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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28
The death rate in each year since 1858 in relation to the mean of the period 1859-94 is shown
in diagram X., the dotted line in the diagram also showing the death rate in relation to the mean of
diphtheria and croup.
If the London death rate from diphtheria be compared with those of other English towns having
a population of more than 200,000 inhabitants, it will be seen that London in the period 1884-93 had
a higher rate than that of any of these towns except Salford, which it equalled, and that in 1894 London
had a higher rate than any of these towns except West Ham.
Diphtheria—Death rates per 1,000 living.
| Ten years, 1884-93. | 1894. | ... ... | Ten years, 1884-93. | 1894. | |
|---|---|---|---|---|---|
| London | 0.35 | 0.61§ | West Ham | 0.28 | 0.80 |
| Manchester | 0.23 | 0.28 | Bristol | 0.11 | 0.21 |
| Liverpool | 0.316 | 0.19 | Bradford | 0.06 | 0.08 |
| Birmingham | 0.13 | 0.15 | Nottingham | 0.10 | 0.08 |
| Leeds | 0.08 | 0.19 | Hull | 0.08 | 0.14 |
| Sheffield | 0.11 | 0.20 | Salford | 0.35 | 0.31 |
The following table enables comparison to be made between the diphtheria death rate of London
in 1884-93 and 1894 and the corresponding diphtheria death rates in ten foreign cities—
Diphtheria—Death rates per 1,000 living.
| 1884-93. | 1894. | 1884-93. | 1894. | ||
|---|---|---|---|---|---|
| London | .35 | .61§ | St. Petersburg | .49 | 1.02* |
| Paris | .69* | .42* | Berlin | 1.00 | .80 |
| Brussels | .13 | .24* | Vienna | .66† | 1.11 |
| Amsterdam | .38 | .22 | Rome | .41 | .09 |
| Copenhagen | .82 | .66 | New York | 1.02 | 1.20 |
| Stockholm | .97* | .93* |
The year 1894 is characterised by a marked decrease in the death rate from diphtheria after
continued increase in three successive years.
The following table shows that in 1894 the disease has especially attacked males and females at
the younger ages; also that there has been a greater incidence on females than on males if the totals at
" all ages " be considered, but that up to two years of age males have suffered more heavily than females,
and that after this age the greater incidence has been on females. This is especially marked when 20 years
of age is reached, a result probably due to the fact that the care of the sick is usually undertaken
by women.
The death rate of males at " all ages " and up to two years of age has also been greater than
that of females, but females have at subsequent ages generally suffered a heavier mortality than males.
So, again, the case mortality has been greater in the case of males than in the case of females at " all
ages, but not at each of the several ages.
‡Diphtheria, 1894.
| Age period. | Males. | Fenjales. | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 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. | 4,987 | 1,287 | 25.8 | 243 | 63 | 6,203 | 1,431 | 23.1 | 270 | 62 |
| 0— | 166 | 93 | 56.0 | 298 | 167 | 115 | 67 | 58.3 | 203 | 118 |
| 1— | 380 | 226 | 59.5 | 762 | 453 | 353 | 207 | 58.6 | 701 | 411 |
| 2_ | 448 | 199 | 44.4 | 859 | 381 | 477 | 241 | 50.5 | 910 | 460 |
| 3— | 587 | 238 | 40.5 | 1,161 | 471 | 605 | 227 | 37.5 | 1,169 | 439 |
| 4— | 520 | 164 | 31.5 | 1,058 | 334 | 548 | 200 | 36.5 | 1,110 | 405 |
| 5— | 1,510 | 280 | 18.5 | 647 | 120 | 1,830 | 395 | 21.6 | 776 | 168 |
| 10— | 535 | 45 | 8.4 | 251 | 21 | 749 | 47 | 6.3 | 345 | 22 |
| 15— | 259 | 10 | 3.9 | 127 | 5 | 377 | 11 | 2.9 | 166 | 5 |
| 20— | 177 | 8 | 4.5 | 88 | 4 | 367 | 9 | 2.5 | 152 | 4 |
| 25— | 253 | 6 | 2.4 | 73 | 2 | 477 | 14 | 2.9 | 120 | 4 |
| 35— | 94 | 6 | 6.4 | 37 | 2 | 189 | 6. | 3.2 | 67 | 2 |
| 45— | 33 | 7 | 21.2 | 18 | 4 | 80 | 3 | 3.7 | 40 | 1 |
| 55 and upwards. | 25 | 5 | 20.0 | 15 | 3 | 36 | 4 | 11.1 | 16 | 2 |
I have already shown (page 24) that the case mortality of scarlet fever is greatest at the
beginning of the year, and that it gradually declines until the later summer and early autumn months
are reached, subsequently increasing again.
*Including croup.
†Including croup, 1891-94.
§ See footnote (*) page 8.
‡See footnote (*) page 23.