.90 |
| Paris | 0.41‡ | 0.13‡ | Berlin | 0.63 | 0.33 |
| Brussels | 0.12‡ | 0.13‡ | Vienna | 0.68‡ | 0.29‡ |
| Amsterdam | 0.28 | 0.09 | Rome | 0.26 | 0.07 |
| Copenhagen | 0.62 | 0.28 | New York | 0.81 | 0.45 |
| Stockholm | 0.72‡ | l.08‡ |
In the distribution of diphtheria mortality throughout the year 1899, the southern group
of districts had the highest death rate (0.55), and the western group the lowest (0.26); of the
several districts. St. George, Southwark, had the highest death rate (104), and St. Martin-in-theFields
the lowest (0.08). In each of the four quarters of the year the southern group of districts
had the highest death rate.
* The Infectious Diseases (Notification) Act only came into force in 1889.
† The death rate in London from diphtheria, including deaths from croup, was 0.55 in 1889 9.3, an.d 0.45 in 1899.
† Including deaths from croup.
1 See footnote (') page 3. 2 See footnote (*) page 3.
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