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
Chelsea 1897
Annual report for 1897 of the Medical Officer of Health
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Table XII.—Notifications of Scarlet Fever per 10,000 of Population from 1890 to 1897.
| 1890. | 1891. | 1892. | 1893. | 1894. | 1895. | 1896. | 1897. | 1890-7. | |
|---|---|---|---|---|---|---|---|---|---|
| Chelsea (Home District) | 33.1 | 20.4 | 50.4 | 65.0 | 31.6 | 65.8 | 56.7 | 41.4 | 45.5 |
| Kensington | 23.4 | 18.8 | 43.5 | 56.1 | 22.8 | 31.4 | 59.8 | 43.7 | 37.4 |
| Fulham | 33.9 | 13.4 | 54.6 | 70.3 | 51.0 | 31.5 | 55.2 | 64.4 | 46.8 |
| Hammersmith | 36.3 | 23.1 | 46.5 | 66.5 | 32.5 | 36.9 | 51.1 | 37.5 | 41.3 |
| Paddiugton | 18.4 | 22.0 | 45.4 | 64.6 | 23.6 | 33.9 | 63.9 | 38.9 | 38.8 |
| St. George's, Hanover Sq. | 18.2 | 17.2 | 42.6 | 74.8 | 32.4 | 38.0 | 42.8 | 22.0 | 36.0 |
| Westminster | 23.1 | 20.4 | 53.3 | 76.5 | 26.1 | 33.1 | 41.8 | 34.1 | 38.5 |
| St. James's | 20.1 | 26.0 | 28.0 | 46.7 | 24.8 | 35.0 | 32-5 | 57.8 | 33.9 |
| West London | 25.6 | 20.1 | 47.3 | 64.6 | 30.8 | 37.1 | 54.6 | 43.5 | 40.4 |
| London | 36.7 | 27.4 | 63.7 | 86.0 | 42.6 | 45.2 | 58.1 | 51.3 | 51.3 |
And, indeed, it almost appears as if the abnormal prevalence of
the disease, after nearly exhausting itself in Hammersmith, thence
spread eastwards to Fulham, and theuce slowly still passed eastwards
into Chelsea, taking a period of some five years in its extension. The
maximum intensity of this expanding wave of diffusion appears to
have been reached in Chelsea in 1896, when the case-rate reached the
high figure of 57 per 10,000, and the death-rate was no less than 1.28
per 1,000. In Kensington a sustained high case-rate from 1893 is
seen in a lesser degree, broken, however, by a fall in the rate in 1894.
In Paddington a high case-rate is seen for only two years in succession,
whilst in St. George's, Hanover Square, there has been but little
fluctuation from year to year in diphtheria prevalence. The parishes
of Westminster and St. James's, having smaller populations, are,
perhaps, more liable to be capriciously affected, but the figures show a
greater prevalence of diphtheria at the end of the period under review
than at its commencement.
The diphtheria death-rates of the various districts correspond fairly
with the case-rates, the parishes having the highest case-rates in any
year, having also the highest death-rates, and vice vend. An extra
prevalence of diphtheria is certainly not compensated for by any
greater mildness in type of the disease, as is sometimes seen in the
case of scarlet fever. On the contrary, the experience of Chelsea shows
that great prevalence of the disease is accompanied by increased severity
of type and a high mortality in proportion to cases.
The conclusions that may be drawn from these tables are not
necessarily discouraging for the future, for they appear to indicate that
whilst a wave of high diphtheria prevalence has taken possession of
London since 1892, this wave is probably now on the downward grade.
The tables are also suggestive of the fact that diphtheria is one of those
diseases of which the infection has a partiality for and tends to cling to