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21
Following the outbreak in the other block there was rigorous segregation of
the children and of the staff and it must be assumed that the second outbreak had
had no connection with the first.
During 1949, 433 cases of puerperal pyrexia were reported, or 7.51 per 1,000
total births, compared with 7.40 in 1948.
Deaths in London from rheumatic fever in 1949 numbered 16, of which 6 were
were among children under fifteen years of age. Corresponding figures in 1948
were 30 and 15 respectively.
To complete the picture it is necessary to consider also the deaths under 45
years assigned to heart disease, since apart from deaths due to congenital heart
disease the vast majority of these deaths are rheumatic in origin. The following
table shows the distribution of heart disease deaths under 45 according to age in
recent years.
Puerperal
pyrexia
Rheumatic
fever

No clear post-war trend can be discovered but if anything the tendency is
downward.
Scabies became notifiable in London in August, 1943. Notifications in 1949
numbered 1,311, compared with 2,484 in 1948. The effect of improved control
resulting from notification is evident from the persistent decline in incidence shown
by the figures in Table 11 (p. 126). Great progress has been made and the attack rate
in 1949 was less than one-twentieth of the rate experienced six years earlier.
The incidence of scarlet fever was slightly higher than in 1948; there were
4,945 cases (1.46 per 1,000), compared with 4,568 (1.37 per 1,000) in the previous
year. There was only one fatal case in 1949. Fifty years ago the annual death roll
in London amounted to over 1,000.
There were three notifications of smallpox. All three cases, temporarily residing
in London, were passengers from an infected ship. One case was fatal. The Medical
Officers of Health of the Metropolitan Boroughs concerned took immediate action
to trace and observe all contacts ; no secondary cases 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. No case of
typhus fever has occurred in London since 1947.
There were 5,754 notifications of whooping-cough during the year, compared
with 10,450 in 1948. As can be seen from Table 11 the incidence varies considerably
from year to year. There were 27 deaths, giving a death-rate of 0.008 per 1,000
(crude case mortality 0.47 per cent.). Corresponding rates for 1948 were 0.016 per
thousand and 0.53 per cent. It will be seen from Table 3 that the fatality from this
disease is now a sixtieth of what it was fifty years ago.
The numbers of cases of infectious disease reported from schools in 1949 and
other years are shown in Table 16 (p. 130). 1949 was again a light year for German
measles. The decline in the incidence of ringworm continues. The downward trend
of scabies, already remarked upon, is reflected in the school figures. There was also a
further fall in the incidence of impetigo. The incidence of scarlet fever was a little
higher than in 1948. Cases of whooping-cough were much less frequent than in the
previous year. The incidence of measles and of chicken-pox also was light. Cases of
mumps were much less numerous than in 1948, when the incidence was exceptionally
high.
Scabies
Scarlet fever
Smallpox
Typhus
fever
Whoopingcough
Infectious
disease in
schools