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
Paddington 1914
Report on the vital statistics and the work of the Public Health Department for the years 1914-18 (inclusive)
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SICKNISS.
| 1914-18 | 6.92 | 1.37 | 11.29 |
| 1909-13 | 5.60 | 1.90 | 16.10 |
The fatalities among cases removed to hospital were lower than those among patients
treated at home. Attention may be specially directed to the fatality of enteric fever
(Table 7).
A comparison of the fatalities observed in M.A.B. Hospitals among patients removed
from the County as a whole and from the Borough shows that the latter had a higher
recovery rate. (See below).
Fatality rates per 100 cases treated in Hospital (M.A.B.).
| Diphtheria | 7.9 | 7.9 | 6.8 | 6.7 | 7.7 | 5.1 | 8.8 | 4.7 | 5.4 | 6.5 |
| Scarlet Fever | 1.4 | 2.0 | 1.8 | 1.9 | 1.8 | 0.9 | 1.8 | 1.6 | 1.9 | 0.7 |
| Enteric Fever | 17.1 | 16.7 | 131 | 17.3 | 13.4 | 14.3 | 7.7 | 6.7 | — | — |
"Meningitis" Group.—This general designation is used to cover notifications of—
| Cerebro-spinal fever (or meningitis) | 31 | cases reported during 1914-18. |
| Posterior Basic Meningitis | 4 | „ „ „ „ |
| Anterior Polio-myelitis | 9 | „ „ „ „ |
The numbers of cases reported each year are shown in Table III., Appendix.
Five of the reported cases of cerebro-spinal fever were ultimately marked "errors," viz.,
3 in 1915 (30 per cent. of the notifications) and one each in 1916 and 1917. The seasonal
distribution of the cases—excluding" errors"—based on the reported dates of onset, is shown
below.
Jan. Feb. Mch. Apr. May. June July Aug. Sept. Oct. Nov. Dec.
Cerebro-spinal fever 4 2 2 6 2 2 1 — 1 1 1 4
Posterior Basic Meningitis 1 2 — — — — — — — — — 1
Anterior Polio-myelitis 1 1 — — 1 — — 1 3 2 — —
There is no record of any case having been traced to a previous case, nor of any spread of
infection from a case reported locallv.
The fatalities averaged for the five years, calculated after exclusion of "errors, were—
Cerebrospinal fever 26 cases, 17 deaths—73 per cent combined 66.6 per cent.
Posterior Basic Meningitis 4 „ 3 „ 75 „
Anterior Polio-myelitis 9 „ 2 „ 22 „
In addition to the 17 deaths among the 20 reported cases of the first disease, there were
two other (un-notified) deaths (in 1916) from that cause—one a soldier and the other a
civilian. Two cases notified as cerebro-spinal fever—marked "errors"—terminated fatally,
the causes of death being tubercular meningitis in one, and cerebral tumour in the other.
In April, 1918, attention was called in The Lancet to certain groups of cases with
symptoms suggestive of "botulism"—a disease originally traced to the consumption of
sausages infected with a special organism. In May the Medical Officer of Health of the
County issued a circular letter asking for reports of any cases coming to light in the Borough.
Three such cases were reported, viz.:—
f. set 2 sickened May 9 or 10 (died of tubercular meningitis),
f. „ 7 „ „ 18 recovered,
f. „ 26 „ „ 30 recovered.
In no instance was there any paralysis of the oculo-motor muscles. Towards the end of
the year it was recognised that the proper diagnosis of the cases was Encephalitis Lethargica,
and the disease was made notifiable as from January 1, 1919.
Puerperal Fever.—During the five years 34 cases were reported (see Table III.,
Appendix), of which 3 were marked "errors." Institutional treatment was given to 25 cases,
or 80.6 per cent, of all cases. The deaths recorded numbered 17, giving a fatality of 55 per
cent, (after exclusion of "errors"). The fatality varied from 30 per cent, in 1914 to 100 in
1918.