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Scabies became notifiable in London in August, 1943. Notifications in 1954 numbered
699, as compared with 527 in 1953. The attack rate (0.201 per 1,000) in 1954, while
showing an increase for the first year since notifications began still compares favourably
with the rate (6.70) experienced in 1944, the first complete year for which notifications
were received after the disease became notifiable.
Scabies
The number of notifications of scarlet fever in 1954 was 2,444. Only in 1941, when
a high proportion of schoolchildren were absent from London, has a lower figure than
this been recorded. Although incidence appears to be considerably less than it was
50 years ago the fall in mortality during the same period has been even more striking.
At present the disease is a mild illness only rarely giving rise to complications and there
were no deaths from scarlet fever in 1954. During the middle of the 18th century
scarlet fever was also so mild as to cause the famous physician Thomas Sydenham to
describe it as ' a disease in name only '. During the last 200 years scarlet fever has more
than once changed its face and become for a period one of the major killing diseases.
Should this happen again physicians will find themselves armed with therapeutic
weapons not available to their forebears.
Scarlet fever
There were no notifications of smallpox during the year. Smallpox
Details relating to tuberculosis appear in the section which follows.
There was one case of epidemic typhus, occurring in a man recently arrived in this
country following a journey by air and rail from Eastern Europe. He had been infected
before arrival in this country and no secondary spread occurred.
Tuberculosis
Typhus fever
There were 4,691 notifications of whooping cough during the year—a smaller
number than for some years past. There were only four deaths, three of them of
children under five years of age giving a fatality ratio of 0.085 per cent.
Whooping
cough
The number of cases of certain infectious diseases reported from schools in 1954 and
previous years is shown in Table 9, page 223.
Infectious
diseases in
schools
TUBERCULOSIS
Recent trends
During the past ten years, the outstanding change in this disease, in London, has been
its greatly reduced mortality. (See Table 4, page 220, the Diagram on page 24 and
Tables T1 and T2 on pages 30 and 31.) In 1944 there were 2,073 deaths from lung tuberculosis
(representing a rate of 0.75 deaths per 1,000 total population) compared with
596 deaths (a rate of 0.18 per 1,000 population) in 1954. This improvement is undoubtedly
due mainly to the advent and increasing use during this period of new and
successful specific drug remedies and to more widely available new thoracic surgical
measures. A steady improvement in the availability of hospital beds for the treatment of
tuberculosis has also exerted a beneficial effect. In 1954 almost 90 per cent, of all
tuberculous deaths were due to the pulmonary form of this disease.
Mortality
Twenty per cent, of the deaths from lung tuberculosis occurred among persons aged
between 15 and 45 years. In this age group, in the years 1941-45 pulmonary tuberculosis
accounted for 26 per cent, of all deaths (all causes); in the year 1950 its contribution
was 18 per cent., while in 1954 the proportionate mortality of this disease had fallen
to 5.4 per cent. Nevertheless, in this reproductively and economically important age
group, lung tuberculosis remains responsible for more deaths than any other single
defined disease of any one organ.
Seventy-seven per cent, of the deaths in 1954 from all forms of tuberculosis occurred
among persons aged over 45 years and the majority (79 per cent.) of these deaths were
in men. In this age group the contribution which tuberculosis made during 1954 to
total mortality from all causes in both sexes was 1.6 per cent, compared with 2.2 per
cent, in 1950 and 2.6 per cent, in 1940. In the age group 45-65 years, the number of
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