View report page

9
Altogether there were 8 deaths, i.e., 7 in this country and one at Marseilles.
No deaths occurred in London among those who were infected on the ship.
There was, however, one fatal case of smallpox in Woolwich shortly after this
time. The patient was an unvaccinated boy, age 9, a pupil at one of the Council's
elementary schools. He fell ill on 4th May, his rash developed on 5th May, he
was removed to hospital on the 10th, and died on 16th May. The source of infection
was not conclusively traced, but enquiries elicited the fact that the boy had attended
a fair on Woolwich Common on 20th April, and it was later ascertained that an
employee at one of the stalls—a dart stall—which the boy is said to have visited,
belonged to a family, living in Gravesend, in which four cases of smallpox had occurred,
two of them proving fatal. There was a history of a possible missed case in the
family and an examination of the youth who was employed at the dart stall revealed
a few indefinite scars. In the absence of other evidence, it appeared probable that the
origin of infection in the fatal case in Woolwich was linked up with the Gravesend
cases through the medium of the fair. About that time there was a series of smallpox
cases at Gravesend, Tilbury, Sheerness, Grays and Sheppey, i.e., districts associated
with shipping traffic.
The importation of virulent smallpox from the East exemplifies the constant
risk which is being run in this country and especially in London from the maritime
traffic between England and smallpox-infected areas in the East. It is, therefore,
inevitable that vessels, with a history of smallpox on board, arrive from time to time
in the Port of London, or discharge passengers at Marseilles or other ports en route
for London, and the precaution of keeping such persons under observation is one of
considerable importance.
The first line of defence in this network of organised preventive measures in
London is occupied by the Port of London Authority, upon whose vigilance much
depends. The fact that the virulent variety of smallpox is comparatively seldom
introduced into London, and that, even when such cases do occur, the disease rarely
spreads to any material extent, provides eloquent testimony to the vigilance of the
port authorities and the energetic measures taken by the metropolitan public health
authorities.
The prevalence of the mild type of smallpox in London renders these precautions
against the introduction of variola major all the more necessary and important,
in view of the complications and difficulty which would arise in the event of the
co-existence of the mild and more fatal types of the disease.
Measles.
The deaths from measles totalled 206 compared with 1,358 in 1928. The deathrates
in the metropolitan boroughs are shown in the table on page 18.
Whooping
cough.
There were 1,141 deaths from whooping cough in London during 1929 compared
with 405 in 1928. The epidemic prevalence was foreshadowed by a marked increase
in deaths towards the end of 1928, and its severity is shown by the fact that the
total number of deaths during 1929 exceeded that in any year since 1918. The
distribution of the mortality in the various metropolitan boroughs in 1929 is shown
in the table on page 18.
Scarlet
Fever.
There were 15,855 cases of scarlet fever notified in 1929 (52 weeks), the corresponding
figure for 1928 being 15,297. The attack-rate was 3.6 per thousand as
against 3.5 in 1928. The deaths numbered 75, giving a death-rate of 0.02 per
thousand of the population at all ages, and a case-mortality of 0.5 per cent.
Diphtheria
The notified cases of diphtheria numbered 11,788 in 1929 (52 weeks) compared
with 12,155 in 1928. This gives an attack-rate of 2.7 per thousand, being the same
as in the preceding year. There were 350 deaths as against 399 in 1928. The casemortality
was 3.0 per cent.
Diarrhœa
and enteritis.
Diarrhoea and enteritis caused 768 deaths among children under two years of age
or 10.96 per thousand births. The corresponding rate in 1928 was 10.32