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 1919
[Report of the Medical Officer of Health for London County Council]
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The factor which has mainly contributed to the low infant mortality was the remarkably small
number of deaths due to measles and whooping-cough ; in addition the deaths from tuberculosis were
very low, and those from respiratory diseases, notwithstanding the influenza epidemic, were well below
the average. On the other hand, as compared with 1918, the deaths from premature birth and from
diarrhoea both showed slight increase, the latter being due to a short period of high temperature late
in the summer.
The following table has been prepared to enable comparison to be made of the exceptional figures for
| Disease. | 1911. | 1912. | 1913. | 1914. | 1915. | 1916. | 1917. | 1918. | 1919. |
|---|---|---|---|---|---|---|---|---|---|
| Measles | 531 | 373 | 330 | 279 | 491 | 173 | 396 | 276 | 55 |
| Whooping cough | 433 | 440 | 326 | 414 | 482 | 352 | 202 | 498 | 72 |
| Influenza | 19 | 25 | 37 | 38 | 32 | 16 | 22 | 259 | 114 |
| Phthisis | 70 | 64 | 59 | 62 | 57 | 38 | 65 | 36 | 28 |
| Tubercular meningitis | 192 | 150 | 132 | 137 | 143 | 128 | 120 | 91 | 77 |
| Other tubercular diseases | 193 | 155 | 144 | 156 | 155 | 113 | 127 | 61 | 32 |
| Meningitis | 192 | 127 | 127 | 136 | 202 | 161 | 159 | 96 | 90 |
| Bronchitis | 809 | 690 | 752 | 605 | 776 | 525 | 561 | 498 | 421 |
| Pneumonia | 1,380 | 1,261 | 1,526 | 1,282 | 1,644 | 1,161 | 1,231 | 1,191 | 846 |
| Other respiratory diseases | 90 | 65 | 78 | 69 | 61 | 48 | 48 | 27 | 34 |
| Diarrhoea | 4,447 | 1,206 | 2,519 | 2,608 | 2,126 | 1,380 | 1,291 | 970 | 1,217 |
| Premature birth | 2,059 | 2,037 | 1,954 | 2,000 | 1,797 | 1,629 | 1,387 | 1,311 | 1.685 |
| Congenital debility, etc., excluding premature birth | 1,933 | 1,554 | 1,531 | 1,507 | 1,550 | 1,377 | 1,226 | 1,021 | 1,048 |
Infectious diseases.
Smallpox.
During the year 1919, 26 cases of smallpox were notified, four of which proved fatal; in two
cases the diagnosis was not confirmed. The majority of the cases occurred during the first three months
of the year, and in my last Annual Report I described the localised outbreak which commenced on the
7th December, 1918, and terminated at the end of March. There were 18 cases altogether, during the
period in question, viz. in St. Pancras (12), Islington (2), Battersea (2), Holborn (1) and Westminster (1),
all of them being directly or indirectly connected. Only two of the cases proved fatal. The origin of
the outbreak was attributed mainly to unrecognised cases occurring among colonial soldiers on leave in
London, and it was pointed out that a disquieting feature was the large proportion of cases remaining
undiagnosed until some time after the appearance of the rash. A circular letter was sent by the Council
to all medical practitioners, in April, 1919, drawing attention to the facilities offered by the Council for
expert assistance in diagnosing suspected cases, and the services of the Council's smallpox expert were
claimed in 47 suspected cases during the course of the year, of which number 7 were diagnosed as
smallpox.
Between the end of March, which marked the termination of the aforementioned outbreak, and
July, 10 further cases of smallpox occurred. These 10 cases were the outcome of 6 distinct and separate
invasions, but fortunately the disease did not spread further. The following tabular statement shows
the presumed origin of the disease and other particulars concerning the 10 cases under review.
The following tabular statement shows the presumed origin of the disease and other particulars concerning the 10 cases under review.
| Probable origin. | Initials of case, age, and sex. | Address. | Dates of | Remarks. | |
|---|---|---|---|---|---|
| Rash. | Removal to hospital. | ||||
| 1. Portugal (Lisbon) | A.B., 19, m. (seaman) | Scandinavian Sailors' Home, Poplar | 5 May | 5 May | Patient left Lisbon, where smallpox was prevalent on 24th April. Arrived at the Sailors' Home 30th April. |
| 2. Italy (Naples) | A.O., 16, m. (seaman) | Porten-road, Hammersmith | 4 May | 6 May | Patient embarked on s.s. "Stork" at Naples with three other passengers, one of whom was convalescing from smallpox. The s.s. "Stork" left Naples 19th April and arrived at Fresh Wharf, London Bridge, 30th April. Patient seen by Dr. Wanklyn (6th May), who advised immediate removal to hospital. |
| 3. Portugal (Oporto) | J.N., m. (seaman) | Seamen's Hospital, Greenwich, ex-s.s. "Canta-bria" | 9-10 May | 11 May | Patient, a seaman on board s.s. "Cantabria," which arrived in London Docks about 9th May from Bilbao (14th April). Vessel stayed at Oporto about a week up to 28th April, where it was considered infection was contracted. |
| 4? Colonial soldiers on leave | L.D., 25, f. | Lambeth | 30 May | 31 May | Patient spent holiday, 16th-20th May, in company with Colonial soldiers on leave. No other possible source could be discovered. |
Deaths of
children
under one
year of age.