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19
It will be seen that there has been a slight reduction of juvenile deaths from
heart disease ; there were 10 in 1948 compared with 12 in 1947.
Scabies became notifiable in London in August, 1943. Notifications in 1948
numbered 2,484, compared with 5,304 in 1947. The effect of improved control
resulting from notification is evident from the persistent decline in incidence shown
by the figures in Table 11, facing page 122.
Scabies
The incidence of scarlet fever was slightly higher than in 1947—4,568 cases
(1.37 per thousand), compared with 4,331 (1-31 per thousand). There were only
two fatal cases in 1948. Fifty years ago the annual death roll in London amounted
to over 1,000.
Soarlet fever
There was no notification of smallpox.
No case of typhus fever occurred. In the immediate post-war years, a few
infections were imported to this country from liberated concentration camps
and war-wrecked areas of Europe. Four of these cases occurred in London. It is
to be hoped that under more normal conditions London will again be free of this
disease as it was for many years prior to 1945.
Smallpox
Typhus
fever
There were 10,450 notifications of whooping-cough during the year, compared
with 9,267 in 1947. The death-rate was 0.016 per thousand (crude case-mortality
0.53 per cent.). Corresponding rates for 1947 were 0.025 per thousand and 0.89 per
cent. It will be seen from Table 3 that the fatality from this disease is now less than
a thirtieth of what it was fifty years ago.
Whoopingcough
The number of cases of infectious disease reported from schools in 1948 and
other years are shown in Table 17, page 126. 1948 was a light year for German measles
and ringworm. The downward trend of scabies is reflected in the school figures.
There was also a fall in the incidence of impetigo. The incidence of scarlet fever,
whooping-cough and chickenpox was not significantly different from that of 1947
but there were more cases of measles. Cases of mumps were numerous and the
incidence greatly exceeded that of any recent year.
Infectious
disease in
schools
Detailed figures of new cases of tuberculosis notified in 1948 are shown in '
Tables 12 to 16, pages 122 to 125. Non-civilians are included in the statistics and total
populations are used except where otherwise stated.
The general trend of morbidity and mortality since 1921 is indicated by Table 12,
p. 122, and is also illustrated by diagram, p. 20. The persistent decline in deaths and
notifications during the inter-war years was substantial. New cases of pulmonary
disease were reported at the rate of 2.1 per 1,000 living in 1920 and at only 1.3 per
1,000 in 1938, a fall of about 40 per cent. in just less than twenty years. In 1938 the
death-rate from pulmonary disease was 0.64 per 1,000, i.e., about 40 per cent. lower
than the 1920 rate of 1.04; a saving of some 1,600 deaths annually at the 1938
population level. In the early years of the war the upsetting of the balance between
input and output of energy, the general deterioration in living conditions, the strain
placed upon the population by bombardment and the increased opportunities for
the spread of infection, all combined to reverse the trend of both morbidity and
mortality and by 1941 the ground gained in the inter-war years had been lost.
Mortality rates rose to a peak of 1.10 per 1,000 for pulmonary disease and 0.15 per
1,000 for non-pulmonary disease in 1941, but in so far as this rise was mainly due to
the impact of the hard conditions of war upon existing advanced cases, it was
shortlived, and the mortality quickly began to decline again as the war progressed.
By 1946 the mortality rates had fallen below the pre-war levels and for the
present at least they may be regarded as having reached the level to which they
might have declined if the pre-war trend had not been interrupted.
Tuberculosis