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10
Rheumatic
fever
Deaths in London from rheumatic fever in 1945 numbered 28, of which 13 were
among children under fifteen years of age. Corresponding figures in 1944 were 46
and 14, respectively.
Scabies
Scabies became notifiable in London in August, 1943. Notifications in 1945
numbered 14,753, compared with 16,450 in 1944. It is too early to measure the
effect of improved control resulting from notification, but the reduction is gratifying.
Scarlet fever
The incidence of scarlet fever was approximately the same as in 1944-4,252
cases (1.64 per thousand), compared with 4,153 (1.69 per thousand). There was
only one fatal case in 1945.
Measles
The dramatic reduction in the case mortality from measles has already been
mentioned in connection with infant mortality. In 1945, 23,518 cases of measles
were notified (9.07 per thousand), compared with 7,499 (3.05 per thousand) in 1944.
The deaths numbered 31, i.e., 0.012 per thousand living (0.13 per cent. of cases).
In 1944 there were only 7 deaths (0.003 per thousand living and 0.093 per cent.
of cases). A precise measure of the fall in case mortality in recent years cannot
be given, as the first complete year of notification was 1939, when the fatality had
already been considerably reduced. Previously, information as to the number of
cases was limited to the reports of school authorities based upon absences. Such
dual records as exist and other evidence suggest that these reports cover only 40 per
cent. of those cases which would have been notified had the regulations been in force.
On this assumption, it is estimated that the comparable case mortality figures are:-
1931-35 0.80 per cent.
1936-40 0.47 „ „
1941-45 0.20 „ „
The average death-rates per 1,000 living during the same periods were:-
1931-35 0.089
1936-40 0.043
1941-45 0.014
Smallpox
If the light incidence of the war years is taken into account, these figures fit the
trend indicated by the estimated case mortality percentages.
There were four notifications of smallpox, only two were confirmed and neither
was fatal. A soldier who had never been vaccinated and who had three times
refused vaccination in the Army, returned to Camberwell from Italy by air. Ten
days later he was admitted to hospital suffering from smallpox. All known contacts
were recommended to be vaccinated. A sister, at the same address, was vaccinated
on the day of admission of her brother to hospital, though she had already been in
contact for several days and was admitted to hospital eleven days later with smallpox.
Two neighbours in adjacent houses were later taken ill and admitted to hospital
and notified as smallpox, but the final diagnosis was vaccinial malaise in one case
and scabies in the other.