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 1909
[Report of the Medical Officer of Health for London County Council]
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they are due to premature discharge of the first patients from the hospitals. In Woolwich, of 996
cases, 81 were retained at home and, as Dr. Davies states, without a second case occurring in the
house.
Proportion of cases of scarlet fever removed to hospital.
It will be seen from diagram X that the proportion of cases of scarlet fever admitted to the
hospitals of the Metropolitan Asylums Board was about the same as in the preceding year.
Proportion of cases erroneously certified.
Cases certified to be those of scarlet fever and admitted into the hospitals of the Metropolitan
Asylums Board in which the diagnosis was not subsequently confirmed, constitute in successive years
the following percentage of the total cases admitted :—
| Year. | Percentage. | Year. | Percentage. |
|---|---|---|---|
| 1901 | 5.6 | 1906 | 4.9 |
| 1902 | 4.7 | 1907 | 6.8 |
| 1903 | 6.4 | 1908 | 5.8 |
| 1904 | 6.7 | 1909 | 6.9 |
| 1905 | 5.4 |
Diphtheria.
The cases of diphtheria (including membranous croup) notified in the Administrative County of
London in 1909 (52 weeks) numbered 6,679, compared with 8,002 in 1908 (53 weeks). The number
of deaths was 605 in 1909 (52 weeks) compared with 724 in 1908 (53 weeks;.
It is well to bear in mind that the case-rate and case-mortality may be affected by variations
in the extent of use of bacteriological methods of diagnosis, the effect of which is to increase the
notified number of clinically mild cases of the disease.
The diphtheria case-rates, death-rates, and case-mortality in 1909, and preceding periods, are
shown in the following table :—
| Period. | Death-rate per 1,000 persons living. | Case-rate per 1,000 persons living. | Case-inortality per cent. |
|---|---|---|---|
| 1861-70 | 0.18 | __ l | |
| 1871-80 | 0.12 | _l | _1 |
| 1881-90 | 0.26 | _l | _l |
| 1891-1900 | 0.492 | 2.6 | 18.8 |
| 1901 | 0.29 2 | 2.7 | 10.9 |
| 1902 | 0.25 2 | 23 | 10.8 |
| 1903 | 0.16 2 | 1.7 | 9.6 |
| 1904 | 0.168 | 1.6 | 10.0 |
| 1905 | 0.12 3 | 1.4 | 8.4 |
| 1906 | 0.152 | 1.7 | 8.6 |
| 1907 | 0.16 2 | 1.8 | 8.9 |
| 1908 | 0.15 2 | 1.6 | 9.0 |
| 1909 | 0.13 2 | 1.4 | 9.1 |
The death-rate in each year since 1858 in relation to the mean death-rate of the period 18591909
is shown for diphtheria and also for diphtheria and croup combined in diagram XII. It will be
observed that the death-rate from diphtheria and croup of 1909 was almost identical with that of 1905,
which was the lowest recorded in London.
The case rate was the same as in 1905, in which year the rate was the lowest recorded in
London.
The monthly case-rate and case-mortality in each of the years 1891-1909 in relation to the mean
of the period is shown in diagram XIV.
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 quinquennium 1904-8 the London rate was exceeded by that
of all except that of Leeds, Sheffield and Leicester, and in 1909 was exceeded by the rates of all except
Leeds, Sheffield, West Ham, Nottingham and Leicester.
1 The Infectious Disease (Notification) Act came into force in 1889. 2 See footnote (J), page 6.