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 1898
[Report of the Medical Officer of Health for London County Council]
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23
Diphtheria.
The cases of diphtheria notified in the Administrative County of London in 1898 numbered
11,883, compared with 13,217 in 1897. The number of deaths registered from this cause in 1898
was 1,760, compared with 2,245 in 1897. The figures quoted for the year 1898 give an annual caserate
of 2.6. and an annual death-rate of 0.39 ner 1.000 living.
The diphtheria case and death-rates in 1898 and preceding periods are shown in the following 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 |
| 1897 | 0.501 | 3.0 | 17.0 |
| 1898 | 0.391 | 2.6 | 14.8 |
The death-rate in each year since 1858 in relation to the mean death-rate of the period
1859-98 is shown for diphtheria, and for diphtheria and croup combined in diagram IX.
It will be seen that the decline in diphtheria prevalence and fatality, pointed out in my last
report, has been continued.
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 1888-97 the London rate exceeded the rates of all of these towns, and in 1898 exceeded the
rates of all except Leeds and West Ham—
| Towns. | 1888-97. | 1898. | Towns. | 1888-97. | 1898. |
|---|---|---|---|---|---|
| Bristol | 0.13 | 0.14 | |||
| Manchester | 0.26 | 0.10 | Nottingham | 0.08 | 0.10 |
| Liverpool | 0.17 | 0.23 | Bradford | 0.07 | 0.07 |
| Birmingham | 0.21 | 0.26 | Hull | 0.12 | 0.07 |
| Leeds | 0.11 | 0.54 | Salford | 0.41 | 0.15 |
| Sheffield | 0.16 | 0.26 | West Ham | 0.43 | 0.63 |
It will be seen from the following table that the London death-rate from diphtheria was, in
the period 1888-97, lower than the death-rates of any of the undermentioned foreign cities, except
Paris, Brussels, Amsterdam, and Rome, while in 1898 the London rate was only exceeded by the
death-rates of Stockholm, St. Petersburg, and New York. The inclusion of deaths from croup,
however, in the case of several of these towns makes comparison of the death-rates of little value—
| Towns. | 1888-97. | 1898. | Towns. | 1888-97. | 1898. |
|---|---|---|---|---|---|
| St. Petersburg | 0.75 | 1.04 | |||
| Paris | 0.47† | 0.10† | Berlin | 0.67 | 0.34 |
| Brussels | 0.12† | 0.09† | Vienna | 0.70† | 0.32† |
| Amsterdam | 0.30 | 0.12 | Rome | 0.29 | 0.06 |
| Copenhagen | 0.71 | 0.19 | New York ... | 0.93 | 0.42 |
| Stocholm | 0.71† | 0.67† |
In the distribution of diphtheria mortality throughout the year 1898, the eastern and
central groups of districts had the highest death-rate (0.44), and the western group the lowest
(0.32). Of the several districts Holborn had the highest death-rate (0.73), and St. George, Hanoversquare,
the lowest (0.12). In the first quarter of the year the northern group of districts had the
highest (0.55), and the western group the lowest death-rate (0.40). In the second quarter the
eastern group had the highest (0.38), and the western and southern groups the lowest (0.30). In
the third quarter the central group had the highest (0.57), and the northern the lowest (0.20). In
the fourth quarter the southern group had the highest (0.59), and the western group the lowest
death-rate (0.29).
The Infectious Diseases (Notification) Act only came into force in 1889.
1 See footnote (1) page 3.
† Including deaths from cronp.
2 See footnote (2) page 3.