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

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London County Council 1912

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

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Report of the County Medical Officer—General.
41
It will be seen that among the several sanitary districts in the period 1907-11 the enteric fever
death-rate was highest in Poplar (0.08), and lowest in Woolwich and Lewisham (0.02); in the year
1912, Fulham (0.05) had the highest enteric fever death-rate , while six districts had a death-rate of
0.01 only and in Stoke Newington and the City of London there were no deaths. The death-rates
from enteric fever in London in each of the four quarters of the year 1912 were as follows : first quarter,
0.03 ; second quarter, 0.02 ; third quarter, 0.03; and fourth quarter, 0.03.

35-45. The fatality was greatest among males aged 25-35 and females aged 35-45.

Age-period.Males.Females.
Notified Cases.Deaths.Case-mortality per cent.Rates per 100,000 living.Notified Cases.Deaths.Case-mortality per cent.Rates per 100,000 living.
Cases.Deaths.Cases.Deaths.
All Ages —3707119.11733345215.5142
0—1- 111.181-11.040
1—2--
2—3-1-
3—7-3
4-5251
5—4124.919141249191
10—4436.82224349.2212
15—57814.030431516.0152
20—421330.822746510.8192
25—821720.6235711115.4163
35—531630.0185511223.4154
45—21628.410331722.5133
55 & upwards1243325211545.242

Euteric fever
cases aiul
deaths byage
and sex,
Loudon.
35-45. The fatality was greatest among males aged 25-35 and females aged 35-45.
Age-period.
Males.
Females.
Notified
Cases.
Deaths.
Casemor
tality
per cent.
Rates per 100,000
living.
Notified
Cases.
Deaths.
Casemor
tality
per cent.
Rates per 100,000
living.
Cases.
Deaths.
Cases.
Deaths.
All Ages —
370
71
19.1
17
3
334
52
15.5
14
2
0—
1
- 1
11.1
8
1

-
11.0
4
0
1—
2
-

-
2—
3
-
1
-
3—
7
-
3

4-
5
2
5
1
5—
41
2
4.9
19
1
41
2
49
19
1
10—
44
3
6.8
22
2
43
4
9.2
21
2
15—
57
8
14.0
30
4
31
5
16.0
15
2
20—
42
13
30.8
22
7
46
5
10.8
19
2
25—
82
17
20.6
23
5
71
11
15.4
16
3
35—
53
16
30.0
18
5
51
12
23.4
15
4
45—
21
6
28.4
10
3
31
7
22.5
13
3
55 & upwards
12
4
332
5
2
11
5
45.2
4
2
In the reports of medical officers of health there is no mention of any considerable local prevalences
of enteric fever during the year; in fact, in the whole of the administrative county only 704 cases were
notified in 1912, as compared with 1,022 during 1911. Most of the reports contain notes on the probable
origin of infection so far as this could be learned by inquiry. Thus, of 386 cases occurring in 17 boroughs
51, or 13.2 per cent., were supposed to have been contracted outside the borough, mostly at the seaside
or abroad. In 1911 the proportion was 19.3 per cent. of 471 cases, and in 1910 was 15.7 per cent.
of 733 cases. Mention is made in particular cases that special articles of food, such as shell fish,
fried fish, water-cress and ice cream were consumed shortly before the onset of illness.
Some of the reports contain notes upon particular cases. Thus in Paddington, one patient, a child
one year old, was deemed to have been infected by his mother, who was found to be a " carrier." The
mother had suffered from an attack of enteric fever some eighteen months previously while in India.
In Finsbury the first case was that of a patient who had been medically treated for " influenza and
debility," who kept at his work during the course of his illness and died while being removed to hospital.
He had stayed in the country before his illness became acute, but the source of infection could not be
traced. Three patients had eaten shell-fish obtained at the seaside from polluted estuaries, although in
one case there was a distinct warning to visitors pointing to the fact that the water was sewage polluted.
Dr. Alexander gives a statement of supposed causes and predisposing influences in all the cases occurring
in Poplar so far as the information could be obtained. Among the cases, two had been bathing in the
River Thames, one had been staying in the country for ten days where well water was used, and one
had eaten unsound fruit thrown away as refuse ; a group of 4 cases occurred in one family, but there was
no history of the source of infection. Dr. R. K. Brown gives a table of 7 cases occurring in Bermondsey
as an illustration of the way the disease spreads from person to person, and of the mischief a wrongly
diagnosed case may cause. A woman was first attacked, but her complaint was diagnosed as rheumatic
fever with pneumonia and she was nursed at home. A month later her husband was notified as suffering
from enteric fever, and about the same time his sister was stated to have pneumonia. Three weeks
later a brother had pneumonia, and three weeks after this another sister was diagnosed as having the
same complaint. Within the next ten days or so a second and third brother had been notified as suffering
from enteric fever. Dr. Brown suggests that all the cases were probably of the same nature. There was
a second small family outbreak in Bermondsey, but all the other cases were sporadic. In Woolwich, too,
Dr. Davies states that of 6 cases occurring in one family, the first was the mother, who was treated in a
general hospital for pneumonia ; on her return home her four children developed enteric fever ; the
mother, as the result of bacteriological examination, was notified and removed to a fever hospital, but
was discharged too soon, giving rise to a " return " case in the person of her husband. Two other cases
in Woolwich, are said to have resulted from infection by a " carrier " case of long standing, a girl who had
been in India, where she had had " fever " some two or three years ago.
18820 F