View report page

17
need for constant vigilance in the detection of smallpox introduced from abroad ;
and the fact that the infection was promptly suppressed is another instance of the
value of the out.county work to the county itself.
Information was received from the Port of London Authority of the arrival
of two cases of smallpox in the Port, one in March and the other in July. Both
patients were members of the crews of the vessels concerned and were removed
to the P.S.A. Hospital, Denton, near Gravesend. Particulars of all contacts were
communicated to the authorities concerned for observation. In addition to the
above, information was received from various ports around the coast, during the
course of the year, concerning contacts of cases of smallpox occurring on board
vessels arriving in this country and these were followed up.
Infectious Diseases
The attack.rates and death.rates in London and the constituent boroughs are
shown in the table on p. 57.
Measles caused 386 deaths in London during 1923, the death.rate being .08 per Measles,
thousand as compared with .34 in 1922 and .05 in 1921. Owing to the abnormal
birth.rate in 1920 the number of children entering upon the principal age of measles
attack was much above the average in 1923. Towards the end of the year it became
apparent that a considerable prevalence was at hand, and in the first quarter
of 1924 the deaths numbered 907, this being in excess of any total for the
winter quarter since 1915. A diagram showing the periods of excessive measles
mortality in London and the metropolitan boroughs since 1910 will be found
on page 98.
There were 432 deaths from whooping.cough in London during 1923, the death. Whooping.
rate being 09 per thousand as compared with 25 in 1922. The question of the cough,
influence of climatic conditions on the prevalence of whooping.cough is
discussed later (see p. 99), where a diagram will be found showing the periods
of excessive whooping.cough mortality in London and the metropolitan boroughs
since 1910.
A further decline in the prevalence in London of scarlet fever occurred in 1923, Scarlet fever,
the number of cases notified being 10,047 (52 weeks), as compared with 17,181 in
1922 and 32,703 in 1921. The decline was general throughout London, but a remarkable
prevalence of some severity occurred in central Islington during the summer.
The area involved was not attacked so severely as the rest of the borough in the
preceding summer. The prevalence was maintained throughout the period of the
holidays when the schools were closed and school infection cannot, therefore, have
played any considerable part in the dissemination of infection.
The deaths in 1923 in London numbered 116, the corresponding figure for 1922
being 301.
Although on the decline, the diphtheria cases still remain high relatively to Diphtheria,
scarlet fever. There were 10,301 cases in 1923 (52 weeks) as against 15,247
in 1922 and 16,293 in 1921. The deaths numbered 616 in 1923 as against 1,145
in 1922.
There were 946 deaths among children under two years of age from diarrhoea Diarrhoea
and enteritis in London during 1923, this being 10.3 per thousand births. The Enteritis.
corresponding rate last year was 7.13, this being the lowest mortality from these
causes recorded in London.
The deaths from tuberculosis of the respiratory system in London during 1923 Tuberculosis,
numbered 4,432, giving a death.rate of .97 per thousand. The corresponding figures
for the preceding year were 4,888 and 1.08, respectively. Deaths from other forms
of tuberculosis numbered 853, as against 936 in the preceding year. The deaths and
death.rates by sexes annually in the past ten years have been as follows :—