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21
Deaths in London from rheumatic fever in 1952 were 25, of which 7, as in 1951,
were children under 15.
Rheumatic
fever
Account must also be taken of all 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 years, according to age, in recent years :

There would appear to be a fairly steady downward trend in the death-rate,
interrupted in 1949 and 1950, but subsequently resumed. Under the age of 15 the number
of deaths is so small that considerable fluctuation must be expected from random
causes, and the six deaths in this age group in 1952 does not necessarily mean that any
significant rise has taken place.
Scabies
Scabies became notifiable in London in August, 1943. Notifications in 1952
numbered 535, as compared with 572 in 1951, continuing the decline since the initiation
of notification. The attack rate (0.159 per 1,000) in 1952 was less than l/40th of the
rate experienced eight years earlier.
Scarlet fever incidence was higher in 1952 than in 1951. There were 5,263 cases
(1.56 per 1,000), compared with 1.10 per 1,000 in the previous year. Only three deaths
from scarlet fever or streptococcal sore throat occurred in 1952. Fifty years ago the
annual death roll in London was over 500.
Scarlet
fever
There were no notifications of either smallpox or typhus in London during 1952.
Smallpox and
typhus
Detailed figures of new cases of tuberculosis notified in 1952 are show in Tables 9
to 12 (pages 178 to 181). Non-civilians are included in the statistics and total (home)
populations are used.
fuberculosis
The general trend of morbidity and mortality since 1921 is indicated in Table 9
(page 178) and is also illustrated by the diagram below. The consistent 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 population in 1920, and only 1-3 per
1,000 in 1938, a fall of about 40 per cent, in just under 20 years. During 1938 the
death-rate from pulmonary tuberculosis was 0-64 per 1,000, i.e., about 40 per cent,
lower than in 1920 ; a reduction of some 1,600 deaths annually at the 1938 population
level. In the years of the war 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 inter-war years had been lost. Mortality rates rose
to a peak of 1-02 per 1,000 for pulmonary disease and 0-14 per 1,000 for non-pulmonary
disease in 1941. In so far as this rise was mainly due to the impact of the hard conditions
of war upon existing advanced cases, it was short-lived and mortality began to decline
again as the war proceeded. By 1946 the mortality rates had fallen below the pre-war
levels and they may now be regarded as having fallen below even the level to which
thev might have been expected to decline on the basis of the pre-war trends.