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It will be seen from the foregoing table that in the period 1904-8 the highest whoopingcough
death-rate obtained in Shoreditch (0.58), and the lowest in Hampstead (0.10); in the year 1909
Shoreditch (0.63) had the highest death-rate and Westminster and Woolwich (0.11) the lowest. The
whooping-cough death-rates in each of the four quarters of the year 1909 were as follows : first quarter,
0.30 ; second quarter, 0.35 ; third quarter, 0.19 ; and the fourth quarter, 0.20 per 1,000 persons living.
The following table shows that when the London sanitary districts are grouped according to
the proportion of the population living more than two in a room, in tenements of less than five
rooms, the incidence of whooping-cough mortality progressively increases from the least to the most
overcrowded groups of districts.

The annual reports supply but little information concerning whooping-cough, but reference is
made in a few to the need for better recognition by the public of the dangerous nature of this disease.
As pointed out by Dr. Davies, medical officer of health of Woolwich, much could be done by health
visitors in this direction, but he adds "to do so, however, would require an increase of staff." Such
information as medical officers of health obtain concerning the occurrence of attacks of whooping-cough
is derived, in the main, from school teachers. The number of cases reported, so far as stated in the
annual reriorts. was as follows:—

Whooping-cough among school attending children is dealt with much on the same lines as measles
In Woolwich all children under five years of age were excluded from attendance at a number of
schools for several weeks, and the same course was adopted in Lewisham in the case of two schools.
The medical officer of health of Islington reports that some schools were disinfected on account
of prevalence of whooping-cough among the children, and the medical officer of health of Lambeth
states that the homes of children so suffering were disinfected.
Reference will be found on page 106 to a memorandum issued in 1909 by Dr. Newsholme and
Dr. Newman, medical officers of the Local Government Board and Board of Education respectively,
dealing with the administrative measures necessary for the prevention of the spread of infectious diseases
among children attending elementary schools.
Typhus.
There were no deaths from typhus registered in the Administrative County of London during
the year 1909. The death-rates from this disease in successive periods have been as follows:—

In this table '000 indicates that the deaths were too few to give a rate of .0005; where — is inserted
no doat.li nrrmrrpd.
1 See footnote (2), page 6. 2 See footnote (-), page 25.
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