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
City of Westminster 1909
[Report of the Medical Officer of Health for Westminster, City of]
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44
Nine cases were eventually decided not to be diphtheria; on the
other hand, probably some were not discovered.
There were 18 deaths. In one instance the cause of death was not found until after death, so it could not be notified.
| Diphtheria. | 1901. | 1902. | 1903. | 1904. | 1905. | 1906. | 1907. | 1908. | 1909. |
|---|---|---|---|---|---|---|---|---|---|
| Deaths per 100 Oases— | |||||||||
| The City | 10.o | 11.o | 8.6 | 3.4 | 4.2 | 7.6 | 11.o | 9.9 | 8.0 |
| The County | 10.9 | 10.8 | 9.6 | 10.2 | 8.6 | 8.8 | 8.9 | 9.0 | 9.0 |
The mortality is greatest among children at ages 1 to 5 years; at
that period it amounted to 15.8 per cent. of the cases notified; under
1 year of age it is only 3 per cent., and between 5 and 15 years,
3.9 per cent.; there were no deaths in the 42 persons whose ages were
over 15 years. The mortality in St. John and Victoria Wards was
8.8 per cent. of the cases notified.
In one or two instances, cases of suspicious sore throat were
discovered at certain schools, and, in co-operation with the Medical
Officer of the Education Committee, the throats of the children in the
classes affected were examined, as well as those of other members of
their families, and bacteriological reports were obtained in respect
thereof Thus in connection with one school 18 persons proved to
have the specific organism in their throats, and 2 of them had been ill
some weeks previously, and were probably acting as sources of infection
in the school; after they were excluded, no further cases were detected.
The teachers had instructions to exclude from school any child with
a sore throat until a certificate (based upon bacteriological examination)
was produced stating the child to be free from infection. These 18
persons had no signs of diphtheria which could be seen by the naked
eye, and it is considered by some to be unlikely that they would cause
infection to others. It is also doubtful whether persons who are
carrying an infectious organism without showing any effects from it
can, strictly speaking, be said to be suffering from diphtheria. Without
attempting to clear up these disputed points, I think that it is in the
public interest to regard such cases as diphtheria, and to take
precautions accordingly; and this action appears to be justified by the
result in the case of the school mentioned above.
The importance of having an examination made of persons in
contact with diphtheria patients was exemplified in a family in which
a baby was taken suddenly ill. There were five other members of the
family and a servant, none of whom at the time showed definite
symptoms of diphtheria, although one had a slight sore throat and the