London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1896

[Report of the Medical Officer of Health for London County Council]

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London County Council.
Memorandum by the Medical Officer of Health on a local prevalence of Diphtheria in
(Printed by order of the Public Health Committee, 4th March, 1897.)
The attention of the committee has been directed to diphtheria prevalence in Camberwell. I
have therefore prepared certain statistics on this subject, which I beg to submit for the committee's

Comparison may be made between the diphtheria case and death rates in London and Camberwell thus— Diphtheria.

Case rate per 1,000.Death rate per 1,000.Case rate per 1,000.Death rate per 1,000.

During the last three years, therefore, both the diphtheria case rate and death rate of Camberwell
have been greater than those of London as a whole.
Interest for the moment, however, centres in an area extending on both sides of that portion
of Rye-lane, Peckham, which is situated between the points where Rye-lane is crossed by the railway
line, and where it meets East Dulwich-road.
This area has during 1896 suffered exceptionally from diphtheria, and with a view to the
convenient statement of the statistics I have selected a group of 12 enumeration districts which
practically represent it. This group, which at the census of 1896 had a population of 20,777 persons,
I shall in this statement describe as the " affected area."
The following case rates for the year 1896 deserve consideration*—
Diphtheria case rates, 1896.
Per 1,000 living.
London 3.1
Camberwell (less the affected area) 4.8
" Affected area " 14.6
The affected area is, however, deserving of consideration from another point of view, viz., the age
incidence of the disease. For the purpose of comparison it is necessary to use the London figures of
1895, the last year for which the notified cases of diphtheria, have been distributed into ages.

The following results are thus obtained—

All ages.0—3.3—5.5—10.10—15.15 and upwards.
Notified cases of diphtheria— " Affected area," 189630438551244740
London, 189511,2232,0072,3163,3131,2872,300
Case rate per 1,000 living— "Affected area," 189614.6325.5052.5849.4620.462.98
London, 18952.566.2811.457.012.970.78
Excess per cent. of rates of affected area over London rates+ 471+ 306+ 359+ 606+ 589+ 282

Again, if comparison be made between the age incidence of the disease on persons who were first attacked in households and those who were subsequently attacked, it is found that the incidence on the school age is greater in the case of the former than in the case of the latter,† thus—

Age period.Number of " fitst attacks " in households.Number of subsequent attacks.Number of " first attacks " at each age per cent, of " first attacks " at " all ages."Number of subsequent attacks at each age per cent. of subsequent attacks at " all ages."
Ages 0—3261210.719.7
,, 3-5441118.118.0
„ 5-101042042.832.8
„ 10—1333413.66.6
„ 13 and upwards361414.822.9
All ages24361100.0100.0

* The only material relating to the affected area I have for examination is that contained in the notification lists of the
Metropolitan Asylums Board.
†These figures are derived from the notification lists of the Metropolitan Asylums Board, which have been examined to see
whether a previous case had occurred in any invaded house within a month antecedent to the date of certification.