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further the rate of immunisation; great efforts must be made to ensure that there is
no falling off in the existing proportion immunised. To leave children unprotected
is to invite the return of those tragedies which, only a decade ago, occurred with
appalling and needless frequency. In 1939 there were over 2,000 confirmed cases of
diphtheria in London and 98 deaths.
The mortality from diarrhoea and enteritis under two years of age (64 deaths)
amounted to 1.20 per 1,000 live births, compared with 1.73 in the previous year
The following diagram shows the trend of mortality in London and England and
Wales in recent years. Ten years ago the London rate was twice as great as the
national rate. It now appears that the difference between the London rate and the
Diarrhoea
and
enteritis
average for the country as a whole is small but favourable to London, and that both
rates are declining. Enteritis is not a notifiable disease in London but hospital
reports indicate a. much lowered in 1950.
Notification of fevers of the enteric group numbered 63 compared with 58 in 1949.
There were only 3 deaths. In 1900 there were 767 deaths.
Enteric
fevers
A large part of the reduction in the incidence of typhoid fever since the middle
of the 19th century 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. Much can
also be expected from the increasing use of serological tests for Vi-agglutinins in
convalescent typhoid patients to ascertain which patients are likely to become
chronic carriers, in order that they can be diverted into suitable occupations—a
matter in which there is scope for liaison between the public health and hospital
authorities.
There were 566 notifications of erysipelas in 1950, giving an attack rate of 0.167
per 1,000, compared with 0.173 in 1949. The incidence of this disease has been
declining continuouslv since 1941. There was one death in 1950.
Erysipelas

During Influenza