View report page

18
rates are declining. There is no doubt that further progress is possible and officers
of the Public Health Department are at present engaged in an intensive study of
causal factors in order to improve preventive measures.
DIARRHŒA AND ENTERITIS
MORTALITY PER 1,000 LIVE BIRTHS
Enteric
fevers
Erysipelas
Influenza
Measles
Notification of fevers of the enteric group numbered 58 compared with 48 in
1948. There were only two deaths. In 1900 there were 797 deaths.
A large part of this reduction in the incidence of typhoid and the now too often
forgotten conquest of the once dreaded cholera is due to the improvement in water
supplies and a detailed account of this progressive improvement was given in the
report for 1948.
A rising standard of personal cleanliness has also played an important part in this
saving of lives. But for continual vigilance enteric fever might easily return as an
important cause of death, and as has been illustrated by minor outbreaks in recent
years, the public cannot afford to relax their efforts to maintain high standards of
personal hygiene, and of care in the production and handling of food.
There were 583 cases of erysipelas in 1949, giving an attack rate of 0.173 per
1,000 compared with 0.215 in 1948. The incidence of this disease has been declining
continuously since 1941. There was 1 death in 1949.
There were 372 deaths (0.023 per 1,000) from influenza during the year; 1948
had been an exceptionally light year for respiratory mortality generally with only
78 influenza deaths and a much larger figure was expected in 1949. During recent
years the deaths have been:—
Year Influenza deaths
1940 569
1941 397
1942 198
1943 726
1944 206
1945 171
1946 371
1947 284
1948 78
1949 372
There has been no major attack of influenza since 1937, although there has
frequently been bacteriological evidence of the presence of the virus.
Measles became notifiable in London in 1938. Before this year records of
incidence were built up from reports of absences from school, from hospital admissions
and from mortality records. Up to the outbreak of the war of 1939-45
there had been biennial epidemics of such magnitude that more than 70 per cent.
of children suffered an attack before age 15. The evacuation movements of 1939
and subsequent years disturbed this biennial rhythm and since 1940 the outbreaks
have been annual and of the same order of magnitude each year. The overall incidence
has been reduced to such an extent that the risk of attack before age 15 has
now fallen to 60 per cent.