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
London County Council 1894
[Report of the Medical Officer of Health for London County Council]
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The scarlet fever death-rate of London can be compared with that of other large English towns having a population of more than 200,000 inhabitants by reference to the following table—
Scarlet fever—Death rates per 1,000 living.
| Ten years, 1884-93. | 1894. | Ten years, 1884-93. | 1894. | ||
|---|---|---|---|---|---|
| London | 26 | .22+ | West Ham | .27 | .15 |
| Manchester | .43 | .22 | Bristol | .27 | .07 |
| Liverpool | .49 | .45 | Bradford | .31 | .32 |
| Birmingham | .20 | .15 | Nottingham | .17 | .23 |
| Leeds | .43 | .13 | Hull | .19 | .18 |
| Sheffield | .58 | .12 | Salford | .57 | .55 |
In the period 1884-93, therefore, the London rate was lower than that of any of these towns
except Birmingham, Nottingham, and Hull, and in 1894 was only exceeded by those of Liverpool,
Bradford, Nottingham, and Salford.
If the London death rate of scarlet fever be compared with the death rates of the following ten
foreign cities, it will be seen that in 1884-93 the London rate was exceeded by that of only three of
these cities, while in 1894 it was exceeded bv six—
Scarlet fever—Death rates per 1,000 living.
| 1884-93. | 1894. | 1884-93. | 1894. | ||
|---|---|---|---|---|---|
| London | 26 | .22† | St. Petersburg | .66 | .59 |
| Paris | .09 | .06 | Berlin | .21 | .26 |
| Brussels | .05 | .05 | Vienna | .20 | .31 |
| Amsterdam | .20 | .04 | Rome | .05 | .02 |
| Copenhagen | .24 | .67 | New York | .50 | .27 |
| Stockholm | .80 | .36 |
In the following table will be found the age distribution of the cases of scarlet fever which
were notified during the year, and the case mortality at each age. As in 1893 the greatest incidence
of the disease was upon males and females between four and five years of age ; but it may be said that
the greatest incidence of death was on males between one and two years, and on females between three
and four years of age, whereas, in the preceding year, the greatest incidence of death was on males
between three and four years, and on females between two and three years of age.
The statistics of 1891, however, show no practical difference between the death rates of males
at the several ages, 1, 2 and 3. So again the statistics of that year show no practical difference between
the death rates of females at the ages one and two.
While the case rates at " all ages " of males and females are practically equal, the male death
rate at " all ages " is somewhat higher than that of females.
The highest case mortality was among males between one and two years of age, and among
females under one vear.
* Scarlet fever, 1894.
| Age period. | Males. | Females. | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Cases. | Deaths. | Case mortality per cent. | Rates per 100,000 living. | Cases. | Deaths. | Case mortality per cent. | Rates per 100,000 living. | |||
| Cases. | Deaths. | Cases. | Deaths. | |||||||
| All ages. | 8,737 | 491 | 56 | 425 | 24 | 9,703 | 483 | 50 | 423 | 21 |
| 0— | 177 | 26 | 14.7 | 318 | 47 | 141 | 26 | 18.4 | 249 | 46 |
| 1— | 393 | 78 | 19.8 | 788 | 156 | 419 | 70 | 16.7 | 832 | 139 |
| 2— | 663 | 81 | 12.2 | 1,27 1 | 155 | 665 | 74 | 11.1 | 1,269 | 141 |
| 3— | 832 | 78 | 9.4 | 1,646 | 154 | 877 | 82 | 9.4 | 1,695 | 159 |
| 4— | 821 | 72 | 8.8 | 1,670 | 146 | 932 | 56 | 6.0 | 1,888 | 113 |
| 5— | 3,551 | 120 | 3.4 | 1,522 | 51 | 3,865 | 126 | 3.3 | 1,640 | 53 |
| 10— | 1,386 | 19 | 1.4 | 651 | 9 | 1,661 | 27 | 1.6 | 765 | 12 |
| 15— | 438 | 6 | 1.4 | 215 | 3 | 516 | 6 | 1.2 | 228 | 3 |
| 20— | 221 | 5 | 2.3 | 110 | 2 | 263 | 8 | 3.0 | 109 | 3 |
| 25— | 198 | 5 | 2.5 | 57 | 1 | 274 | 6 | 2.2 | 69 | 2 |
| 35— | 38 | 1 | 2.6 | 15 | — | 62 | 2 | 3.2 | 22 | 1 |
| 45— | 14 | — | — | 8 | — | 17 | — | — | 8 | — |
| 55 and upwards. | 5 | — | — | 3 | — | 11 | — | — | 5 | — |
* In the preparation of this table, the question whether the persons, who were attacked and who died, belonged to London is
disregarded, the percentage being calculated on the number of cases notified in London, and the number of deaths occurring in London
and the institutions belonging to London. Inasmuch as the age of the patient is not in all cases recorded in the notification certificate,
it has been necessary to distribute such cases among the various ages proportionat ely.
†See footnote (*), page 8.