London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1950

[Report of the Medical Officer of Health for London County Council]

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The death-rates per 1,000 living in 1950 in London and for the whole country were:—

PulmonaryNon-pulmonary
London 0.3610.036
England and Wales 0.3210.043

With regard to morbidity the rate of occurrence of new cases of pulmonary
tuberculosis rose by nearly 50 per cent, between 1938 and 1941, and remained at the
higher level until the end of the war, when it began to decline, at first quite rapidly.
The statistical improvement was, however, short-lived, for between 1947 and 1949
the notification rate rose slightly. It must, however, be remembered that diagnostic
services are now more used than ever before and also that new methods such as mass
miniature radiography now discover early cases which formerly would have recovered
without notification or would not have been notified until the disease was more
advanced. It is almost certain that part of the rise in the notification was due to
improved case-finding and that pre-war and post-war rates are not strictly comparable.
It is, therefore, all the more gratifying that the primary notification rate
for pulmonary disease in 1950, 1.53 per 1,000, was considerably below the rate of
1.68 per 1,000 recorded in 1949. The war-time increase in morbidity from nonpulmonary
tuberculosis was less severe than for the pulmonary form and the rates
have fallen below the pre-war level and have continued to decline to a very low
level. The non-pulmonary notification rate in 1950 was 0.16, the same rate as for
1949.
The age distribution of new notifications of tuberculosis is shown in Tables
11(a) and (6), and age specific notification and death-rates are shown in Tables 12(a)
and (6).
With regard to notifications, the improvement in 1950 was common to all age
groups, except at ages 0.4, where many more cases of pulmonary disease are now
reported than formerly. Whether or not this increased level of reporting at infantile
ages is wholly real or in part represents increased radiological detection of primary
lesions is not known. In any case, if the potential infection is from adult to child,
improvement in morbidity at very young ages is likely to lag behind that of adults.
The non-pulmonary cases have been analysed, according to the site of the lesion,
in Table 13. The incidence of abdominal tuberculosis continues to be very much
lower than before the war. It is difficult to make any statement about the incidence
of meningeal tuberculosis as there is reason to believe that many cases are not
notified owing to difficulties in diagnosis. A few years ago the death figures sufficed
to measure incidence, but since the introduction of streptomycin a number now survive
and mortality is certainly declining. The incidence of tuberculosis of bones and joints
seems stationary. Tuberculosis of the peripheral glands, which showed in children
a large war-time rise, is now steadily becoming a rarer event.
The tuberculosis service over the last 50 years is reviewed on pages 81 to 93.
Food
poisoning

Since the beginning of 1949 food poisoning has been a notifiable disease. Reports in 1949 were probably incomplete, but in 1950 863 cases were reported, an attack rate of 0.25 per 1,000. The sex and age distribution was:—

AgeMalesFemales
0-47656
5-144048
15-44136229
45-646499
65+4466
Age unknown14
361502