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 1926
[Report of the Medical Officer of Health for London County Council]
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6. There is no reliable evidence that the disease is spread by direct contact,
nor any data for computing an incubation period if infection does take place.
It is of interest to compare these conclusions with the above table representing
1,327 cases, i.e., over four times as many as those on which the Sheffield conclusions
were based. It will be noted that the deductions as regards paragraphs (2) and (3)
correspond broadly with the London figures, except that on the larger number
of cases the difference in the incidence and mortality as between males and
females is not very marked, and also that the preponderance of male cases ceases
to be a special feature after the age of 20 years or thereabout. In this connection
it is appropriate to quote a passage in the Sheffield report dealing with the greater
susceptibility of males in the earlier years of life, which reads as follows:—"These
figures are too small to form the basis of any general conclusions, butif
confirmed by larger statistics, it suggests a greater susceptibility to infection in the
central nervous system of the male as compared with the female during the period
when sexual maturity is achieved and most active." Interpreting the London
figures, it would appear that the balance in favour of male cases is most noticeable
during the period of puberty and whilst sexual maturity is in process of being formed
rather than when it has become achieved.
With regard to the conclusions (4), (5) and (6), of the report quoted above, it
may be stated that, generally speaking, the experience in London conforms with
that of Sheffield. On the question of leakage in the notification of cases it is
estimated that in London the number of cases which escape notification exceeds by
about 50 per cent. the number which are officially notified.
| Notified. | Non-notified. | |||||
|---|---|---|---|---|---|---|
| Under 16 years. | Over 16 years. | Total. | Under 16 years. | Over 16 years. | Total. | |
| 1. Total number of cases (1919-25) | 448 | 1,112 | 1,560 | — | — | 2,000 (circa) |
| 2. Not confirmed as genuine cases | 60 | 175 | 235 | — | — | — |
| 3. Fatal* | 111 (5) | 384 (31) | 495 (36) | 26 | 74 | 100 |
| 4. Now apparently well | 119 | 254 | 373 | 39 | ? | ? |
| 5. Slight sequelae, not interfering with occupation, schooling, etc. | 23 | 38 | 61 | 14 | ||
| 6. Suffering from sequelae which partially interferes with occupation or schooling | 38 | 62 | 100 | 45 | ? | |
| 7. Wholly incapacitated | 75 | 105 | 180 | 150 | ? | |
| 8. No. among (6) and (7) showing conduct changes | 60 | 54 | 114 | 64 | ? | ? |
| 9. No. among (6) and (7) showing Parkinsonism | 23 | 31 | 54 | 7 | ? | |
| 10. Untraced | 22 | 94 | 116 | - | - | - |
| *The figures in parentheses denote the number of deaths among patients in which the cause of death was registered as being due to some morbid condition other than encephalitis lethargica. | ||||||
The need for further residential accommodation.—The limited accommodation
at the Metropolitan Asylums Board's Hospital, Winchmore Hill, i.e., 100 beds, while
perhaps adequate as a clearing house for juvenile cases of chronic epidemic encephalitis,
falls far short of the actual needs as regards the permanent care of
individual sufferers.
To what extent the provision will be met by the new Mental Deficiency Bill,
if it becomes law (see p. 133), is doubtful, but in any case there remains the problem
of dealing with older persons. Applications are constantly being received for the