View report page

In both England and London the mortality from Diphtheria
was less in the decade 1871-80 than in 1861-70, but in the decade
1881-90 it was greater than in the second, and in London had
increased to a higher ratio even than in the first decade.
Comparing London to England, in the first decade the ratio
of mortality was about 5 per cent, lower than that of England,
in the second decade about equal, and in the third about 6 per
cent, higher.
It is strange that whilst formerly it was more prevalent in the
rural districts it now appears to affect the urban most.
In the Greenwich District most of the cases were confined
to young children of school age. Some years ago this disease
used to be confined to the eastern part of the Parish, especially
in the Marsh district, but this year it has visited every part. I
believe that owing to the highly infectious character of this
disease, it is largely spread in Schools.
Sir Thome Thome (Medical Officer to the Local Government
Board), in his Milroy Lectures on Diphtheria in 1891,
showed that since 1871, whereas the annual Death Rates from
all causes from the seven principal Zymotic diseases, and from
Enteric Fever, have been steadily falling in England and Wales,
in large towns and in London the annual Death Rates from
Diphtheria have been rising slightly in England and Wales, more
markedly in the large towns, and most markedly in London.
Whilst the mortality of Diphtheria is still steadily rising,
that of Enteric Fever is equally steadily falling pari passu with
improved sanitation, and the mortality of Scarlet Fever is also
lulling pari passu with increased Hospital isolation; so that