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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measles. The mean mortality rates for each sex, together with the Index Numbers for 1914-18 are shown below.
| Mortality per 1,000. | Females. | |||||
|---|---|---|---|---|---|---|
| Males. | ||||||
| Ages (yrs.) | 1909-13 | 1914-18 | I.N. | 1909-13 | 1914-18 | I.N. |
| 1-2 | 33.9 | 36.7 | 108 | 29.0 | 33.7 | 116 |
| 2-3 | 12.0 | 14.4 | 120 | 11.8 | 14.8 | 125 |
| 3-4 | 6.5 | 11.8 | 181 | 6.4 | 10.1 | 156 |
| 4-5 | 5.7 | 5.8 | 102 | 5.9 | 6.6 | 112 |
It is of interest to record that the maximum and minimum rates were recorded during the second period at ages—
| Males. | Females. | |||
|---|---|---|---|---|
| 1-2 yrs. | Max. 54-5 (1917), | Min. 19.8 (1914) | Max. 65.8 0918), | Min. 13.9 (1914) |
| 2-3 „ | „ 30.1 (1918), | 5.4 (1916) | „ 25.2(1917), | 6.3(1916) |
| 4-5 „ | „ 8.7(1918), | 2.3 (1916) | „ 10.4 (1918), | „ 2.3 (1914) |
| At ages 3-4 years— | ||||
| Maximum rates (.both sexes) were observed in 1918 | 19.5 males; | 19.6 females. | ||
| Minimum „ „ „ „ „ „ 1910 | 4.3 „ | 4.4 „ | ||
Space forbids a more complete discussion of the incidence of mortality which, it may be
remarked, shows signs of progressive increase as the war dragged on. tor the same reason
the data as to causes of death must be passed over. One additional calculation ought,
however, to be mentioned. By totalling the survivors at the four ages—thus obtaining the
numbers at risk in each quinquennial period—the mortality rates for the group 1-5 years are
found to be—1909-13, 11.8 per 1,000; 1914-18, 13.7. The Index Number for 1914-18 is
116, which confirms to some extent the number for all ages (persons) arrived at by other
methods.
Measles.—Records of the prevalence of this disease have been collected systematically
by the Department since 1898, but, except such as was given by "Form 84," the information
was entirely voluntary. In March, 1914, the Council made an Order—subsequently confirmed
by the Local Government Board—requiring notification of the disease under Sec. 55
of the Public Health (London) Act, 1891. In November, 1915, the Local Government
Board issued the "Measles Regulations"* under the Public Health Act, 1875 and the
Public Health Act, 1896, making notification of measles and rubeola (commonh called
"German Measles") compulsory throughout England and Wales as from January 1, 1910.
As a consequence the Council's Order of 1914 was rescinded in 1916. The issue of those
Regulations may be taken to have brought to a successful conclusion the demand for
notification which was first urged bv the (late) Vestry of Paddington in 1890.
As might be expected the introduction of compulsory notification involved a disturbance
in the records of this disease, hitherto mainly of cases among school children attending the
Public Elementary Schools. In part, compulsory notification accounts for the great increase
in certain Wards, e.g., the two Lancaster Gate Wards, to which attention will be directed
later on.
Hitherto the records of rubeola have been kept separately from those of measles, the
separation being possible as it was based ori the observations of the Women Inspectors
without control by medical certification. Such separation is now deemed inadvisable.
That fact requires to be kept in mind when considering the increase in the numbers of
reported cases observed since 1914. The numbers of cases reported annually are shown in
Table III., Appendix.
The annual average (as deduced from the weekly records) for 1909-13 is 1,342, and that
for 1914-18, 2,157, showing an average increase of 815 (or 60'7 per cent.) cases each year.
Comparing the numbers reported in the four quarters of the year, it is found that in the
second period of five years there has been a considerable shifting of time distribution—a fact
which is also apparent in the weekly records kept in the Department. During 1909-13, the
percentages of all cases recorded during the year reported in each quarter were—
1st Quarter 33 9; 2nd Quarter 408; 3rd Quarter 8-9 ; 4th Quarter 16.4
and those recorded during 1914-18—
1st Quarter 42*5; 2nd Quarter 45.7 ; 3rd Quarter 7.3 ; 4th Quarter 4.4
*The Council's Order required the notification of all cases of Measles—excluding Rubeola. The Regulations
of 1915 prescribed the notification of first cases only (in families) of both diseases.