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The great improvement in housing and social conditions has been
the main factor in bringing about this change, but the advance of
medical science in prevention and treatment has also played a very
considerable part. It cannot however be denied that fortuitous alterations
in the character of some infectious diseases for some of them,
such as Scarlet Fever and Measles, have become less virulent and some
such as Encephalitis lethargica, and the variety of Influenza which
appeared in 1918 have come and gone in the intervening years. Throughout
historic and probably prehistoric times, there have been similar
variations in the incidence and virulence of diseases for reasons which
we do not understand, some appearing for the first time, or becoming
more virulent for years, and then becoming milder or disappearing
altogether.
smallpox. There were 88 cases with 10 deaths in 1901 but this was an
unusual circumstance at that time, and accounted for by an outbreak
which commenced in London in August; a similar outbreak might well
occur at the present time. Many pages of report describe the details
of this event. Much concern is expressed about the vaccination state
of the population. Although the vaccination of infants was at that
time compulsory, there was widespread evasion of the requirements, either
by the declaration of objection on grounds of conscience, or in other
ways. No reliable data were available to the Medical Officer of Health
but from the investigation of children in the schools he concluded that
from 15 to 25 per cent of them were unvaccinated.
There were no cases in 1963.
Diphtheria. In 1901 there were 289 cases with 36 deaths and in 1963
there were no cases.
It may be noted that the bacteriological examination of swabs
for doubtful cases was already undertaken by the Council in 1901, as
was also the free issue of Antitoxin for immediate use before a patient
could be transferred to hospital, and as a preventive inoculation to
contacts.
Typhoid Fever. In 1901 there were 65 cases with eleven deaths and in
1963 there were no cases.
The Widal blood test was already in 1901 undertaken free on behalf
of the council for doubtful cases.
Scarlet Fever. In 1901 there were 495 cases with 19 deaths. Owing to
the severity of the disease at that time there were almost certainly
very many serious and lasting complications in the cases that recovered
The Medical Officer of Health reports at length on the investigations
regarding 24 of the cases, most of which arose as a result of drinking
milk which was eventually traced as coming from a particular farm in
Staffordshire, where four of the farmers family were found to be
suffering from the disease.
In 1963 there were 43 cases all of them mild and transient.
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