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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On June 5th a boy, E.C., aged 7, living at a house in the same road as the
house occupied by the five persons above referred to, was removed to the SouthEastern
Hospital. This lad too was found to be suffering from typhus.
On July 24th E.B., an elder sister, aged 16, of the "B" children, and on June
26th the boy, E.B, aged 7, referred to above and belonging to the same family, were
removed to the South-Eastern Hospital. On June 30th another brother was removed
to the hospital.
Finally, on July 4th, a man, J.R., aged 76, living in the house occupied by the
family B., was taken to hospital. He too was found to be the subject of typhus, and
the case was notified.
Dr. Stevens, the medical officer of health of Camberwell, informs me that the
girl E. B., aged 16, (who was removed to hospital on June 24th) worked at a place
where mattresses coming from Woolwich were unpicked. Dr. Stevens adds that as
far as he can make out she last attended there j ust before Whitsuntide.
Only one case belonging to this group was fatal.
July.—On July 11th a girl aged 9, living in Hammersmith, was certified to be suffering from
typhus. The child was not removed to hospital. She died on July 17th, and the case
was certified as typhus fever, 17 days. No information could be obtained with regard
to a possible source of infection.
On July 29th a boy, aged 10, living in Lambeth, was certified to be suffering from typhus.
The boy was taken ill on July 23rd. On that day he had been away from home and
drank some water from a "frog-pond," and his illness was attributed to this circumstance.
He was removed to the South-Western Hospital on July 26th, and he died
there. With reference to the possible source of infection it was noted that an uncle
of this boy had travelled as a steerage passenger from Australia, and arrived home 14
days before his nephew was taken ill.
August.—On August 15th a man, aged 54, living in Hackney, was certified to be suffering
from enteric fever. The patient died at his own home, and the cause of death was
returned as typhus. The medical attendant gave it as his opinion that the malady
was caused by sewer emanations some four weeks prior to the commencement of the
November.—On November 8th a male, aged 18, living in St Luke was certified to be suffering
from typhoid fever. He was removed to the South-Eastern Hospital, and was there
found to be the subject of typhus. The patient was a picture-frame maker. Inquiry
was made at his home and at the place where he worked, but no source of infection
could be traced. The illness did not prove fatal.
Enteric Fever.
The number of cases of enteric fever notified in the administrative county of London in 1896
was 3,196, and the number of deaths belonging to the administrative county was 564, compared with
3,521 cases and 598 deaths in 1895.
The rates in 1896 and preceding periods were as follows—

Enteric fever.

Period.Death rate per 1,000 living.Case rate per 1,000 living.Case mortality per cent.

The death rate from this disease in each year since 1868, in relation to the mean death rate of
the period 1869-96 is shown in diagram XVI. It will be observed that during the last twelve years
the death rates from this disease have been below the mean of that period.
In an appendix to my annual report for the year 1894, I discussed the question whether there
was indication of any relation between certain exceptional floods in the Thames and Lea, and an
exceptional increase of prevalence of enteric fever in the 49th, 50th, and 51st weeks of the year, and I
published for purposes of comparison a diagram representing the number of cases of enteric fever
included in the weekly notification lists in relation to the mean of the years 1890-93. Diagram XVII.
is obtained by similar treatment of the cases notified in the years 1890-6, the notification figures for
seven complete years being now available. Comparison of the two diagrams, the one based on the cases
of 1890-3, the other on the cases 1890-6, shows that they are in substantial agreement. So far therefore
the addition of the cases of subsequent years tends to show that the diagram of 1890-3 was one with
which the diagram of 1894 could be properly compared. The diagram representing the cases
notified in 1896 is also given. It affords no evidence of behaviour of enteric fever similar to that of
1894, nor indeed were floods experienced in the latter part of 1896, such as occurred in 1894.
In the distribution of this disease in London throughout the year in the first quarter the central
1 See footnote (1), page 7.