Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Willesden]
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15
Whooping Cough
Whooping cough vaccination was started in Willesden in 1947 as a venture, with no controls for
comparison. It was hoped that if whooping cough vaccination was effective, there would in time be a marked
reduction in its incidence and mortality similar to what was experienced with diphtheria immunisation. It
is far too early to judge the effectiveness of whooping cough vaccination owing to the relatively small
number of children who have been protected up to date. In 1949 it appeared to have had an appreciable
effect on the incidence, but the figures of the following years unfortunately dispelled this hopeful illusion.
There has been no significant reduction in whooping cough in Willesden in the last tew years.
Year | Population | Child population | Number of cases notified | No. of deaths per 1,000 population | Case rate | Death rate | No of children vaccinated | Total immunised | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
0—4 | 5—15 | Willesden | England & Wales | Willesden | England & Wales | Willesden | England & Wales | Willesden | England & Wales | ||||
1936 | 190,000 | - | _ | 743 | _ | 12 | 2090 | 3.910 | - | .063 | .051 | - | - |
1937 | 188,030 | - | - | 626 | - | 11 | 1600 | 3.329 | - | .058 | .039 | - | — |
193? | 187,600 | - | - | 277 | - | 3 | 1052 | 1.476 | - | .016 | .026 | - | — |
193' | 188,000 | - | - | 672 | - | 5 | 1229 | 3.574 | - | .026 | .030 | - | — |
1940 | 152,030 | - | - | 82 | 53,607 | 2 | 2459 | .539 | 1.280 | .013 | .017 | - | — |
1941 | 127,230 | - | - | 505 | 173,330 | 5 | 2065 | 3.969 | 4.151 | .039 | .062 | - | 1999 |
1942 | 138,600 | 10,000 | 15,500 | 460 | 66,016 | 4 | 1143 | 3.319 | 1.576 | .029 | .021 | - | 4493 |
1943 | 144,430 | 10,424 | 17,480 | 238 | 96,136 | 3 | 746 | 1.648 | 2.275 | .021 | .029 | - | 4211 |
1944 | 139,510 | 11,440 | 17,740 | 401 | 94,044 | 4 | 570 | 2.874 | 2.215 | .029 | .028 | - | 1531 |
1945 | 161,954 | 12,460 | 18,430 | 215 | 62,601 | 3 | 527 | 1.327 | 1.470 | .018 | .018 | - | 2476 |
1946 | 170,550 | 13,191 | 20,389 | 377 | 92,936 | 4 | 489 | 2.210 | 2.170 | .023 | .020 | - | 2687 |
1947 | 175,900 | 15,107 | 20,830 | 571 | 92,682 | 6 | 905 | 3.246 | 2.153 | .034 | .022 | - | 1964 |
1948 | 179,900 | 15,544 | 20,663 | 423 | 146,410 | 2 | 748 | 2.351 | 3.366 | .011 | .017 | - | 2609 |
1949 | 181,120 | 15,270 | 21,430 | 205 | 102,816 | — | 527 | 1.132 | 2.325 | — | .012 | 1615 | 2465 |
1950 | 181,700 | 14,930 | 22,410 | 648 | 157,781 | 2 | 494 | 3.566 | 3.584 | .015 | .009 | 822 | 1886 |
1951 | 179,647 | 13,847 | 22,995 | 543 | 169,441 | — | 456 | 3.023 | 3.873 | — | .010 | 1163 | 2874 |
1952 | 180,400 | 13,846 | 24,000 | 328 | 114,868 | 1 | 492 | 1.818 | 2.623 | .005 | .011 | 946 | 1615 |
England | England |
There are many difficulties involved in interpreting the results.
Firstly, whooping cough notifications, like those of measles, never reflect accurately the actual number
of cases present. Indeed, it has been estimated that they reach only 50 per cent, of the total. Since 1948,
every child is provided with a doctor free, and it is likely that a higher proportion of cases of whooping
cough has been notified than hitherto.
Secondly, chloramphenicol undoubtedly has a beneficial effect if given in the early stages, and this
would probably have had some effect in the last few years in reducing the mortality, and by killing the
organisms in the early stages limit the extent of their spread.
Finally, as whooping cough usually attacks children earlier than other infectious diseases, often
before they are six months old, protection must be given very early if any useful result is to be expected.
The Medical Research Council has already produced evidence to show that whooping cough vaccination
is effective and we should be able to obtain more evidence if its value in the future, particularly if
there is an increase in the number of young infants who are vaccinated.
330 cases were notified in 1952 (328 confirmed), but a total of 334 (172 were children under the
age of 5 years) came to the notice of the health visitors. There was one death from whooping cough in
an illegitimate child of under six months.
Pneumonia and Influenza
126 cases of pneumonia were notified in 1952 (113 confirmed). There were 89 deaths from
broncho.pneumonia, lobar pneumonia and pneumonia (unspecified), and 12 deaths from influenza.
Other Infectious Diseases
Disease | Cases notified (number confirmed in brackets) | |
---|---|---|
Typhoid fever | 11 | (9) |
Dysentery | 218 | (160) |
Malaria | 1 | (1) |
Poliomyelitis and polio.encephalitis | 11 | (5) |
Meningococcal infection | 13 | (8) |
Encephalitis lethargica | 2 | (1) |
Smallpox | — | (-) |