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 1896
[Report of the Medical Officer of Health for London County Council]
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34
Diphtheria.
The cases of diphtheria notified in the Administrative County of London in 1896 numbered
13,825 compared with 11,231 in 1895. The number of deaths registered from this cause in 1896 was
2,666 compared with 2,292 in 1895. The figures quoted for 1896 give an annual death rate of 0.59
per 1,000 living and a case mortality of 19.3 per cent.
The diphtheria death and case rates in 1896 and preceding periods are shown in the table—
| Period. | Death rate per 1,000 living. | Case rate per 1,000 living. | Case mortality per cent. |
|---|---|---|---|
| 1861-70 | 0.18 | _* | - |
| 1871-80 | 0.12 | _* | — |
| 1881-90 | 0.26 | _* | — |
| 1891 | 0.311 | 1.5 | 22.5 |
| 1892 | 0.441 | 2.0 | 22.2 |
| 1893 | 0.741 | 3.2 | 23.3 |
| 1894 | 0.611 | 2.6 | 23.6 |
| 1895 | 0.521 | 2.6 | 20.4 |
| 1896 | 0.591 | 3.1 | 19.3 |
The death rate in each year since 1858 in relation to the mean of the period 1859-96 is shown
in diagram X. There was increase both of death rate and case rate in 1896 upon the rates of 1895
and decrease of fatality.
If the London death rate from diphtheria be compared with the death rates of other large towns
in England having populations of more than 200,000 persons, it will be seen that in the period 1886-95
the London rate exceeded the rates of any of these towns, while in 1896 the London rate was higher
than the rates of any except West Ham.
| Towns. | 1880-95. | 1896. | Towns. | 1886-95. | 1896. |
|---|---|---|---|---|---|
| London | .41 | .602 | Bristol | .13 | .16 |
| Manchester | .26 | .15 | Nottingham | .07 | .06 |
| Liverpool | .16 | .24 | Bradford | .06 | .07 |
| Birmingham | .16 | .53 | Hull | .09 | .23 |
| Leeds | .09 | .12 | Salford | .39 | .23 |
| Sheffield | .14 | .16 | |||
| West Ham | .39 | .70 |
It will be seen from the following table that the London death rate from diphtheria was in the
period 1886-95 lower than the death rates of any of the undermentioned foreign cities except Brussels,
Amsterdam and Rome, while in 1895 the London death rate was only exceeded by the death rates of
St. Petersburg and New York.
| Towns. | 1886-95. | 1896. | Towns. | 1886-95. | 1896. |
|---|---|---|---|---|---|
| London | .41 | .602 | St. Petersburg | .54 | .90 |
| Paris | .58† | .18† | Berlin | .82 | .31 |
| Brussels | .13† | .15+ | Vienna | .75† | .40† |
| Amsterdam | .32 | .32 | Rome | .36 | .09 |
| Copenhagen | .83 | .17 | New York | 1.05 | .80 |
| Stockholm | .86† | .11† |
In the distribution of diphtheria mortality in London throughout 1896 the western group of
districts suffered most heavily, and the central the least, in the first quarter. In the second quarter
the eastern group of districts had the highest death rate, and the western and the central had the
lowest. In the third quarter the southern group suffered most heavily, and the central the least. In the
fourth quarter the southern group again had the highest death rate, and the central group again had
the lowest. In the whole year the eastern group of districts had the highest death rate (0.66), and
the central the lowest (0.42), the London death rate being 0.59; the highest death rate occurred
in Chelsea (1.17), and the lowest in St. James Westminster (0.09).
1 See footnote (1), page 7.
2 See footnote (2), page 8.
* The Infectious Diseases (Notification) Act only came into force in 1889.
† Including deaths from croup.